Low carb and putting on weight

[borofergie]

I'm pretty much "all-in" with the low-carb high-fat thing at the moment

I'm following a (very) low-carb / high-fat diet, so if it's true that eating fat is bad for you, then I'm done for. But to be honest that is more influenced by Bernstien, Phinney and Volek than Taubes. I do love Taubes writing though...

The fact that you are ''all in'' with what Taubes et al are saying Stephen very little would persuade you otherwise.

Not at all, I like to read extensively around a subject. I'm reading Marion Nestle's "Why Calories Count" right now (a very vocal opponent of Taubes), and she has some very compelling arguments. I'm also a big fan of Stephan Guyenet's blog for example (another vocal critic of Taubes).

I think that there is some truth in Taubes hypothesis, and that insulin (and therefore carbohydrate) plays a critical role in the energy regulation of your body but I don't think it's the whole story. If you'd read the book you'd see that even Taubes doesn't think that it's the whole story.

The point is this, I think that it's great that people have an opinion on a wide variety of topics, but for intelligent debate you need to have an informed opinion, and not rubbish people as "fundamentalists", "fanatics" "paranoid" (with paranoid followers), or "loonies", and describe their work as a "feorie".

Check my post-count, nearly 1000 posts and none of those are to do with T1 diabetes or Insulin. I'm haven't read around either of those topics, and I don't have any personal experience. Therefore I don't think that I'm qualified to have a useful opinion on those subjects, so I steer clear.

This forum works around the principal that there are lots of equally valid ways to control your diabetes, a principal that I endorse completely. However, it seems to be OK to rubbish very-low-carb dieting and the science behind it. If you can do that from an informed viewpoint then fine, we can have a debate about it (I love that), but it's simply not OK to rubbish a diet followed by a significant number of diabetics without doing the work to back it up.

And for the record, I'm always open to have an opinion swayed by intelligent argument and reasoned debate.

I've not read or even viewed a Taubes video and would never intend too unless the current thinking changes, authors like these are appealing to the like of you as you follow a very low-carb diet and need some reassurance that the dietary path you are following is the right one, to the majority of diabetics and non-diabetics alike most would never have heard of these authors never mind believe in their views.

I'm a T2 diabetic on diet only. I don't have the luxury of insulin or even metformin (or a DSN, an endocronologist or a podiatrist). How else am I supposed to control my diabetes other than by reducing carbohydrate?

Since Low-Carbing has been forced on me (by a broken enodcrine system), I do my best to understand what the secondary implications on my health might be from removing carbohydrate from my diet. I am deeply reassured by what I have read from Volek, Phinney, Bernstein and Taubes, and I've seen a great improvement in my own health as a result, but I'm also interested in the flaws in their arguments (which was the point of the "all-in" statement above which you took out of context).

And you're right, most T2 diabetics don't know about low-carb and the benefits that it can have on controlling their condition. The reason that I am here is because I want to give them an informed choice. I don't think that very-low-carbing is the only way to control diabetes, but it is a good way, and it shouldn't be dismissed as a "feorie" for "fundamentalists", "fantatics" and "paranoid loonies".

I'm not 'diverting argument' merely pointing out that Taubes et al are irrelevant to the vast majority of people and experts on health-care, the reply to Hana was in response to her saying cals in/cals out doesn't work.......it sure did work for me!

I'm going to say this in bold, because it's important:
Low-carbing (and very low-carbing) are very relevant to T2 diabetics that are not controlled by insulin. Bernstein, Phinney, Volek and Taubes provide a scientific backgrount to why low-carbing works, and why it isn't bad for your health. If you don't think that is relevant to diabetics, then I don't know what is.

 

[Sid Bonkers]

Since the dietary advice to diabetics changed [around 30 years ago] from" eat less carb sand learn exchanges" to eat what you like and take more medicine".

Eat what you like and take more meds, whos giving that advice? :lol:

As to Reading Gary Taubes , Sid,
the man spent YEARS researching scientific papers to answer questions and did a brilliant job.
My edition of Taubes book, which is an original US one, has 66 pages of references to scientific papers.
He certainly used a lot of evidence in his attack on orthodoxy. and the book is ery readable
When weight loss diets have been examined, it has been shown that many of them work if people stick to them, but that all have drop-outs. the drop out rate for calorie control diets is high and the relapse rate, leading to regaining lost weight is high too.
Hana

Taubs "research" has been shown to be very selective, some data left out entirely and much of the rest cherry picked, if you want to believe it all thats fine but dont try to convert me, I'm a ultra low carb atheist

As for diets not working, I would have to agree with that statement, you only have to look at Dr Atkins weight when he died of heart failure and there are many other low carbers who cant seem to loose weight despite being very knowledgeable, I read on Jimmy Moores LLLCV web site that he tipped the scales in Jan this year at a not so trim 260lbs now I dont know many better informed low carbers than him, so whats the problem if ULCHF is so good?

 

[xyzzy]

Where you and I really differ (and correct me if I'm wrong Sid) is that you don't think a problem exists in the NHS and its current attitudes and recommendations regarding treatment. I most certainly do. For example you haven't addressed my statement:

The misearble failure of the NHS's own statistics speak for themselves. For example in 2008 over 70% (so 7 out of 10 people) had an HbA1c greater than 7.5% which is the NHS's own very lax upper limit and as you know exceeds even the 8.5 mmol/l NICE guideline that this country still clings to.

I dont think the current NHS recommendations are that bad, no, but let me qualify that statement.

The figures above (7 out of 10) do not show whether the 70% are even following NHS advice do they?

...

Yes again I'm not too far away from what you have said and agree IF you get a decent set of HCP's on your case then you are likely to get reasonable treatment. You are proof of that but because you did get such good treatment I think you tend to see things through rose tinted glasses somewhat.

The problem is as you say that treatment is patchy at best or it my words "the system is failing" but you seem to be willing to accept that patchiness whereas I don't. For example I have seen what that patchy treatment did to my son for 13 years and what it would be doing to me now if I let it. We all pay our taxes and should expect a good informed level of treatment.

I actually think what Hana wrote

xyzzy
I think I have part of the answer to one of your questions on why NHs targets are so lax.
Many doctors have found that patients are looking for a quick and easy solution to everything. They don't expect to have to make an effort.
Since the dietary advice to diabetics changed [around 30 years ago] from" eat less carbsand learn exchanges" to eat what you like and take more medicine". This has encouraged the "Take the easy way out" culture. Doctors are taught the lax targets, because someone thinks those are fairly easily attainable, by MOST diabetics. In the process the Healthcare professions have lost the knowledge of NORMAL carbohydrate metabolism and truly Don't know what a NORMAL BG or HbA1c are. Ask some. they simply tell you the target numbers. In fact the Normal/non-diabetic numbers are not easy to find.
The myths have become self perpetuating. diabetics are only expected to achieve a level of control, which was found to be easily achievable.
Add to that crummy dietary advice and you have today's situation.

makes a lot of sense. To me it is this attitude of "take the easy way out" that causes the patchiness Taking her comments one stage further and being a bit more forceful.

Being ignorant of things or allowing people to do the "easy way out" is not an excuse though is it? It still ends up killing those people young and what's far more immoral or even criminal in my book is you never gave them the option of "doing the hard way" because that way was never explained to them.

Now what I am quite willing to accept was say 10 years ago the "way" was hard. Little research had been done on controlled carb regimes and the drugs elevator / G.I approach may well have been the best based on the then prevailing research.

What I can't accept is that today with all the evidence regarding "grams / day" and that other countries have accepted that evidence and its shown to work in 95% of T2D's that we should still be pushing the "It's too hard to do" message. It is so defeatist. It's why I get so LOUD about this. For examples you can take my earlier LOUD statement

It still ends up killing those people young and what's far more immoral or even criminal in my book is you never gave them the option of "doing the hard way" because that way was never explained to them

and make it even more indefensible by making it

It still ends up killing those people young and what's far more immoral or even criminal in my book is you never gave them the option of "doing the hard way" because that way was never explained to them. EVEN WHEN IT WAS SHOWN IT WASN'T REALLY THAT HARD.

So to me the whole thing revolves around modernisation and acceptance by the establishment that the old ways are no longer the best ways. I can see this is a big change for the country to accept as its not just diabetics but the whole starchy carb is healthy view. These "battles" happen whenever a new theory is shown to be correct. For example in 1905 Einstein did it to the 19th Century physics community and in the 1920's and 1930's the Quantum Mechanics brigade did it to Einstein. You will find those battles going on throughout all disciplines whether science based or not. In the end the new theory prevails as it will with controlled carb regimes. It already has in many countries.

 

[phoenix]

If you look at my post on this thread viewtopic.php?f=2&t=28287. You'll see that I had a lot of help. I know that T2s locally (when referred or self referred) to the hospital also have a good dietary help. What they are told appears to work, it is based on conventional principles (carbs /fat) but it is prescriptive.

If we look at the far past in the UK the Lawrence lines diet was advocated. A line was divided into halves.The first half included 5g carbohydrate, the second 7.5g protein and 15g of fat. Each line was 185 calories.There were lists to work from so for example a patient could choose 6oz of beans from the carbs list and 1oz of bacon from the protein/fat list.
A person was told how many lines they were allowed.
A man that weighed 165lbs would be allowed 10 lines .
(brief explanation here p262
http://www.ncbi.nlm.nih.gov/pmc/article ... 4-0015.pdf
This diet was used widely and his books went through many editions (so presumably were read and used) until at least the late 50s (think I remember 60s but the last one on Amazon is 59)

It was a low carb, high fat diet. It was also calorie restricted.
It was a prescriptive diet, if people stuck to it they apparently did well loosing weight and improving glucose levels (but these weren't tested as they are today) but a lot of people didn't stick to it. CVD rates for diabetics in this period were high.

On the other thread,Nigel mentions the exchange diet, this was a sort of development of the Lawrence diet : foods are grouped into basic types — starches, fruits, milk, meat, sweets, fats and free foods. The proportions of each varied a bit over the years with carbs increasing and fats decreasing.
http://www.mayoclinic.com/health/diabetes-diet/DA00077
it was calorie counted (lots of people prescribed the 1800 cal diet) could be prescriptive and like all diets people didn't stick to it.
And CVD deaths didn't go down.

Not going into the history after this (gets controversial!) but lets just say it was felt a good idea to reduce the fat and increase the carbs in the diet because of the high incidence of CVD. Most of the research I've seen in this period concerning people with diabetics though was about high fibre carbs, not any old carbs. Later this idea developed into the GI (with the realisation that it wasn't fibre alone that differentiated carbs).
There seems to be far less individual in the UK now. The lines and exchange methods were only applicable if you were told how many lined or exchanges to eat , It seems that people get given some far too general general guidelines.

DUKs guideline with 7-14 portions of carbs a day of varying portion size and a nod to the GI seems incredibly unhelpful and if you compare the GI list on the website with this one derived from Sydney one wonders as to its accuracy. There are better guides than this available like the Idaho plate method which at least demonstrate portion size.(but not GI)
http://www.diabetes.org.uk/Guide-to-dia ... fAodXXTtaQ
http://www.the-gi-diet.org/lowgifoods/

I do think that calories count (and I have read Taubes but that's another essay as it is a very thick book ).As far as I know all but one study in a metabolic ward demonstrates that people who are only allowed to eat prescribed amounts lose the expected amounts of weight. (in the odd one out the researchers point out that it was difficult to control cheating)
You could read Colpo on that one (but put your metaphorical earphones on as he is a very 'loud' and aggressive blogger)
For all sorts of reasons it's very difficult to be really be objective about what we eat, all day every day. Outside a metabolic ward it's very much harder to lose weight.

I think that many people can and do lose weight on a low carb diet because they do in fact cut calories. I also think that some who go down the high fat route (lashings of cream and butter as one person used to say) don't lose the weight they want to. I find it ironic that the couple of very low carbers I know who were always thin advocate eating higher fat to stop weight loss.As fat is 9 Calories a gram I think that makes absolute sense.
I think that the amount of Calories we need also alters. As we lose weight, or get older,our calorie needs reduce so what works at first or last time we dieted may not work later on.

 

[noblehead]

I'm going to say this in bold, because it's important:
Low-carbing (and very low-carbing) are very relevant to T2 diabetics that are not controlled by insulin. Bernstein, Phinney, Volek and Taubes provide a scientific backgrount to why low-carbing works, and why it isn't bad for your health. If you don't think that is relevant to diabetics, then I don't know what is.

Couldn't agree more that low-carbing is relevant to type 2's (and type 1's) and that is why I point members to the excellent information that Daisy posts when we have newbies to the forum, this advice has stood the test of time and is a good starting point from which to work from.

The 'Cholesterol is Con' and 'high fat/high protein diets are safe ' brigade are of little relevance to me as I don't subscribe to their theories and simply go with what has served me best for the last 21.. ( :roll: ) years.

 

[catherinecherub]

Oh zxxy, the drugs elevator/G.I. approach. What a way to describe it. :lol: :lol: :lol: :lol:

There are plenty of people who use the low G.I. approach without the need to increase their medication and like the ultra low carbers they modify their diet to suit their management of blood sugars. A great number of them have come here, used that method and moved on. They also do not feel the need to keep banging on about it but will answer specific questions. I think I explained it to you at one time when you couldn't understand why you got high readings with a fruit salad if it was not incorporated within your meal :?: Many low carbers are using the G.I. index too.

There is much more to using G.I. than looking at a list of foods and thinking that it will be alright to eat any that are listed low G.I. My surgery promotes it for Type2's and goes to great lengths to be informative about it.

If you do not understand this approach then you really cannot comment on it. The main essentials are portion control of carbohydrates, incorporating all food groups within a meal and test, test and test again until you get the hang of it and decide what you can and cannot eat. Not much different from any other method really,

Of course we could all be barking up the wrong tree according to this article. It may be the genetics and the composition of our saliva. Our amylase levels may differ causing different glycemic responses.
http://www.sciencedaily.com/releases/20 ... 144115.htm

 

[Paul1976]

Hi, everybody!

Hi Doctor Nick!!!

 

[xyzzy]

Oh zxxy, the drugs elevator/G.I. approach.

Yes that's how many T2's would see it. Especially the ones who are now on insulin and feel cheated and very very angry with the system now they can see that a valid alternative existed which they weren't told about.

There are plenty of people who use the low G.I. approach without the need to increase their medication and like the ultra low carbers they modify their diet to suit their management of blood sugars.

Yes they are mostly T1's or T2's who are now on insulin. In those cases I have no issue with low G.I. My T1 son currently emphasises a low G.I regime more than a low carb one. I even backed up Phoenix in the sarah69 thread the other day and pointed out to fellow T2's that Sarah was an insulin user and as such a low carb diet while a choice was not the only choice and that a low G.I diet may well be more applicable for her needs. When have you done it the other way round? When have you posted to say "If you cut your carbs low enough then as a correctly newly diagnosed T2 you may be able to give up meds and get excellent control." If you were a Swedish or German HCP you would be saying things like that.

They also do not feel the need to keep banging on about it

Sorry Catherine you're getting personal again just as you do every time you perceive either your GI viewpoint or your HCP status is being challenged. Won't rise to it but will simply keep pointing it out so that the gentle readers can see. Next time I will push the "I object" button and let the admins decide.

If you do not understand this approach then you really cannot comment on it.

No I may not understand all of it but I can comment that it doesn't work and put across why. 70% of diabetcs have an HBA1C more than 7.5%, the current system is failing admit it and move on. Again your whole tone is to try and paint me as some VLC fundamentalist rather than engage with the issues in an adult and responsible way. People are noticing you and others do that quite a lot and I suspect like me wonder why.

 

[SweetHeart]

If you do not understand this approach then you really cannot comment on it. The main essentials are portion control of carbohydrates, incorporating all food groups within a meal and test, test and test again until you get the hang of it and decide what you can and cannot eat.

We've done this test, test and test again bit. My husband has done it thoroughly and, going by all the lancet pricks, literally painstakingly. It does work and we've eliminated all of the foods that send his levels through the roof. The foods we've eliminated are all white starchy carbs - anything with white flour, any pasta, anything rice or white potatoes and, interestingly, yoghurt of any sort whatsoever sends his levels through to the teens from an average of 5.1mmol.

Our SDN is still convinced MH should be eating these things, in however small portions, at every meal despite evidence to the contrary. She loves that his levels have dropped so much, but she simply cannot agree with how it's being done, even though we did exactly what she suggested. He does eat Burgen bread (2 slices max every other day) and sweet potatoes once a week, but an ounce of cooked rice or spud will take him to 9^ mmol +2 hours after eating. I think he's decided it really isn't worth it.

What we're left with is a low carb diet.

Julia

 

[catherinecherub]

zxxy,

I work in psychiatry not the field of diabetes. If I was a DSN then I could comment but it is not my expertise and I am not going down that path. I cannot dictate to other HCP's how they manage their patients. A DSN would know very little about psychiatry as that is not their chosen field. You had just as well say that I should be involved in all disciplines within the NHS. It doesn't work like that.

You seem to get very personal about the fact that I am an HCP and should be doing more about diabetes education, it is not my remit within the NHS. I also query the supposition that people using the G.I. method have to use extra meds, including insulin and feel cheated. How do you know this, have you got any stats, research etc? If you have, where these people just told to use G.I. and left to get on with it without any explanation?
G.I. works if you know enough about it, end of story as far as I am concerned. I cannot comment about how other people have failed using the G.I. method for a Type2 as I do not their personal stories or how they have been taught about G.I. There are people that eat many more carbs than I do and still manage to control their diabetes. What would you say to them?

Daisy's advice gives the information about carbohydrates and I do not want to confuse newly diagnosed about the G.I. If they ask, I am willing to explain.

The best advice anyone can give is to eat to your meter isn't it?

 

[librarising]

How about you reading this piece http://carbsanity.blogspot.co.uk/2012/0 ... mment-form I'm pretty sure you wont want to as it pretty much exposes Taubes for what he is, a seller of diet books.

Just read it, Sid, and despite all my efforts didn't find the science. Enough anecdotal of the "my dad smoked forty fags a day and lived to a healthy ninety" variety.
And an overflowing of sarcasm of a fairly low order that must appeal to some, but never me.

I was once a member of a fundamentalist church. I left (over twenty years ago) and I moved on, without need to belittle my former associates.
Sadly, that blog tells me more about the writer than nutrition.

I would never say that one size fits all, or that genetic predispositions don't play a part.

I got into Taubes, when I realised I needed to get clued up on proper nutrition. He simply exposed (can I say that word a thousand times - EXPOSED ) bad advice based on dodgy research. If that last bit doesn't interest you, that's fine.

And I don't agree with Terry Pratchett's observation. I find open-mindedness to be liberating, and other theories to be non-threatening. I like the observation that a mind has to be like a parachute. Only working when it's open

I am trying at this period in my life to understand what's truly helpful for me to eat long-term.
I ate anything with seeming impunity for the first 40 - 50 years of my life. Something's gone wrong somewhere.
Thriving short-term doesn't cut it for me.
That's because chronic diseases tend to surface over time.

Geoff

 

[xyzzy]

zxxy,
I work in psychiatry not the field of diabetes.

...

Catherine.

First it is not my intent to get personal with any HCP's but I will challenge those ones who defend the current status quo and not see the unnecessary damage they do everyday to so many ordinary people by clinging onto outdated and outmoded beliefs.

So yes I make no bones about it I would reform the system "root and branch" rather than just tinker around the edges. I have never had much time for tinkerers especially when the thing they are tinkering with is so fundamentally broken.

I think you misunderstand what my reforms would be. While I would happily introduce Swedish health care practices into the NHS over carbohydrates, cholesterol, BP, safe levels and weight that really isn't my biggest gripe. The big complaint I have is as Hana pointed out earlier which is the culture of "its too hard to try to change" and "lets not challenge people they might get offended". Its those attitudes I object to more so than any grams of carbs policy. The bottom line is Catherine we could play ping pong back and forth with low carb / low GI forever I just want people to admit BOTH work and that there should be no problem recommending either so long as whichever will keep your levels safe. If your levels aren't safe then ALL alternatives including LC and VLC should be presented truthfully rather than the current position of push stronger meds and then onto insulin. You must admit Catherine that happens in far too many cases.

You may say I'm far too interventionist but what is the NHS if it isn't the most interventionist policy this country has ever introduced. It should lead, it should SHOUT the truth, it should get angry with me for getting fat, it should have told me I was killing myself, it should have given me the option to try a low carb diet, it should have given me a meter and test strips rather than tell me I would go mad, it should.... well you get it.

I haven't read Phoenix's diet post stuff fully yet but a surface glance just seems to re-enforce my view (sorry Phoenix). At some point it looks like we were pushing low carb or whatever but it didn't seem to work not for any dietary reason but because people wouldn't do it. Rather than continue with a stronger health message policy makers went for the easy option and have been making things easy and dumbing stuff down ever since. I'm sure the conspiracy theorists will be out soon over why!

So its not you I'm having a go at personally its your defence of those policy makers.

Back in the 1950's when the smoking debate erupted I guess there were policy makers who laughed when after an initial attempt lots of people still didn't give up smoking. Over the years the anti-smoking message got louder and LOUDER until today it mostly seems to work. My God, it finally even got through to me! That anti smoking message was shouted loudly and clearly by the NHS and that's the difference. To me the diabetes message isn't loud and clear its "if you can't give up smoking 100 a day smoke 60 a day instead". That will still kill you but maybe just a bit slower. Worse it appears that message doesn't change even when someone comes along and says "take this remedy then you maybe able to give up entirely".

So sorry I will keep banging on until something changes, someone has to.

Take care

 

[phoenix]

So its not you I'm having a go at personally its your defence of those policy makers.

I didn't think I was, I thought I was rehearsing history.

I certainly don't think that giving an info sheet and at best 10 min with the dietitian is a good way of helping people make changes.

My personal experience is that when diets are individually planned, and when the education is thorough it works. I've seen it in action with T2s here. (I have helped out with the language a few times and got to know some of the people... you try explaining marmite to a French dieticienne!)

The problem is if where there are a lot of people with D, it would be extremely expensive.
The standard course here for T2s (not in France but locally) is 4 days as an in patient, occasionally when someone is very overweight it extends to 3 weeks.
The diet used is relatively conventional. Possibly, not quite as low fat as promulgated in the US and UK, certainly a lot about beneficial fats , so probably slightly lower in carbs, The types of foods used are influenced by the med diet as eaten in SW France... so some grain, lots of veg, some fruit , some dairy everyday, meat and quite a lot of fish. I've no idea what they would say to a vegetarian.
The GI is emphasised as a tool . It seems to incorporate a mixture of the diets described in the Swedish advice (see below). Like all things medical here, the education is quite paternalistic. The doc and dieticienne know best, and people follow it (I was told off by other patients for not eating enough carbs at lunch one day!)
The dietary guidelines are evidence based. I'm not going to search for the document but they use much the same evidence as in the UK. Both are influenced by the guidelines of the EASD http://www.dnsg-easd.org/info/general/D ... /guida.pdf

The Swedish recommendations that you like suggest individual advice and describe several diets (though I think they overlap)
"There is scientific evidence that several diets can be good for Diabetes. It allows for more individualized dietary advice that is based on the patient's own wishes."

They say that there is evidence for the efficacy for a traditional diabetes diet/a med diet/atraditional +low gi diet and a moderate (30-40%) carb diet. Although they describe lower carb diets,they say that "There is no scientific basis to assess the effect of extreme carbohydrate diet in diabetes. " .
http://translate.google.co.uk/translate ... md%3Dimvns

 

[xyzzy]

They say that there is evidence for the efficacy for a traditional diabetes diet/a med diet/atraditional +low gi diet and a moderate (30-40%) carb diet. Although they describe lower carb diets,they say that "There is no scientific basis to assess the effect of extreme carbohydrate diet in diabetes. "

Sorry Phoenix I am full of hot cross buns and gin to compensate but I will try my best.

You are correct but I have never said anything different. There is certainly a difference between what the Swedes count as a moderately restricted (30%) total carbohydrate diet which they actively recommend and the starchy carbs with every meal advice given in the UK for example from the British nutrition foundation. I am sure other more "expert" forum members on diet could provide you more detailed differences.

Current advice is that we should get half our energy needs from carbohydrates, with at least one third of our daily intake of food being starchy carbohydrates. According to the British Nutrition Foundation, the average adult's daily diet meets this target with women getting 47.7 per cent of their daily energy from carbs (203g) and men 48.5 per cent (275g).

Sorry Phoenix 275g / day is what gave me T2D and 275g would give me a long and painful death. Even 200g would do the same job no matter what the GI was. I go to my sons for Sunday dinner quite often. He cooks low GI as T1. As a 13 year adult T1 with an enormous knowledge of diabetes I'm sure he knows what low GI is. His meals spike me and I could show you my meter to prove it. Good for him though and they're lovely.

Here's another set of quotes taken from the document, my bold to show why in my "new member" posts I recommend reducing starchy carbs. I think the key phrase is "than a traditional diabetes diet" don't you?

In recent years, moderate carbohydrate diet scientifically studied and in increasing quantities. Several studies have examined the effect of a moderate carbohydrate reduction even in diabetic patients.

The diet consists of meat, fish, shellfish, eggs, vegetables, legumes and vegetable proteins and fats from olive oil and butter. The diet includes less sugar, bread, cereals, potatoes, root vegetables and rice than a traditional diabetes diet.

Several international guidelines for the dietary management of people with diabetes recommend today a diet that is broadly similar moderate carbohydrate diet, especially in overweight and decreased sensitivity to insulin.

...

With a diet low in carbohydrate content, it is easier to avoid rises in blood sugar after meals.

...

Moderate carbohydrate diet may be helpful in diabetes. The diet has a positive impact on long-term blood sugar (A1C) and weight and improves blood lipids (ie, increases HDL cholesterol in patients with low HDL cholesterol).

As for VLC. I have always stated that in that country while the diet is not overtly recommended it is not actively discouraged either. If it was why would it give examples of VLC as a means of control. If it thought it were bad it would say so. All it ends up saying about VLC is

Follow-up In addition to the usual follow-up of people with diabetes (HbA 1C , blood lipids, blood pressure, weight and self-directed or systematic measurement of blood glucose) should be used to monitor renal function. Since the diet effects are less known, it is important to monitor how the diet affects the medical treatment. The risk of hypoglycemia should be particularly considered when treatment with insulin or drugs that release insulin. If the patient does not lose weight with a weight first goes down then rise, these follow-up measures are particularly important

Whenever I mention VLC in the context of the Swedes I always say "they do not actively discourage it just recommend their HCP's closely monitor a person who elects to do VLC" That's what the above quote says...

Don't underestimate the effect of LCHF is having in Sweden. As recently as January this year one of their leading newspapers did a 100 page pull out about it. It seems to be sweeping away everything in it path.

http://translate.google.com/transla....kostdoktorn.se/expressens-100-sidor-om-lchf/

As I said to Catherine earlier we could continue to play these grams / day and diet games forever however I thought we had reached a consensus on "eat to your meter" which by its mere definition must mean you and I, Catherine, Sid, noblehead, Grazer, Stephen and everyone else who buys and advocates that mantra must believe that if someone's meter says they can only eat 100 grams / day to keep safely under 8.5 then you or anyone of the people I have mentioned would have no problem recommending them to do it or maybe I'm misinterpreting that as well.

In any event I suspect you are misunderstanding the main thrust of my gripes. It's not grams / day, VLC or GI it's the state of diabetes care in the UK which many of us think needs completely reforming. implementing something along the lines of the Swedish model is just a small but important part of that reform. Simple as that. Have a good Easter Phoenix and I hope your family is well.