Low carb questions and testing

[crabby999]

Background: diagnosed T2 four months ago with hb1ac of 11.8%. Followed the nhs diet for 3 months and after 3 months reduced my score to 8.2%. Now taking 200g metformin but after finding this forum, i want to make significant improvements by adopting lchf diet and blood testing.

I've got some general questions/concerns:

1. Lack of fruit. Always taught that fruit contains nutrients that are good for long term health. Will i be missing something by adopting lchf and if so, is there a supplement you recommend?
2. Saturated fat. For snacks, i eat cheese and whipping cream. Most of my fats are unsaturated. Should i be concerned about saturated fat? I think my cholesterol was 4.7%
3. Calcium. Is there a good alternative to standard milk you recommend? Used to drink a glass of milk a day so will miss this
4. Blood testing. I want to test and record my blood once a day to see if its improving. Whats the best time of day to do this? I assume morning before you eat anything?
5. Blood testing. For testing the impact of individual meals, i am testing before a meal and two hours after. If there is a rise of more than 2% then i am going to look at making the meal less carby and then retesting. If i get more than 2% increase 3 times then i will remove meal from diet. Is this the correct way to test?
6. Blood testing. My blood levels have been about 6.2% in the morning for the last 3 days. What should i realistically be aiming for and how quickly? I see lots of people with scores of about 5.5%
7. Whey protein. There's a company called phd that sells diet whey protein bars and shakes. The bars contain sugar alcohol but the shakes dont. They are both low on normal sugar. I'm basically looking for a special treat to drink and eat maybe once a week. Should i avoid these bars and shakes or are they ok? I'm going to do a blood test when i get them but i just want to know i'm not trashing my progress or health.
8. Cafes. I've got kids who like to eat cake at a cafe which makes me feel sad when i cant join them. Do you have any strategies to cope with this as i'm starting to resent going to them. I've resorted to taking some nuts with me but it doesnt do the trick.

Sorry for all the questions

 

[Guzzler]

Hello and welcome.

You would be wise to keep fruit to a minimum at least for a few weeks to allow the liver to release its fatty deposits (fructose is stored in the liver as fat which promotes insulin resistance). A few raspberries or strawberries with double cream or full fat greek yoghurt is usually fine but as always, test your blood glucose before and after.

There is no harm in eating saturated fats. As for cholesterol, when you are actively losing weight this itself can skew your cholesterol levels for a while plus the Total Cholesterol number is pretty meaningless as a marker, you need the breakdown values to be able to judge your status.

Milk is higher in carbs than double cream for e.g and there is plenty of calcium in cheese.

Testing. Best method is to test as soon as you wake, before you jump up and start your day. As for meals, you have it right.
Fasting readings are trickier than pre and post prandial readings and are often the last to improve.

The decision to buy protein shakes or bars is a personal one but always read labels for nutrition and ingredients. Some people react to them others do not.

Eating out can be tricky at first. Once your palate changes, which it will, you will no longer feel that you are missing out on anything.

Loads of recipes and information on this site and at https:/www.dietdoctor.com including sweet treats. We have a food and nutrition section here on the forum, have a wander around and see what you think.

 

[Rachox]

Hi crabby999 and welcome to the forum. First let me link in some useful info for you here:
https://www.diabetes.co.uk/forum/threads/basic-information-for-newly-diagnosed-diabetics.17088/
I’ll try to answer your questions.
1) The lowest carb fruits are berries. I eat a few raspberries and strawberries everyday but I believe that there are no nutrients in fruit that you can’t get elsewhere.
2) I’ll leave this one for @bulkbiker to answer, it’s his speciality
3) Calcium can be obtained from full fat Greek yoghurt or double cream which are both low carb.
4 and 5) Fasting blood sugar is the last one to normalise once you’ve taken action to put your blood sugars right, the before and after meals readings are far more helpful initially as they help you learn what foods you can and can’t tolerate.
6) As I said before fasting levels are the slowest to come down, I like to see below 5.5 mmols/litre (not % )
7) Regarding PhD supplements, I eat the PhD smart bars they are low carb, around 2 - 3g impact carbs. I think the whey protein bars are higher carb, I haven’t tried them or the shakes.
8) I always carry a PhD bar or a Carb Killer bar in my bag for those café occasions.
Don’t worry about all the questions that’s what the forum is for

 

[crabby999]

Many thanks for the quick responses. I really needed the reassurance that i'm on the right track as my nurse wasnt very helpful.

Can you summarise what results i should be asking the nurse to test for? They told me my hb1ac, cholesterol and they did a urine test that i think looked at proteins. What are the most useful?

I discovered dietdoctor today. Never really cooked in my life but i have to start somewhere. I just hope my food looks like theirs!

I know this is premature, but do you have a feel as to when you can start reducing metformin e.g if hb1ac is below 6 mmols for X months? My nurse gave me a disapproving look when i asked if metformin was a temporary drug

 

[bulkbiker]

1. Lack of fruit. Always taught that fruit contains nutrients that are good for long term health. Will i be missing something by adopting lchf and if so, is there a supplement you recommend?

Nothing in fruit that you can't get elsewhere and not having it reduces both the sugars in it. I'd say have a few berries if you have to but not necessary. 50g or so of raspberries in some full fat yoghurt with cream is nice.

2. Saturated fat. For snacks, i eat cheese and whipping cream. Most of my fats are unsaturated. Should i be concerned about saturated fat? I think my cholesterol was 4.7%

No need to worry about saturated fat as up to date thinking is that there is no problem with it. "Snacking" however is best avoided so eat meals with cream and cheese if you like but try to avoid snacking. It simply means your meal wasn't big enough. I try to eat only twice a day max to limit insulin production so I can access fat stores easier.

3. Calcium. Is there a good alternative to standard milk you recommend? Used to drink a glass of milk a day so will miss this

I have double cream in hot drinks as opposed to milk. Milk is far higher in carbs. As alternative there are lower sugar milks like lactofree but try not to have too much of those.

4. Blood testing. I want to test and record my blood once a day to see if its improving. Whats the best time of day to do this? I assume morning before you eat anything?

First thing in the morning. I get up pee weigh then blood test every day. Don't forget to record the info (I use a spreadsheet) otherwise its a bit pointless and then when you have a database you can make funky graphs of your improvement over time and stun your diabetes nurse!

5. Blood testing. For testing the impact of individual meals, i am testing before a meal and two hours after. If there is a rise of more than 2% then i am going to look at making the meal less carby and then retesting. If i get more than 2% increase 3 times then i will remove meal from diet. Is this the correct way to test?

Its not 2% but 2 mmol/l i.e if your pre prandial blood is at 6 then you ideally would see a rise up to a max of 8 mmol/l 2 hours after.. Ideally the rise would be lower and in a perfect world your blood may even drop a bit ofter eating.

6. Blood testing. My blood levels have been about 6.2% in the morning for the last 3 days. What should i realistically be aiming for and how quickly? I see lots of people with scores of about 5.5%

My FBG took about 6 months of ultra low carb to "normalise" and is usually around 5 mmol/l but it does take time so don't fret about it too much.

7. Whey protein. There's a company called phd that sells diet whey protein bars and shakes. The bars contain sugar alcohol but the shakes dont. They are both low on normal sugar. I'm basically looking for a special treat to drink and eat maybe once a week. Should i avoid these bars and shakes or are they ok? I'm going to do a blood test when i get them but i just want to know i'm not trashing my progress or health.

Eat real food.. if it comes out of a factory avoid it. Shakes, bars anything like that is usually full of process rubbish that you don't want to be eating even if it carries a low carb label. Use your condition as a good excuse to clean up what you eat. Fresh home made food from raw ingredients is always best.

8. Cafes. I've got kids who like to eat cake at a cafe which makes me feel sad when i cant join them. Do you have any strategies to cope with this as i'm starting to resent going to them. I've resorted to taking some nuts with me but it doesnt do the trick.

I look on cakes as non food poison items these days.. a black coffee with double cream is your friend in these situations.

Good luck with your dietary changes and welcome.

 

[bulkbiker]

I know this is premature, but do you have a feel as to when you can start reducing metformin e.g if hb1ac is below 6 mmols for X months? My nurse gave me a disapproving look when i asked if metformin was a temporary drug

I gave it up after 3 weeks of being tied to the loo. The pills went in the bin and I cut carbs and started intermittent fasting..
That was me .. maybe see how you get on with them and see what your blood sugars do.

 

[Rachox]

The best thing to do is to ask for on line access, so you can look at all your results at your leisure. All patients in England (if that is where you are) have that right. Any you don’t understand just ask here!

 

[bulkbiker]

2. Saturated fat. For snacks, i eat cheese and whipping cream. Most of my fats are unsaturated. Should i be concerned about saturated fat? I think my cholesterol was 4.7%

as if by magic

https://www.diabetes.co.uk/news/201...,-worldwide-research-team-warns-98061526.html

 

[ianf0ster]

Hi crabby999,
Your question in black, my answer in red
I've got some general questions/concerns:

1. Lack of fruit. Always taught that fruit contains nutrients that are good for long term health. Will i be missing something by adopting lchf and if so, is there a supplement you recommend?
-Most fruits contain similar nutrients to each other and also similar nutrients to vegetables. LCHF still allows for some fruit consumption (just not that ridiculous 5 a day = kill yourself with sugar garbage). Plus there are fruits that are generally treated as vegetables: A). Avocado, which is great for LCHF, B). Aubergine (or EggPlant) take a big one and slice it into rounds to use as a substitute for bread/dough or pasta in 'lasagne, pizza etc., C). Tomato (very versatile and edible for most on LCHF in small quantities), D). Cucumber. courgette/marrow - you get the point!

2. Saturated fat. For snacks, i eat cheese and whipping cream. Most of my fats are unsaturated. Should i be concerned about saturated fat? I think my cholesterol was 4.7%
- See some of 'The Fat Emperor's videos . Dietary fat (even saturated fat) does not make you fat, or clog up your arteries. I have had a triple bypass and upon discovering this forum I cut my statin dose in half and started eating LCHF including lots of hard Cheese, Cream and Coconut Oil (all saturated fat). So I had better be right about this!

3. Calcium. Is there a good alternative to standard milk you recommend? Used to drink a glass of milk a day so will miss this
- Leafy green veg like Kale and Spinach contain lots of calcium, as do cream, yoghurt and cheese. If you really love the taste of the thin waste-product from cream you could try diluting any low carb unflavoured yoghurt until it is tasteless enough for you LOL !

4. Blood testing. I want to test and record my blood once a day to see if its improving. Whats the best time of day to do this? I assume morning before you eat anything?
-Testing once per day isn't a good idea, especially before breakfast. 1). You will have been fasting and when you fast for too long your the liver boosts your blood glucose using up stored fat deposits. 2). There is the 'Dawn Phenomenon', a more extreme version of number 1. 3). The fasting Blood Glucose level is the slowest to reduce, you will need to look at the trend over months, even years for that - so why test every day? If you must test every day then test before bed time, although if you last meal was only 2 or 3 hours before then that will/may influence the result.

5. Blood testing. For testing the impact of individual meals, i am testing before a meal and two hours after. If there is a rise of more than 2% then i am going to look at making the meal less carby and then retesting. If i get more than 2% increase 3 times then i will remove meal from diet. Is this the correct way to test?
-With the before/after meals you should also look to try and keep your 'after' to below 8.5 (medication permitting). Yes, some medication like statins and Steroids increase your Blood Glucose (and turn people from pre-diabetic to fully Type 2 diabetic)!
Also the meals/foods that you initially exclude, you may later be able to tolerate in small quantities after the LCHF diet has reduced the fatty deposits around your liver and made it more sensitive to the insulin that you naturally produce,

6. Blood testing. My blood levels have been about 6.2% in the morning for the last 3 days. What should i realistically be aiming for and how quickly? I see lots of people with scores of about 5.5%
- 6.2 is great for now. Don't expect a quick reduction because the fasting Blood Glucose levels take the longest to reduce.

7. Whey protein. There's a company called phd that sells diet whey protein bars and shakes. The bars contain sugar alcohol but the shakes dont. They are both low on normal sugar. I'm basically looking for a special treat to drink and eat maybe once a week. Should i avoid these bars and shakes or are they ok? I'm going to do a blood test when i get them but i just want to know i'm not trashing my progress or health.
- I am going to be blunt (and unpopular with some) : Eating processed garbage got us into this state - so do you really think that eating a processed 'healthy' protein bar will improve your condition or your diet? For the sake of your health, snack on the good stuff like nuts and cheese!

8. Cafes. I've got kids who like to eat cake at a cafe which makes me feel sad when i cant join them. Do you have any strategies to cope with this as i'm starting to resent going to them. I've resorted to taking some nuts with me but it doesnt do the trick.
-Nuts are good, but fat with protein is more filling, so I eat nuts with mature cheddar. But you could try eating a dried unprocessed meat such as biltong etc. Or if the cake make you crave a sweet taste, get an 85% (or greater) Cocoa-Solids dark chocolate bare look for under 30gm Carbs. then break it into whatever sized carb treat allowance' you can afford to give yourself that day Only take the allowance amount with you. Eat it slowly and savour the smoothness and intense taste.

 

[Guzzler]

Hi crabby999,
Your question in black, my answer in blue:
I've got some general questions/concerns:

1. Lack of fruit. Always taught that fruit contains nutrients that are good for long term health. Will i be missing something by adopting lchf and if so, is there a supplement you recommend?
-Most fruits contain similar nutrients to each other and also similar nutrients to vegetables. LCHF still allows for some fruit consumption (just not that ridiculous 5 a day = kill yourself with sugar garbage). Plus there are fruits that are generally treated as vegetables: A). Avocado, which is great for LCHF, B). Aubergine (or EggPlant) take a big one and slice it into rounds to use as a substitute for bread/dough or pasta in 'lasagne, pizza etc., C). Tomato (very versatile and edible for most on LCHF in small quantities), D). Cucumber. courgette/marrow - you get the point!

2. Saturated fat. For snacks, i eat cheese and whipping cream. Most of my fats are unsaturated. Should i be concerned about saturated fat? I think my cholesterol was 4.7%
- See some of 'The Fat Emperor's videos . Dietary fat (even saturated fat) does not make you fat, or clog up your arteries. I have had a triple bypass and upon discovering this forum I cut my statin dose in half and started eating LCHF including lots of hard Cheese, Cream and Coconut Oil (all saturated fat). So I had better be right about this!

3. Calcium. Is there a good alternative to standard milk you recommend? Used to drink a glass of milk a day so will miss this
- Leafy green veg like Kale and Spinach contain lots of calcium, as do cream, yoghurt and cheese. If you really love the taste of the thin waste-product from cream you could try diluting any low carb unflavoured yoghurt until it is tasteless enough for you LOL !

4. Blood testing. I want to test and record my blood once a day to see if its improving. Whats the best time of day to do this? I assume morning before you eat anything?
-Testing once per day isn't a good idea, especially before breakfast. 1). You will have been fasting and when you fast for too long your the liver boosts your blood glucose using up stored fat deposits. 2). There is the 'Dawn Phenomenon', a more extreme version of number 1. 3). The fasting Blood Glucose level is the slowest to reduce, you will need to look at the trend over months, even years for that - so why test every day? If you must test every day then test before bed time, although if you last meal was only 2 or 3 hours before then that will/may influence the result.

5. Blood testing. For testing the impact of individual meals, i am testing before a meal and two hours after. If there is a rise of more than 2% then i am going to look at making the meal less carby and then retesting. If i get more than 2% increase 3 times then i will remove meal from diet. Is this the correct way to test?
-With the before/after meals you should also look to try and keep your 'after' to below 8.5 (medication permitting). Yes, some medication like statins and Steroids increase your Blood Glucose (and turn people from pre-diabetic to fully Type 2 diabetic)!
Also the meals/foods that you initially exclude, you may later be able to tolerate in small quantities after the LCHF diet has reduced the fatty deposits around your liver and made it more sensitive to the insulin that you naturally produce,

6. Blood testing. My blood levels have been about 6.2% in the morning for the last 3 days. What should i realistically be aiming for and how quickly? I see lots of people with scores of about 5.5%
- 6.2 is great for now. Don't expect a quick reduction because the fasting Blood Glucose levels take the longest to reduce.

7. Whey protein. There's a company called phd that sells diet whey protein bars and shakes. The bars contain sugar alcohol but the shakes dont. They are both low on normal sugar. I'm basically looking for a special treat to drink and eat maybe once a week. Should i avoid these bars and shakes or are they ok? I'm going to do a blood test when i get them but i just want to know i'm not trashing my progress or health.
- I am going to be blunt (and unpopular with some) : Eating processed garbage got us into this state - so do you really think that eating a processed 'healthy' protein bar will improve your condition or your diet? For the sake of your health, snack on the good stuff like nuts and cheese!

8. Cafes. I've got kids who like to eat cake at a cafe which makes me feel sad when i cant join them. Do you have any strategies to cope with this as i'm starting to resent going to them. I've resorted to taking some nuts with me but it doesnt do the trick.
-Nuts are good, but fat with protein is more filling, so I eat nuts with mature cheddar. But you could try eating a dried unprocessed meat such as biltong etc. Or if the cake make you crave a sweet taste, get an 85% (or greater) Cocoa-Solids dark chocolate bare look for under 30gm Carbs. then break it into whatever sized carb treat allowance' you can afford to give yourself that day Only take the allowance amount with you. Eat it slowly and savour the smoothness and intense taste.

Hi Ian. I cannot actually read your comment because the colour is so faint. Would you consider editing it though this is just a request not to be considered a critisism. Thanks.

 

[Resurgam]

Consider that tomatoes, avocados, courgettes, aubergines, cucumbers and various other things which are considered vegetables are actually seed containing fruits - if there are nutrients we need and which only fruits contain, then we don't have to select the high carb fruits to get them.

 

[Listlad]

Hi crabby999,


2. Saturated fat. For snacks, i eat cheese and whipping cream. Most of my fats are unsaturated. Should i be concerned about saturated fat? I think my cholesterol was 4.7%

- See some of 'The Fat Emperor's videos . Dietary fat (even saturated fat) does not make you fat, or clog up your arteries. I have had a triple bypass and upon discovering this forum I cut my statin dose in half and started eating LCHF including lots of hard Cheese, Cream and Coconut Oil (all saturated fat). So I had better be right about this!



.

@ianf0ster

You mention hard cheese in blue, Ian. How about the soft cream cheeses? Do you have a reason for not including the soft cheeses?

 

[crabby999]

The only problem i have with metformin is a slight rumbling in my tummy so i'm happy to continue with this until my hb1ac score improves

One area where i am struggling to get answers is neuropathy. For about 3 months i have a constant sensation at the base of my toes in both feet. The nurse did the test where she touched my toes with a small rod and i could feel the rod so i'm not completely numb. Is there anything i can do to remove this sensation, its not painful but i dont want it to worsen. My bmi is about 22 so i dont think its related to my weight. My doctor & nurse just told me to get my hb1ac score down and see if that improves my feet which didnt feel very helpful

Would you recommend i start a fasting regime now? I've been pretty overwhelmed by all the info i have had to process on lchf that i was trying to avoid this until later. Will i be missing out on a big improvement if i ignore this?

 

[ianf0ster]

@ianf0ster

You mention hard cheese in blue, Ian. How about the soft cream cheeses? Do you have a reason for not including the soft cheeses?

Just that hard cheeses are popularly considered to be worse for you than soft cheeses. Also I find it easier to carry a chunk of hard cheese around with me during the day.

 

[ianf0ster]

…….
One area where i am struggling to get answers is neuropathy. For about 3 months i have a constant sensation at the base of my toes in both feet. The nurse did the test where she touched my toes with a small rod and i could feel the rod so i'm not completely numb. Is there anything i can do to remove this sensation, its not painful but i dont want it to worsen. My bmi is about 22 so i dont think its related to my weight. My doctor & nurse just told me to get my hb1ac score down and see if that improves my feet which didnt feel very helpful

Would you recommend i start a fasting regime now? I've been pretty overwhelmed by all the info i have had to process on lchf that i was trying to avoid this until later. Will i be missing out on a big improvement if i ignore this?

We are not doctors (and even a doctor would have to examine you to give an opinion for your case), however many forum members have reported even apparently unrelated conditions improving after they get their HbA1c down and have had it controlled for months/years.

Whether you do just LCHF, Keto , Intermittent Fasting or Periodic Fasting is all a personal decision as to what suits you best. But remember that you are trying to choose a lifestyle here - this isn't for just until your HbA1c is back down below the diabetic levels. - You can't then go back to eating as much carb as you did before! This is your future life.

 

[bulkbiker]

@ianf0ster

You mention hard cheese in blue, Ian. How about the soft cream cheeses? Do you have a reason for not including the soft cheeses?

Soft cheeses often have a higher carb count than hard.. a quick look at some food labels will show which are better and which not so great.

 

[Listlad]

Just that hard cheeses are popularly considered to be worse for you than soft cheeses. Also I find it easier to carry a chunk of hard cheese around with me during the day.

Ha. Yes, a chunk of Brie or a scoop of marscapone isn’t quite so portable.

 

[Listlad]

Soft cheeses often have a higher carb count than hard.. a quick look at some food labels will show which are better and which not so great.

I did check and some seem remarkably low.

Brie 0.5g per 100 so soft cheeses are low carb too @crabby999

 

[crabby999]

Thanks for all the responses, its really helped

One final question. How do you cope with ordering lchf foods at restaurants? Most dishes are carb loaded and i'm allergic to cooked fish. This problem is magnified when you go on holiday and have limited choice for a whole week - i was thinking of self catering hols in future

 

[bulkbiker]

Thanks for all the responses, its really helped

One final question. How do you cope with ordering lchf foods at restaurants? Most dishes are carb loaded and i'm allergic to cooked fish. This problem is magnified when you go on holiday and have limited choice for a whole week - i was thinking of self catering hols in future

Steak. leave the rest of the rubbish on the plate or ask for the steak without the rest of the rubbish.