Low-carb - why were dietary guidelines changed?

[Administrator]

I'm seeking to understand low-carb diabetes diet better, in order to assess how much of our support to throw behind it. It basically seems to me that it is doing a lot of people a lot of good. Am I right in thinking the diabetes diet guidelines were steered away from low-carbing to 'eating anything healthy within reason' relatively recently? If so, why was this?

Best,

Admin

 

[hanadr]

My husband's Grandfather was a pharmacist in Troon and Kilmarnock South of Glasgow( Katherine's area) and various members of the family remember that carbs were restricted for diabetic patients, who included Grandmother. I think that the modern diet is a reponse to the "easy life" philosophy Of Now. Immediate gratification for everyone and no-one need do without. It's easy to bump up the medication, so why make people do without anything? the long term doesn't matter
What we need is a dietician of the previous generation who can tell us for sure. Ally is too young to know. Perhaps someone can get in touch with the dieticia''s professional body. They may have the information we need.

 

[sugarless sue]

I remember being put on a 'diabetic' diet in the 60's ,it was for weight loss not diabetes but it restricted all the starchy carbs and the simple sugars.I think that this all changed sometime round the 80's but i'm sure there has been a thread on here about it.Someone will know!

 

[hanadr]

I have written to the British dietetic Association to ask. With a bit of luck, we'll get an answer.

 

[ally5555]

hana - who have you written too - I am a member of the BDA.

the BDA is only one cog in the wheel and whilst dietitians have input into things like the NICE guidleines alot of the decisions are made by commitee - FSA, COMA etc. . Alot of the public health stuff is produced by nutritionists who are not specialist in disease management as dietitians are.
Guidelines for non diabetics encourage the use of wholegrains but portion controlled - I think most dietitians hate to see wooly advice such as - eat a helping with each meal - what does that mean.?

Dietitians have always urged a carb restriction and i think it is quite important to diferenciate between the type of carbs. People need individaul advice not one size fits all. I am annoyed with Diabetes UK because i feel they are promoting the wrong types of foods - in their meal plans they are encouraging sugary foods etc.

I now have a contact no for one of their dietitians - i hope to speak to her this week.

 

[ally5555]

ps - i meant for diabetes UK!

 

[hanadr]

Ally, I went on to the BDA website and found their enquiries address and wrote to that.

 

[ally5555]

hana - it will prob take a while to get back - there arent any specialists based in the office as most ofthe staff arent dietitians. I will look at the diabetes dietitians website late - dont think yu can access it its in the members only section.

I saw your post on the other thread about the nurse - _ i suppose her only saving grace was she is an asthma nurse but this is half the problem - other HP with outdated advive.

i also think you have to make a distinction between type 1/2

 

[ChezMorgan]

Dont know if this will help but i ws diagnosed in 1980 and was taught to carb count very strictly, but at 260 grams a day ( I was 10 years old)

 

[ally5555]

that seems alot but then kids have different requirements and that was prob before the use of meters too

 

[phoenix]

The' why' things changed was because of research that suggsted that diets high in processed carbs and saturated fats might be involved in the development of Type 2, in insulin resistance and in the development of cardiovascular disease.


The when was from the late 1970s- early 1980s. A World Health Organisation report mentions that the first suggestion that dietary fibre,( as found in minimally processed carbs) might be preventative was in 1975 , in 'Dietary-fiber hypothesis of the etiology of diabetes mellitus.' (Trowell HC.)

In the UK, in the 80s, a diet with a high bean content was trialed and found to be effective '.(Simpson HRC. A high carbohydrate leguminous fibre diet improves all aspects of diabetic control. Lancet, 1981, 1:1--5.' ) This spilled out into popular culture with the F plan diet.
On the diabetes Stories website there's an account of a man who continued eating that diet for many years and had a full and active life. The trial is mentioned several times in earlier research into the glycemic index.
The report goes on to describe the 'convincing' evidence of the protective qualities of whole grain cereals, vegetables and fuits (containing NSP)


The other aspect is the fat element. Very controversial in this forum. You've read on here the various arguments against it's validity
The conventional argument. (and some of the evidence for ) is in the WHO report in both the prevention of diabetes and the next section on prevention of cardio vascular disease.(p82ff)
http://whqlibdoc.who.int/trs/WHO_TRS_916.pdf
They are at present revising their report on treatment.
The recent ADA statement is takes account some recent research including that into low carb diets and includes the evidence base for their recommendations. includes reasons for not (in the present state of knowledge) recommening high protein diets. : http://care.diabetesjournals.org/cgi/reprint/31/Supplement_1/S61

 

[ChezMorgan]

that seems alot but then kids have different requirements and that was prob before the use of meters too

No meters back then, was 5 drops of urine in a test tube with a big fizzy tablet and dont touch it coz it would burn ya fingers LOL

 

[ally5555]

I think the whole thing is just getting very confused and alot of different groups are offering advice.

The is so much evidence on all sides of the equation it is a nutritional nightmare.

oh yes I remember the urine drops and the blood tests that you got the results 2 weeks later.

 

[fergus]

Am I right in thinking the diabetes diet guidelines were steered away from low-carbing to 'eating anything healthy within reason' relatively recently? If so, why was this?

Dan, I think the date you might be looking for is 14.01.77, the publication of the first 'Dietary Goals for the United States.' I think this is when the US Govt. first took an interest in prescribing to its electorate a so-called 'healthy balanced diet' low in saturated fat. This seems to have been the first time a 'low-fat' diet became Govt. policy anywhere in the world. By association, carbohydrates became the good guys on the back of Ancel Keys Seven Nations Study which claimed a direct connection between saturated fat consumption and heart diseae. Nonsense, as we now know.

Nevertheless, from that point on, carboydrates have been the 'healthy staples' of every diet, fats and particularly saturated fats, have been demonised and obesity and diabetes have become epidemic as a result.

fergus

 

[ally5555]

tbh fergus that may be the case for the Us but in thr UK our rec gave always been slightly diff - if you look at food in the 40s and 50s meals were then based on carbs too but whole meal bread and homegrown potatoes.

My own feeling is that we hit problems in the 70s and 80s when people stopped eating real food and now we have generations of people who eat only procesed food that is very high in fat and sugar.

In the 8os carb counting was generally the norm for type 1 and 2 and somewhere, prob coming from DM uk some very wooly guidelines appeared and the carb counting disappeared .

I am goibg to try and speak to a dietitian from dmuk today

 

[IanD]

Could the change be related to the development of drugs & the availability of meters? This allowed control to be measured so that the need for carb restrictive diet control was seen to be unnecessary.

DAFNE rules, OK :evil:

 

[Katharine]

Before insulin was discovered and used for diabetics a very strict low carb diet was the norm.

After insulin diets became higher in carbs but the carb was strictly measured and was still restricted to a maximum 40% of calories.

In the 1940s in the USA the idea that fat caused heart attacks became popular and diets became higher in carbs as fat was restricted. It took a long while for this to cross over the pond to the UK.


In the UK I worked at a diabetic clinic for six months in 1986. Carbs were still being counted but were restricted still to 40% of the calories. By one year later this had been abandoned in favour of "eat anything you like but limit fat". Carb counting and the exhange system was abandoned.

 

[ally5555]

I have just spoken to the dietitians at dUK ! They are planning a review of dietary guidelines next year - tried to push her on lowering the carbs a bit but didnt feel encouraged. I suggested they start looking at what is happening outside their office walls - she didnt know who bernstien was !

So the guidelines at the mo acc to dmuk are 45-60% of calories from carbs. I also pointed out that I didnt think much of the meal plans laden with sugar - that fell on deaf years as well.

So we will have to wait - however they will ask for expert advice and that will come from the diabetes grooup of the BDA - at a meeting I went to last year there were alot of dietitians voicing concerns about the higher figures. They will look at all the research from all sides of the argument - so watch this space! TBH - I can't see anything being produced until 2010!

 

[phoenix]

A bit of googling found these:
This paper describes standard diets used from 1925 to the 1990s
CHO was restricted but only down to 100gms

A major change to the diet came with the publication of The dietary recommendations for diabetics for the 1980's.[3] This was the first policy statement on nutrition from the British Diabetic Association. It abandoned carbohydrate restricted diets for diabetes, aiming to limit fat intake and increase complex carbohydrate and dietary fibre

http://www3.interscience.wiley.com/cgi-bin/fulltext/76503572/HTMLSTART


This describes in detail, the standard Type 2 diet in Belfast in 1981 : 1500 cal, 42%carb, 16% protein 14% fat

.[url=http://journals.cambridge.org...urnals.cambridge.org/download. ... 22a6df2e32[/url]

 

[tubolard]

phoenix,

Can't seem to access this file.

Regards, Tubs.