More on NICE and David Unwin's infographics...

pdmjoker

Well-Known Member
Messages
417
Type of diabetes
Prediabetes
Treatment type
Diet only
From this page which seems to have the whole story: https://theworldnews.net/uk-news/is-a-banana-as-bad-for-type-2-diabetes-as-six-spoons-of-sugar

Quote:

A recent report from the Scientific Advisory Committee on Nutrition concluded there was no difference between low and high carbohydrate diets when it came to weight loss beyond 12 months.

And despite high-level political approval, some experts robustly reject Dr Unwin’s statements about teaspoons of sugar, calling them misleading and unscientific.

When we asked NICE, in light of these findings, on what basis it had endorsed his infographics, it said it had decided to remove them from its website ‘as a precautionary measure… while we conduct our own assessment of the competing evidence claims’. It added: ‘In the meantime, we will ask Dr Unwin not to promote his resource using NICE’s endorsement.’​

I looked at the SACN report and they have the following table 5.1 of "diet definitions".

The SACN report often talks of "lower carb" not "low carb". The cited page equates "lower carb" with "low carb". Just one example of misunderstanding that has proliferated about Low Carb diets and why "Low Carb" diets fare no better in studies.

PS Some of the experts say how a low calorie diet is the only scientifically proven method of getting Type 2 under control. We know of David Unwin's success rate at reversing T2. Has anyone ever seen a quoted success rate for Low Calorie diets? Just a practical point which might be illuminating...

Edited to make more sense...

carb intake.png
...
 
Last edited:

pdmjoker

Well-Known Member
Messages
417
Type of diabetes
Prediabetes
Treatment type
Diet only
Two curious quotes from the article:

Last November, Professor Michael Lean, chair of human nutrition at the University of Glasgow, published findings suggesting low-carb diets may not be a good way to prevent diabetes. The research analysed food questionnaires from more than 12,000 volunteers to calculate their fat, protein, carbohydrate and other nutrient intakes.

Those with the lowest carb intake actually had higher blood sugar than those with normal carb intake.​

and:

Most people on a low-carb diet end up eating more carbs than those on other types of diet, according to studies.​
 

JenniferM55

Well-Known Member
Messages
611
Type of diabetes
Type 2 (in remission!)
Treatment type
Diet only
"Most people on a low-carb diet end up eating more carbs than those on other types of diet, according to studies."

It's like these quotes are published to act as a sort of subliminal message, I wonder how many have been put off low-carb through (what's possibly) dodgy conclusions?
 
  • Like
Reactions: Flora123

Oldvatr

Expert
Messages
8,470
Type of diabetes
Type 2
Treatment type
Tablets (oral)
Here is one low calorie diet claiming T2D Remission rates
https://www.diabetes.org.uk/researc...ht/research-spotlight-low-calorie-liquid-diet
Otherwise known as Newcastle Diet, and currently being marketed by NHS as DIRECT. Unfortunately it does not follow the rest of the NHS mantra of EATWELL and whole grains and starchy foods. But it does seem to be viable for some.

Here is one of the recent science papers that supports the SACN stance
https://www.sciencedirect.com/science/article/pii/S1933287419302673

Edit to add: Also this one is US but also supports low calorie diets
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1868379/
 
Last edited:

pdmjoker

Well-Known Member
Messages
417
Type of diabetes
Prediabetes
Treatment type
Diet only
Another quote from the Mail article:

effectively demonising foods such as bananas, which contain lots of nutrients, raises the risk of deficiencies.​

was written by Barney Calman, who went vegetarian in 2015.

Couldn't the same argument be used with avoiding meat? Vegetarians are entitled to their choices, but there seems to be some inconsistency here...
 

Redshank

Well-Known Member
Messages
132
Type of diabetes
Prediabetes
Treatment type
Diet only
Research based on Food Questionnaires is almost always unreliable as they may as well be based on works of Fiction.
 

NicoleC1971

BANNED
Messages
3,451
Type of diabetes
Type 1
Treatment type
Pump
Two curious quotes from the article:

Last November, Professor Michael Lean, chair of human nutrition at the University of Glasgow, published findings suggesting low-carb diets may not be a good way to prevent diabetes. The research analysed food questionnaires from more than 12,000 volunteers to calculate their fat, protein, carbohydrate and other nutrient intakes.

Those with the lowest carb intake actually had higher blood sugar than those with normal carb intake.​

and:

Most people on a low-carb diet end up eating more carbs than those on other types of diet, according to studies.​
I think Prof Lean is an advocate of the low cal Newcastle diet as his university was involved in that research i.e. he has a dog in the CICO fight.
 

pdmjoker

Well-Known Member
Messages
417
Type of diabetes
Prediabetes
Treatment type
Diet only
Research based on Food Questionnaires is almost always unreliable as they may as well be based on works of Fiction.
Agreed. I can't see how

Those with the lowest carb intake actually had higher blood sugar than those with normal carb intake. o_O

could be at all possible, unless those with the lowest carb intake had T2D. Any other ideas?
 

Oldvatr

Expert
Messages
8,470
Type of diabetes
Type 2
Treatment type
Tablets (oral)
Another quote from the Mail article:

effectively demonising foods such as bananas, which contain lots of nutrients, raises the risk of deficiencies.​

was written by Barney Calman, who went vegetarian in 2015.

Couldn't the same argument be used with avoiding meat? Vegetarians are entitled to their choices, but there seems to be some inconsistency here...
Bananas are contraindicated with two of my cardiovascular meds since it increases the likelihood of hyperkalemia which can be fatal. bananas are also high in amylase which is the enzyme that breaks the sugars down. Amylase is the main enzyme that triggers stage 1 insulin response, so eating one may give too much of an insulin rush, so may not be the most healthy of foods for an IR T2D It is amylase that causes bananas to rot so quickly. bananas eat themselves from the inside out.
 

pdmjoker

Well-Known Member
Messages
417
Type of diabetes
Prediabetes
Treatment type
Diet only
Here is one low calorie diet claiming T2D Remission rates
https://www.diabetes.org.uk/researc...ht/research-spotlight-low-calorie-liquid-diet
Otherwise known as Newcastle Diet, and currently being marketed by NHS as DIRECT. Unfortunately it does not follow the rest of the NHS mantra of EATWELL and whole grains and starchy foods. But it does seem to be viable for some.
Thank you. The DIRECT method seems extreme and unpleasant, and seems bizarre that its proponents say how Low Carb is not tolerable or sustainable...
 

pdmjoker

Well-Known Member
Messages
417
Type of diabetes
Prediabetes
Treatment type
Diet only
Here is one of the recent science papers that supports the SACN stance
https://www.sciencedirect.com/science/article/pii/S1933287419302673

This paper seems to consider LDL-C level crucial (which completely ignores the importance of particle size). Although it does say:

Gjuladin- Hellon et al. identified only three large (n > 100) RCTs that examined the impact of CHO-restricted diets on VLDL-C, apoB levels, or LDL-C particle size. Although the results of these large RCTs showed improvement in these variables for the CHO-restricted diet groups vs the HCLF diets groups, results were limited by the CHO restriction in the diet interventions ranging from ketogenic to nonketogenic and the intensive lifestyle interventions provided to participants may have affected the results.
Happily, we now have this: https://www.onlinejacc.org/content/early/2020/06/16/j.jacc.2020.05.077

 

Oldvatr

Expert
Messages
8,470
Type of diabetes
Type 2
Treatment type
Tablets (oral)
Thank you. The DIRECT method seems extreme and unpleasant, and seems bizarre that its proponents say how Low Carb is not tolerable or sustainable...
As one who has sustained an LC meal plan for over 5 years now, I agree. I look on these 8 week blood sugar and meal replacement diets as being diets that one can turn to as a last resort when there are few or any options left in the toolkit. I liken it to an emergency stop in the car, or the reset button on the computer. From what I have seen so far they are a viable tool and do produce good results, but there is a growing database of anecdotal evidence that shows that the effects do wear off in time and the changes are rarely permanent. To my mind it has the same therapeutic efficacy as a laxative or purgative. An enema is faster acting and cheaper (usually)

But I fear it points to the future where we are encouraged to eat prepared replacement meals that have to be manufactured and fortified with 'goodness' to make them healthy so we get our 5 a day in tablet form. We are already doing this for breads and grain products, and replacement milk products, and fake meat products, so lets go whole hog (omitting the hog of course) and do away with the need for a kitchen or those dangerous culinary knife sets so life becomes so much safer and saves so much waste from landfill and the oceans. Simples. It worked for astronauts after all. Breakfast in a toothpaste tube etx.
 

Oldvatr

Expert
Messages
8,470
Type of diabetes
Type 2
Treatment type
Tablets (oral)
This paper seems to consider LDL-C level crucial (which completely ignores the importance of particle size). Although it does say:

Gjuladin- Hellon et al. identified only three large (n > 100) RCTs that examined the impact of CHO-restricted diets on VLDL-C, apoB levels, or LDL-C particle size. Although the results of these large RCTs showed improvement in these variables for the CHO-restricted diet groups vs the HCLF diets groups, results were limited by the CHO restriction in the diet interventions ranging from ketogenic to nonketogenic and the intensive lifestyle interventions provided to participants may have affected the results.
Happily, we now have this: https://www.onlinejacc.org/content/early/2020/06/16/j.jacc.2020.05.077

As I said it seemed to reflect the current SACN stance which they claim to be fully evidence based. and this is one they seem to use to justify the cholesterol and low fat approaches. I am aware that there are now more recent studies that have a different conclusion. Thank you for the link. The meta studies are interesting but the statistical methods used are new and not yet fully accepted by the establishment.
 

pdmjoker

Well-Known Member
Messages
417
Type of diabetes
Prediabetes
Treatment type
Diet only
As I said it seemed to reflect the current SACN stance which they claim to be fully evidence based. and this is one they seem to use to justify the cholesterol and low fat approaches. I am aware that there are now more recent studies that have a different conclusion. Thank you for the link. The meta studies are interesting but the statistical methods used are new and not yet fully accepted by the establishment.

Yes, I didn't get the impression you fully supported the findings or stance of the paper. :)
Thought it worth having a look to see how credible the paper was, and then reporting back the impression I got.

You seem extremely knowledgeable and I'm v glad you are here!
 

pdmjoker

Well-Known Member
Messages
417
Type of diabetes
Prediabetes
Treatment type
Diet only
As one who has sustained an LC meal plan for over 5 years now, I agree
I imply that's Low Carb not Low Calorie...

The meal replacement aspect of DIRECT is 12-20 weeks followed by gradual introduction of solid food: "Add a ~400kcal meal every 2-3 weeks".

and do away with the need for a kitchen or those dangerous culinary knife sets so life becomes so much safer
All-round win! :)
 

Oldvatr

Expert
Messages
8,470
Type of diabetes
Type 2
Treatment type
Tablets (oral)
I imply that's Low Carb not Low Calorie...

The meal replacement aspect of DIRECT is 12-20 weeks followed by gradual introduction of solid food: "Add a ~400kcal meal every 2-3 weeks".


All-round win! :)
Yes. I forgot that LC stands for both strategies in this debate. I am of course Low Carb. I have never done Low Calorie in my life. I used to control by ignorance and suffered bgl levels in the clouds for many years. My bgl meter became very friendly stating 'HI' whenever I tested and giving excited bleeping noises just like a puppy dog on steroids.

To give an idea of where I am on LC(arb) non keto. A day ago I ate a whole quiche flan with a plateful of veggies, and my bgl never went above 7 mmol/l. In fact my pre /2hrPP /4hePP for that meal were 5.1 / 4.6 / 4.3 and my daily average was 5.2 mmol/l. I am not on insulin treatment, so I think this proves my pancreas is still working even after some 30 years as a T2D
 
  • Like
Reactions: pdmjoker