Dec 2014 update: New research on the Low Carb Diet in general practice

[Bluetit1802]

Though I haven't yet had the official results from my liver scan, the nurse? who did it said it was definitely a fatty liver, though there didn't seem to be any other issues in the liver she could see, She wasn't the most communicative of people, but I can understand that if she isn't a liver specialist I guess.

Though low carbing my weight loss so far is just a couple of pounds over six weeks. I guess I might be eating too much jelly, berries and cream. Typical compensation for the loss of choccy biscuits I guess.

Newcastle Dieting might be the answer I guess, but the thought of it for eight weeks seems a step too far for me. Maybe after my late summer holiday I'll think seriously about giving it a go.

Gordon, I maybe preaching unnecessarily, but to lose weight successfully you need to calorie count as well as carb count. Keep an eye on that cream and especially nuts and cheese.

 

[cold ethyl]

I don't think you need to embark upon anything quite so drastic as the Newcastle diet just yet. Just reduce the jelly,cream, and berries and eat sensible portion sizes. Some people will lose weight on LCHF just by doing that alone, but I think for a lot of us, some portion control and choosing of sensible snacks is necessary, certainly until we learn to recognise when our eating has gone beyond satisfying hunger. I'm afraid if you are anything like me, telling me I can eat as much as I like off a list that includes cheese has to be taken with a pinch of low sodium salt.

 

[gfmoore]

You are <strike>probably</strike> definitely right. But what is a sensible portion? i tried using myfitnesspal, but got bored entering everything. I do know I guess, it's half of what I have now. :big sigh



doh, html tags don't work, it's meant to be a strikeout.

 

[AndBreathe]

I like myfitnesspal, once I managed to work through the foods I eat. Now, I can keep it update really quickly.

For portion size, at the outset, I just ate less of everything than I usually would, and haven't used many things I wouldn't already have been eating. So, I'm not struggling to limit double cream, or cheese. The less than was or reduce by around a third, although clearly for many carbs it was cessation, or,a far higher eduction.

I read many people swearing by Carbs and Cals, but I don't have it myself.

 

[Adelle0607]

It's so heartening to read all your encouraging comments THANK YOU
Update; some of you will remember the research originally on 18 patients - well now there are 36 !! showing very similar results with average weight loss of just under 9.5 kg and very significant drop in HbA1c
A NEW ANGLE: What has got my interest now is the very surprising improvements in liver function which occur rapidly if on a low carb diet So much so from them I can predict who has lost weight and who hasn't before the person steps into the surgery. I wonder if too many folk link abnormal liver function with alcohol when carbs are to blame. I know I often made that mistake before I 'saw the light' Thoughts please

Hi @Southport GP

Me too I was diagnosed with fatty liver 2010 (which I still have) and had pcos during my teens which makes me a candidate for metabolic syndrome altogether....rarely did I drink too so was very surprised when I got to see my liver results...the doctor asked if I drink and I don't usually BUT consumed a fair bit of carbs. This is good news! Not that overweight though...but can still lose a few pounds....


Sent from the Diabetes Forum App

 

[zand]

Excellent point As I understand it about a third of type 2 diabetics don't have raised liver enzymes or fatty liver However conversely I suspect folk with a raised GGT not known to be diabetic should be screened for diabetes .At present the usual thoughts are alcohol or medication as likely culprits where I suspect for many too much glucose long term could be a cause ?

Yes I agree too much glucose long term can be a cause of fatty liver. For me diet drinks played a part too. I drank over 2 litres a day for maybe 6 years, and whilst there is no glucose in them, my body reacted to them as if there was. When I stopped drinking them my ALT figure fell even though I was having more sugar in my diet for a while afterwards. Sorry, I can't explain this very well or scientifically, my head is all over the place at the moment. I have read about this, but can't remember where. I just felt it was important to mention this to you even though my message is rather jumbled.

 

[gfmoore]

Yes I agree too much glucose long term can be a cause of fatty liver. For me diet drinks played a part too. I drank over 2 litres a day for maybe 6 years, and whilst there is no glucose in them, my body reacted to them as if there was. When I stopped drinking them my ALT figure fell even though I was having more sugar in my diet for a while afterwards. Sorry, I can't explain this very well or scientifically, my head is all over the place at the moment. I have read about this, but can't remember where. I just felt it was important to mention this to you even though my message is rather jumbled.

Ohhh, that's interesting. I defo drink more diet cokes now, maybe one or sometimes two cans a day. I thought they were ok. (apart from whatever chemical they put in). I never used to drink them at all, but after stopping the beer...

Got any further references?

 

[Southport GP]

Update on the low carb in general practice research we did- Low carb does works longer term!
The full research paper can be seen here;
http://www.practicaldiabetes.com/SpringboardWebApp/userfiles/espdi/file/March 2014/PP Unwin final proofs revised.pdf
the idea was that you could print off copies for any doubting or interested health care proffessionals.

Some of the responses doubted the results and were not impressed by 'short term improvements' and wondered could the sheme be extended?
Well now i can answer both points

• The latest results after over a year for the original group members on the low carb diet show very similar results; average weight loss 8.4kg, average reduction in HbA1c of 8mmol/mol so the members of the group still have an excellent average HbA1c of 42.7 mmol/mol.

• We were awarded a CCG grant to start a small evening clinic and have now helped 38 people with type two diabetes to loose an average of 9 Kg in weight which has brought about an average improvement in HbA1c of 10 mmol/mol, not to mention the reductions in cholesterol and the pride those folk have in their achievements

I hope to have a further paper published in the Diabesity in Practice paper very soon
While i'm on- have you seen the blog another GP Katharine Morrison has done on this subject at
http://diabetesdietblog.com/ ?

 

[AndBreathe]

Fantastic news! Thank you for thinking of us.

 

[VinnyJames]

I'm now post 12 months since diagnosis and have lost 19kg and gone from 7.4 mmol/L to a projected 5.2 mmol/L

I low carb between 30-70g the majority of days. It works for me.

 

[sanguine]

Excellent, thanks for the update and I look forward to the publication of the new paper.

 

[andcol]

@Southport GP That is excellent. You need to get the work out to more GP practices.

For info I am 32kg down (down 28% of my original mass) and my HbA1c is now 35 mmol/mol from 91 mmol/mol. I started low cal/carb but now on normal diet. If you ask me it is definitely the weight loss that has the largest impact and not the low carb. However without the low carb it is hard to get control so I do see it necessary and if it becomes a lifestyle choice that is great.

A couple of questions if I may indulge (the scientist in me):
1. How low did your patients go with the low carb and did they reduce calories at the same time?
2. Are your patients aiming for further reductions and will you think about testing their "diabetes" when/if they hit normal BMI?
3. Have you taken them off of medication since their reduction?

 

[Andy12345]

as always....Thankyou! your doing a grand job sir!

 

[douglas99]

@Southport GP That is excellent. You need to get the work out to more GP practices.

For info I am 32kg down (down 28% of my original mass) and my HbA1c is now 35 mmol/mol from 91 mmol/mol. I started low cal/carb but now on normal diet. If you ask me it is definitely the weight loss that has the largest impact and not the low carb. However without the low carb it is hard to get control so I do see it necessary and if it becomes a lifestyle choice that is great.

A couple of questions if I may indulge (the scientist in me):
1. How low did your patients go with the low carb and did they reduce calories at the same time?
2. Are your patients aiming for further reductions and will you think about testing their "diabetes" when/if they hit normal BMI?
3. Have you taken them off of medication since their reduction?

In his initial link, it seems no portion control at all, high fat, and high calorie snacks as well, so it would seem unlikely to be a reduction in calories.

7 of the 18 came off meds, some for the diabetes, others for acid reflux, and the diet even improved the blood pressure of his patients to such an extent they came off meds for that as well.

I would be interested in his comments on BMI, and his approach to a maintenance diet after they all hit their target though,

 

[dannyw]

Update on the low carb in general practice research we did- Low carb does works longer term!
The full research paper can be seen here;
http://www.practicaldiabetes.com/SpringboardWebApp/userfiles/espdi/file/March 2014/PP Unwin final proofs revised.pdf
the idea was that you could print off copies for any doubting or interested health care proffessionals.

Some of the responses doubted the results and were not impressed by 'short term improvements' and wondered could the sheme be extended?
Well now i can answer both points

• The latest results after over a year for the original group members on the low carb diet show very similar results; average weight loss 8.4kg, average reduction in HbA1c of 8mmol/mol so the members of the group still have an excellent average HbA1c of 42.7 mmol/mol.

• We were awarded a CCG grant to start a small evening clinic and have now helped 38 people with type two diabetes to loose an average of 9 Kg in weight which has brought about an average improvement in HbA1c of 10 mmol/mol, not to mention the reductions in cholesterol and the pride those folk have in their achievements

I hope to have a further paper published in the Diabesity in Practice paper very soon
While i'm on- have you seen the blog another GP Katharine Morrison has done on this subject at
http://diabetesdietblog.com/ ?

The low carb benefits are clearly obvious and it's posts like these that we need to see more of.

 

[IanD]

Great news! KUTGW

It's relatively easy to persuade folk of the benefits of carb reduction - but the panic sets in when the necessity of increased fat to maintain energy levels becomes apparent.

How did you get the "increased fat" message across?

 

[Mud Island Dweller]

Many than ks for the info it is brilliant to have extra back up

 

[alliebee]

Thankyou so much for this...it makes very interesting reading indeed. I've been lchf for 10 weeks now and my readings down from high teens to average of 6.7. I've lost a stone and a half too during this time. My last Hba1c was 66. I can't wait to see my drs face when I go back for follow up...by the way my GP is type 2 and a low carber himself...its slowly getting the message across I think that this way of eating does really work

 

[Yorksman]

@Southport GP Thanks for the follow up.

 

[Brunneria]

Thank you!