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NHS Choices Dietary advice

D

Daibell

Master
Messages
12,677
Location
Hertfordshire, England
Type of diabetes
LADA
Treatment type
Insulin
A few weeks back I was so incensed by the stupid 'have loads of carbs' advice on the NHS Choices website, I emailed them to say how ridiculous and outdated the advice it was. Today I received a reply:

Thank you for your feedback regarding the role of carbohydrates in the diet.

In the UK, government policy on nutrition is based on advice from expert groups, including the Scientific Advisory Committee on Nutrition (SACN), and before this, the Committee on Medical Aspects of Food Policy (COMA). SACN is a UK advisory committee of independent experts that provide advice to Public Health England (PHE), as well as other government agencies and departments. Its remit includes matters concerning nutrient content of individual foods, advice on diet and the nutritional status of people.

The Eatwell Guide depicts a diet that is based on fruit, vegetables and wholegrain starchy carbohydrates taking into account new recommendations for sugar and fibre from the SACN report on Carbohydrates and Health. Find the report in the following link:
https://www.gov.uk/government/publications/sacn-carbohydrates-and-health-report

In this report, SACN considered a huge volume of evidence and applied strict inclusion and exclusion criteria to ensure that the studies considered were of sufficient quality to enable sound conclusions to be reached. This was in line with SACN’s framework for the assessment of evidence (https://www.gov.uk/government/groups/scientific-advisory-committee-on-nutrition).

The evidence considered by SACN for its Carbohydrates and Health report does not support using a low carbohydrate diet to reduce the risk of Type 2 diabetes. It also concluded that the hypothesis that diets higher in total carbohydrate cause weight gain was not supported by the evidence from the long term Randomised Controlled Trials considered; it also concluded that there is no association between total carbohydrate intake and glycaemia (blood glucose level).

As a result, government recommendations continue to advise the population to consume a diet based on higher fibre foods such as fruit, vegetables, beans and pulses, and to base meals on wholegrain starchy foods such as bread, rice, pasta and potatoes with the skins on.

So, perhaps I should stop my insulin as there is no connection between total carbs and blood sugar level and/or I can pig out on carbs with no weight gain. BTW I looked at the SACN website and the list of members and their Register of Interests. Was I surprised to find that many of the Professor members are funded by food or pharma companies - No. So now you know officially that Carbs are good for us
 
The evidence considered by SACN for its Carbohydrates and Health report does not support using a low carbohydrate diet to reduce the risk of Type 2 diabetes. It also concluded that the hypothesis that diets higher in total carbohydrate cause weight gain was not supported by the evidence from the long term Randomised Controlled Trials considered; it also concluded that there is no association between total carbohydrate intake and glycaemia (blood glucose level).

??? I'm speechless !
 
At least you got a reply - they never answered me when I complained about the Eatwell plate. They are stupid - if there is no correlation between carbs and blood glucose then type 1 diabetics don't need to take insulin to cope with carbs as it wont affect their blood glucose levels. Not sure many type 1's would agree with that, nor type 2s nor anyone with a bit of sense. Note the wording also that there was no evidence from the trials they considered. Hmm perhaps there are trials they didn't consider. i once went to the effort of looking at every single study the PHE use to sustain their nonsense and unsurprisingly not one study could I find that compared the efficacy of a low carb high fat diet (much less a proper ketogenic diet) with the standard diet or with low calorie or high carb. No they used differing amounts of carbs sometimes but nearly always compared to the standard diet so a higher fibre diet compares well to the standard diet which is carby and fatty. But no comparison of their advised diet to a low carb high fat one. If you don't do the studies apparently you don't have to report on them. Clever eh?
 
And they wonder why there is a diabetes epidemic.

I also had a look at the register of interests of the members of SACN, and yes, plenty of interests i big pharma and food manufacturers. Just like the membership of the British Nutrition Foundation that also advises the powers that be on food. ( British Sugar PLC, Kelloggs, United Biscuits ..... and all the rest.
 

Sounds like a lobby group - a lot of spin in the official reply that you received - The BBC's counterpart in Canada the CBC (Go figure) recently aired a really good segment on an attempt to rediscover the pleasures of eating healthy, unprocessed foods, while dispelling the misconceptions fed to the general public by “faulty nutrition science and deceptive marketing practices.” It's of more value than the email you received. - http://www.cbc.ca/passionateeye/episodes/in-defence-of-food
 
"The evidence considered by SACN for its Carbohydrates and Health report does not support using a low carbohydrate diet to reduce the risk of Type 2 diabetes. It also concluded that the hypothesis that diets higher in total carbohydrate cause weight gain was not supported by the evidence from the long term Randomised Controlled Trials considered; it also concluded that there is no association between total carbohydrate intake and glycaemia (blood glucose level)."

Although the answer talks about carbohydrate and "the risk of Type 2 diabetes" it doesn't make any comment about carbohydrate and the risks of the complications of diabetes. This suggests the answer is discussing carbohydrate in the diet of people without diabetes. In people without diabetes, the statement "there is no association between total carbohydrate intake and glycaemia" is not unreasonable. Perhaps NHS choices misunderstood Daibell's point? Without seeing the email they were sent, it is difficult to judge.
 
Thanks. I've listed below my original email to them. Yes the focus was more general than just diabetes but I did mention diabetes. Bearing in mind that the number of diabetics is rising rapidly and there must be a large number with insulin resistance and hence at risk you could say many/most people might see a BS change with high carbs?

Quote:

I remain horrified that NHS Choices continues to ignore the role of carbohydrates in the diet. Your experts appear to be unaware that sugar is just another carb and that all carbs, not just sugar, need to be kept under control as they are a major cause of weight gain and diabetes T2 if not controlled. If the obesity epidemic is to be tamed the NHS must stop talking about just sugar but highlight the role of carbs. I'm a diabetic and am well aware of the effect carbs have on the body. If you are in any doubt read the two main UK diabetes forums and read the contributions of the benefit of carb reduction for both weight reduction and blood sugar.
 
Of course these people are right Come on? This is the very same kind of human intelligence that said the earth was flat or that the planets did not revolve around the Sun. Unless of course COMA & SACN will put forward alternative theories to the science of our solar system as well? in which case we can surely expect the UK government to believe them
 
Looks like it was very clear that the question asked was about T2 diabetics . The comment that that there is no association between total carbohydrate intake and glycaemia (blood glucose level) takes the breath away . I wonder what they think impacts blood glucose ? I can quite believe that because the studies have not been undertaken then they can say that they do not have the evidence of the benefits of low carb. However there is a lot of evidence from this forums personal experience and from a number of medical outriders Newcastle study and others that low carb works . The disappointment is that they are not prepared to even consider doing some larger studies or to mention that there are other options to the current eat well.
 
Daibell said:
The evidence considered by SACN for its Carbohydrates and Health report does not support using a low carbohydrate diet to reduce the risk of Type 2 diabetes.
Click to expand...
Perhaps the SACN could consider some additional or other evidence....?! Whatever evidence they HAVE considered sounds to be at best irrelevant and at worst life-threatening.

In my opinion.

 
(my bold)

This is the sort of comment that really annoys me. I have seen such behaviour previously in other "official" comments, where the subject is the role of carbohydrates, but then in their reply / comment / defence arguments, they subtly (or not so subtly) change the subject to fibre - as if that then justifies the whole of their comments & their attitude to low carb eating. And of course, the low carb supporters will often agree with whatever the statement is about fibre - at which point, they can then say: see - yaa, boo, sucks, told you so!!

In the UK, carbohydrates and fibre are treated separately on any food labelling, and fibre is not included in calculations of total carbs (sugar is included). (I gather fibre is included in total carbs in USA & maybe elsewhere, but we're talking UK here).
 
Speechless! I just want to say....
 
Well as a newly diagnosed T2 all I can say is that 'confused!' It's mind blowing for me to cope with what I am told are facts, and then, with what I am told are facts that contradict the first facts!!!!! If what you say about the professors links to food and pharma companies, surely morally wrong and a conflict of interest!
 
Well, they register their conflicts of interest and claim operationally they don't allow any conflict but what do we think actually happens when these companies provide research funding. It was even worse with the recent new Eatwell Guide where the final voting meeting for the content, I gather, had a very large majority of food manufacturers who did the voting.
 
Thanks, I think explains it. Even though you mentioned that you were diabetic, what you've asserted in your email is that "carbs ... are a major cause of diabetes T2" and that seems to be the point that NHS choices was trying to answer. Although you are correct that the number of diabetics is rising, the prevalence of diabetes is only around 6 or 7% of the population so for a large majority of people the statement they made about total carbohydrate and glycaemia is probably correct.
 

Even if it is correct for non-diabetics, it is still pushed on diabetics on diagnosis, at courses, and anywhere else it can push it. That is what is wrong.
 
I suspect that these comittee members have never used or even seen a bgl meter. Their database comes from the NHS who are dead against SBGM and do not collate any evidence from such activity either. Officially, SBGM is like self harming and to be ignored, hence no link between carbs and bgl exists, QED.
 
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