NICE suspend Dr Unwin’s infographics ?

[Andydragon]

It looks like Prof Kar's comments received quite a reaction.

I don't condone any abuse he received, but patients being blamed by healthcare professionals when calorie-restriction doesn't work for them, is possibly the start of them having strong feelings about dietary matters. As he correctly says,

From my own reading of the subject, in my view, one diet isn't the answer to anything​

I just wish those advising calorie-restriction demonstrated that mindset.

When those patients who have been blamed for the failure of calorie-restriction discover the statistics for how poor the chances of success are for those with obesity or IR, and especially long-term success, feelings become more intense and particularly when they then encounter healthcare professionals who are closed-minded, dismissive and illogical about credible Low Carb evidence.

I haven't been able to verify this, but on that page Prof Kar suggests he was responsible ("in spite of all opposition") for the Low Carb Programme app appearing on the NHS approval list.

PS Please keep any replies civil!

Absolutely disgusted by the comment he said he received by the racist. Someone disagrees with someone’s view and they resort to that...

there is another article about it:
https://www.dailymail.co.uk/health/...gest-banana-isnt-bad-six-spoonfuls-sugar.html

I draw no conclusion either way, lowering carbs has had a change for me personally but am sure there are many other ways that work for different people. The level of vitriol that some come out with because someone dare to have a different opinion saddens me. Debate and differing opinions and scientific method and proof is important

 

[Oldvatr]

Absolutely disgusted by the comment he said he received by the racist. Someone disagrees with someone’s view and they resort to that...

there is another article about it:
https://www.dailymail.co.uk/health/...gest-banana-isnt-bad-six-spoonfuls-sugar.html

I draw no conclusion either way, lowering carbs has had a change for me personally but am sure there are many other ways that work for different people. The level of vitriol that some come out with because someone dare to have a different opinion saddens me. Debate and differing opinions and scientific method and proof is important

He ends up accusing Dr Unwin of lighting the fire to stir up an army of foul mouthed ;supporters;, Eh? where did that come from? The article in the OP was what started the fire raising the discourse from the start. This journalist is showing ignorance all the way through his meanderings. His one correct observation is that there is a difference in that the fructose in banana is not digested in the same way as sugar, What he does not follow up is where it goes instead. The pathway for fructose is direct to the liver where it is converted to trigs that are stored as lipids in the adipose tissue, not muscle (real body fat!), and becomes tummy fat and metabolic syndrome. The banana is not helpful in the T2D fight and the lipids still eventually become blood glucose.

 

[NicoleC1971]

And apparently the infographics on NICE have disappeared today!

For anyone who wants to see them PHC are still quoting them as Nice approved:
https://phcuk.org/nice/
But yes I could not find anything on NIce other than the low fat and healthy wholegrains message.....

Bananas and fruit in general have such a health halo that it is easy for a junk science piece (young and metabolically healthy people probably can cope with banana eating after all but a substantial minority need to be careful about their carbs) like this to attack the idea that anyone who doesn't promote fruit must be a little crazy or faddy.
Stick to your guns Dr David Unwin. We need to reduce diaobesity and we aren't going to do that on Boris's new bikes alone!

 

[NicoleC1971]

He ends up accusing Dr Unwin of lighting the fire to stir up an army of foul mouthed ;supporters;, Eh? where did that come from? The article in the OP was what started the fire raising the discourse from the start. This journalist is showing ignorance all the way through his meanderings. His one correct observation is that there is a difference in that the fructose in banana is not digested in the same way as sugar, What he does not follow up is where it goes instead. The pathway for fructose is direct to the liver where it is converted to trigs that are stored as lipids in the adipose tissue, not muscle (real body fat!), and becomes tummy fat and metabolic syndrome. The banana is not helpful in the T2D fight and the lipids still eventually become blood glucose.

Calling someone a racist is the new way to discredit someone and it is a click bait headline. It does not have to have any factual basis and is designed to take attention away from any sensible discussion about how to cure our national diaobesity problem that's been highlighted by CoVid diabetic mortality.
It is valid to discuss the best ways to help real people and Prof Kar and Dr Unwin have lots of clinical experience with this; the Daily Mail did do a good job of promoting the low carb way of eating a few months ago but I guess the campaign to save the banana sells more papers.

 

[HSSS]

It looks like Prof Kar's comments received quite a reaction.

I don't condone any abuse he received, but patients being blamed by healthcare professionals when calorie-restriction doesn't work for them, is possibly the start of them having strong feelings about dietary matters. As he correctly says,

From my own reading of the subject, in my view, one diet isn't the answer to anything

.....​

I haven't been able to verify this, but on that page Prof Kar suggests he was responsible ("in spite of all opposition") for the Low Carb Programme app appearing on the NHS approval list.

PS Please keep any replies civil!

he also seems to suggest he is responsible for gathering low carb data within the nhs. However his comments in the press about low carb did not come across in the same reasoned way they do in the link above. A shame he spoke less carefully or was misquoted, as he would have not had the backlash he did if the comments from this blog had been published instead.

Now if this quiet advocating of low carb as a valid option is accurate it will be a loss to the cause that he is withdrawing from anything to do with diet and type 2. Will his opinions on type 2 still be sought and given? And who is responsible for advocating for type 2 within the nhs if it’s not him?

 

[Oldvatr]

Here is the current NHS Diabetes prevention plan
https://www.longtermplan.nhs.uk/onl...n-prevention-and-health-inequalities/obesity/

It is basically a low calorie high exercise regime, but there is support for DIRECT (aka Newcastle ultra low calorie) but it is not yet fully endorsed.

 

[HSSS]

Here is the current NHS Diabetes prevention plan
https://www.longtermplan.nhs.uk/onl...n-prevention-and-health-inequalities/obesity/

It is basically a low calorie high exercise regime, but there is support for DIRECT (aka Newcastle ultra low calorie) but it is not yet fully endorsed.

It’s not enough but at least they are acknowledging medication alone isn’t the only way to deal with type 2.

 

[Oldvatr]

It’s not enough but at least they are acknowledging medication alone isn’t the only way to deal with type 2.

Last year PHE was trumpeting that bariatric surgery was the ONLY official way of achieving T2 Remission. We progress it seems.

 

[HSSS]

Last year PHE was trumpeting that bariatric surgery was the ONLY official way of achieving T2 Remission. We progress it seems.

Who knows what next year might bring then ? After half a century of deterioration it’s going to take a while to turn around without losing face.....

 

[Oldvatr]

Here is an article that the Mail produced earlier (2012 to be precise)
https://www.dailymail.co.uk/health/...-bottled-water-youre-eating-realising-it.html

Not a banana in sight, though I think experience teaches us that bananas are not low hanging fruit, If Dr Unwin had not shown normal foods in his graphics there would be no argument (probably)

OOOPS! Just spotted it. Number 17 => 1 banana equates to 4 cubes.

 

[HSSS]

Here is an article that the Mail produced earlier (2012 to be precise)
https://www.dailymail.co.uk/health/...-bottled-water-youre-eating-realising-it.html

Not a banana in sight, though I think experience teaches us that bananas are not low hanging fruit, If Dr Unwin had not shown normal foods in his graphics there would be no argument (probably)

OOOPS! Just spotted it. Number 17 => 1 banana equates to 4 cubes.

I don’t tweet but maybe someone should send this and all the other low carb articles the mail have been doing more recently to the journalist concerned and see what his response is...

 

[Oldvatr]

Seems like Aunty Beeb may have made a booboo too

Sorry, it is Youtube Premium, but I remember it doing the same thing as the infographics, but with bgl meter in tow. You get the idea.

 

[KK123]

This is a bit off topic but I think all these experts should start by not referring to things like 'sugar levels' and 'blood sugar' thereby giving the impression to the general public that it's all about the white stuff we are clearly shoveling into our mouths and that pure sugar granules are floating through our veins. Once people understand that it is actually about ALL carbs and their effects they might stop the hysteria.

 

[pdmjoker]

<snip>

there is another article about it:
https://www.dailymail.co.uk/health/...gest-banana-isnt-bad-six-spoonfuls-sugar.html

I draw no conclusion either way, lowering carbs has had a change for me personally but am sure there are many other ways that work for different people. <snip>

The article says

The conclusion of every expert I spoke to was that, no, eating a banana isn’t ‘the same as’ eating six teaspoons of sugar – for the obvious reason that they’re digested differently. I carried out an experiment that involved eating six teaspoons of sugar, and a banana, on different days while wearing a blood glucose monitor. And it showed more sugar ended up in my blood when I consumed pure sugar, than when I ate the banana.​

1. Rate of digestion isn't the same as overall BG effect.

2. I have already pointed out the bananas in the "experiment" photo looked pretty green (so would have less sugar content than a riper one). I have just recalled reading somewhere that when cooking rice for a shorter length of time, less starch is made available to the body than eg when cooking longer or overcooking it. Point: easy to skew the results of the experiment.

Edit: A comment from Bloss92 in Sydney on the follow-up DM article:

I've never seen an article written by a journalist that had to have a follow up on how his previous article was misunderstood.​

 

[Oldvatr]

The article says

The conclusion of every expert I spoke to was that, no, eating a banana isn’t ‘the same as’ eating six teaspoons of sugar – for the obvious reason that they’re digested differently. I carried out an experiment that involved eating six teaspoons of sugar, and a banana, on different days while wearing a blood glucose monitor. And it showed more sugar ended up in my blood when I consumed pure sugar, than when I ate the banana.​

1. Rate of digestion isn't the same as overall BG effect.

2. I have already pointed out the bananas in the "experiment" photo looked pretty green (so would have less sugar content than a riper one). I have just recalled reading somewhere that when cooking rice for a shorter length of time, less starch is made available to the body than eg when cooking longer or overcooking it. Point: easy to skew the results of the experiment.

Actually his results showed that the peak spike for sugar was higher value than the banana, but to find out a value to support his 'more ended up in my blood' conclusion requires a calculation of the area under the curve which is an integration of magnitude over time, and then the comparison may well work out the same. That is the glaring error in his experiment that made it useless as a hook to hang his opinions on. Not rocket science, but it is science and involves mathematics, For a good approximation, plot the two graphs on grid paper, then count the number of squares under each line.

 

[pdmjoker]

This is a bit off topic but I think all these experts should start by not referring to things like 'sugar levels' and 'blood sugar' thereby giving the impression to the general public that it's all about the white stuff we are clearly shoveling into our mouths and that pure sugar granules are floating through our veins. Once people understand that it is actually about ALL carbs and their effects they might stop the hysteria.

I wondered if that was deliberate, as surely experts in the field would be aware of the possible confusion by using such imprecise terms, eg "Some low-carb evangelists say it’s all about sugar...". I noted Prof Kar didn't say in the followup page that anything in DM was a mis-quote of what he had said...