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not very helpful nutritionist - diet advice welcome

MrsMoose

Well-Known Member
Messages
65
Location
Manchester
Type of diabetes
Type 2
Treatment type
Diet only
Hi all,

I had a dietician appointment last week and to be honest, i learnt nothing of use and wasted £3 on car park charges at the hospital so Im a bit frustrated and at a loss.
She has referred me to a weight management class/course and I am scheduled for a diabeted education course.

We discussed my typical food diary (ignoring that Id just got back from the Oktoberfest, having lived on beer and bratwurst, lol) and she said i had a healthy diet and didnt see any major changes to make other than perhaps tighter portion control.

This is my plan:
  • figure out how to use my blood glucose monitor and test weekly (at the moment)
  • consult my atkins books for ideas
  • consult my diabetes books (ive got 4 of them, 2 cookbooks, diabetes for dummies and I cant remember the name of the other one!)
  • compile a list of foods i eat most often and their calorie/carb content
  • keep a strict food diary
  • weigh myself weekly
Other than waiting for these courses, I've had no other advice - I have to have another hba1c blood test 3 months after my first one.

If anyone has any advice, Id appreciate it as I feel like Im trying to run through mud at the moment!

MrsM
x
 
If you have a meter, test before and after each food type.
That way you'll know what food spikes you, and you can avoid it.
Any other way is really guesswork really.
 
no metformin? you've got your head on the right track with your planning
the atkins induction is too hard core for me. but it is very good. just keep your protein in normal range

these are the sites that helped me
http://www.dietdoctor.com/lchf it’s a long page and a video
http://lowcarbdiets.about.com/od/lowcarbliving/a/Food-Cravings.htm For me, the more carbs we eat the more carbs we want. they don’t give up easy.
http://lowcarbdiets.about.com/od/lowcarb101/a/firstweek.htm

blood testing
http://www.phlaunt.com/diabetes/14045524.php
food counting
http://www.myfitnesspal.com/

Newcastle diet aims in 8+ weeks to mimic or better the rate of ~80% remission, for surgery T2
http://www.ncl.ac.uk/magres/research/diabetes/
http://www.diabetesforecast.org/2010/mar/weight-loss-surgery-and-type-2-diabetes.html

more diet plans
http://diabeticmediterraneandiet.com/low-carb-mediterranean-diet/
http://www.lowcarbdietitian.com/blog/carbohydrate-restriction-an-option-for-diabetes-management

SD codefree meter
http://www.homehealth-uk.com/medical/blood_glucose_monitor_testing.htm
if you buy extra boxes of strips there is a discount code
5 packs 264086
10 packs 975833
 
Hi,

Testing once a week is meaningless. You need to learn which foods your body can cope with, and the only way to do this is by testing before you eat and 2 hours after your first bite. Look at the rise. If it is more than 2mmol/l there is something in that meal that you should be either reducing or avoiding.

Also, please be careful with diabetic cook books. Many of the recipes will include carbs, which are not good for us. There are loads of threads on the forum with good recipes described.

Tighter portion control is good, and a meter will help you with this. You may find, for example, you can cope with 2 small potatoes, but not 3 or 4. A food diary is also a good plan, and if you test your meals then record the results next to the food. You will then see patterns emerging. Carb and calorie counting is also essential in my opinion (others may not agree with the calorie counting bit, but I would not have lost almost 4 stone without doing just that)

Keep posting, and ask questions. We are all here to help.
 
I think things like "tight portion control"just sucks. I wouldn't be able to curb a healthy appetite. Yesterday I had a look at some dietary advice for people who has stopped smoking - as I did last week - and it was appalling. You were supposed to fill half your plate with pasta, rice or potatoes, and have bread with your meal, go low on fat and eat six times a day to prevent eating between meals, jaysus no wonder people get ill and over weight!

You could always try LCHF. You eat until you are full, then you eat again when you get hungry. Low carb high fat. I know a lot of people are scared of the high fat part but really, fat is nutritious and filling and doesn't affect bg. And a lot of people on LCHF find they loose weight rapidly even if they eat 80E% fat so long as they go low on carbs.

Check the Dietdoctor link in Jack 412s post above, Dietdoc is my hero.
 

No, tight portion control works very well.
Re-education of eating habits may take a week or two, but works very well.
The Newcastle Diet is probably the gold standard for this.

There is never just one method.

(fear of fats is lipophobia, not very common though)
 
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Tight portion control works for a few but is difficult to maintain long term. It's bad enough having diabetes, let alone going through life constantly hungry. Reduce the carbs by as much as you feel you can happily manage and replace with eggs, fish, beef, chicken etc. This will not only help keep BG levels stable but you will find it easier to lose weight without going hungry. Anything with the word "diet" in the name ought to be avoided as they are designed for short term use. You need to look long term and change the way you view food. Keep testing BG levels and you will be able to monitor your own success.
 

Portion control means eating enough, not continuing to eat way beyond what you need to.
But admittedly I didn't gain 4 1/2 stone extra by undereating, so there is a bit of catch up involved.
And after I lost the 4 1/2 stone, by eating less, and educating myself to eat less, without feeling hungry all the time, it's very easy to continue to eat only as much as I need to maintain my weight.
Although there is a feeling by many that counting calories will mean you are always hungry, but once you get past that mindset, it is easier.
As said the Newcastle diet, with very limited calories, is the gold standard, and many on here have done it.
The fear of not carrying on eating as much as you want to all the time isn't as bad as it seems.
 
Thanks Douglas. I wasn't suggesting reduced portions doesn't work, I was just stating that diets, by their very nature, are not a lifestyle choice. The Newcastle Diet is very severe and produces a short term effect. I'm pretty sure it works for a few but I don't know of anyone who completed it and still maintains tight numbers. Reduced carb however can be maintained fairly easily, long term, and I know of many people who choose this lifestyle and it works. Good HbA1C and weight loss. I only offer advice gained through experience. Whatever the OP chooses will be their choice. I know what option I would choose.
 
Portion control worked for me. I'm not talking overall portion reduction, just controlling the carb portions, and that is what I understand is meant by portion control. Of course if you reduce the amount of carbs on your plate without replacing the calories, you will be hungry. Portion control to me meant using my meter to learn the actual portion size of carbs I could personally manage, such as 1 slice of bread and no more, 2 spuds and no more, tablespoon of peas and no more etc etc., replacing the missing carbs with other veggies, extra eggs, more fish, and dairy fats. Since I dropped to 60 odd grams of carbs by portion control, I have never once been hungry, never been tempted to eat between meals, have lost nearly 4 stones, reduced my blood sugars and cholesterol, and am not feeling deprived as I am still able to enjoy bread and spuds. I am having no problems maintaining this diet.
 


You have posted your overall calorie intake in the past if I remember?
 
Good advice and that is pretty much what I was suggesting without giving figures. Replacing the carbs with proteins/good fats is the best way forward for the vast majority in my opinion.
 
douglas99 said:
You have posted your overall calorie intake in the past if I remember?
Click to expand...

Yes. I tried to average 1200 calories a day for a gradual weight loss of up to 2lbs a week, including 60g - 65g of carbs. I have now upped my calories to maintain my current weight, but not my carbs until my BS has lowered a bit more, although I am experimenting.
 
1200 was low calorie for me, no matter what mix of food types I put into it, I ate 800 to 1200 calories on my portion controlled diet.
It's interesting, that normally, no matter what the mix is, most diets do come down to some form of calorie restriction in the end.
 
Hi and thanks so much for all the replies!

There's loads of info to keep me going which is fab. I just wish I could get on the forum more often- I've got it on my iPhone, iPad and at work but they expect me to do work at work, not Google diabetic stuff all day

The reason I mentioned weekly testing was simply down the the advice so far from my Dr to try to just eat healthily and get a retest in 3 months so it was as if testing wasn't needed (I bought the monitor anyway after hearing what you guys all said) I was thinking more of making sure I'm going in the right direction and the dietician couldn't really recommend food to leave out so I couldn't think of anything that would spike my bg particularly, other than stuff I know about and would try to reduce like pasta etc. was thinking longer term in working out how much I can cope with but can't hurt to start now.

Thanks again, back soon...
 

The dietician can't really recommend foods, as we all react differently, that's why eating your meter is important.
 
That's the problem with most diets though, the calorific restriction. The vast majority won't stick with them, although clearly Douglas has seem some success. They are fine for a kick start or similar but we need to promote long term lifestyle changes, not diets. Reduced carbs combined with exercise is easier to sustain long term whilst still providing desired effects. Again, you can't please everyone and there will always be those who can't/don't want to give up the bread, chips and pizza. We all make our own decisions and live with the consequences.
 

A room full of them, if the clinic I used to go to was the normal.
That's why the NHS start where they do, and mostly even fail with those simple changes.
 
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