Nurse advises vegan diet not healthy

[AnnieEcowarrior]

I’m newly diagnosed T2, have been vegan for around 5 years and had a difficult start with the nurse at my new GP surgery. He said it’s really not healthy to be vegan when you have diabetes because all the sources of protein have carbs in and has encouraged a resumption of meat and dairy. I don’t believe this to be true and I’m not prepared to do it so now have no confidence in his care. Any advice gratefully received. Thanks
Annie

 

[pzw123]

Basically talking bunkum - (I no longer suffer fools gladly or otherwise)​

Protein​

Consuming enough protein is a concern for many new vegans. However, it may not be as big a problem as we anticipate. Most of us eat far more protein than our body requires, and there are plenty of vegan foods which are good sources of protein:

• nuts, seeds and most of their butters (e.g. cashew, tahini, peanut, almond and Brazil)
• beans and pulses (eg butterbeans, chickpeas and lentils)
• vegetable milks (eg soya, almond and hempseed)
• quinoa
• soya products (eg tofu, soya cheese and soya milk)
• vegan Quorn

Source: https://www.diabetes.org.uk/guide-to-diabetes/enjoy-food/eating-with-diabetes/veganism-and-diabetes

 

[AnnieEcowarrior]

Thank you. I’m not a new vegan, just a new diabetic. What does &#8203 mean?

 

[HSSS]

Pretty much all of which have more carbs than their animal equivalent. And that was the point being made by the nurse. Some of them are good but things like cashews are higher carb nuts and legumes have quite a strong negative effect on many type 2. Test with a meter and see which ones suit you best. Vegan meals typically rely heavily on things like rice pasta bread potatoes etc. All of which are highly problematic for most of us. Finding alternatives is doable but challenging.

Carbs consumed are the part of type 2 diabetes we have the most control over. Can you remain vegan? Yes. Is it easier to regain diabetic control as a non vegan? I definitely believe so, even if only for the much greater range of genuinely low carb foods that also provide your other nutritional needs adequately. Ultimately it’s your choice. We all need to make changes otherwise nothing changes and we remain a diabetic out of control. We all have to choose which ones are acceptable to us.

So you’ve made yours, but the nurse wasn’t wrong, even if he expressed the issue in a way that upset you. It sounds like he was advocating a lower carb way of eating and for that alone I’d willingly take him off your hands as my nurse. Far too many are stuck on a medication, low fat, continued deterioration route and have little idea of the true value of diet in management of the disease. The vast majority of type 2 in remission without drugs on this site are doing it via low carb. Some manage it as vegans. To me after 5 yrs low carb and keto I think doing so as a vegan would be incredibly hard, particularly if you are also trying to meet all the rest of your nutritional goals. Perhaps you can be more dedicated to it than I could.

This section of the forum might help you work out some of the better options that fit you https://www.diabetes.co.uk/forum/category/vegetarian-diet-forum.71/

Diabetes.org and the nhs give some fairly vague and bland, eatwell, low fat, GI based advice creating meals around starch that’s pretty high in carbs regardless of the animal content or not. There’s a lot of us here that tried that and it didn’t help us the way low carb does. They fail (as do the nhs) to recommend self monitoring which is the ultimate in unbiased guidance of what’s good for your diabetes and what isn’t. Oddly the nhs do also support low carb diets by prescribing this sites low carb course. So right now it’s a mess of conflicting advice depending which individual medic you speak with.

 

[pzw123]

Thank you. I’m not a new vegan, just a new diabetic. What does &#8203 mean?

That sounds like a formatting code that a browser doesn't know what to do with.

I tried keto vegan a few times but found it too restrictive, so now I stick to keeping the carbs low. Pulses/lentils/grains etc with the carb load balanced by the insoluble fibre.
I've also had success with restrictive eating within a 6 hour period.

 

[MissMuffett]

I know I keep quoting this so excuse me if I’m starting to sound boring I’m not vegetarian or vegan but get some great ideas from the YouTube channel ‘heavenly fan’ she is vegan and does low carb/keto meals, snacks and the most wonderful flatbread which is only 0.5g carbs and you can make a batch and freeze, a life saver in my opinion as I really miss sandwiches

 

[Redshank]

I am not a Vegan - I eat dairy etc and fish but have not eaten meat for 45 years.

I think it is probably true that it is more difficult to manage diabetes as a Vegan, so you will probably need to work harder at it.
However being a Vegan is an important part of your Emotional well-being and I think a nurse should recognise that.
There are some bits of truth in what was said, but you need to pick out the useful bits

Most of us on here have had to make changes to our diet and have had to learn about the impact of food on our blood sugar. We have also had to learn about carbohydrate content of food
So I suggest looking at your current sources of protein in your diet, and how much carbohydrate is attached to those sources. Can you make switches that would reduce the carbohydrate content of your diet? It is likely that a lot of carbohydrate at the moment comes from grains so some change there is likely to have an impact on your blood sugars.
What else is in your diet that is high in carbohydrate, as reducing these may also have a big impact (e.g. many fruits are high in carbohydrate.

Much Vegan (and indeed non-Vegan) processed food is high in carbohydrate, especially many of those that are substitutes for non vegan alternatives.
A lot of study of labels and nutritional information will be helpful in finding these. Some vegan cheeses for example are fairly high in carbohydrate and very low in protein

The vegetarian diet forum is mentioned and I recommend looking at it.
I also recommend looking at threads on here about using a Blood testing meter to find out what impact particular foods have on you

Good luck with it all

 

[andromache]

Your nurse is probably accustomed to advising people who aren’t terribly switched on about how best to help themselves. He knows that it is far, far easier to eat low carb in a nutritionally-balanced way if you eat animal products, and he’s absolutely right about that. Most of the people he talks to struggle even to understand that bread and grains are digested down to sugars: that’s how big a mountain he has to climb explaining how this stuff works. Maybe he can be forgiven for saying it’s impossible/unhealthy when he maybe actually just meant it’s difficult and was worried that you might struggle to the detriment of your health. You know how committed you are and how much intelligence and energy you are prepared to commit to the task, but he does not. He knows how hard it is for anyone, whatever their food preferences, to get their heads around a change of lifestyle, so he wants to keep it simple. That’s my guess.

 

[JoKalsbeek]

I’m newly diagnosed T2, have been vegan for around 5 years and had a difficult start with the nurse at my new GP surgery. He said it’s really not healthy to be vegan when you have diabetes because all the sources of protein have carbs in and has encouraged a resumption of meat and dairy. I don’t believe this to be true and I’m not prepared to do it so now have no confidence in his care. Any advice gratefully received. Thanks
Annie

A low carb diet is hard enough for a nurse to peddle (and way too few of them do), adjusting it for vegans or vegetarians must seem incomprehensible to them. Mind you, I keep thinking it is next to impossible because I have issues with certain foods (trigger/aggravate other conditions), but I have been assured on here, repeatedly, that it can indeed be done. You just have to really, really know what you're eating, and test your heart out. But that's true no matter what diet you choose to follow within this whole diabetes circus... Test, and see what works for you. Anything low carb (above ground veg, avocado's, and soy things are usually alright, I think quorn too... Shrooms, most but not all nuts etc... I adore my daily coconut yog! Pulses are a no-go for me, but they might be fine for you. Again, worth testing!).

It's easier if you can bulk up your meals with animal fats and protein, I think... But if you can manage without those, still eat a balanced meal with everything in there you need far as micro and macro nutrients go, or know what to supplement for... I don't know if you're on metformin, or will be on it, but that'll make your B12 plummett, so something to be mindful of should you get on that.

I do hope you'll get to go back to the nurse with excellent numbers and tell him "Ha! See what I did there!?". Good luck!
Jo

 

[nikipre]

I was mostly vegan (apart from eggs), but have gone back to being vegetarian since diagnosis (pre diabetic). I tested the effects of oat milk, lentils etc - things that featured in my diet a lot before but they just caused a spike that was too high after a couple of hours. I decided to put my health first but it’s totally your choice and I’m positive you can stay low carb and vegan, will probably just mean alot of meal repetition. Good luck with it

 

[Deleted member 388305]

I have been eating a whole-food, plant-based, low-fat diet for about 16 months. The distinction between that diet and a vegan one is important if you are living with Type 2 diabetes. I have had diabetes for 40+ years. My A1c is at a non-diabetic level. My lipid panel is well below the recommended levels, as are my ApoB test and High Sensitivity C Reactive Protein test. I am not yet off of my blood pressure medicine, which I have also been on for 40 years, but it continues to drop. I ate a very low carb diet for the 20 years preceeding my current diet. The results with it were good initially, but over time, became harder and harder to achieve (as well as having my cholesterol levels continue to rise). I never eat less than 200gr of carbohydrates a day and often more. I eat around 50gr of fiber and less than 30gr of fat (mostly from nuts).

Initially, low-carb results are more rapidly seen (practically immediately). But you are treating symptoms rather than causes. Eating low carb avoids having to deal with rising blood sugars, but does not treat insulin resistance. No matter how long you are on a low carb diet, if you eat a high carb meal, your blood sugars are going to spike sky high. WFPB low-fat diet resolves the insulin resistance which normalizes those spikes over time.

All the above has been my experience. I’m not trying to convince anyone to change their eating, but I think the nurse mentioned by the OP doesn’t know how a WFPB low-fat diet works or equates it with veganism or vegetarianism.

 

[Mini Dachs Mum]

It is a bit trickier but doable. I have been vegan for nearly twenty years. About a year ago started eating vegan low carb / keto and have come off Glicizide and looking at reducing coming off metformin soon. I follow heavenly_fan on YouTube for keto vegan baking and cooking. I use Konjac rice, noodles and pasta as a substitute for the more carby originals. Only eat berries for fruit and practice intermittent fasting. I have become quite happy with this way of eating. I don’t do as much keto baking as I did at the start. I do eat tofu and tempeh and some vegan meats but always check the carb content before buying. I save vegan schnitzels for eating out with a salad and no chips as they are too carby to eat regularly so a treat. It is also the best vegan option for me when eating out unless I just have a salad.

 

[HSSS]

Eating low carb avoids having to deal with rising blood sugars, but does not treat insulin resistance. No matter how long you are on a low carb diet, if you eat a high carb meal, your blood sugars are going to spike sky high. WFPB low-fat diet resolves the insulin resistance which normalizes those spikes over time.

Yes a single high carb meal in the midst of a long term low carb diet will produce a spike because the body is not acclimated to it. Just a couple of days of carbing up resolves this excessive response and is in fact widely recommended before any glucose insulin test or challenge as a result. It’s physiological not pathological insulin resistance ie demand, or lack of demand more precisely, not disease driven. The ability to increase carbs, to a degree, is seen by many long term low carbers and that is evidence that insulin resistance has improved. The fact that other conditions like high blood pressure and lipid ratios and triglycerides also improve (all metabolic syndrome markers like type 2) also shows the underlying issue of hyperinsulimia/IR has improved does it not?

How are you assessing the statement that WFPB low fat has resolved IR? Is this solely a personal experience statement or an evidential based statement?

I think the nurse mentioned by the OP doesn’t know how a WFPB low-fat diet works or equates it with veganism or vegetarianism.

The nurse was discussing veganism not wfpb so how do we know what they thought of the latter?

 

[Paul_]

I’m newly diagnosed T2, have been vegan for around 5 years and had a difficult start with the nurse at my new GP surgery. He said it’s really not healthy to be vegan when you have diabetes because all the sources of protein have carbs in and has encouraged a resumption of meat and dairy. I don’t believe this to be true and I’m not prepared to do it so now have no confidence in his care. Any advice gratefully received. Thanks
Annie

I'm not a vegan so don't have much to offer in specific knowledge from that perspective, but if we're talking about doing a vegan version of any of the million different LCHF diet approaches, can't see why it wouldn't be possible as a vegan.

It's all about finding the carb limit you can set yourself in a day, where your BG isn't significantly impacted in the wrong direction, but where you still have a sufficient range of food/ingredient options to make the diet sustainable.

Being vegan makes an LCHF diet harder to design, no doubt about it, but if you're willing to put in the effort then there's no reason why it should be less healthy in my opinion.

 

[Paul_]

WFPB low-fat diet resolves the insulin resistance which normalizes those spikes over time.

I think you'd struggle to find any evidence or scientific data for ANY diet "resolving" insulin resistance. Diets, in and of themselves, don't resolve anything related to diabetes - it's an incurable, but manageable, condition with certain diets. Most diets get the credit for "resolving" one condition or another, but in most cases diets are simply causing weight loss and/or improving factors influencing a condition. To this end, weight loss improves insulin sensitivity, but never completely resolves insulin resistance, and it doesn't matter which diet is used to achieve that loss.

 

[Deleted member 388305]

You’d have to read the books for an full understanding of the idea, but in very simplistic terms, it is that dietary fat and the fat in your muscles and the abdominal fat are what interferes with insulin's ability to manage glucose and causes insulin resistance. That is why weight loss in general is beneficial for type 2. It is a diet (with very slight differences) recommended by a number of docs that are well known, at least in the US - Ornish, McDougal, Barnard, Esselstyn, Gregor, Fuhrman as well as the folks at Forks Over Knives, Mastering Diabetes and Dr. Campbell (Phd) who wrote The China Study. I realize that, just because they say so doesn’t make it true, but they cite a lot of studies and have a lot of clinical success.

Again, I’m not trying to talk anyone into this, I’m just saying that it is possible to use this. If you are eating a lot of carbs and your labs are normal (non-diabetic) and you don’t have to test your blood sugar anymore, and all the other metabolic markers are either normal or approaching that without medication, wouldn’t you consider that to be a reversal? Perhaps I used the wrong word.

 

[Paul_]

You’d have to read the books for an full understanding of the idea, but in very simplistic terms, it is that dietary fat and the fat in your muscles and the abdominal fat are what interferes with insulin's ability to manage glucose and causes insulin resistance. That is why weight loss in general is beneficial for type 2. It is a diet (with very slight differences) recommended by a number of docs that are well known, at least in the US - Ornish, McDougal, Barnard, Esselstyn, Gregor, Fuhrman as well as the folks at Forks Over Knives, Mastering Diabetes and Dr. Campbell (Phd) who wrote The China Study. I realize that, just because they say so doesn’t make it true, but they cite a lot of studies and have a lot of clinical success.

Again, I’m not trying to talk anyone into this, I’m just saying that it is possible to use this. If you are eating a lot of carbs and your labs are normal (non-diabetic) and you don’t have to test your blood sugar anymore, and all the other metabolic markers are either normal or approaching that without medication, wouldn’t you consider that to be a reversal? Perhaps I used the wrong word.

You're talking about putting diabetes into remission, that's the word you're looking for, and as you acknowledged in your first post then that was done on a low carb diet, not WFPB.

All I'll say is that while you're not actively selling the WFPB diet, you are promoting the diabetic "dream" - a world where eating high carb for at least 16 months is possible, without medication, with it also being lower in fat and thereby removing cholestoral risks, with no adverse impact on blood glucose, and that you've cured insulin resistance in the process - albeit while also quietly acknowledging that 20 years of low carb (LCHF) is what got you into remission in the first place.

Can you stay in long term remission on 200g of carbs a day and low fat? Who knows, I've not seen anyone talking of that, or WFPB, in probably 100 hours of research on diabetes management/remission over the past 5 weeks, but I could have missed it. I saw plenty of low carb vegan/veggie diet approaches, but not WFPB specifically as a diabetes management approach. A quick Google search for the specific phrase of "WFPB diabetes" just now did return some results, however these are mostly links to articles by the doctors you mentioned on non-mainstream medical news websites, or about how a wholefood vegetarian/vegan plant based diet can help with the prevention of T2D onset, which seems logical and nothing particularly revolutionary given its already well known these groups have a lower probability of metabolic syndrome and diabetes (for example, I knew this before I was diagnosed with diabetes and researched the topic). One point I did learn on this brief Google search and that is noteworthy is that most of these articles talk of WFPB being high in unsaturated fats, which is very different from your original summary of your diet being "low fat". WFPB actually seems to be higher carb, higher fat, and lower protein in its truest form, based on what I've read.

You've had 16 months of success with your form of WFPB and I can't claim to have read the entire internet. Maybe all those doctors you quote are right, or maybe they're just quacks selling snake oil, you never can tell these days. For balance, my opinion is the same of all the LCHF doctors selling the dream that there isn't any bad cholesterol, or that we don't need fibre at all in our diets. Maybe they're right, or maybe not and they're just selling a dream. I err on the side of caution, treating my health like I would money these days since my T2D diagnosis - i.e. if it sounds too good to be true, it probably is, and that goes double when a miracle is pushed by doctors selling books and doing YouTube videos for ad-click revenue. I'm not qualified to be able to disprove what any of these doctors say, but whatever the diet approach, some of it sounds too good to be true in my humble opinion.

We'll have to agree to disagree on approach, like people did in the good ol' days before forums and social media, plus that way we don't hijack someone else's thread in the process. You have your approach and I genuinely wish you continued success with it for years to come. If it isn't, just don't forget your proven and tested 20 year success with LCHF.

 

[TriciaWs]

The low carb program has some low carb meal ideas for vegans, and if your local health body is funding it you can get a voucher to join as it is approved by the NHS.
Otherwise, look very carefully at your reaction to pulses, I have to mainly avoid them but others are fine with small portions. And plant milks vary a lot in the amount of carbs, even if made from the same nut different brands vary.

I'm not vegan but some generic tips.
Buy a decent meter and at first test before then 2 hrs after every meal., If it spikes too high the meal had too many carbs you are aiming for no more than a 2mmol/L rise.
Note that eating fats with the meal may delay the spike a little.
I carb counted and tested everything for the first few weeks, then as my numbers fell I counted/tested any new foods/new combinations plus a day per week of testing after every meal.
A lot of work at first but it gets much easier over time.

 

[Deleted member 388305]

You're talking about putting diabetes into remission, that's the word you're looking for, and as you acknowledged in your first post then that was done on a low carb diet, not WFPB.

You have your approach and I genuinely wish you continued success with it for years to come. If it isn't, just don't forget your proven and tested 20 year success with LCHF.

If that is what I said, it is definitely not what I meant to say. I was able to keep my A1c between 6 and 7% while I did low-carb for 20 years. I was never able to get it below 5.7%. I was never able to get my cholesterol numbers where I wanted them. My blood pressure never improved (I’ve been on blood pressure medicine longer than I’ve had diabetes). We will have to agree to disagree, as you suggested. My long time endocrinologist is thrilled with my results.

Also, regarding this:
"One point I did learn on this brief Google search and that is noteworthy is that most of these articles talk of WFPB being high in unsaturated fats, which is very different from your original summary of your diet being "low fat". WFPB actually seems to be higher carb, higher fat, and lower protein in its truest form, based on what I've read."

It is possible to eat a WFPB diet that is high in fat. That is not this diet, which is why I added “low fat” to my description of the diet. the low fat aspect is critical to the success of the diet. Here is breakdown of what I ate yesterday and what the foods were, if anyone is interested. Fat was only 10% of the diet.

, if anyone is interested. Fat was only 10% of the diet.

 

[AnnieEcowarrior]

Thank you, that looks very much like what I eat, just never labelled it as a ‘diet’. Looks good