Obesity epidemic - letter to Daily Mail

[IanD]

To: Ms Sophie Borland

[email protected]


Dear Ms Borland,


Re: OBESITY UK (13/1/2014)


The problem is wrong diet advice from the health professionals, particularly that complex carbohydrates are good, & that fat consumption should be minimised. Experience, together with many studies, shows that a low carbohydrate, high fat diet (LCHF) is better, for weight loss, general health & diabetic control.


I am a T2 diabetic, diagnosed in 2000 at the age of 61, with a BMI of 29. The diet advice I was given was to eat plenty of complex carbohydrates, low fat/sugar/salt & keep active. I did, & in 7 1/2 years I was suffering a range of debilitating & painful diabetic complications. I was told at diagnosis that I would suffer complications however well I kept to the diet. They were right. My active life was over. I had very strong motivation to get well & found help on the www.diabetes.co.uk forum, where many contributors have discovered the benefits. I contribute as IanD.


In May 2008 I learnt of the benefits of a low-carbohydrate, high fat diet. I immediately stopped eating the obvious carbohydrates, & within 3 months I was out of pain & able to play tennis again.


Six years on, 75 years old in March, I am a stable 25 BMI, fit & well, & playing tennis & table tennis at club standard. Annual diabetes health checks have shown no cardio or other problems, & the professional advice I now receive is to continue with my LCHF diet & life-style.


I note the latest leaflet from “change for life” stresses low fat/low sugar, & advises giving skimmed milk to children over 5. Where does their energy come from? Fat provides double the energy of carbohydrates, & is more sustaining. Diabetics can prove that by blood glucose testing.


I will be happy to provide further information, internet links, etc.


Yours faithfully,

 

[carraway]

I like it. I also like your results. Proves a point doesn't it?.............

Cara

 

[Daibell]

Great and well done. I personally wouldn't stress the 'high' fat aspect but to have enough to give you the calories you need whilst low-carbing. But as you quite rightly say it's reducing the carbs that is vital

 

[Yorksman]

I remember a well known scientific researcher writing about a press conference on findings of their latest research: -

"We had fun in trying to answer the journalists questions in such a way that would not allow them to report the story they decided that they wanted to tell"

'Obesity epidemic' is good copy, 'some people eat more than is good for them' isn't. It isn't a debate, it's not an exchange of information. The story is already written, all they want is some quotes which they can use to support it.

 

[Jumapi]

Hi Ian G. Your post was very helpful. However my Drs advice was low carbs and even lower fat. The reason being I am overweight. By BMI measurements I am obese. Yes I'm overweight I agree. I'd love to weigh a couple of stone less. I have gained quite a lot of that two stone by being on steroids for the past nine months. My Dr agrees with that and even said it was very likely the steroids which brought on the diabetes to some extent. My question is -- How do I keep the diabetes under control and lose weight at the same time? I know exercise is part of the answer but I am 76 yrs old and arthritis and poly myalgia slowed me down because of pain and exhaustion. I can't walk very far without pain and get very out of breath after ten mins and need to stop. I don't need the lectures and the "must try harder" I need helpful advice on what to do.
Jumapi


Sent from the Diabetes Forum App

 

[CollieBoy]

Hi Ian G. Your post was very helpful. However my Drs advice was low carbs and even lower fat. The reason being I am overweight. By BMI measurements I am obese. Yes I'm overweight I agree. I'd love to weigh a couple of stone less. I have gained quite a lot of that two stone by being on steroids for the past nine months. My Dr agrees with that and even said it was very likely the steroids which brought on the diabetes to some extent. My question is -- How do I keep the diabetes under control and lose weight at the same time? I know exercise is part of the answer but I am 76 yrs old and arthritis and poly myalgia slowed me down because of pain and exhaustion. I can't walk very far without pain and get very out of breath after ten mins and need to stop. I don't need the lectures and the "must try harder" I need helpful advice on what to do.
Jumapi

IMHO,
our GP is merely parroting what he has been told and the avice should be Low carbs and enough GOOD fats to sustain you!
Try cutting back on the carbs to help the DB. The fats should help you to feel full and banish the hunger and help weigt loss.
I am personally "in danger" of my diabetician declaring me cured, with my HbA1c in the 5.4s and my OGTT peaking at 9.8 and exiting @ 5.8 at 2 hrs.

 

[Unbeliever]

Exercise helps in kickstarting your metabolism and is good in other ways but it is still possible to lose weight by low carbing alone. I take it you are still on steroids? In that case it may be more difficult I have to agree with daibell about the fats. Don't avoid fat and make sure that he fats you eat are good natural fats but don't look fior extra fat while trying to lose weight..
You may ot feel as full as you could with high fats but if you are not exercising you should not be so hungry either..

 

[ElyDave]

Define low carbs please.

Like many industries I come across profesionally, daibetes has it's own language, acronyms etc. Unless everyone understands what those mean and agrees those then we could all be saying the same thing but talking very different substance.

As an example, on my recent DAFNE course (where I was appalled by the dietary advice, but that's another story) I was very surprised by how much more carbs everyone appeared to be eating vs me. Typically I'm on 100-150g/day, but that includes days as low as 70g, and as high as 325 for a long bike ride. Overall I'd say I'm on moderate to low carbs, but others may disagree.

In this game perception is everything

 

[IanD]

Hi Ian G. Your post was very helpful. However my Drs advice was low carbs and even lower fat. The reason being I am overweight. By BMI measurements I am obese. Yes I'm overweight I agree. I'd love to weigh a couple of stone less. I have gained quite a lot of that two stone by being on steroids for the past nine months. My Dr agrees with that and even said it was very likely the steroids which brought on the diabetes to some extent. My question is -- How do I keep the diabetes under control and lose weight at the same time? I know exercise is part of the answer but I am 76 yrs old and arthritis and poly myalgia slowed me down because of pain and exhaustion. I can't walk very far without pain and get very out of breath after ten mins and need to stop. I don't need the lectures and the "must try harder" I need helpful advice on what to do.
Jumapi


Sent from the Diabetes Forum App

Exercise becomes difficult when you are in pain - I couldn't do a light exercise circuit designed for heart patients when I was in trouble. (I'm not a heart patient, but my wife is.) It is unlikely that you would be able to exercise sufficiently to lose any weight, but chair & breathing exercises will be helpful for general health.

I find powdered nuts & seeds a good basis for my diet.
B'fast - 4-5 desert spoons total of ground almonds, dessicated coconut or coconut flour, crushed/milled flax seeds, mixed to a paste with boiling water. You can add cream, sweetener, low cal choc drink, 2-3 chopped apricots for added flavour. That lasts me till lunchtime (4-5 hours)

Lunch or evening meal - meat & plenty of veg, with grated full-fat cheese, without carbs, followed by sugar-free jelly & double cream, or salad. I use a stock cube & tomato puree in the veg, & thicken the gravy with ground almonds or drink it as soup.

If you "need" a bread substitute, have a cracker or oat cake, with butter. I make a "nut cake" using a cake recipe but replacing the flour with 150 (5 oz) powdered nuts (& baking powder), no sugar, 100 g mixed butter & olive oil, 3-4 eggs. I make that 3 times a week. Keep it in the fridge or it will go mouldy like bread.

Drink plenty, but NOT fruit juice - it's 10% sugar. I favour tea or water, or no sugar squash.

Low carb snacks - that nut "porridge", full fat cheese (without bread, or crackers), nuts. If I want to take out a snack, nuts, cheese, cooked little sausages or a mix of powdered nuts with coffee powder - add boiling water & milk or cream & stir well - you won't need biscuits. Other snacks are peanut butter, sandwich spread or cheese spread with a cracker.

Don't let your friends bully you into eating what they provide. My friends are used to me refusing EVERYTHING, & now provide nuts, or an apple or orange not banana. If the fruit are big, I share them. 2 fresh fruit a day is my limit.

I take a multivitamin & mineral tablet daily - just in case I'm missing something in my diet, & glucosamine with chondroitin to help keep my joints flexible.

And no, I don't get constipated or windy. And I'm sure my teeth are better than with the old high carb diet. DUK tell us we need carbs for brain function - I don't - I do the DM centre page puzzles

I hope that gives you enough food for thought, & will help you with your health & weight loss.

 

[Jumapi]

Very helpful thanks. I don't get very hungry as a general rule.
A problem I do have with the forum is all the acronyms people use. To us new to this it can cause a lot of confusion. Is there somewhere that explains what they all stand for?
JumpingJumping

 

[Jumapi]

My iPad insists I should be "jumping"! Sorry
Jumapi

 

[SamJB]

Define low carbs please.

Like many industries I come across profesionally, daibetes has it's own language, acronyms etc. Unless everyone understands what those mean and agrees those then we could all be saying the same thing but talking very different substance.

As an example, on my recent DAFNE course (where I was appalled by the dietary advice, but that's another story) I was very surprised by how much more carbs everyone appeared to be eating vs me. Typically I'm on 100-150g/day, but that includes days as low as 70g, and as high as 325 for a long bike ride. Overall I'd say I'm on moderate to low carbs, but others may disagree.

In this game perception is everything

That's the problem, Dave; there is no definition. I'd say that low carbing is the practice of avoiding starchy food and adherents typically have daily carb doses less than 100g. Most of the well-controlled carb counting Type 1s on here have daily doses similar to you. I'd call this a reduced or moderate carb diet as it is less than the GDA of around 300g.

 

[PhilT]

Well done for writing. The recent debate has been largely data free - obesity hasn't increased rapidly over the last 10 years for example and sugar consumption is declining so I don't think bringing facts to the debate will be welcome ;-)

 

[Yorksman]

Exercise becomes difficult when you are in pain - I couldn't do a light exercise circuit designed for heart patients when I was in trouble. (I'm not a heart patient, but my wife is.) It is unlikely that you would be able to exercise sufficiently to lose any weight, but chair & breathing exercises will be helpful for general health.

Quite. I was in that condition a long time ago. In fact, the consultant told me not to exerise at all.

I eventually got better, much to everyone's surprise, but it left me overweight and unfit. In time I put on more weight and developed osteoarthritis in my ankle. I couldn't even walk without pain. I needed to exercise to lose weight and improve my heart but couldn't, so I put on more weight and got even more unfit.

I broke the cycle by swimming, then floor exercises, then gentle rowing gently, walking with two trekkings sticks and then cycling. They are all low impact type exercises. It's moving the limbs without putting a strain on the joints and you can go at a nice sedate pace if you want. The heart does get stronger, you don't need to pump iron to achieve that. Slow and steady over many months will do it.

This isn't exercise designed to burn off calories, but it has two benefits. Firstly, it keeps you supple and prevents you seizing up entirely and secondly, it releases hormones which trigger the production of digestive enzymes which reduce your blood lipids dramatically. In other words, although this type of exercise won't burn off existing fat, it does stop new fat being laid down. With a reduction in calorie intake, slowly, over time, weight reduces.

I have been told by several elderly people who were at the 'falling down stage' as they put it, that Tai Chi has given them their balance back and generally increased their levels of fitness, because they have become more active. A few have said that they used to use sticks to walk but now don't need them and that they also walk more quickly. One was very happy to find that he could return to his vegetable plot and dig once again. He used to fall over before apparantly. He'd put his foot on the spade but rather than it getting pushed into the soil, he would simply push himself backwards. There is usually a way to improve but I tend to agree that most of what is written, 'get down to a gym' or 'go jogging' is aimed at a different type of person.

 

[IanD]

Thanks, Yorksman - that should be very helpful to the elderly, overweight & inactive folk who do need practical advice.

 

[IanD]

Very helpful thanks. I don't get very hungry as a general rule.
A problem I do have with the forum is all the acronyms people use. To us new to this it can cause a lot of confusion. Is there somewhere that explains what they all stand for?
JumpingJumping

It's obviously important to restrict your eating to reduce calorie intake. A weekly weigh should show you how you are doing. I find I don't get hungry on my diet. I maintain a satisfactory weight (25 BMI) & have adequate energy for by activities without top-ups of enrgy drinks & bananas.

TLA - Three Letter Acronym
PDUTLA - People Don't Understand Three Letter Acronyms
BMI - Body Mass Index - Weight Kg / height squared (metres) over 25 is overweight;
BG (BS) - Blood Glucose (Blood Sugar) measured by the finger prick test
HbA1c - glycated haemoglobin (A1c), which identifies average plasma glucose concentration.
BP - Blood Pressure
Low Carb - below about 100 g per day - vastly less than the NHS/DUK recommendation of about 300 g/day
Calories - Kcal - is a measure of the heating effect - energy level - of foods. Carb & Protein, about 4 Kcal/g, fats & oils, about 7 Kcals/g.

 

[IanD]

I've had neither reply nor acknowledgement. Has anyone seen my letter in the "letters" page ? I don't buy the DM every day.

 

[Sid Bonkers]

Hi Ian G. Your post was very helpful. However my Drs advice was low carbs and even lower fat. The reason being I am overweight. By BMI measurements I am obese. Yes I'm overweight I agree. I'd love to weigh a couple of stone less. I have gained quite a lot of that two stone by being on steroids for the past nine months. My Dr agrees with that and even said it was very likely the steroids which brought on the diabetes to some extent. My question is -- How do I keep the diabetes under control and lose weight at the same time? I know exercise is part of the answer but I am 76 yrs old and arthritis and poly myalgia slowed me down because of pain and exhaustion. I can't walk very far without pain and get very out of breath after ten mins and need to stop. I don't need the lectures and the "must try harder" I need helpful advice on what to do.
Jumapi

Hi Jumapi, you are quite correct to say that to increase dietary fat when you are already overweight is not the answer and will not lead to weight loss especially as you are on steroids.

I was diagnosed with diabetes after taking prednisolone for three years for a respiratory condition and as you are aware long term pred use does make you put on weight unless you are very strict with your diet which is hard as prednisolone also of course gives you a hunger that can not be satiated.

I was diagnosed at just over 18.5 stone and managed to lose 4 stone in the first 12 months without increasing my fat levels at all in fact as I ate considerably less at meal times I would actually of eaten a lot less fat in real terms. Since my initial weight loss I have not only maintained my weight but have actually lost over another stone over the last 4 years and I have still not increased the amount of fat I eat. Fat contains over twice the number of calories than all other food groups so it makes absolutely no sense to eat more...

There is absolutely no reason to eat more fat if you are overweight and dieting as as you loose weight you will require fewer calories to fuel your new lower weight, you will only loose weight by eating fewer calories (less food) whether you low carb or not and the only way to maintain any weight loss is to continue to eat less food as if you return to your old eating habits you simply put the weight back on...

 

[Dillinger]

My question is -- How do I keep the diabetes under control and lose weight at the same time? I need helpful advice on what to do.
Jumapi

Hi Jumapi,

I would follow what Ian said; drop as many carbohydrates from your diet as possible; this will markedly improve your blood sugars; and thereby keep your diabetes under control and you will lose weight. Have a look at the low-carb recipe section.

There is a lot of good evidence that links obesity to carbohydrates (especially refined carbohydrates) and not to fat. The only hormone in our bodies that causes fat to be laid down is insulin and the thing that elevates insulin levels in the blood is glucose which all carbohydrates are converted into. Give it a go and I'm sure you'll get the sort of results that Ian describes.

Best

Dillinger

 

[mcdonagh47]

To: Ms Sophie Borland



Dear Ms Borland,


Re: OBESITY UK (13/1/2014)


y,

But hang on, with BMI of 29 you weren't obese so your experience is not strictly relevant to the management of obesity.

Plus you seem to be confusing and running together two separate issues - the management of obesity and the management of diabetes.

And again we would need a peer reviewed study of 100 or so individuals like you ( with a control group obviously) before any meaningful conclusions could be drawn - a study with one subject means nothing.