Patient UK advice

[Beechnut]

Hello everyone I've just been diagnosed as prediabetic and given advice from my GP to follow a healthy diet based on a print out he gave me from Patient UK. The puzzling thing is the diet is heavy on starchy cards and low in far but further down in the article it says that high carb diets are responsible for higher death rates and that all forms of fat including saturated fat are responsible for fewer deaths. I'm totally baffled by this advice it's so contradictory. Having gone back to the references given in the article I find that they are actually advising a change in advice for patients but it's obviously not happening. I'm sure others have experienced this I wondered if you could say whether you followed the high carb low fat advice or not. Thank you.

 

[Taighnamona]

Hello everyone I've just been diagnosed as prediabetic and given advice from my GP to follow a healthy diet based on a print out he gave me from Patient UK. The puzzling thing is the diet is heavy on starchy cards and low in far but further down in the article it says that high carb diets are responsible for higher death rates and that all forms of fat including saturated fat are responsible for fewer deaths. I'm totally baffled by this advice it's so contradictory. Having gone back to the references given in the article I find that they are actually advising a change in advice for patients but it's obviously not happening. I'm sure others have experienced this I wondered if you could say whether you followed the high carb low fat advice or not. Thank you.

A few decades ago I followed nhs advice to eat high carb low fat and went on to develop full blown diabetes.
I’m now very much low carb, have reduced my meds, lost and kept weight off and my last two A1Cs were 41 and 39.
Please take advice and do your own research but the truth is that type 2 diabetics cannot process carbs.

 

[lovinglife]

Hi @Beechnut & welcome to the forum

No wonder you are confused by that leaflet, diagnosis is hard enough to get your head around without that kind of mixed up message.

Many of us with T2 and pre diabetes follow a low carb or keto diet to control our BG. Carbs aren’t the best thing as all carbs turn to sugar

Take your time to have a good read around the forum, there’s some links in my signature below if you toggle down that you may find helpful.

Being pre diabetic you may not need drop to very low carb or keto to get into the none diabetic range. The best thing in your armoury will be a meter to test what foods do to your BG. Suggested testing is test at first bite and then 2 hours after - you are looking for a rise of no more than 2. If the rise is over 2 then the carbs in your meal may need adjusting down, under 2 and what you ate was fine. Personally I also aim for no more than 7ish 2 hours later but I do prefer to be lower.

Unfortunately the NHS rarely fund meters fit T2 diet only so most of us self fund. If you need a meter there are a lot of affordable ones on the market

Like I say have a good read round and take time to digest, it’s a big learning curve and a big mindset change to start to believe that carbs may not be the best thing and fat is fine

 

[Antje77]

The puzzling thing is the diet is heavy on starchy cards and low in far but further down in the article it says that high carb diets are responsible for higher death rates and that all forms of fat including saturated fat are responsible for fewer deaths. I'm totally baffled by this advice it's so contradictory.

Hi @Beechnut , welcome to the forum.

This sounds like someone has followed more recent research on carbs and fats (the second part of your print out).
And someone didn't dare to take out the old part, possibly because the high carb low fat message has been so ingrained in their brain for decades that they couldn't wrap their head around it that it's wrong.
Resulting in a completely ridiculous message of course, but at least the correct message is in there too. Most of us only got the advice to lower fats and up the 'healthy' carbs.

I went low carb right after diagnosis and don't keep an eye on the fats, happy to munch on pork scratchings and butter my veggies without thinking about it.
Like others said, a glucose meter is your best friend!

I think you'll find this short piece written by one of our members more useful than the handout: https://josekalsbeek.blogspot.com/2019/11/the-nutritional-thingy.html

 

[Beechnut]

Thank you so much everyone for this information I shall definitely start reading about the effect of carbs (thanks for the link Antje77) and testing my bs regularly for a bit. I thought it was a bit odd to be told to eat lots of bread and pasta and low fat because I've been doing that for years and the result is I'm overweight with prediabetes!

 

[Resurgam]

Thank you so much everyone for this information I shall definitely start reading about the effect of carbs (thanks for the link Antje77) and testing my bs regularly for a bit. I thought it was a bit odd to be told to eat lots of bread and pasta and low fat because I've been doing that for years and the result is I'm overweight with prediabetes!

I was given loads of copies of the first part of that printout. I used them to light the barbecue in the days after diagnosis as my HbA1c was 91 by then and I was hugely overweight after decades of insistence on that bad advice.
Humans can live without carbs, but need protein and fat to survive.

 

[Beechnut]

Yes I'm beginning to realise that after reading on here for a while today. Before diagnosis I suffered for years from symptoms of reactive hypoglycaemia always following a carb heavy meal whereas GP says RH is caused by too FEW carbs! It's very hard for me to process at the moment all the information from GP/NHS seems to be contradictory but it's great to get other people's experiences and I feel like things are beginning to make sense.

 

[Helen H]

Just to give you some hope, I was told November 23 that I was prediabetic. I was enrolled on the NHS/Oviva Preventing Diabetes program. They wanted me to follow the Eatwell Plate but I told them (after reading lots of info on here and also Michael Moseley‘s Fast 800 diet)) that I wanted to follow a low carb high fat/Keto diet. They agreed relunctantly and at first were quite good but then went to the high carb advice so I left the program. I initially did 20g carbs/day and time restricted eating (only eat between 12pm and 8pm) and lost 2 and half stone within 4-5 months - bmi went from 27 to 21 and a year later my HBA1C went from 42 down to 37 in Nov 24. (Incidentally my GP didn’t ask me how I had done it or even acknowledged it at all). I have to see him every year as I also have an underactive thyroid which I have found out can also be linked to higher blood glucose levels. My cholesterol levels have increased on the keto diet so I have made a few tweaks (less eggs/red meat/butter - more avocado oil.chicken/fish). I have to have bloods done again in June so will see if that has any effect. I did refuse a statin (as one of their many side effects can be to raise blood glucose levels) and even if the diet tweaks make no difference I have already decided not to take a statin. Also, I have found the low carb way of eating the easiest way of eating to stick to once you get your head round it.

Have a good read around on here, I have found so many people’s stories inspirational and informative. Good luck on you journey.

 

[Beechnut]

Thank you Helen I am reading and learning but the thought of a low carb high fat diet sounds hard for me as a carb fiend (particularly bread). I'm allergic to nuts so can't have some low carb breads. Also I'm programmed for low fat I've been eating that way for over 40 years and the thought of eating so much fat is scary. BHF say there is still evidence that it causes heart disease. I don't know what to make of it all at the moment but I can see so many success stories on here with low carb. My friend a long term Type 2 swears by the Slimming World diet which is low fat. I'm in a bit of a tizz with all this information but I'm determined to find my way. I'm so grateful to the people on this forum.

 

[lovinglife]

Thank you Helen I am reading and learning but the thought of a low carb high fat diet sounds hard for me as a carb fiend (particularly bread). I'm allergic to nuts so can't have some low carb breads. Also I'm programmed for low fat I've been eating that way for over 40 years and the thought of eating so much fat is scary. BHF say there is still evidence that it causes heart disease. I don't know what to make of it all at the moment but I can see so many success stories on here with low carb. My friend a long term Type 2 swears by the Slimming World diet which is low fat. I'm in a bit of a tizz with all this information but I'm determined to find my way. I'm so grateful to the people on this forum.

I do keto and don’t do high fat, I do normal fats but don’t add loads of fats. So I leave the fat on meats, eggs, cheese a little bit of cream, butter but normal portions not everything slathered in it, avocados, really good extra virgin olive oil, I restrict my dairy a bit only because it makes me gain weight. Normal amounts of mayo. Full fat Greek yogurt Oily fish like salmon, mackerel smoked salmon (my favourite) coconut oil, you only need to eat to satiety. No need to fear fat & make it the demon you’ve been led to believe. I’m the same as you 40 years on low fats and never full.

I’m on a medical diet for another condition at the moment so my food is very restricted and boring. But my favourite go to breakfast is a slice of smoked salmon, half of avocado and a chopped up egg with a teaspoon of mayo, that’s a normal level of fats that are very good for you, keeps me going for 6 hrs

 

[Helen H]

Thank you Helen I am reading and learning but the thought of a low carb high fat diet sounds hard for me as a carb fiend (particularly bread). I'm allergic to nuts so can't have some low carb breads. Also I'm programmed for low fat I've been eating that way for over 40 years and the thought of eating so much fat is scary. BHF say there is still evidence that it causes heart disease. I don't know what to make of it all at the moment but I can see so many success stories on here with low carb. My friend a long term Type 2 swears by the Slimming World diet which is low fat. I'm in a bit of a tizz with all this information but I'm determined to find my way. I'm so grateful to the people on this forum.

Hi Beechnut, it is overwhelming to start with - I know the feeling. I loved my carbs as well and did slimming world (the worst thing I ever did as it made me obsessed by food and calories which I never used to be). Bread was an issue for me but I now use Heylo low carb bread which as far as I am aware does not use any nut products in it - but I would advises you are best to check with them first. It is very expensive but it fills the need I have for bread and makes my way of eating sustainable. The “low fat” issue - I was the same but it didn’t take me long to get away from it. I don’t and won’t eat low fat yoghurts, cheese etc it has to be full fat. I would really recommend getting hold of a copy of the fast 800 diet by Michael Moseley - it has some recipes/diet plans in it but the main thing I found it helped with is getting the fact that carbohydrates are not good for people with elevated blood glucose levels and how losing fat stored around your liver and organs (visceral fat) has such an impact on your health (that is where my fat was stored - all around my middle and not on my hips/bum/legs). It has now gone from there I am pleased to report.

You may find that you do not have to go as extreme as 20g carbs/day - I did as I am an all or nothing kind of person. I have now increased my carbs to about 40g/day but these generally come from vegetables or fruit (berries). I occasionally allow myself a treat such as fish and chips whilst on holiday or a Chinese meal for a special occasion. As lovinglife says above I have tweaked my diet to be more normal fats rather than high fat - so avocado oil for cooking, a little butter if I have toast with eggs, more chicken but I do still eat red meat, more fish although I am not a fish lover so it is either tinned tuna or cod fillets.

Hope the above helps in some way.

 

[MrsA2]

Hi @Beechnut
The best impartial advice for you would come from your own body if you start a regular regime of testing your own bg. Your body isn't going to lie to you!
The meter would soon show you if carbs have too high an effect on your bg.

@Rachox keeps a list of current finger pricker, which is the cheapest way of doing it.
Or some spend £50 every 2 weeks for continuous monitoring that attaches to your arm.
Either would give you invaluable, irrefutable proof about what your body can handle and what it can't. No one elses opinion involved at all!

There lots on here about how, why and when of monitoring . Have a good read around

 

[Rachox]

If you’re interested in getting a meter @Beechnut , here’s some info with links for UK meters, and to be clear I have no commercial connections with any of the companies mentioned.



HOME HEALTH have the Gluco Navii, which is a fairly new model and seems to be getting good reviews.

https://homehealth-uk.com/all-produ...ose-meter-test-strips-choose-mmol-l-or-mg-dl/



Links to the strips for future orders:

https://homehealth-uk.com/all-products/glucose-navii-blood-glucose-test-strips-50-strip-pack/



Then they sell the older SD Code Free, details to be found here!

https://homehealth-uk.com/all-products/codefree-blood-glucose-monitoring-system-mmoll-or-mgdl/





SPIRIT HEALTHCARE have a meter called the Tee2 + which is quite popular:

https://shop.spirit-health.co.uk/co...e2-blood-glucose-meter?variant=19264017268793



The strips are to be found here:

https://shop.spirit-health.co.uk/co...py-of-tee2-test-strips?variant=19264017367097



If there is a choice of units of measurement then ‘mmol/L’ are the standard units in the UK, ‘mg/dl’ in the US, other countries may vary.



Don’t forget to check the box if you have diabetes so you can buy VAT free. (for all meters and strips)



If you’d like to try a free 15 day trial of the Freestyle LIBRE 2 plus follow this link:

Sampling | Diabetes Care | Abbott



Dexcom also offer a free trial of their Dexcom one + here

The Dexcom ONE+ CGM (Continuous Glucose Montoring) system | Dexcom

 

[Beechnut]

Thank you for all this information. I am finding it so interesting to find out all these things. I have eaten low carb for a couple of days and the amazing thing is I feel completely satisfied with my food after a meal unlike in the rest of my entire adult life when I have been hungry one or two hours after eating and feel like I could devour a whole loaf of bread! It's truly astonishing. I've bought a low carb cookbook by Katie Caldesi which has a foreword by Dr David Unwin. There are some wonderful recipes and it explains the benefits of low carb really clearly. I will look for Michael Mosley's book too. I'll be very interested to see how foods affect my glucose using a meter. Your knowledge and experience is very much appreciated.

 

[KennyA]

Thank you for all this information. I am finding it so interesting to find out all these things. I have eaten low carb for a couple of days and the amazing thing is I feel completely satisfied with my food after a meal unlike in the rest of my entire adult life when I have been hungry one or two hours after eating and feel like I could devour a whole loaf of bread! It's truly astonishing. I've bought a low carb cookbook by Katie Caldesi which has a foreword by Dr David Unwin. There are some wonderful recipes and it explains the benefits of low carb really clearly. I will look for Michael Mosley's book too. I'll be very interested to see how foods affect my glucose using a meter. Your knowledge and experience is very much appreciated.

Those of us old enough will also remember that prior to 1980ish, the standard medical advice for losing weight was to reduce starches and sugars - ie carbohydrates. We didn't have the T2 problem then that we do now.

You might also be interested in some recent research, including a comprehensive 2019 review of the saturated fat hypothesis by the Journal of the American College of Cardiology. Until recently the American College of Cardiology has been vehemently pro-low-fat, so this paper marks a significant change in direction:

https://www.sciencedirect.com/scien...tm_medium=referral&utm_campaign=the-arrow-188

From the conclusions:
•Several foods relatively rich in SFAs, such as whole-fat dairy, dark chocolate, and unprocessed meat, are not associated with increased CVD or diabetes risk.
•There is no robust evidence that current population-wide arbitrary upper limits on saturated fat consumption in the United States will prevent CVD or reduce mortality.

This is far from the only evidence - faced with the failure of low-fat diets to do anything about increasing levels of obesity and T2 (and that low-fat has contributed to them), there is an increasing body of work that says official dietary advice has been wrong for nearly half a century.

 

[lovinglife]

My dad was diagnosed T2 very early 80s, I was still at home then and remember it being very different from todays advice of the eat well plate, he was given a diet sheet with pictures & weights of carbs, and the carbs were minimal, I small golf ball sized potato. Lots of above ground veg, meats fats.

The most surprising thing was he actually had 3 home visits from a dietitian who looked over his food diary and how he was doing and advised on reducing carbs further!

 

[Beechnut]

That is so interesting about the sat fat KennyA. Lovinglife did the 1980s advice work for your father with his type 2?

 

[lovinglife]

That is so interesting about the sat fat KennyA. Lovinglife did the 1980s advice work for your father with his type 2?

For many years yes, but he went from diet only to fixed insulin very quickly after about 20 years so now with what I’ve learned here I question if he actually had LADA, though I never followed that up. As by this time he was elderly and was starting with Alzheimer’s & it would have served no purpose

 

[Chris24Main]

@Beechnut - about a year ago I would have described myself as "almost vegetarian" - and definitely of the Jack Sprat variety - I struggled to put a piece of meat that had any fat on it in my mouth without gagging, and I would trim it all off before cooking, to the point that it was a waste of money buying steak - most of it would go in the bin.

So - following this low-fat approach, I lost so much muscle in getting my weight down, that I had an inguinal hernia, and was soon after diagnosed diabetic.

Makes no sense - I was just furious, and decided to come here, and start learning for myself.. soon enough I realised that nearly everything I thought to be rock solid abut food was just nonsense - it's hard to wrap your head around.

The journey you have been on - I'm amazed at how quickly you've adapted - great inspiration for all of us.

 

[KennyA]

That is so interesting about the sat fat KennyA. Lovinglife did the 1980s advice work for your father with his type 2?

If you liked that, here's some more. It's increasingly hard to find any research supporting low-fat these days, but I think it will take healthcare systems and the media years to catch up. In addition, I'd recommend the book "Rethinking Diabetes" by Gary Taubes. It's an excellent account of the conflict between the diet and the medication camps in diabetic medicine, with patients as collateral damage.


Total cholesterol and all-cause mortality by sex and age: a prospective cohort study among 12.8 million adults - Scientific Reports

It is unclear whether associations between total cholesterol (TC) levels and all-cause mortality and the optimal TC ranges for lowest mortality vary by sex and age. 12,815,006 Korean adults underwent routine health examinations during 2001–2004, and were followed until 2013. During follow-up...

www.nature.com

No simple conclusion from this huge Korean study but - U-curve associations between TC levels and mortality were found in both men and women. The TC range associated with the lowest mortality was 210–249 mg/dL (5.4- 6.4mmol/l). When age was further considered, U-curve associations were observed regardless of sex or age, and the optimal TC range for survival was 210–249 mg/dL (5.4- 6.4mmol/l) for each age-sex group, except for men at 18–34 years (180–219 mg/dL or 4.6-5.6 mmol/l ) and for women at 18–34 years (160–199 mg/dL or 4.1-5.1 mmol/l) and at 35–44 years (180–219 mg/dL or 4.6-5.6 mmol/l)


Re-evaluation of the traditional diet-heart hypothesis: analysis of recovered data from Minnesota Coronary Experiment (1968-73)

Objective To examine the traditional diet-heart hypothesis through recovery and analysis of previously unpublished data from the Minnesota Coronary Experiment (MCE) and to put findings in the context of existing diet-heart randomized controlled trials through a systematic review and...

www.bmj.com

Conclusion: Available evidence from randomized controlled trials shows that replacement of saturated fat in the diet with linoleic acid effectively lowers serum cholesterol but does not support the hypothesis that this translates to a lower risk of death from coronary heart disease or all causes. Findings from the Minnesota Coronary Experiment add to growing evidence that incomplete publication has contributed to overestimation of the benefits of replacing saturated fat with vegetable oils rich in linoleic acid.

Is the use of cholesterol in mortality risk algorithms in clinical guidelines valid? Ten years prospective data from the Norwegian HUNT 2 study

Many clinical guidelines for cardiovascular disease (CVD) prevention contain risk estimation charts/calculators. These have shown a tendency to overestimate risk, which indicates that there might be theoretical flaws in the algorithms. Total cholesterol ...

www.ncbi.nlm.nih.gov


Conclusion: ".....If our findings are generalizable, clinical and public health recommendations regarding the ‘dangers’ of cholesterol should be revised. This is especially true for women, for whom moderately elevated cholesterol (by current standards) may prove to be not only harmless but even beneficial."