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Patient UK advice

Thank you lovinglife that's very sad about your father. Chris24Main thanks for that I'm not really adapting well it's just that I could tell the difference immediately from my first low carb meal that I was not feeling the ravenous, stuff your face with everything in sight that I feel on low fat. I almost always end up losing weight and then bingeing when on low fat. That's why it's so amazing to me. However it is still not easy to stay away from carbs even though I see what they are doing to me.
Thanks for the further references on saturated fat KennyA. I saw GP today he's taken me off statins because I have an inflamed liver which was perfectly normal until I started taking them. Got to have a liver scan but GP is convinced it's the statins. Bit disappointed because they had brought my cholesterol down effectively. To control my cholesterol now GP says don't do low carb do Mediterranean instead and went on to tell me to eat wholegrains, olive oil and oily fish all of which I eat already but even artisan whole grain sourdough if eaten alone gives me RH symptoms. Hey ho. I'll keep reading and testing. As others have said my meter is my guide. Thank you all.
 
Ok - some more to confound then...

The Mediterranean diet - this was basically the guy who had invented the theory of cholesterol causing heart disease, travelling around southern Italy post war and interviewing the people there about what they were eating, then writing up a fantasy for the American audience - there were people around at the time, recently interviewed for Politico, who said (haven't got the quote to hand) - "it was embarrassing for my parents, they would say, 'come back tomorrow, we haven't got any food to eat today, we'll eat tomorrow''

It's never been a thing.

Though - the olive oil industry loves it - and who doesn't love a good olive oil.

Then - that same guy - he himself said later in life “There’s no connection whatsoever between cholesterol in food and cholesterol in the blood. None. And we’ve known that all along. Cholesterol in the diet doesn’t matter at all unless you happen to be a chicken or a rabbit.”

So olive oil and fish - fine, but you should also realise that the entire wholegrain thing is about - refined grains are less bad for you if you have more of the grain - it isn't about the grain itself being good, it's about minimising the damage from refined grains. Totally irrelevant if you just don't eat anything starchy - as our grandmothers knew.
 
@Chris24Main I do the Mediterranean diet, and I have to be honest, there are not that many carby recipes. If you take out Pizzas, which I have never liked and flat breads, which I cannot eat as they contain gluten, most of these med recipes use fresh veggies, meats, fish, dairy and olive oil. I tend towards North African , Spanish, Israeli and Middle Eastern foods. Just to make sure I looked through my Mediterranean cookbooks, I’ll name one as a reference, ‘The New Mediterranean Diet Cookbook’ by Nancy Harmon Jenkins and there were very few carb laden recipes.
 
I have a Greek recipe book that my Greek friend sent me. There are a lot of bean recipes but otherwise mostly veg with some fish, meat, chicken and cheese although she does often say have this with a piece of bread. Are beans very high in carbs? Chris2Main do whole grains take longer to break down into glucose and if so does that matter?
 
I have nothing against those meals in general. Ironically, I'm currently reading "change your diet, change your mind" by Dr Georgia Ede, and the last chapter I read was on what a meaningless fantasy the "Mediterranean diet" is and was.

Greek, Italian sure - but Mediterranean? Does that mean Libyan? Tunisian? Maltese? - it's just vague yet appealing enough, that you can use the idea to sell something - which was precisely the original point.

Real foods made from real ingredients with a high level of animal husbandry and great techniques for drying and curing meats. That's what the Mediterranean diet means to me -but it will be something equally specific to everyone else.

Beans are little storage bags full of stuff to make plants out of - so, as much as l personally love eating beans - I prefer not to for the moment - and I can see from trials with a CGM that they definitely contain too many carbs for me - but everyone is different - best to test for yourself.

Grain - yes, that really is fascinating on the historical level - all of the stuff that is supposedly good for you - well, it's all literally indigestible sugar. Why do we think that is good for us? There was never any science to say so. Sure, it gives variety, texture and maybe even taste. But the bottom line is that you cannot digest it. Your gut microbiome may, and may digest some into things you can use - though as I understand it the most beneficial compound is actually something we can make from meat quite easily, but do we want to give ourselves the best nutrition, or the bacteria that shares our body. It's all just stuff that we have to push through our body and out the other end, often creating issues as it goes (IBS, leaky gut, inflammation - though obviously not for everyone). So, why do we think it's so good? Well, because it's so much better than eating the starch refined, because that will be digested so much faster and turned into sugar. There is no doubt that eating a wholegrain thing is better than eating that thing refined; but the grain itself is (in my opinion having delved deep into the history of various parts of the food industry) really just a way of selling the idea of eating the thing. If you want to reduce your insulin and blood glucose - not eating the starchy thing is always better than eating the wholegrain version. As a basic principle, what you do is entirely your choice, and no judgement from me - the flip side of this is that so many delicious things are made from starchy stuff.

And really - the thing I have against the "Mediterranean diet" - is that this is where the idea of wholegrain comes from - there was no scientific basis for it before Ancel Keyes lifted it off the top of his head and turned it into a fantasy of dappled sunlight through olive groves, and rustic but happy folk in balance with nature and social living. Just what the public (who were terrified of the seeming epidemic of heart disease that was really all about smoking) wanted to hear.
 
I stayed off legumes etc - chickpeas, broad beans, cannelini, all those, for two or three years because of the high carb/high volume. Then I made a chicken and chickpea curry (I'd normally just have the chicken) and decided to see what impact some chickpeas had. Answer was not very much. So I tested for other legumes and had much the same results.

I have no idea whether it was always that way from the beginning, or whether in the 3 years of keto I acquired enough insulin sensitivity to cope with legume carbs. Carbs from anything flour-based, though, still a big no. Moral of the story - it's worth trying and testing even when you're pretty sure what the answer is going to be, because sometimes it isn't.
 
I guess people respond differently because l am on a more or less Mediterranean diet - not specially trying to lose weight but to lower my A1c. I am also intermittent fasting 16/8 -ish, with minimal snacking. I went from A1c 88 in October to 50 recently. I eat modest amounts of pasta (white), barley, new potatoes, frozen then toasted real sourdough bread, etc, but always in the context of a larger meal, with fats and protein. The one frightening spike I had was when I gorged on Bombay mix. I'm not recommending this or anything. Just saying it seems to be working for me. Things holding me back now - stress, poor sleep, eating too quickly.
 
If what you’re doing is working for you then that’s fine, it’s your diabetes no one else’s and we all have to find a lifestyle that is sustainable for ourselves long term. Going very low carb isn’t for everyone and not everyone needs to cut their carbs so drastically to get good numbers. You have room to reduce carbs a bit further if you need to later. A drop from 88 to 50 in 5 months is an amazing result well done
 
Fantastic - and that really is an impressive reduction in your blood glucose.
Everyone should have joy in what they eat - I'm not trying to take any of that away from anyone. Enjoying eating should be at the top of anyones list of what makes for a good lifetime regime.
And if you identify with the ideal of a particular range of food recipes - that's also great.

I'm not criticising anyone for their own personal choices - and I absolutely love a plate of pasta. I had a plate of tagliatelle in tomato sauce in a cafe in Turin about 25 years ago that I still remember now as one of the best meals I've ever had.

The very specific thing I'm saying is that the idea of the Mediterranean diet is much more of a marketing tool for anti-meat sentiment and for pushing vegetable oils as a substitute for saturated fat. It was lauded as "the best possible diet" by Harvard University several years before any studies were done on it, and has always been something of a cherry picked fantasy, more about ideology than nutrition.

In many ways - I'm saying "enjoy your pasta - and enjoy your white pasta" - because the idea of wholegrain was pretty much made up to sell the book about the diet, was based on nothing more than one man's personal bias (and this was a guy with lots of biases - though in the interest of fairness, he did retire to the south of Italy and lived to be over 100, so there's that)
 
Thank you. It's 4 months actually. Mid-October to mid-February. ☺

I'm surprised by how well it's gone. I wonder if I will have diminishing returns and will have to adjust further. My goal is a normal glucose level AND increased insulin sensitivity. The latter has never been tested.

I've been diabetic for perhaps 20 years but misunderstood it until October, when I had a wake-up call. I'm disappointed in the NHS but ultimately I am to blame.
 
Agree about having a most amazing, simple spaghetti with tomato sauce in Italy. I can't think how wholemeal pasta is Mediterranean.
 
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