Thoughts and Results from the NHS Diabetes Prevention Programme

[Beating-My-Betes]

I'm in two minds to continue with the programme

Seeing as you're already on the plan, maybe give it a determined trial. Set yourself a limit (Until the end of Summer, perhaps), and if you haven't seen any results, then look for alternatives.

One thing I would urge (If you are willing to give it a go), is to keep an eye on either of the fat or the carbs. My intuition is that most of those who do something similar to Eatwell, NHS, WW etc. Don't keep an eye on their fat levels, which is important if you're going to be eating relatively high-carb. This isn't just a case of monitoring the added fats, but also becoming more aware of the fats that are in animal foods. This is not to demonise fats, per se. However, keeping both high levels of carbs and fats is a problematic no-man's land. These plans are designed around a template of lower-fat, so if you are going to commit to those plans then it's something to keep a look out for.

I've attached a PDF document with links to various testimonials, from people who are using high-carb plans to beat their diabetes. The plans they are following are plant-based/vegan. As such, it's a little easier to avoid overeating on fats. Unlike those who run these programs, I don't believe one has to adopt a fully vegan diet to achieve good diabetic results. However, I would try to keep animal foods to a minimum, at least to start with, as you work out a way of fitting in different types of foods within that lower-fat footprint

Another thing that's really important is to concentrate on those 'free' foods (I think that's what WW calls them; at least, they used to). I'm talking about the veggies. We have stretch receptors in our guts, as part of a complex feedback system which determines hunger and satiation. Leveraging the lower-caloric-density, higher bulk, of these foods will help the feeling of fullness and satiety, as well as offer tons in the way of micro-nutrients and antioxidants.

I could offer more advice, but it might be easier to show you.

Over the last few days, I have been testing various reference meals, ready to start a plan along the lines of Eatwell/NHS/WW/MasteringDiabetes (There really is a lot of crossover). Tomorrow will be my 1st day, so maybe keep an eye on my blog. It might not be something you'd follow exactly (I'm 100% vegan and will likely be eating more calories than you'll need), but it might give you some ideas. And if for nothing else, you'll at least have a compadre here And if you are in need of help navigating nutritional planning, I might be able to help with that also

 

[BuddyB]

I'm vegetarian and have been for over 20 years now, but my rule of thumb is that the best veggies carb-wise are grown above ground - one of the things that I learned from Diet Doctor right at the start.

The Eat Well plate was covered on the ICS Health and Wellbeing course, but so was making good carb choices i.e. low carb choices. It covered good stuff like suggestions for swapping higher carb food for lower carb, etc. The emphasis was on keeping carb intake low. IIRC the Eat Well plate was used to help with portion sizes more than food groups. Keeping your blood sugar level steady was also covered and how the GI worked.

The NHS ICS course was focused on information to help prediabetics make changes to their lifestyle, whereas the NHS WW course does not focus on prediabetes at all. I have no doubt that you will get good results from the NHS WW course, but you will not learn anything about the relationship between nutrition and diabetes.

 

[Geordie_P]

Seeing as you're already on the plan, maybe give it a determined trial. Set yourself a limit (Until the end of Summer, perhaps), and if you haven't seen any results, then look for alternatives.

One thing I would urge (If you are willing to give it a go), is to keep an eye on either of the fat or the carbs. My intuition is that most of those who do something similar to Eatwell, NHS, WW etc. Don't keep an eye on their fat levels, which is important if you're going to be eating relatively high-carb. This isn't just a case of monitoring the added fats, but also becoming more aware of the fats that are in animal foods. This is not to demonise fats, per se. However, keeping both high levels of carbs and fats is a problematic no-man's land. These plans are designed around a template of lower-fat, so if you are going to commit to those plans then it's something to keep a look out for.

I've attached a PDF document with links to various testimonials, from people who are using high-carb plans to beat their diabetes. The plans they are following are plant-based/vegan. As such, it's a little easier to avoid overeating on fats. Unlike those who run these programs, I don't believe one has to adopt a fully vegan diet to achieve good diabetic results. However, I would try to keep animal foods to a minimum, at least to start with, as you work out a way of fitting in different types of foods within that lower-fat footprint

Another thing that's really important is to concentrate on those 'free' foods (I think that's what WW calls them; at least, they used to). I'm talking about the veggies. We have stretch receptors in our guts, as part of a complex feedback system which determines hunger and satiation. Leveraging the lower-caloric-density, higher bulk, of these foods will help the feeling of fullness and satiety, as well as offer tons in the way of micro-nutrients and antioxidants.

I could offer more advice, but it might be easier to show you.

Over the last few days, I have been testing various reference meals, ready to start a plan along the lines of Eatwell/NHS/WW/MasteringDiabetes (There really is a lot of crossover). Tomorrow will be my 1st day, so maybe keep an eye on my blog. It might not be something you'd follow exactly (I'm 100% vegan and will likely be eating more calories than you'll need), but it might give you some ideas. And if for nothing else, you'll at least have a compadre here And if you are in need of help navigating nutritional planning, I might be able to help with that also

Most of my favourite foods are plant-based, but I find I can't eat them anymore. I followed the links in this post to see if there was anything new, especially for breakfast, which I struggle with. Found the following:

Crispy French Toast Cups with Bananas Foster Topping

INGREDIENTS

• 1½ cups unsweetened, unflavored plant-based milk, such as almond, soy, cashew, or rice
• 3 tablespoons chickpea flour
• 2 tablespoons flaxseed meal
• 2 teaspoons pure vanilla extract
• 1 teaspoon ground cinnamon
• 1 cup crispy brown rice cereal, lightly crushed
• 12 slices 100% whole wheat bread
• 2 sliced bananas
• ½ cup pure maple syrup
• ¼ cup orange juice
• Dash of ground nutmeg
• Optional garnishes: chopped toasted pecans, fresh berries, fresh mint, and/or ground cinnamon

I see no way in which this, and many of the other recipes from Forks over Knives, wouldn't be deeply injurious to my health.
I'd *love* to eat it, no doubt, and if eating like this 'cured' diabetes as they claim, I'd join the programme and never look back.
But really. Can we honestly say this would be suitable for non-insulin dependent diabetics?

 

[jjraak]

:

Crispy French Toast Cups with Bananas Foster Topping

INGREDIENTS

• 1½ cups unsweetened, unflavored plant-based milk, such as almond, soy, cashew, or rice
• 3 tablespoons chickpea flour
• 2 tablespoons flaxseed meal
• 2 teaspoons pure vanilla extract
• 1 teaspoon ground cinnamon
• 1 cup crispy brown rice cereal, lightly crushed
• 12 slices 100% whole wheat bread
• 2 sliced bananas
• ½ cup pure maple syrup
• ¼ cup orange juice
• Dash of ground nutmeg
• Optional garnishes: chopped toasted pecans, fresh berries, fresh mint, and/or ground cinnamon

But really. Can we honestly say this would be suitable for non-insulin dependent diabetics?

WHAT !!!

surely no one is giving THAT as advise to anyone to help avoid or manage T2D ?

Shocked & horrified if they are.

 

[EllieM]

Seems to me that there is one way to tell whether a diet works. Use your meter and if it controls your blood sugar levels it works, if it sends them in to the stratosphere it doesn't.....

 

[Oldvatr]

Wow, I feel patronised by that and I'm not even T2. Do they assume that T2s never do any strenuous activity?

If you look at the age profile of T2D it used to be like a hump-backed whale and was skewed to the older population. T2 was a disease of old age. Us old farties tend to slow down with age so exercise becomes an increasingly difficult option as our comorbidities take over control. That is the classic picture that used to be applied to everything from diagnosis to mortem. But modern lifestyle seems to be leveling the curve out as it is becoming more prevalent in the younger generations. Sadly the NHS training and HCP advice seems to still be locked into the old pattern even now. It is a behemoth. And the cost of changing it and all the regulations it requires is prohibitive and would deeply disturb the smooth (?) running of the whole NHS machine.

 

[Beating-My-Betes]

Most of my favourite foods are plant-based, but I find I can't eat them anymore. I followed the links in this post to see if there was anything new, especially for breakfast, which I struggle with. Found the following:

Crispy French Toast Cups with Bananas Foster Topping

INGREDIENTS

• 1½ cups unsweetened, unflavored plant-based milk, such as almond, soy, cashew, or rice
• 3 tablespoons chickpea flour
• 2 tablespoons flaxseed meal
• 2 teaspoons pure vanilla extract
• 1 teaspoon ground cinnamon
• 1 cup crispy brown rice cereal, lightly crushed
• 12 slices 100% whole wheat bread
• 2 sliced bananas
• ½ cup pure maple syrup
• ¼ cup orange juice
• Dash of ground nutmeg
• Optional garnishes: chopped toasted pecans, fresh berries, fresh mint, and/or ground cinnamon

I see no way in which this, and many of the other recipes from Forks over Knives, wouldn't be deeply injurious to my health.
I'd *love* to eat it, no doubt, and if eating like this 'cured' diabetes as they claim, I'd join the programme and never look back.
But really. Can we honestly say this would be suitable for non-insulin dependent diabetics?

Firstly, it's important to point out that FOK is not a diabetes-specific program. If it were, this would likely be labelled as an occasional treat. Given the opportunity-cost of nutrition, I don't think that many would choose this as a main meal. By the time one had eaten enough, the macros would be unnecessary given the end result. There are more filling and more nutrient-dense breakfasts. Moreover, you won't find this recipe in the Mastering Diabetes program.

Secondly, this recipe makes 12 small cupcake-sized servings:

As an occasional dessert, and within an IIFYM (If It Fits Your Macros) paradigm, these don't represent a huge hit.
Broken down into 12 servings, the calories total approx. 180, with C34/P7/F2.4. Given that the plan is based upon a low-fat template, this makes perfect sense. And given that FOK is marketed to everyone, and not just diabetics, this is not out-of-bounds for most. I'm also sure that the ingredients could be manipulated to favour other macro profiles. One could probably substitute out some of the sweetening for stevia or erythritol, protein powder could be added etc.

Are they going to work for those on Keto? Of course not. But there are people, (some even on this forum), who eat at a carb level where they could indulge in these if they wanted to.

Of course, Macros aren't the whole picture. For something so insignificant, these have quite a nice micronutrient profile

---------------------------------

Now...Having said that FOK isn't a diabetes-specific program, doesn't mean that there aren't diabetics finding success with it (There are testimonials included in the document to which I linked). I'm going to go out on a limb and make the assumption that those who are using the program for such are not making their breakfasts with this recipe; at least not on a daily basis.

As to the idea of these recipes being injurous to health? There are countless testimonials of people who have both subjective experience and objective data that counter that notion. I only selected a few that were diabetes-related, but the testimonials, just as with keto, cover a very broad selection of symptoms, conditions and life-threatening illnesses having vanished.

 

[Oldvatr]

WHAT !!!

surely no one is giving THAT as advise to anyone to help avoid or manage T2D ?

Shocked & horrified if they are.

The advice approved and given by NHS has to be applicable to all participants, so has to be vegetarian/ vegan compatible, The High Carb, Ultra low-fat mantra that they follow and which is being reflected in the latest Eatwell, will apply.

 

[lucylocket61]

Firstly, it's important to point out that FOK is not a diabetes-specific program. If it were, this would likely be labelled as an occasional treat. Given the opportunity-cost of nutrition, I don't think that many would choose this as a main meal. By the time one had eaten enough, the macros would be unnecessary given the end result. There are more filling and more nutrient-dense breakfasts. Moreover, you won't find this recipe in the Mastering Diabetes program.

Secondly, this recipe makes 12 small cupcake-sized servings:

View attachment 49870

As an occasional dessert, and within an IIFYM (If It Fits Your Macros) paradigm, these don't represent a huge hit.
Broken down into 12 servings, the calories total approx. 180, with C34/P7/F2.4. Given that the plan is based upon a low-fat template, this makes perfect sense. And given that FOK is marketed to everyone, and not just diabetics, this is not out-of-bounds for most. I'm also sure that the ingredients could be manipulated to favour other macro profiles. One could probably substitute out some of the sweetening for stevia or erythritol, protein powder could be added etc.

View attachment 49875

View attachment 49876

Are they going to work for those on Keto? Of course not. But there are people, (some even on this forum), who eat at a carb level where they could indulge in these if they wanted to.

Of course, Macros aren't the whole picture. For something so insignificant, these have quite a nice micronutrient profile

View attachment 49877

View attachment 49878


---------------------------------

Now...Having said that FOK isn't a diabetes-specific program, doesn't mean that there aren't diabetics finding success with it (There are testimonials included in the document to which I linked). I'm going to go out on a limb and make the assumption that those who are using the program for such are not making their breakfasts with this recipe; at least not on a daily basis.

As to the idea of these recipes being injurous to health? There are countless testimonials of people who have both subjective experience and objective data that counter that notion. I only selected a few that were diabetes-related, but the testimonials, just as with keto, cover a very broad selection of symptoms, conditions and life-threatening illnesses having vanished.

I am interested. How are your blood sugar levels on the high carb low fat eating plan going? Some figures would be great. How long have you had type 2 diabetes and do you take any meds for it?

 

[lucylocket61]

33g of carbs in one go would spike me terribly. Unless you mean 33g of carbs for all 12 @Beating-My-Betes ?

 

[lucylocket61]

There are countless testimonials of people who have both subjective experience and objective data that counter that notion. I only selected a few that were diabetes-related, but the testimonials,

How many of these testimonials are from diet controlled type 2 diabetics?

This forum section is about type 2 prediabetics. We need to make sure our advice is suitable for them.

 

[Beating-My-Betes]

I am interested. How are your blood sugar levels on the high carb low fat eating plan going? Some figures would be great. How long have you had type 2 diabetes and do you take any meds for it?

In January, my FBG was averaging circa 18. Within a couple of weeks, i got down to an average of 9. Unfortunately, didn't manage to keep on the wagon for too long. So despite still eating pretty high-carb, I was still eating too many fats (Too many, in the context of a high-carb plan). Despite this, I've managed to keep an average of 9-10. Not great, by any means, but a lot better than 18.

Diagnosed a few Summer's back. Will be doing a spring-clean soon, so hope to find the documentation. When I first felt really bad symptoms, I bought a meter and tested FBG @ around 180 (Old meter; different measurements). I immediately went on a plant-based diet (Hadn't been vegan at the time), and 10 days later when I went to receive blood-test results, my FBG was already @120. They put me on a low-dose of Metformin and sent em on my way.

After Metformin ruined one of my Summer's, then threatened to ruin my Autumn and Winter, I dumped them in the bin. Unfortunately, for various reasons, I didn't manage to stick to any plan.

It's taken a long time for me to get to the point where I'm ready to take this on (It's much more involved than just eating differently), but I am ready. I have spent the last few days testing various repeatable meals with which I can establish (hopefully downward) trends. So you'll have many figures to peruse

 

[Beating-My-Betes]

33g of carbs in one go would spike me terribly. Unless you mean 33g of carbs for all 12 @Beating-My-Betes ?

Probably not the place to talk about spikes, but it is 33 per cake.

 

[Beating-My-Betes]

How many of these testimonials are from diet controlled type 2 diabetics?

This forum section is about type 2 prediabetics. We need to make sure our advice is suitable for them.

You can check the document that I embedded, for more info about the testimonials.

My initial post was intended as advice for either diabetic or pre-diabetic. It wasn't me who brought up the dessert. Like I said, it's not something I would advise for anything other than the odd occasion.

 

[Antje77]

Time to get back on topic, which is the NHS Diabetes Prevention Programme.

 

[Oldvatr]

Time to get back on topic, which is the NHS Diabetes Prevention Programme.

It's a moot point and being pedantic, a Prevention Programme means it is aimed at those who do not have diabetes to prevent them from catching it in the first place. Therefore Eatwell is not unexpected in that context.

 

[BuddyB]

It's a moot point and being pedantic, a Prevention Programme means it is aimed at those who do not have diabetes to prevent them from catching it in the first place. Therefore Eatwell is not unexpected in that context.

Just to clarify that the Eatwell plate is not part of the WW prediabetic course materials. It was included in the ICS course, but was tempered with information about better food choices (lower carb, no added sugar, etc.) for each quadrant of the plate. It was also used as a guide to portion control as was the hand - open or closed in a fist. The two course I have experienced are quite different and IMHO the ICS course was specifically aimed at preventing prediabetics developing diabetes. The WW course is not specifically aimed at preventing prediabetics developing diabetes.

If it is permitted, I do have pdf versions of the materials given to participants that could be uploaded. I suspect it would be classed as copyright infringement though.

 

[Oldvatr]

Just to clarify that the Eatwell plate is not part of the WW prediabetic course materials. It was included in the ICS course, but was tempered with information about better food choices (lower carb, no added sugar, etc.) for each quadrant of the plate. It was also used as a guide to portion control as was the hand - open or closed in a fist. The two course I have experienced are quite different and IMHO the ICS course was specifically aimed at preventing prediabetics developing diabetes. The WW course is not specifically aimed at preventing prediabetics developing diabetes.

If it is permitted, I do have pdf versions of the materials given to participants that could be uploaded. I suspect it would be classed as copyright infringement though.

Yes, it would infringe copyright.

 

[NicoleC1971]

Yep, they supplied us all with the eat well guide, which I'm completely aware of as I've been trying (but failing) to eat healthily for years.

I will be honest, I left abruptly after the first 20 minutes or so, so didn't hear much more stuff they came up with.

It's a weight loss programme without being a weight loss programme. I've pulled details up from an email I had, which I don't think really helps anyone try to reduce the risk of prediabetes specifically. But you guys are far more knowledgeable than I, so if I'm incorrect, please do let me know.

"Our sessions cover all aspects of being pre-diabetic and cover the below.

• Understanding diabetes
• What is a balanced lifestyle
• Exploring activities (moderate exercising)
• Habits, values and obstacles
• What is a healthy diet
• Best ways to enjoy physical activity
• Stress, mindfulness and mindful eating
• Solutions for a healthier you
• Physical activities within your community
• Thoughts, self-compassion and visualisation
• Knowing your health
• Designing a physical activity plan
• Sleep and creating a health blue print"

The first session was related to diabetes, looks like the others are weight loss specifically. I fully understand that weight is a factor, but it's not always the main reason why. My dad wasnt the biggest of men (a relatively healthy 16 stone for a strong 6'1 70 year old) and he had type 2 for about 10 years (passed away 3 years ago hence the past tense)

I think you're right to ask since the underlying strategy here is the classic 'Eat Less Move More'. As you say you have been trying that for years and it hasn't worked. I doubt you are lacking in motivation given your experience with your dad.
I like Gary Taubes way of talking about this failed strategy i.e. thinking that fat/diabetic people are just like lean, healthy people minus willpower doesn't work. Fat and/or diabetic people have a different metabolism. Excess weight is just another symptom of that rather than the cause of it.
So if you can ignore the dietary advice would these sessions be of any use to you? Perhaps it could be useful to have a regular focus on making changes to your diet. IMO the best strategy would involve turning off the carbs tap rather than cutting calories. That is a viable option and is supported by the NHS guidance!

 

[Oldvatr]

I think you're right to ask since the underlying strategy here is the classic 'Eat Less Move More'. As you say you have been trying that for years and it hasn't worked. I doubt you are lacking in motivation given your experience with your dad.
I like Gary Taubes way of talking about this failed strategy i.e. thinking that fat/diabetic people are just like lean, healthy people minus willpower doesn't work. Fat and/or diabetic people have a different metabolism. Excess weight is just another symptom of that rather than the cause of it.
So if you can ignore the dietary advice would these sessions be of any use to you? Perhaps it could be useful to have a regular focus on making changes to your diet. IMO the best strategy would involve turning off the carbs tap rather than cutting calories. That is a viable option and is supported by the NHS guidance!

Also supported by the NHS is the Low Carb Program diet from this site (DCUK) It is a long time since I took it, and it was free in those days.
https://www.diabetes.co.uk/news/2020/dec/low-carb-program-launches-nhs-login-access.html