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Time for new NHS diet guidelines?

Discussion in 'Diabetes Soapbox - Have Your Say' started by JSG207, Aug 16, 2017.

  1. frankbegbie

    frankbegbie · Well-Known Member

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    There's way too much money involved in food and drug manufacture for them to admit
    that they are poisoning us with their food and selling us snake oil to cure us.

    They are pure evil and care only about profit and little about how they atain it.
    Governments will do nothing as they are in the pockets of the corporations.

    It's every man for themselves I'm afraid. But it will all end in tears when the bill comes in.
     
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  2. ickihun

    ickihun Type 2 · Master

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    As our wear living well trainer said to one of the women yesterday. He cannot make anyone eat one way or the other. It's just a guide!
     
  3. Fleegle

    Fleegle Type 2 · Well-Known Member

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    It is very frustrating.
    Yet equally I don't think there are any long term studies.
    Personally I think the advice should be - here is the eat well plate and drugs, people don't get better on that but we know all about the impacts you will have through very long term studies.
    Or - here is an approach which will stop it getting worse for at least a period of time but we have no long term studies - take your pick.

    It is the lack of options that is most annoying.
     
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  4. Daibell

    Daibell LADA · Master

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    It's also helpful for T1s to avoid weight gain when on insulin.
     
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  5. Daibell

    Daibell LADA · Master

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    This has been discussed for years on this forum. Little will change things until the food and pharma lobby stop controlling the big institutions. Many of the professors etc providing advice have research funded by food and pharma and the end result is obvious. The recent update to the Eat Well Guide was largely influenced by the food industry lobby with very little medical input. Things will change slowly but within the NHS going against the higher level dictates is not the way medicine works so DNs have to tread carefully.
     
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  6. AlexMagd

    AlexMagd Type 2 · Well-Known Member

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    Although it's easy to blame Big Pharma I also think it's a lot to do with the consequences of decisions. LCHF is a relatively new trend and there haven't been a ton of studies done on it (though more all the time). The NHS has to be responsible before making recommendations - my impression is that their approach is very 'wait and see' rather than back something they see as a fad diet which doesn't have strong support in research.

    What's particularly frustrating is that if they would adopt the new approach then you would start to see genuinely low-carb products in supermarkets as it became the norm for diabetics, which would make everyone's lives easier.

    Same with Diabetes UK - though by pumping money into Prof Taylor's studies in Newcastle they're showing willingness to try new avenues of treatment. Though also worth remembering that Taylor and Lean both seem somewhat sceptical about low-carb as their own results show calorie restriction to be successful

    Doesn't help when you're faced with doctors who just follow the official advice though - though my GP was nice trying to get her to understand what I wanted to do with LCHF was like swimming through treacle.
     
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  7. bulkbiker

    bulkbiker Type 2 · Oracle

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    But to be fair there a lot of low carb products in the supermarket.. fresh, real food.. avoid processed **** and you are half way there already. Meat, fish, eggs, greens, salad, cheese,cream and butter form the basis of my eating and all are available from almost any food shop.
     
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  8. AlexMagd

    AlexMagd Type 2 · Well-Known Member

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    Yes of course, sorry - I meant more in the way of pre-made foods and alternatives.

    As someone just recently diagnosed it's such an enormous dietary adjustment. I'd guess like a lot of people who get Type 2 I'm not a great cook and have always been time-poor. I would love to be able to buy low-carb sauces, or coconut flour tortillas from the supermarket with the same ease that you can pick up a bag of pasta or a loaf of bread.

    Kind of in the same way that gluten-free has become so widely known now that even small supermarkets stock products suitable for those with an intolerance - whereas 10 years ago they'd have to make everything themselves
     
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  9. Chook

    Chook Type 2 · Well-Known Member

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    Food planning, shopping and cooking does get easier.... there will come a day when you will realise that you automatically think about the foods you can have rather than mourning the loss of the foods you can't.

    As you are time-poor you might want to think about bulk cooking when you do have time. In my home we don't make anything complicated for just the two of us for one meal - any casseroles, stews, chillies, roasts, etc are made in batches of 6 to 12 portions after eating what we want we then freeze the remaining portions individually - it means that when we are pushed for time there is always something nice to eat in the freezer to zap in the microwave. I also find my (large) slow cooker very helpful for cooking casseroles and things - often its just a case of sling all the ingredients in, add some stock or wine (or both) and turn it on for eight hours while we're out.
     
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  10. SockFiddler

    SockFiddler Type 2 · Well-Known Member

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    Hi (again) @AlexMagd !

    I'm unable to cook at the moment. I'm not bone-idle (well...), but I can't stand for more than 2 minutes which means I have to zip about the kitchen on an office chair, meaning I can't safely stir pots and lots of washing up is very difficult to get done. On top of that, I'm moving house and have about 300 other reasons why bouts of cooking are beyond my capabilities.

    BUT...

    Slow cookers are amazing inventions and only need attention once an hour, and will turn out - with even the most basic of abilities - plentiful, healthy meals that you can munch happily away on. Plus I'm a big fan of throwing lots of veggies into a (disposable) oven tray (onions, cauli, peppers, mushrooms, sprouts, courgettes - anything, really) topping that with some meat (belly pork works well, chops, chicken breasts wrapped in bacon), dosing the whole lot with garlic salt and olive oil and then forgetting about it for 90 minutes. (If you use and reuse the tray, you'll get a delicious stock of meat and veg juices collecting at the bottom that will only enhance future foods. I reuse my trays up to 4 times)

    Smaller cuts of meat will cook faster, and in a typical oven tray you can easily fit enough food for 2 people to be happily sated for a whole evening at least.

    Other "cheats" include a massive bowl of tuna-mayo in the fridge, with dollops being added to those salads that come already in the bowls - that'll last you a good few days. Lots and lots of ham, egg-mayo, cheese. Occasionally I'll cook off an entire pack of bacon (in the George Foreman) and shove the lot in a food bag in the fridge to make for quick breakfasts. You can also boil eggs well in advance and they'll keep in their shells for up to a week.

    Anything fatty will fill you up super-fast (I find I can only eat a small amount of cheese these days). Dry spices are your friends - experiment with Jamaican Jerk, Chinese Five Spice, Mixed Herbs. Don't forget, also, that a pint of full-fat milk will fill you up on the hop, too.

    Final thing is snacking - a relatively good lunch will mean I'm not up for a heavy dinner, so will cheerfully tuck into berries and cream (if you use frozen berries, you get a delicious, weird kind of ice-cream), celery and brocolli with a dip are great (read the labels on these - hummus and onion and garlic have surprised me in the past), especially with a bit of ham, Peperami and a couple of Babybel.

    You can also enjoy things like pre-packaged cauli-cheese, though I do my own super-easy version now, at a fraction of the cost for four times the amount:

    Glass oven-proof bowl
    Cauli florets
    Bacon lardons
    Double cream
    Parmesan, cheddar
    Garlic Salt
    Oven
    An hour of doing other things
    Cheese on top when finished, under the grill to brown.
    Put it in your face.

    Don't forget there's a thousand ways to add variety and flavour to a basic, no-fuss diet, too - olives, pickles, balsamic vinegar, Marmite, cheap meat cuts (braised beef in the oven with red wine, peeled shallots and mushrooms), nut oils (Balsamic and sesame oil makes the BEST in-a-rush salad dressing), lemon juice etc etc

    I felt much the same as you at first - "How on Earth am I going to manage such a sweeping change when I can barely stand, can't extend my food budget and have no time to spend on this?"

    Make friends with your oven. :)
     
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  11. cott97

    cott97 Type 2 · Well-Known Member

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    Do you cook the cauliflower before putting in oven?
     
  12. SockFiddler

    SockFiddler Type 2 · Well-Known Member

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    Nope! Far too much work!* Though I do make sure that it's well-basted in oil or juices already in the pan and, if it's a hot oven, I'll try to turn it once to stop it from browning too much.



    *Though, seriously, me and pans of hot water shouldn't mix at the moment - I can't reliably lift, carry and twist.
     
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  13. donnellysdogs

    donnellysdogs Type 1 · Master

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    How come some Docs Like Dr Unwin, Dr Joanne McCormack, Dr Aseem Malhotra, Professor Robert Taylor can get away from the NHS and speak out? (All different areas, Oncology, Heart etc)

    Why is it that some NHS people can speak out and publications are made but still the NHS do not listen??

    I dont understand how these professionals can step outside the 4 walls if NHS thinking and others cant....
     
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  14. bulkbiker

    bulkbiker Type 2 · Oracle

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    Because they are motivated, angry and interested rather than just doing the job... According to Dr Unwin he was very disheartened with his job so he and his wife decided to tackle something hard as a challenge and uncovered LCHF from this very site and started to get it going with "his" Type 2's. He says he uses the "individualised approach" recommendation in the NICE guidelines to cover himself if he were to be challenged (but after winning his innovator of the year award hopefully that won't happen).
     
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  15. SockFiddler

    SockFiddler Type 2 · Well-Known Member

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    The NHS encourages innovation- I know! It's shocking! But through NHS England and the CQC, innovation is both encouraged and rewarded.

    In hospitals there are "CQUIN"s - https://www.england.nhs.uk/nhs-standard-contract/cquin/cquin-16-17/ - specific targets that pay out extra cash and stem from an innovative idea or project that must demonstrate efficacy over time. In the children's hospital the CQUIN I was involved with was a new disabled children's assessment which involved retraining nurses and doctors (they loved that!), new systems, new paperwork and a new way of approaching children and their families about their needs. Our CQUIN target was 90% of all disabled children assessed within 48 hours of admission. I rarely get to boast about this, so will smugly type that we hit 98% within 24 hours and the CQUIN reward was enough cash to pay a part-time family bed-side support worker for 12 months.

    I don't know whether CQUINs extend to GP surgeries, but I know that local authority Health and Wellbeing Boards will also fund community health innovation projects (e.g. flu jab coverage to reduce strain on local services in the Autumn and Winter) and the results of these good practise challenges are all reported back to NHS England.

    The rate of change is really slow. And it's frustrating when it all seems to obvious to us who took the plunge without really thinking twice or waiting for permission. But even on these forums we're seeing reports of DNs, GPs and even consultants who often accept low carb as a solution - if not actually recommend it.

    There are still not enough, of course, and too many people with T2's are still being given advice that we consider dangerous to health. But the ability to innovate is built into the NHS structure, and (to loop back to DD's question) that's how come those listed Drs were able to go off-piste and try something new.
     
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  16. donnellysdogs

    donnellysdogs Type 1 · Master

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    GP Practices got all their DES targets to hit but just dole out meds to hit the targets ie flu jabs..
     
  17. copepod

    copepod Type 1 · Well-Known Member

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    A tip for coping with boiling veggies in a pan - either place veggies inside a chip pan metal basket inside pan, so you can lift chip basket, tap it against inside edge of pan to shake off water or use a slotted spoon to fish out veggies. No need to move a pan of hot water - leave until water has cooled before moving to pour it away.
     
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  18. DCUKMod

    DCUKMod I reversed my Type 2 · Master
    Staff Member Administrator

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    In a professional world, the guidelines are a "safe" place to be, when it comes to their insurers, and probably their insomnia.
     
  19. ringi

    ringi Type 2 · Well-Known Member

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    Also, Dr Unwin was thinking of giving up work as he was having no fun just using more and more drugs as a GP. Hence he did not have a lot to lose......
     
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  20. midnightrider

    midnightrider Type 2 · Well-Known Member

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    The NHS recommendations, to be fair, are in conjunction with regular exercise (both cardio and muscle building).
    After being diagnosed I brought BG under control with exercise and about 100g Carbs/day. I now have about 200g/day of carbs on average without increasing my average BG of 4.5 / HbA1c 32. I am still experimenting with my diet as I don't want to lose any more weight or to cut my exercise (11st 7lb now after being c.17st at Xmas).
    However, it depends on activity. I may have a bowl of porridge (made with almond milk) and fruit for breakfast if I am going out for a long walk or on the rowing machine for a while or both. I will probably have toast & avocado afterwards or maybe mackerel or something similar. I find that I cannot do much exercise now without a loading of carbs. I could when first diagnosed as exercise was not as vigorous and I had plenty of stored fat too.
    If, however, I have to spend the morning working at the computer at home, or (God forbid) sitting in a meeting, then it is bacon and eggs for me. I have tested a couple of times having porridge and not exercising and BG goes down just fine but I no longer feel comfortable eating lots of carbs if I'm not about to burn them up.
    I don't believe that any discussion about diet is really relevant without including levels of activity.
     
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