Warning: new NHS 'Living with Type2 Diabetes' web page

[ianf0ster]

More bad advice coming from official sources:

https://twitter.com/i/web/status/1743217756269400334

 

[JoKalsbeek]

I don't understand how they can help people pay for the program here, and still insist carbs are fine elsewhere...

 

[AlexMagd]

They're not wrong about there being no cure (yet), but that carb advice is pretty terrible.

I wonder if they're still giving the "no need to test if you're T2" advice I got when I was diagnosed.

 

[Rachox]

Where’s the eye rolling reaction emoji when you need it?!

 

[BigAlan]

I don't understand how they can help people pay for the program here, and still insist carbs are fine elsewhere...

The power of the high carb / low fat / ultra processed food lobby.

 

[zand]

My surgery gave me a good low carb leaflet at my last review. It even mentioned a link to a keto site. I'm glad some doctors have finally seen the light, pity the NHS official advice hasn't kept up.

 

[HairySmurf]

I don't understand how they can help people pay for the program here, and still insist carbs are fine elsewhere...

Nobody questions that a low carb diet is ideal for managing diabetes, however diabetes is just one of a huge number of medical conditions that are associated with diet. A low carb diet must be high in protein or high in fat, or both, otherwise you starve to death.

Imagine a world in which the information in the following article is true, complete and impossible to argue with. This relates to a recent study, published in the Journal of Internal Medicine, which is based on data relating to the lifestyles and deaths of 371,159 people going back to the 1990s. I'd link the actual study but it's behind a paywall and I'm not going to pay for it:

Low carb diets INCREASE your risk of an early death

Harvard University, in Cambridge, Massachusetts, researchers were a part of a study that compared whether low fat or low carb diets could expand a person's lifespan.

www.dailymail.co.uk

Now imagine there was a pill you could swallow in that world which permanently cures Type 2 Diabetes. The pill will take six months off your lifespan if you swallow it.

In that world, would you choose a low carb, high fat diet and hope for the extra six months of life? Or would you take the pill and eat a diet that was associated with the longest projected lifespan?

This isn't the world we live in of course, we live in a world where even the finest specialist doctors disagree and argue about the best course of treatment for a single medical condition. Official advice from an organization like the NHS, which is responsible for the health of an entire country, is always going to be a compromise between many competing viewpoints and based on constantly changing, imperfect information. It's medical advice by committee.

*edited for typos

 

[MrsA2]

In that world, would you choose a low carb, high fat diet and hope for the extra six months of life? Or would you take the pill and eat a diet that was associated with the longest projected lifespan?

To me it's not about the length of my life, but the ability to live whatever duration I have with my eyesight and all my limbs, and with a sufficient level of mobility and cognition to enjoy it

 

[JoKalsbeek]

Nobody questions that a low carb diet is ideal for managing diabetes, however diabetes is just one of a huge number of medical conditions that are associated with diet. A low carb diet must be high in protein or high in fat, or both, otherwise you starve to death.

Imagine a world in which the information in the following article is true, complete and impossible to argue with. This relates to a recent study, published in the Journal of Internal Medicine, which is based on data relating to the lifestyles and deaths of 371,159 people going back to the 1990s. I'd link the actual study but it's behind a paywall and I'm not going to pay for it:

Low carb diets INCREASE your risk of an early death

Harvard University, in Cambridge, Massachusetts, researchers were a part of a study that compared whether low fat or low carb diets could expand a person's lifespan.

www.dailymail.co.uk

Now imagine there was a pill you could swallow in that world which permanently cures Type 2 Diabetes. The pill will take six months off your lifespan if you swallow it.

In that world, would you choose a low carb, high fat diet and hope for the extra six months of life? Or would you take the pill and eat a diet that was associated with the longest projected lifespan?

This isn't the world we live in of course, we live in a world where even the finest specialist doctors disagree and argue about the best course of treatment for a single medical condition. Official advice from an organization like the NHS, which is responsible for the health of an entire country, is always going to be a compromise between many competing viewpoints and based on constantly changing, imperfect information. It's medical advice by committee.

*edited for typos

I'm probably missing the point because I have a rather full mind that the moment: I'm likely to start on medication that could vastly improve my quality of life, after almost 4,5 decades of living in sheer misery, but it could possibly shave years off of my heart functioning, and it doesn't function well to begin with. Would I make a 6 month sacrifice to eat whatever? No. Because I've seen what my bloodwork tells me. Low carb, high fat fixed my diabetes, fixed my non alcoholic fatty liver disease, my cholesterol is fine.... All's good, in a plethora of areas. I wouldn't trade that for being able to eat spuds and cake. I miss high tea's, yeah, and I should've indulged more when I could way back when, but that's come and gone. Some things are worth sacrificing time for. Some, aren't, when there are perfectly fine other ways that suit one's lifestyle, health and needs.

I was just wondering why a place that has conceded low carb works, and works well, still says it also doesn't at the same time. It sends out mixed signals and those really, really are unhelpful to the newly diagnosed. There's many options for treatment, low carbing is just one of them. Ah well. I should get myself in gear, lots to do to day. Sorry for being thick.

 

[catinahat]

I was just wondering why a place that has conceded low carb works, and works well, still says it also doesn't at the same time.

I think this is because the people at the top of all our organisations, including the government. Never admit that there is the slightest possibility, that maybe, just maybe, they have got it wrong.
The recent Post Office scandal is a prime example of the way they will do anything to cover up their own failings, without a thought of how their actions impact people's lives.

 

[Outlier]

Also we can bear in mind that it is very difficult to prove a negative. Nobody knows when anyone is going to die, including themselves. I therefore take a politely jaundiced view of any asserting that this or that will shorten/lengthen lifespan. It isn't a holistic view - we are more than our illness(es) and for many of us, we are more than one illness.

 

[HairySmurf]

I'm probably missing the point because I have a rather full mind that the moment: I'm likely to start on medication that could vastly improve my quality of life, after almost 4,5 decades of living in sheer misery, but it could possibly shave years off of my heart functioning, and it doesn't function well to begin with. Would I make a 6 month sacrifice to eat whatever? No. Because I've seen what my bloodwork tells me. Low carb, high fat fixed my diabetes, fixed my non alcoholic fatty liver disease, my cholesterol is fine.... All's good, in a plethora of areas. I wouldn't trade that for being able to eat spuds and cake. I miss high tea's, yeah, and I should've indulged more when I could way back when, but that's come and gone. Some things are worth sacrificing time for. Some, aren't, when there are perfectly fine other ways that suit one's lifestyle, health and needs.

I was just wondering why a place that has conceded low carb works, and works well, still says it also doesn't at the same time. It sends out mixed signals and those really, really are unhelpful to the newly diagnosed. There's many options for treatment, low carbing is just one of them. Ah well. I should get myself in gear, lots to do to day. Sorry for being thick.

My question about the magic pill isn't about eating spuds and cake, it's about lifespan and overall health. If it were a completely established, unarguable fact, according to the medical community, that a low carb, high fat diet would kill you faster than taking the magic pill, how strong would your faith in the LCHF diet be?

At present the data, imperfect as it is, seems to say that a low carb diet is a great way to lose weight fast while keeping blood glucose under control, but also says that it's a terrible diet to eat for the rest of your life. T2 diabetes causes a range of awful health conditions over the long term, but, it would seem, so does eating a high fat diet. You mention that your cholesterol is fine, but it is the same kind of medical science that tells you what a fine level of cholesterol is that also tells you that a high fat diet is unhealthy.

It would seem that the NHS is happy to support a low carb diet program that is specific to T2 diabetes. It would seem that it also believes (to the extent that an organisation can 'believe' anything) that it is better to take medication in the long term and keep fat intake low than it is to control T2 diabetes using diet alone, if that diet must be very high in fat to get the job done. A low carb diet can be good, and bad, at the same time.

Best of luck with your new medication. I hope it works out extremely well for you.

 

[LittleGreyCat]

Follow the money.

If there is a choice between a pill and a lifestyle change the medical community will back the pill and the patient should seriously consider the lifestyle changes.
Drug companies live by selling drugs.
They also fund much of the medical community.

A different "just consider this".
If there was a drug to permanently cure T2 in one dose, how likely is it that the drug companies would actively market this?
It would cost them an absolute fortune.

Consider also if there is a recommendation to avoid all ultra processed foods, limit oneself to fresh above ground vegetables, fats and protein, how much support the food industry would give this?
How many aisles in the supermarkets would magically disappear?

Don't be surprised then when mainstream charities seem reluctant to recommend what we regard as obvious.
I raise the issue with DUK from time to time.
Latest response is "We are looking at it but the jury is still out."

 

[HairySmurf]

A different "just consider this".
If there was a drug to permanently cure T2 in one dose, how likely is it that the drug companies would actively market this?
It would cost them an absolute fortune.

Which drug company? They are competitors. They seek profit on behalf of their shareholders and seek to steal market share from one another.

Guaranteed, like 100% guaranteed, in the real world we live in, if a drug company that does not have a very profitable Ozempic equivalent drug on the market could develop and sell a single dose cure for T2 and charge whatever they like for it, they would do it. They would race to do it and try to patent it.

It would be staggeringly profitable, raise their share price to ridiculous highs, and set them up with enough capital to develop more drugs for other medical conditions for decades. It's not as if there aren't plenty of other health problems out there to make more money off. We won't run out of illnesses to cure any time this century.

 

[daffy1]

Follow the money.

If there is a choice between a pill and a lifestyle change the medical community will back the pill and the patient should seriously consider the lifestyle changes.
Drug companies live by selling drugs.
They also fund much of the medical community.

A different "just consider this".
If there was a drug to permanently cure T2 in one dose, how likely is it that the drug companies would actively market this?
It would cost them an absolute fortune.

Consider also if there is a recommendation to avoid all ultra processed foods, limit oneself to fresh above ground vegetables, fats and protein, how much support the food industry would give this?
How many aisles in the supermarkets would magically disappear?

Don't be surprised then when mainstream charities seem reluctant to recommend what we regard as obvious.
I raise the issue with DUK from time to time.
Latest response is "We are looking at it but the jury is still out."

How I agree with this. I have constantly been told I eat two few carbs and will suffer muscle wastage . But when I go on the advice of a diabetic dietician who insists I have porridge with double cream on a morning and I tell her that would make me high for most of the day. She basically tells me I’m talking rubbish and they will come down in 2 hours. They don’t.
It would be interesting if clinical tests were done in a residential setting over a month with one lot following the higher carb and the other following low carb that most diabetics follow and comparing the results

 

[ianf0ster]

Nobody questions that a low carb diet is ideal for managing diabetes, however diabetes is just one of a huge number of medical conditions that are associated with diet. A low carb diet must be high in protein or high in fat, or both, otherwise you starve to death.

Imagine a world in which the information in the following article is true, complete and impossible to argue with. This relates to a recent study, published in the Journal of Internal Medicine, which is based on data relating to the lifestyles and deaths of 371,159 people going back to the 1990s. I'd link the actual study but it's behind a paywall and I'm not going to pay for it:

Low carb diets INCREASE your risk of an early death

Harvard University, in Cambridge, Massachusetts, researchers were a part of a study that compared whether low fat or low carb diets could expand a person's lifespan.

www.dailymail.co.uk

Now imagine there was a pill you could swallow in that world which permanently cures Type 2 Diabetes. The pill will take six months off your lifespan if you swallow it.

In that world, would you choose a low carb, high fat diet and hope for the extra six months of life? Or would you take the pill and eat a diet that was associated with the longest projected lifespan?

This isn't the world we live in of course, we live in a world where even the finest specialist doctors disagree and argue about the best course of treatment for a single medical condition. Official advice from an organization like the NHS, which is responsible for the health of an entire country, is always going to be a compromise between many competing viewpoints and based on constantly changing, imperfect information. It's medical advice by committee.

*edited for typos

In my opinion, you are wrong:

1. There are medical researcher around who still believe that dietary fat causes Type 2 Diabetes.
2. Dr David Unwin's has published that his low carb T2 and T1 patients actually have improved kidney function on Low Carb despite eating more protein (and fat). I have not heard of any diet related disease that low carb makes worse, in fact it improves nearly all of them as well as many diseases thought to have no link to diet (such as depression).
3. Since low carb improves health across the board, how can it simultaneously shorten lifespan?
4. A certain Walter Willett of Harvard is well known for publishing studies based on food surveys, the results of which supposedly support veganism. On closer examination they either don't or are at best not statistically sound. In the worst cases the actual results and the written summary are diametrically opposed!

 

[Resurgam]

Following my GP printout high carbohydrate low fat diet, I was unable to even pick up a knitting machine. I was hugely fat, using sticks to get around.
Now I am able to do the University knitting machine service again, I do over 30 machines in a week and get a nice bit of money to go on holiday to a week long folk festival in Sidmouth.
Several times I have started conversations with 'They are lying to you. I don't know why they should, but that advice could kill you.'

 

[HairySmurf]

In my opinion, you are wrong:

1. There are medical researcher around who still believe that dietary fat causes Type 2 Diabetes.
2. Dr David Unwin's has published that his low carb T2 and T1 patients actually have improved kidney function on Low Carb despite eating more protein (and fat). I have not heard of any diet related disease that low carb makes worse, in fact it improves nearly all of them as well as many diseases thought to have no link to diet (such as depression).
3. Since low carb improves health across the board, how can it simultaneously shorten lifespan?
4. A certain Walter Willett of Harvard is well known for publishing studies based on food surveys, the results of which supposedly support veganism. On closer examination they either don't or are at best not statistically sound. In the worst cases the actual results and the written summary are diametrically opposed!

This will be my last post on this thread as I don't want to argue, I just wanted to express my opinion on why NHS advice is formulated the way it is, as best I can. To your points (and I'm absolutely not an expert):

1: Yes, and I believe, depending on what stage you choose as the starting point in the cascade of issues that leads (in most cases) from healthy with a normal appetite to hungry and insulin resistant to Type 2 Diabetes, they may be partially right. I don't know of anyone who feasts on dry white bread. Starch, by itself, isn't something that people tend to eat to excess. Spread a little butter on the bread and it's appeal increases. Add sugar to the mix, say in the form of a pizza - starch in the base, sugar in the sauce, fat in the cheese and some more fat and sugar in the goodies on top that add deliciousness and suddenly you have a food that people tend to overeat in a massive way. Speaking for myself, I would consume a whole lot of calories in one sitting if I was eating pizza. I believe that neither starch nor fat, by themselves, have that effect on appetite and satiety.

2 and 3: Off the top of my head, how about bowel cancer. How many tens of thousands of this doctor's patients have lived long enough to die of cancer and how do those rates compare with the average? We don't know, we can't know, the sample size is too small and not enough time has passed since they started the diet to know for sure. (assuming this doctor you mention is currently practicing).

 

[Kernow Debra]

Well worth a read, when you see who actually had input to the Eatwell guide.
The mind truly boggles!

Because it has NHS/ Public Health England backing, you’d hope it was designed by nutritionists, dieticians etc.

Eatwell Guide – conflicts of interest – Zoë Harcombe

www.zoeharcombe.com

 

[ianf0ster]

Just to clarify:
There is no evidence that people eating Low Carb have any higher incidence of bowel cancer.
The idea that fibre is required for a 'healthy bowel' appears to be a myth, since transit of carnivore food takes less time and is more completely digested than is vegetable foods.
So far as the cancer itself, numbers far too small to be of significance, but:
Both my brother and I have a pre-cancerous bowel condition (MYH Associated Polyposis). I eat low carb, he doesn't. I (as yet) have no bowel cancer, he's had his whole colon removed because of bowel cancer.