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What is the evidence that the eatwell plate is wrong?

T

Tannith

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Where does the evidence come from that the eatwell plate - max 50% carbs max 35% total fat - is wrong? For normoglycaemics that is. American and Australian suggested proportions of macronutrients are similar.
 
Good question. Most ive seen has made an assosciation between rising levels of diabetes and higher carb intakes with reccomendations to lower fat intake but, and its a big but ( well a couple actually)
1) an assosciaaion is not proof, there are way too many possible variables at play
2) the assosciation that is drawn between rising diabetes rates and higher carb intake usually relates to highly processed, nutritionally poor and generally **** carbohydrates that come along with ****** trans fats
Dont think the eatweel plate said to eat 50% processed carbs
 
This is just my opinion. Those proportions of macronutrients for non diabetic people are generally ok.
I think that everyone would benefit from a lower carbohydrate intake and eating a less carb dependant diet for overall well being but trying to convince otherwise healthy people to change would be swimming against the tide.
 
Tannith said:
Where does the evidence come from that the eatwell plate - max 50% carbs max 35% total fat - is wrong? For normoglycaemics that is. American and Australian suggested proportions of macronutrients are similar.
Click to expand...

There's as little evidence that it is wrong for non Type 2's as there is that it is good for non Type 2's.
However from the anecdotal evidence that LCHF is better for so many Type 2's there's no reason to believe it wouldn't be good for everyone.
The reason the US UK and Australian diets are so similar is that the US used to lead the world in these kind of things (unfortunately).
Also it fairly clear that since this dietary advice was advocated the incidence of Obesity and Type 2 diabetes in the general population has rocketed even though it has also been shown that a large part of the popualtion do indeed follow the eatwell guidelines.
 
The ADA in USA have stopped recommending their version of Eatwell. They have also removed their objection to low carb diets, and now no longer specify any particular diet. It is clear that they see that the evidence for Eatwell is weak otherwise they would still advocate it for diabetics

http://www.ndei.org/ADA-nutrition-guidelines-2013.aspx.html
The following has submenu selection to view other aspects of the 2016 guidance e.g. lifestyle changes/
http://www.ndei.org/ADA-2013-Guidelines-Criteria-Diabetes-Diagnosis.aspx.html

The Eatwell plate is IMO probably perfectly suitable for anyone that does not have a metabolic disorder such as diabetes, thyroid issues, et al. But here in UK it is being phased out in favour of low carb diets in many other fields such as epilepsy treatment, cancer recuperation, some conditions of the elderly. Again, there are virtually no RCT studies that support Eatewell, but there are quite few supporting an LC diet (As I listed in another post/ recently) Again, the work done by Dr Unwin at his Stockport surgery shows that the NHS can save money by supporting diabetics in using an LC diet and stopping adherence to Eatwell. From memory their limited trial showed annual saving of about £20k. Their findings and report were posted on this site recently.

If someone is happy to use Eatwell then that is their choice, provided they are given a choice. What is wrong is that NICE PHE and DUK offer no choice, and mandate Eatwell to all patients regardless of need.

Edit to add that I forgot recent moves to include LC diet into CVD care by the BHF and the US equivalent organisation.
 
A lot more people have Type2 then before the eat well plate come in.
Yet a lot fewer people have cancer since "smoking is bad" come in.

As people are just as likely to keep to each set of advice, is it not reasonable to assume that advice that does not work is wrong......
 
Hi @Oldvatr
When Dr Unwin spoke at the Public Health Collaboration Conference in June last year, the practice savings he mentioned were around £40,000 annually. I haven't seen more recent figures, but i am sure they exist.
 
Brunneria said:
Hi @Oldvatr
When Dr Unwin spoke at the Public Health Collaboration Conference in June last year, the practice savings he mentioned were around £40,000 annually. I haven't seen more recent figures, but i am sure they exist.
Click to expand...
I can't remember the exact figures but all of the low carb doctors who spoke at PHC conference this year (Dr Unwin included) had the lowest spend per capita for diabetes care in their respective CCG's. If nothing else I would have though that this would lead the NHS to consider amending or at least being more flexible in their dietary recommendations.
 
ringi said:
A lot more people have Type2 then before the eat well plate come in.
Yet a lot fewer people have cancer since "smoking is bad" come in.

As people are just as likely to keep to each set of advice, is it not reasonable to assume that advice that does not work is wrong......
Click to expand...
It is possible to measure the reduction in smoking but nobody knows how many people really keep to the Eatwell guide. Certainly for some of the people on the DESMOND type course I attended, cutting carbs to the Eatwell guide would have been a major improvement.
 
Well it may be OK for normoglycaemics, but it looks pretty horrible for us 'abnormoglycaemics': I haven't actually seen much debate about it being bad for non-diabetics. If such a debate is taking place, I would imagine you could argue that training people, especially those who need to be concerned about their weight and diet, to rely primarily on saccharides for nutrition and health is wrong enough to merit concern.
 
Brunneria said:
Hi @Oldvatr
When Dr Unwin spoke at the Public Health Collaboration Conference in June last year, the practice savings he mentioned were around £40,000 annually. I haven't seen more recent figures, but i am sure they exist.
Click to expand...
Dr Unwin used the low carb diet as a REDUCING diet. He recommends replacing starchy carbs with fruit & veg. He does not recommend replacing the calories from carbs with calories from extra fat, so presumably the fat proportion of the diet doesn't change. The calories lost from the lower carbs would produce the weight loss. This gives a slower version of the ND as it is based on removal of some food (starchy carbs) with no replacement with extra fat. If carbs are replaced with fat, weight loss will presumably not occur, so the element of reduction of liver fat, which is what lowers the bgs, will not happen.
 
Tannith said:
Dr Unwin used the low carb diet as a REDUCING diet. He recommends replacing starchy carbs with fruit & veg. He does not recommend replacing the calories from carbs with calories from extra fat, so presumably the fat proportion of the diet doesn't change. The calories lost from the lower carbs would produce the weight loss. This gives a slower version of the ND as it is based on removal of some food (starchy carbs) with no replacement with extra fat. If carbs are replaced with fat, weight loss will presumably not occur, so the element of reduction of liver fat, which is what lowers the bgs, will not happen.
Click to expand...

I was referring to the financial savings made in the practice budget by reducing prescription costs.
 
Tannith said:
Dr Unwin used the low carb diet as a REDUCING diet
Click to expand...
Really? where did you get that from.. when I heard him speak I don't recall him mentioning calorie restriction at all. Also I don't think the man who refers to bananas as "sugar sticks" will be recommending that particular piece of fruit.
I replaced my carbs with fat.. lots of it and lost 8 stone.. so I'm afraid your theory doesn't quite stack up.
 
I was blessed with the eat well plate when I was diagnosed and it was recommended you eat porridge for breakfast. When I finally acquired my first meter and strips I found porridge was sending me to 15/16 and it was there a long time. Sticking to that level of carbs was also increasing my weight and everything else. I did a lot of reading, switched to moderate carbs first (about 40/50g daily) then VLC < 20g. My BGs came down , my weight came down by about 22 lbs currently , blood pressure normalised and cholesterol improved significantly. I improved to the extent that my meds were reduced.
I also feed my non diabetic family members a lot of the low carb things I cook and they tend not to notice other than they've lost weight too. My son and his wife have now gone VLC (non diabetic) and are doing really well with their weight.
I can honestly say if I'd stuck with the eat well version I'd be probably 3 sts heavier and on insulin. It certainly didn't work for me.
 
There is abundance evidence that the Eatwell plate is wrong.
please read my blog for a small proportion of the studies and references.

http://www.diabetes.co.uk/forum/blog-entry/a-unifying-theory-of-disease.1795/

In my view, it is a crime that Fasting Insulin is not tested for everyone. Everyone should also be notified that their fasting insulin range should be around the level of 2-6 iUI/ml . The current normal range is 2-25 yet above 9 is indicative or pre-diabetes in 80% of cases . it is truly pathetic that we have not realised this and started testing it. especially when the test clearly cannot be that difficult to do, given that both @bulkbiker and I managed it.

I believe that when the world chose Total Cholesterol as the main marker for monitoring personal health - it was pretty much a crime against humanity ( even though no doubt done with the best of intentions. ). Researchers have been trying and failing to prove that reducing Total Cholesterol does anything to improve all cause mortality for the last 30 years.

Had the world chosen Fasting Insulin as the number we should all know then personal health would look very different today, the world would be a fitter place and processed foods would not cause the health problems they currently do.
 
Tannith said:
Dr Unwin used the low carb diet as a REDUCING diet. He recommends replacing starchy carbs with fruit & veg. He does not recommend replacing the calories from carbs with calories from extra fat, so presumably the fat proportion of the diet doesn't change. The calories lost from the lower carbs would produce the weight loss. This gives a slower version of the ND as it is based on removal of some food (starchy carbs) with no replacement with extra fat. If carbs are replaced with fat, weight loss will presumably not occur, so the element of reduction of liver fat, which is what lowers the bgs, will not happen.
Click to expand...

You need to read the report.
<<<
The low-CHO diet
Participants were counselled by the GP and practice nurse about the clinical benefits of weight loss, making
an effort to link this with patients’ own best hopes for health improvement. A diet sheet was provided (see
Box 1 in Unwin, 2014) containing a brief explanationof the low-CHO diet as a possible weight loss strategy by reducing dietary sources of sugar; in particular, high-starch foods, such as bread, pasta and rice.
Weighing of food or calorie counting was not advised as this was thought to be less sustaina ble (Ogden and
Wardle, 1990). In place of carbohydrate-rich foods, an increased intake of green vegetables, whole-fruits, such as blueberries, strawberries, raspberries and the “healthy fats” found in olive oil, butter, eggs, nuts and full-fat plain yoghurt were advocated.>>>>

That last sentance shows it is not an LF diet, and has increased fat.intake. He does not say it is LCHF, thats true, but in essence it is compatible. The HF part of LCHF is to provide energy for fat burning, which requires a VLC diet, which there is no evidence that the study requires participants to go keto, so large intake of fat is not necessary. In that case, a sub 130g carb diet will use fat to increase weight as described under LCHF diet guidelines, as you describe in your post. This is perfectly compatible with LCHF, and is a technique I use myself too.

Not everybody needs to go full keto, It is a matter of choice.
 
Brunneria said:
I was referring to the financial savings made in the practice budget by reducing prescription costs.
Click to expand...
I can only go by what I see published, and I did not attend the symposium The text in the study report is

<<<
This may explain why our practice is the only one in the Southport and Formby CCG to have static diabetes drug costs for 3 years running, generating savings of approximately £20 000 per year.>>>>>

If they actually succeeded in saving more then it must be reported somewhere, but I have not seen it. The report is an approx value so could be updated as you say.

Edit: it may be the £40k figure is the savings made since the trial ended, which was about 2 years ago.
 
bulkbiker said:
Really? where did you get that from.. when I heard him speak I don't recall him mentioning calorie restriction at all. Also I don't think the man who refers to bananas as "sugar sticks" will be recommending that particular piece of fruit.
I replaced my carbs with fat.. lots of it and lost 8 stone.. so I'm afraid your theory doesn't quite stack up.
Click to expand...
Agree. It is possible to run an LC diet that lowers bgl and loses weight due just to the glucogen store depletion, and the use of Keto to reduce adipose fat around the liver is another thing entirely. There are other LC diets that could be followed, and not all roads lead to LCHF.

In actual fact, the team were surprised that the low carb diet seems to lower NAFLD before the weight loss kicked in, as evidenced by an ultrasound scan perfomed on one patient (n=1) so it seems an LC diet works in parallel to reduce bgl levels, weight loss, and reduce NAFLD. There was no claim made for reversal and the report shows that follow up found that patients who managed to keep their weight off also kept bgl low, but this indicated an element of control, not cure. The report also shows that the lipid markers generally improved even in the presence of higher fat intake which they mention as being reassuring.
 
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