Who’s to blame ?

[Jaylee]

It doesn't have to put you into a deficit. You can be in deficit if you want to, you can eat to your BMR (don't get me started on BMR calculators!), or you can forget calories completely and just eat to levels your body indicates it needs through hunger/appetite/fullness.

For me personally, I combine a bit of all three approaches, depending on what I'm doing that day, how I feel, and a few other factors.

I don’t buy into calories.

The app for pre ordering at the canteen at my old place of work really wagged fingers at me for a man’s daily allowance..
that was just a mid morning break, brunch. I don’t do breakfast on waking. Too busy correcting a liver dump with insulin. That’s my “breakfast.”
I count the carbs of course. That is my focus staying “rubber side down” with insulin.
It’s like MPG on a car which from what I remember is an average of 68 MPH?
Baloney. Other factors like tire pressure, payload weight, engine maintenance.. Even the “drag” going uphill?

Life is not a test track..

 

[Lamont D]

My own view on counting stuff is irrelevant for me!
I have had lactose intolerance since very young, as others have had food allergies and such.

What most T2s have is a dysregulation of blood glucose levels. That means, that you have a bit less tolerance to carbs and sugars amongst other dietary ingredients. Which for some should be a warning that restrictions of these intolerant foods should be part and parcel of a balanced diet designed by you for you!
And of course meds that will help with your individual medical treatment.

In my case, I have near total intolerance to carbs and sugars. And the same advice pertains to lactose intolerance or say, a peanut allergy, you have to avoid them.

If you get your balanced dietary regime right. Then you should see an improvement in your health and the hba1c levels and fasting BG levels should respond to it and n time return to hear normal levels range!

We all need individual treatment, we need to find a way to improve health. Food is an important part of that.
Be careful how you approach it.

 

[Paul_]

I don’t buy into calories.

The "calories in, calories out" model (CICO) relies on someone knowing their BMR (I did warn you not to get me started, now you pay the price with having a long post in reply! ). BMR calculators I've tried (and I've tried a lot of them) give me a result range of 2100 to 3100. Then you need to calculate exercise calories somehow, so people use a fitness tracker, but most of these overestimate the calorie burn of most activities. People end up with an incorrect BMR, by as much as +1000 calories, which they're then using when adding inaccurate exercise calorie burn.

Now I'm a bit of a data geek. What I can say from the past 3 months on keto is that if I consume 2000-2200 calories per day, I maintain my weight. If I consistently eat over that, I gain weight. If I eat between 1500 and 1900, I lose weight at varying rates (also influenced by other factors in terms of that rate). Interestingly, when I remove calories from view in my app and eat to my body's cues, I generally consume between 1500 and 1800 calories per day.

CICO has some merit, however it's detrimentally flawed by the problem that invalidates so many models for all sorts of things - Garbage In, Garbage Out. Without 3 months of data like I have, or scientific equipment/tests for measuring BMR, most people don't have any hope of ever getting the numbers needed to base a successful diet on.

 

[Fenn]

I'll get flamed for saying this on here but I'm going to say it anyway. The OP is T2 so without medical qualifications I'd probably say a keto diet is ok. But this is why I left this forum for many months: keto is a fad diet. I'm sticking to that. From what I've read people (with T2) can have great success with it. Good. Ketosis, however, can be deadly for people with other types of diabetes. These people on Reddit are idiots

I’m not sure what flamed means but deadly for T1? Can injecting too much insulin be deadly? Too little? Running high sugars? Well those were all things I did before keto, keto has been fantastic for me, my blood sugars are amazing and my insulin use has been drastically reduced, it has been ages since I was hypo. Life changing is the best thing since….. nevermind

Is fad a different way of saying “it’s too hard for me”? Is it for everyone? No! am I touchy about people bad mouthing keto? Yep! Let people try it and decide for themselves without “it can be deadly” comments (advice? Lol)

 

[plantae]

I don't think anyone is going to have a go at you for the way you've expressed your concerns here. I don't agree with your concerns, as some other replies have outlined, but expressing concerns in the way you have shouldn't be an issue.

As for keto being a "fad" diet, I don't think the high level principles of it are a fad (they're actually based on a significant amount of science imo), but some of the lower level aspects that some elements of the keto community promote definitely are in my opinion. These lower level aspects generally have zero science to support them, for example extended fasts for a week or more, or water fasts which are just outright dangerous without very specific knowledge and monitoring. However, keto generally, from a stance of limiting carb intake and reducing processed foods to a minimum, is a sound dietary approach in my view.

Not many people agree with my view and I won't mention it again after this. I know people on here have had great success with Keto and that's great.

From https://en.wikipedia.org/wiki/List_of_diets#Fad_diets

"Keto" or ketogenic diet (but for the purpose of weight loss instead of epilepsy seizures reduction)[71][104][105]:

A 2020 review looked at a very low carbohydrate ketogenic diet that was high in fat but low in protein. It found that it was an effective means for weight loss in those who are overweight or obese, yielding an average weight loss of 10 kg over four weeks, with maintenance of the weight loss for up to two years. However, concerns about serum sodium levels led the authors to propose the diet only be used in "selected" people, and under strict medical supervision.[74]

In 2021 the American Heart Association issued a scientific statement on dietary guidance to improve cardiovascular health which noted that "there is insufficient evidence to support any existing popular or fad diets such as the ketogenic diet and intermittent fasting to promote heart health"

Since anyone can edit Wikipedia perhaps we should. We could add "diabetes control" to the list of exceptions, for example, but I can't find a reliable source

I knew I shouldn't have mentioned it but those are not my words although I may edit it later today

 

[plantae]

Is fad a different way of saying “it’s too hard for me”? Is it for everyone? No! am I touchy about people bad mouthing keto? Yep! Let people try it and decide for themselves without “it can be deadly” comments (advice? Lol)

I didn't mean to bad mouth people, I was referring specifically and only to a diet (not people who choose to follow it). My deadly comment wasn't hyperbole

 

[plantae]

I’m not sure what flamed means but deadly for T1? Can injecting too much insulin be deadly? Too little? Running high sugars? Well those were all things I did before keto, keto has been fantastic for me, my blood sugars are amazing and my insulin use has been drastically reduced, it has been ages since I was hypo. Life changing is the best thing since….. nevermind

Is fad a different way of saying “it’s too hard for me”? Is it for everyone? No! am I touchy about people bad mouthing keto? Yep! Let people try it and decide for themselves without “it can be deadly” comments (advice? Lol)

I don't know the biochemistry well enough to give a reasonable answer. I'm responding to @Antje77 as well here so am keeping this response kind of general. I tried the keto diet (even though it's classified as a fad diet unless for epilepsy control under medical supervision, and don't blame me for that label please, it's what the literature says). For the last year I've eaten low carb (mostly less than 70g carbs a day) but have recently started having sandwiches again for lunch. I didn't find anything too hard, in fact I found it very easy because I don't like foods heavy with carbs in general. The problem I encountered, and not everyone will encounter this I suppose, is that I monitor my ketones as well as BSL. BSL except for the last few week has been 98% TIR. My problem was that ketones were consistently in the 2.0 mmol/L range even though BSL was ok -- say 6.0 because that's my average. Now, most of what I read says that you have to have high BSL as well as high ketones (2.0 is high-ish) for DKA to become a problem, but is that true? My endo certainly didn't like my ketones being 2.0ish. I did specify that this probably isn't an issue for T2s. I was on fixed doses of insulin for a while and that may have influenced things, I don't know. But when the issue of elevated ketones came up I was not on fixed doses and my BSL was normal. Nearly everything I read suggests that DKA is only a problem if both BSL and ketones are high, but is that true?

 

[Paul_]

Not many people agree with my view and I won't mention it again after this. I know people on here have had great success with Keto and that's great.

From https://en.wikipedia.org/wiki/List_of_diets#Fad_diets





Since anyone can edit Wikipedia perhaps we should. We could add "diabetes control" to the list of exceptions, for example, but I can't find a reliable source

I knew I shouldn't have mentioned it but those are not my words although I may edit it later today

Despite my enthusiasm for low carb generally, and keto specifically, I get some of what you're saying in regards to the fad diet thing.

When I come here to this forum and see the practical side of low carb / keto, it's not a fad in my opinion. It's a very practical, I'd argue simpler, approach to blood glucose management and weight loss, focusing on the high level low carb / keto principles - some of which most diets recommend and even some medical bodies (e.g. reducing processed foods).

When I go to Reddit, wider social media, or keto specific forums/sites on the internet, I completely see some of what you're saying. Everyone thinks they're a doctor on these resources. Everyone thinks they have simple answers to complex medical conditions and these simple answers are always an indicator of the poster's bias and personal preferences. There's out and out dangerous advice posted every day, people attempt to diagnose without any medical qualification at all, they idolise specific "doctors" who promote agendas that suit people's bias without any relevant medical qualification in said area (I'm talking the Dr Berg types here - the scientologist chiropractor who claims to be an expert on cholesterol and cardiac issues), and there's a general preaching of keto "mantras" in response to any given condition/issue/problem. I'd go one further than "fad" to describe keto when it's discussed on these platforms - it's a cult. Deviation from the keto purists' dream or keto doctrine is punished with aggressive replies, or cries of "you need to watch [insert unqualified "doctor" name here] and stop being a sheep!" 80% of what I see posted on these platforms is prime fad diet territory - claiming simple solutions, promoting unsustainable methods/practices, and doing so with little/no scientific basis or benefit.

 

[plantae]

Despite my enthusiasm for low carb generally, and keto specifically, I get some of what you're saying in regards to the fad diet thing.

When I come here to this forum and see the practical side of low carb / keto, it's not a fad in my opinion. It's a very practical, I'd argue simpler, approach to blood glucose management and weight loss, focusing on the high level low carb / keto principles - some of which most diets recommend and even some medical bodies (e.g. reducing processed foods).

When I go to Reddit, wider social media, or keto specific forums/sites on the internet, I completely see some of what you're saying. Everyone thinks they're a doctor on these resources. Everyone thinks they have simple answers to complex medical conditions and these simple answers are always an indicator of the poster's bias and personal preferences. There's out and out dangerous advice posted every day, people attempt to diagnose without any medical qualification at all, they idolise specific "doctors" who promote agendas that suit people's bias without any relevant medical qualification in said area (I'm talking the Dr Berg types here - the scientologist chiropractor who claims to be an expert on cholesterol and cardiac issues), and there's a general preaching of keto "mantras" in response to any given condition/issue/problem. I'd go one further than "fad" to describe keto when it's discussed on these platforms - it's a cult. Deviation from the keto purists' dream or keto doctrine is punished with aggressive replies, or cries of "you need to watch [insert unqualified "doctor" name here] and stop being a sheep!" 80% of what I see posted on these platforms is prime fad diet territory - claiming simple solutions, promoting unsustainable methods/practices, and doing so with little/no scientific basis or benefit.

I hope I haven't been misunderstood. I have no issue at all with low carb eating and until recently that is the way I ate (I now have two slices of bread for lunch most days so can't say I'm a low carb eater anymore, but until recently when I added the lunch sandwich to my diet I was definitely low carb. Apart from that bread at lunch I still am). I have no problem with that and think it's a good idea. What I have a problem with is the Reddittors who insist that you eat so few carbs that your body goes into ketosis. There's no (zero) evidence that getting most of your energy this way is beneficial except for certain medical conditions (e.g. epilepsy and under medical supervision) that I can find. Although I wasn't specifically aiming to be keto my daily intake of carbs was low enough that my ketones were at what my endocrinologist called a dangerous level. My BSL was normal. This is one reason I added bread back to my diet. I trust my endo more than I trust random people on Reddit. I've seen on this forum comments saying that as long as your BSL is normal it doesn't matter what level your ketones are at but my endo says otherwise and I believe him and even if I didn't believe him I can find evidence of it (euglycemic diabetic ketoacidosis). If people want to restrict their carbs then I think that's probably a good idea (I'm not a Dr). If people wan't to restrict them so much that they're following a diet called Keto then I will caution them that it's not without risks (I'm not a Dr). And I will call it a fad diet because that's what the literature calls it

 

[Paul_]

So to pick off a few points (you likely know, but more for any newbies reading the thread):

1) Low carb / keto while on medications with risk of hypos, or insulin - this should only be done with your doctor's full knowledge, monitoring, and medication dosage alterations to compensate for lower carb intake. It's not something I, or this forum that I've seen, recommends be done without that in place. I'd also add that I'd recommend anyone considering a drastic change in diet/lifestyle only do so with the full knowledge of their doctor.

2) Ketones - If you're in nutritional ketosis, generally speaking then ketones should be used by your body for energy. You shouldn't have a build up in your bloodstream as such because they're used as fuel when carbohydrate isn't a readily available dietary energy source. It's why the keto fanboys on Reddit, pushing that they test to see if they're in ketosis, are generally just wasting their money on urine strips and expensive blood monitors for ketones, then stressing that their levels are low. They're probably low because these people are in ketosis and their body is using ketones for fuel. However, if point 1 above is followed, this can monitor for any issues and catch any circumstances where this "general" rule doesn't apply to someone's physiology.

3) Benefits of nutritional ketosis - For me, the main problem here is misunderstanding the purposes of ketosis. Ketosis itself doesn't control blood glucose, or result in weight loss directly. Lowering carb intake helps control blood glucose, whether that's down to keto levels of intake is up to the individual. Ketosis helps lower appetite, so an indirect consequence is weight loss through lower overall consumption, plus fewer cravings for carb based foods. In addition, some studies have shown that the keto diet promotes visceral fat loss in the short term, which is important when it comes to conditions related to diabetes, e.g. fatty liver, insulin resistance, lower pancreatic function etc. Overall though, studies show that weight loss can be achieved on any diet, of any model, and longer term the initial benefits of keto on visceral fat are also seen on other diet models too. For me personally, the lower appetite and cravings in ketosis definitely help me to maintain my diet, weight loss, and blood glucose control.

Some links to studies/articles I've found (usual disclaimer - I'm not a doctor, nutritionist, or a scientist, my understanding may be incorrect):

Effects of the Ketogenic Diet on Glycemic Control in Diabetic Patients: Meta-Analysis of Clinical Trials - PMC

Introduction The ketogenic diet is a diet that relies on reducing carbohydrate intake to a minimum while increasing fat intake. This induces a state of ketosis where it is hypothesized to favor fat metabolism for energy instead of carbohydrates. The ...

www.ncbi.nlm.nih.gov

Long-term effects of a ketogenic diet in obese patients - PMC

Although various studies have examined the short-term effects of a ketogenic diet in reducing weight in obese patients, its long-term effects on various physical and biochemical parameters are not known. To determine the effects of a 24-week ...

www.ncbi.nlm.nih.gov

Ketogenic diets and appetite regulation - PubMed

The appetite suppressant effect of ketogenic diets may be an important asset for improving adherence to energy restricted diets and weight loss outcomes.

pubmed.ncbi.nlm.nih.gov

Effect of a ketogenic diet on hepatic steatosis and hepatic mitochondrial metabolism in nonalcoholic fatty liver disease - PMC

Ketogenic diet is an effective treatment for nonalcoholic fatty liver disease (NAFLD). Here, we present evidence that hepatic mitochondrial fluxes and redox state are markedly altered during ketogenic diet-induced reversal of NAFLD in humans. ...

www.ncbi.nlm.nih.gov

There are more, however these sum up the majority of what I found during researching keto.

Overall, as @Spirit01 has very eloquently outlined in posts on this thread, it's down to individual goals, motivations, and preferences as to whether a keto diet is suitable. Some may also have medical reasons and/or conditions that don't make it suitable. However, for many people, it can have some real benefits for glycemic control and weight management.

 

[Fenn]

I do unfortunately recognize myself in some of your non flattering comments, I have no idea what Reddit is nor do I look at any social media except this forum, I don’t have Facebook or twister etc but I am a fan of certain YouTube doctors (I won’t link my favourite as it proves you right about my cult lol) I suppose I believe so completely in keto (and fasting) that I am sensitive about it, is it possible I’m finding research that fits my personal experience? Yes, I will try harder to see a down side to keto despite myself.

 

[Jaylee]

I do unfortunately recognize myself in some of your non flattering comments, I have no idea what Reddit is nor do I look at any social media except this forum, I don’t have Facebook or twister etc but I am a fan of certain YouTube doctors (I won’t link my favourite as it proves you right about my cult lol) I suppose I believe so completely in keto (and fasting) that I am sensitive about it, is it possible I’m finding research that fits my personal experience? Yes, I will try harder to see a down side to keto despite myself.

A few years back I was listening to Steve Wright in the afternoon on digital at work. (Radio 2?)

He spoke of being T2 & his dietary change in passing. (Something about substituting with cauliflower.)
Lol, I was meant to be working….
One day he had Mary Berry on the show. She’d brought cakes. (That’s what she does celebrity baker.)
Long story.. she was also on some ancestry program where it transpired her great great grand father was also a baker supplying workhouses. He was accused of doctoring bread. Anyhow..

She’d brought cakes into the radio show for the crew & Steve Wright respectfully declined due to his T2.

Her response jaw dropped me.. paraphrasing she used the “F word.” “Oh I don’t believe in these fad diets…”

Looking up the definition of “fad.” Reveals similar results? https://dictionary.cambridge.org/dictionary/english/fad
Basically something picked up & dropped as a latest “thing.” Moving on to the next?

If low carb works for the individual & they have stuck with it achieving consistent positive results. Who can disparage with a flippant & misused definition of the F word..

 

[Paul_]

I do unfortunately recognize myself in some of your non flattering comments, I have no idea what Reddit is nor do I look at any social media except this forum, I don’t have Facebook or twister etc but I am a fan of certain YouTube doctors (I won’t link my favourite as it proves you right about my cult lol) I suppose I believe so completely in keto (and fasting) that I am sensitive about it, is it possible I’m finding research that fits my personal experience? Yes, I will try harder to see a down side to keto despite myself.

Sorry if my post was a bit blunt, didn't intend it to be, and I'm definitely not encouraging anyone to look unnecessarily for downsides.

Keto works very well for me, it's the best diet I've ever experienced by a mile. I've had a number of improvements to my health in the 3 months I've been doing it. However, my concern is that some keto communities are very prone to dismissing genuine concerns too easily. If some keto purists are to be believed, there's literally no downsides, only upsides, and every concern can be explained away. LDL cholesterol isn't dangerous, it's protective. Dietary fibre isn't needed, doesn't have any benefits, isn't related to colon health, and dietary sources of it are a scourge on human health. Steak is all you need for every nutritional need. Every problem can be solved by supplementing electrolytes, or reducing carbs even further. If you're at 0 carbs and are having issues, it's because you don't exclusively eat red meat and dared to eat fish or chicken. Exercise has no benefits, not even for mental health. I've seen all these lines pushed when it comes to keto. Meanwhile, the pro-keto doctors the keto "cult" link to make millions from ad-click views on YouTube, have books to sell, and electrolyte powders to punt for extortionate prices. Maybe these elements of the keto community are right, maybe I'm being overly cynical. I certainly don't subscribe to the traditional dietary/health advice on many topics, but it seems a bit of a push to believe everything that's claimed to counter keto concerns can all be correct/true. It's just too convenient for my liking and heavily supported by doctors with too much to personally gain, while in some cases having too little qualification or experience in the area they preach.

Ultimately, diet is a very personal thing. I've accepted the potential risks of a keto diet, benefitted so far from it, and I've put my concerns in the "I'll worry about it if I have to and blood tests show I should" pile. That's my choice. Some people might not want to do that though and I think the least we can do is understand that if the last 50 years has demonstrated anything, it's that health/diet/nutrition is far from being fully understood by anyone.

 

[RobynV]

Well, here's a puzzle for you. Not at my most recent visit to hospital but the time before I was put on the "diabetic menu". For breakfast I wasn't allowed to have the scrambled eggs that I ordered, they gave me porridge and orange juice instead. I was not allowed to have the roast beef for lunch that I'd ordered (I can't remember but I think they gave me potato salad or something). For dinner I was not allowed to have the chicken curry that I ordered, they substituted it with pasta in some kind of white sauce, a bread roll with margarine (butter is bad!) and creme brule for dessert. I kicked up a huge stink and got put back onto the normal diet so I could order low carb meals but it was a struggle. Who's to blame? First there is not supposed to be a "diabetic diet" in Australia -- we're meant to follow the normal dietary guidelines that every other person is supposed to eat. The problem there (and I studied nutrition at Uni so have read the guidelines many, many times) is that they're *very* high in carbs. One meal (e.g. yucky pasta in white sauce) is more carbs than I'd normally in a day. Everything is high in carbs. There is no RDI per se, but they suggest 65% of total daily energy to come from carbs. So, I've never followed the guidelines because I simply don't like platefuls of pasta, mashed potato, rice for breakfast, etc etc etc. So who's to blame? I don't know but I think the national guidelines have a lot to answer for

So true! I’ve tried to politely explain to my Oz GP that 65% carbs is strange. Even if they are ‘healthy whole grain types’. Humans have large brains and upright bodies from starting to eat more meat and fat. It was a huge evolutionary change. I appreciate the cultural tone of gentle and constant support of this forum; of being non judgemental. After a month of low carb I’ve lost some weight. I’m still learning which foods to reduce and which to avoid. I’ve changed the order I eat. As a child I ate (cheap cuts) of meat and 2 or 3 veg. Often including potatoes - mashed with butter and skins. Sweets were a treat. Still waiting for endo appt, and have other issues. I’m prepping myself for (more) poor advice. I’ve done a lot of pin prick tests. Too many! But it has been the best form of personal education. I’m going to try a cgm to see what’s happening at night. I hope I will be able to keep coping with diet only. But if not, I know I can find answers here; and diabetic meds are not the worst thing in the world.

 

[Spirit01]

I was watching TV this morning and they were showing how Kendal cake is made. Oh my days, that stuff has to be diabetes in a bar if you eat it regularly. I’ve had a lovely beef stew for 2 days now and have to confess I just had to have a couple of small dumplings but there was lots of veg. I had to smile because I remember my dear mum, Nan, aunties saying about meat pudding, dumplings, and anything made with flour & suet “eat up boy, you need to eat stuff that will stick to your chest”. Ah bless them lol. I can’t think I ever knew exactly what it meant but as I got older it certainly stuck to my waist

 

[Antje77]

they were showing how Kendal cake is made. Oh my days, that stuff has to be diabetes in a bar

Please don't blame particular types of food for causing diabetes by referring to them as 'diabetes on a plate'.
For the majority of people, who aren't prone to develop diabetes, they can handle carbs quite well, and they may live to a ripe old age without a hint of blood sugar issues on a carb heavy diet with the regular addition of sugary treats.

We have enough people believing we're all to blame for our own diabetes by indulging in sweets, no need to promote this belief ourselves.

 

[Spirit01]

Please don't blame particular types of food for causing diabetes by referring to them as 'diabetes on a plate'.
For the majority of people, who aren't prone to develop diabetes, they can handle carbs quite well, and they may live to a ripe old age without a hint of blood sugar issues on a carb heavy diet with the regular addition of sugary treats.

We have enough people believing we're all to blame for our own diabetes by indulging in sweets, no need to promote this belief ourselves.

Have you read the content of the whole thread or just picked up on this little bit ?

 

[Jaylee]

I was watching TV this morning and they were showing how Kendal cake is made. Oh my days, that stuff has to be diabetes in a bar if you eat it regularly. I’ve had a lovely beef stew for 2 days now and have to confess I just had to have a couple of small dumplings but there was lots of veg. I had to smile because I remember my dear mum, Nan, aunties saying about meat pudding, dumplings, and anything made with flour & suet “eat up boy, you need to eat stuff that will stick to your chest”. Ah bless them lol. I can’t think I ever knew exactly what it meant but as I got older it certainly stuck to my waist

Dumplings.. we called em through mum & older sister, “dough boys.”

Stodgy stew weights. Seemed like the size of a “scotch egg”:when I was a kid.. They were “gert lush,” back in the day..

 

[Spirit01]

Dumplings.. we called em through mum & older sister, “dough boys.”

Stodgy stew weights. Seemed like the size of a “scotch egg”:when I was a kid.. They were “gert lush,” back in the day..

Jam roly poly, plum duff, those were the days . I can’t remember the last time I tasted a steak & kidney pudding followed by a treacle pudding, delicious. Can’t touch it now but the occasional dumpling will certainly pass my lips. Nostalgia & humour is a wonderful gift that I fully embrace. Thank you for your lovely reply which made me chuckle

 

[Jaylee]

Have you read the content of the whole thread or just picked up on this little bit ?

I’m seeing a sense of irony? Once apon a time they where “balance” options.. (in the care free days.)
However. Metabolism was left out of the equation for some of us.

I also appreciate the “diabetes in a” motif.. it was (infamously) put on a coffee house receipt? from a derogatory employee. Reclaim “it.”

I get your comment..