yogurt

Lufc,

I'm not sure where you get the idea of "a stupid amount of sugar" from. If I can try to put it in a way that won't do your head in, all carbohydrates convert to glucose in your blood and so raise your blood glucose level. Some carbohydrates are slow acting so convert to glucose over a period of time, others are fast acting and convert to glucose quickly. But all forms of sugar (sucrose, fructose, lactose and sugar alcohols) are already glucose so will raise your blood glucose immediately.

This is why it is so important that a diabetic should look not just at what the sugar content is of any food, but what the carbohydrate content is. And it is very easy to be fooled by labels that say "low sugar" when all the manufacturer has done is to switch the sugar for something equally harmful.

Fat doesn't enter into it at all because fat has absolutely no effect on your blood glucose. Its just that some diabetics mistakenly think that they should be looking out for low fat foods (which won't help their diabetes at all) instead of low carbohydrate foods.

Because a lot of type 2's are also overweight they also look at low fats so that they can lose some weight.But,as Dennis says,it's the carbs that are important in diabetes. Losing the weight,especially around your middle,can help stabilise your blood sugars.

Knowledge is the key to control

Dennis having just gone onto Byetta am having a revamp on my knowledge base. The fats n sugars argument has never been fully explained. I picked up on your previous thread about sugars but why arnt fats so critical ?

Just picked this up on Dlife,might be of some use although it's US I think.

http://www.dlife.com/dLife/do/ShowConte ... ch_08.html

Knowledge is the key to control

David,

Fats aren't so critical because they have a negligable effect on your blood sugar. Carbs, and sugars are carbohydrates in their simplest form, will have the biggest impact on your blood glucose levels. Your blood sugar levels are the single most important guage of your control over diabetes of course.
Government advice took a bit of a wrong turn in the late 70's early 80's when people were advised to eat less fat because of concerns surrounding cholesterol and heart disease. The evidence is ambiguous at best, while there appears to be much that links excessive carb consumption with coronary risk factors - namely LDL, HDL and triglyceride levels.

In a nutshell, it's the sugars, not the fats we need to be wary of.

All the best,

fergusc

Hi Dennis,

Don't mean to sound dim but a bit confuse here. Is there any level that we should be checking ie 5g carb of which sugars per 100g or is it just the basic carb level that we need to check and if so what should that level be.

Hope this makes sense, not sure that it does now I've read it back, but maybe you get what I mean?

Michelle.

Hi David,

Fergus has said it all really, and is a shining example of how we can control BG levels by controlling carb intake. Can I recommend that you have a look at a book called "The Diabetes Solution" by Dr Richard Bernstein. In chapter 9 he explains brilliantly in layman's terms how fats and carbohydrates work. You may not necessarily agree with or want to follow the quite strict diet that he recommends, but the book is brilliant for just giving an understanding of how the 3 basic building blocks of protein, carbohydrate and fat interact and how they can be balanced to control diabetes.

Michelle, It is very easy to be confused about carbohydrates and sugar, and most people are! If you look back at earlier posts from newly diagnosed people you will see a common theme of "right, I've cut out sugar so I don't need to do anything else do I?" As Fergus said, sugar is just a carbohydrate in its simplest form. Imagine you want a yoghurt and there's only 2 left in the shop. One contains 35g carbohydrate of which 30g is sugar. The other contains 50g carb, of which 10g is sugar. Most people would go for the second one because it has much less sugar, but they should go for the first one because it is the carbohydrate count that is important, not the sugar. (Or better still don't buy either - have a couple of plums instead - only 9g carbs for the two!)
Does that answer your question?

Dennis, you spoilsport, I only have ONE Biccywix! The Tesco yog is Total 0% which according to the label is, per hundred gm: 52 kcal, carbs 4%, protein 9%, fat 0% & is made from skimmed cows milk & culture. Goes well in curry sauce too. Now if only I can crack the peanut butter code for satay, I will be made.<font face="Arial"></font id="Arial"><font color="teal"></font id="teal">

Whitemare

Hi, Fergusc.

Fats are important, not from an insulin point of view, but from a cholesterol point of view. Diabetics need low cholesterol, especially LDL which comes from animals. We need a certain amount of HDL which comes from plant oils like olive & rapseed oil. Our sticky sugary blood can't cope with the extra load, so switching from lard to oil makes sense: & when you are losing weight, limiting fats & oils, since they are high in calories, makes perfect sense.

Whitemare

Dennis - Fergus thanks for the insights. In a few short sentences i have gained more usefull info than any professional has been able to impart and in a manner that is digestible.

Now that im on Byetta the prospect of losing a few lbs is very real and worthy of some effort. Food intake is probably the hardest part!!

Hi Whitemare,

You've got the wrong end of a few sticks there, I'm afraid!

First of all, cholesterol is sooo yesterdays news. It's a very poor indicator of chd risk, I'm afraid. Not only that, but cholesterol isn't really ingested, it's mostly (75%) manufactured by the liver. In response to carbohydrates!
On the subject of which, you'll find that carbs simultaneously lower HDL and raise triglycerides, both of which will increase chd risk.

Incidentally, the link between lower cholesterol and increased cancer risk is much stronger than the link between cholesterol and heart disease.

Oh, and while I'm at it, the idea that you'll lose weight by limiting calories from fats and oils is just plain daft. Are we supposed to eat carbohydrates instead? That's the sort of thinking that's lead to low-fat diet's full of hidden starches and sugars which demand much more insulin and so DO cause people to gain weight.

All the best,

fergusc

Thanks, Fergusc, perhaps I was being a little simplistic. I was talking in the context of a balanced varied diet, rich in vegetables, limiting the carbs & fats to lose weight. But you do need a bit of fat - about one olive a day should do it - for vascular health.
Food science is an interest of mine, it's my work area.
Staying away from processed food & ready meals ( have you seen the hidden sugar & salt in some of these?) & eating fresh ingredients simply prepared is worth it in itself. You can get a delicious tomato sauce from fresh toms, canned toms & puree & it doesn't NEED the six tablespoons of sugar & three of salt in the commercial sauces. That's for effect, by the way, not off a label
Since my cholesterol levels seem to be okay, this approach is working for me.<font face="Arial"></font id="Arial"><font color="teal"></font id="teal">

Whitemare

Hi Fergusc and Whitemare,

I'd just like to second Whitemare here. You don't need to massively increase your carb intake in order to eat a low fat diet. And losing weight by cutting down on fat makes perfect sense! There are over twice the number of calories per gram in fat as there is in carbohydrate, and high fibre foods will fill you up as much as high fat foods will. And lets not forget that while a small amount of some fats are good for us, eg omega 3 found in oily fish, fat doesn't add any other nutritional value to our diets. Carbohydrates on the other hand, are full of vitamins and (buzz word) 'antioxidants'.

As for cholesterol, I'm not sure that I agree with you Fergusc, that cholesterol is last years news. LDL, or 'bad cholesterol' is raised in response to a high saturated fat intake. And HDL, or 'good cholesterol' is raised by high fibre intake. Exercise also has a positive affect on cholesterol ratios. As an independent risk factor it may not be a good indicator of heart disease, but when there is another risk factor present, eg diabetes, it becomes much more reliant. Heart disease is this country's biggest killer, and as diabetics we already have an increased risk of developing it. So why take the chance? Why not just cut down a bit on the fat? And yes, eat low fat yoghurt...

Best wishes
Michelle :wink:

Michelle, you are the breath of fresh air that I've been waiting for, however, you better start putting up the sandbags immediately!

Hi Michelle,

If I could just take you up on a couple of your points (no sandbags needed), "Carbohydrates are full of vitamins" - absolutely spot on. For example
Vit A - fruits and vegetables, including carrots, sweet potato, chili peppers, spinach, kale, spring greens, cantaloupe melon, mango, cabbage
Vit B1 - sunflower seeds, fruits, vegetables
Vit B2 - soy beans, broccoli
Vit B3 - grapenuts, peanuts, peanut butter, asparagus, almonds
Vit B5 - alfalfa sprouts, peas, lentils, mushrooms
Vit B6 - lentils, fruits (esp banana and prunes)
Vit C - fruits (like, blackcurrants, citrus fruits, guava, kiwi fruit, oranges, papaya, rosehips, strawberries) and lightly boiled or raw vegetables (like, red chili peppers, bell peppers, broccoli, Brussels sprouts, cauliflower, spring greens)
Vit E - soy beans, almonds, hazelnuts and sunflower seeds, fruits, avocadoes, sun-dried tomatoes, and leafy green vegetables
Vit H - nuts and fruits
Vit K - green tea, dark green leafy vegetables, skins of fruit and vegetables
The point is that nobody has ever suggested that you should not eat these, or eat less of them. They all contain sensible amounts of carbs, but also other beneficial things such as fibre and cis oils. The big problem is that we are constantly told by the "experts" to eat diets high in carbohydrate in the form of bread, pasta, potatoes and rice. All these will do is provide a carbohydrate overload, resulting in unnecessarily high blood sugars.

You also said "Heart disease is this country's biggest killer, and as diabetics we already have an increased risk of developing it. So why take the chance? Why not just cut down a bit on the fat?" Its not just in the UK this applies but also in the US. Sometime around 2005 the American Medical Association (in response to the huge increase in heart disease) commissioned Stanford University to undertake an independent year-long research into the relative merits of low carb/high protein, medium carb & protein and high carb/low protein diets, particularly with regard to the effects on cholesterol. Stanford was chosen because they are renowned for their impartiality - they refuse to accept commercial funding for any research they undertake.

Stanford used Atkins as the low carb diet, Zone as the mid range diet, LEARN the high carb diet, and Ornish as the extremely high carb and almost zero fat diet. The results were made public in 2007 and surprised many by showing that those on the low carb diet (Atkins) initially showed a rise in all lipids (LDL, HDL and Trigs), but by the end of the year they registered the greatest decrease in LDL and blood pressure and the greatest increase in HDL. It is this research that is now starting to change governmental thinking on what should constitute a balanced "heart-protective" diet and has lead the US to announce new guidelines that protein and carbohydrates should be eaten in equal parts. In the US government bodies are at last starting to realise that, when they have been advocating a national diet high in carbs and low in fats and proteins for the last 20 years, and throughout that period heart disease has been rising, perhaps they didn't really understand the mechanics of heart disease after all!!

Well said, Dennis.

Vitamins are probably worthy of a thread all to themselves, but I should say that A,D,E and K are all fat-soluble. Also, all vitamins, apart perhaps from E, B9 and C, are abundant in meat and dairy foods, so it's not as if carbs are essential from that point of view. So fats actually have a vital role in nutrition.

As for cholesterol, there's virtually no correlation between serum cholesterol and mortality rates. You're right that excercise will lower cholesterol, but it has many other benefits as well of course. We humans have a feedback mechanism which largely regulates cholesterol and its production by the liver. By far the most of the cholesterol in our bloodstream is actually manufactured in-house! Triglyceride levels are a much more informative measurement of vascular health. They closely match blood sugar profiles and are extremely elevated after a high carbohydrate meal. Fat and cholesterol is not responsible for high-risk lipid profiles in most people.

We all know that fat has 9 cal per gram compared to carbs and proteins 4 cal, which is why people are often told to reduce fat in order to save calories and thus lose weight. It seems to make sense when foods are burnt in a coloric bomb to see how much energy is there, but in reality it all falls apart when you introduce human hormones into the equation. Again, it's insulin response that is far more important. Insulin is also the primary regulator of fat metabolism in the body, and our metabolism becomes screwed up in the presence of excess insulin. Fats and proteins require very little insulin, while carbohydrates can demand an enormous insulin response.

Hypertension, elevated lipid profiles, increased cardiac risk factors and, of course, diabetes are often grouped together under the term 'metabolic syndrome' because they occur together so often. One of the most consistent markers for these conditions is abnormal insulin levels.
It's a common mistake, even amongst physicians, to believe insulin is responsible only for transporting sugar out of the bloodstream. In fact, it does a whole lot else besides, which makes it's careful regulation so important.

Anyway, you may have opened a lery low-carb can of worms!

All the best,

fergus

Hello,

I only mentioned the benefits of eating vegetables because it sounded to me that Fergus seemed to think that following a low fat diet means a diet “full of hidden starches and sugars”, which vegetables aren't, and are therefore a good substitute for other high fat foods (unless you happen to deep fry everything!).

I also find it confusing when 'experts' tell diabetics to base their meals on starchy carbohydrates, but I found reading more about glycaemic index (GI) really helped. And before you say it, I know that higher fat foods have a lower GI. But, sticking firmly to my belief that high fat foods are bad for you, this does explain that there are ways of reducing insulin response to carbohydrates without increasing the fat and protein content of your diet.

And thank you Dennis, for pointing the Stanford study out to me. While I'm still not convinced, my mind remains open...

Take it easy

Michelle

My daughter is only 9 and has just been diagnosed so we are new to carb counting as well. Asda yogurts are 19g which is good for the size of pot. We have found rosemary conelly scales really good as it works out the carb content for you especially usefull when labels are hard to understand.
Good luck.

Michelle, you're quite right. It's perfectly possible to eat a low fat diet while avoiding hidden starches and sugars. My concern was that eating a low-fat diet seems to be a core principle for so many people, without any persuasive evidence that it is beneficial to health. We can assume it's got to be healthier because dietary fat has been so demonised over the past three decades. Or can we?

Trouble is, all the evidence that seemed to implicate fat simultaneously ignored the effect on health of carbohydrate and protein. In other words, many studies have set out to prove this hypothsis rather than openly considering all the available evidence. All have failed.

The evidence is much firmer linking refined carbohydrates (flour, white rice, sugar) with all of the conditions referred to as metabolic syndrome. These deseases are absent in populations around the world until 15-20 years after the adoption of a Western diet.

My point was that 'low-fat' packaged foods lining the shelves of supermarkets are invariably higher in carbohydrate and so, rather than being protective against metabolic syndrome, perhaps actually exaccerbate it?

All the best,

fergus

Hi MIchelle,

Many thanks for your response, and for realising that I wasn't just having a go at your views. I can see that you have both a professional and personal interest in the subject so can I suggest that you do some research on Ancel Keys. He was the food guru who really started the whole thing about fatty foods being bad for you and therefore high carb must be the answer.

He was the Jamie Oliver of his day and had enormous influence with the US government at that time and they were prepared to accept whatever he said as being an absolute truth, even when it was often only his opinion and not backed by any scientific evidence. It was purely on his evidence the the US adopted the high carb, low fat and low protein diet that has existed until 2006. Other countries, UK being one of them, just followed whatever the US said without any research of their own, simply on the basis that if the US thinks it is right then it must be - after all they have all this research at their disposal!

A good place to start on Ancel Keys is
http://en.wikipedia.org/wiki/Ancel_Keys

One thing that the Wikipedia biography doesn't mention is that all of his work in Minnesota was funded by the Wheat Growers Association of America. Hardly surprising that his research reached the conclusions that it did!