NHS Advice

[Beardyrich]

Being recently diagnosed with type 2, I have found information on diets from various sources.
The general consensus seems to be to avoid white starchy foods like potatoes, pasta, white rice, white bread, things made from white flour etc. Fats are OK in moderation but try and choose healthier fats such as olive oil, rapeseed oil and spreads containing poly and mono-unsaturated fats.
Proteins are OK as they do not spike blood sugar levels. Sugary items are a no no.
This is the reasoning behind what I buy when I go food shopping. It takes a little bit of getting used to when there are so many things which I used to enjoy eating are now on the blacklist.
So far, so good? I've lowered my blood sugar levels over the last couple of months and lost almost 2 stone.
Now, this morning I have seen the advice given on the NHS website which seems to contradict what I have believed to be the right way to control blood sugar levels and lose weight.

The advice given is this...

There's nothing you cannot eat if you have type 2 diabetes, but you'll have to limit certain foods.

You should:
Eat a wide range of foods – including fruit, vegetables and some starchy foods like pasta. Keep sugar, fat and salt to a minimum. Eat breakfast, lunch and dinner every day – do not skip meals.

Confused? I am.There are plenty of foods that I cannot eat! I no longer eat potatoes, pasta, white bread and as for oils, I thought that healthier oils and spreads were beneficial???
Some fruits are also high in natural sugars, particularly tropical ones, which can spike blood sugar levels, so people acting on this advice could be damaging themselves without knowing it. Oh how I wish it was easier for newly diagnosed people to be able to determine what to buy at the shops. Don't get me onto food labelling, I'll save that for another time.

 

[Docb]

It is true that There's nothing you cannot eat if you have type 2 diabetes, but the follow up should be something like you will have to limit certain foods but what and by how much will vary from individual to individual and case to case. It is true that you should eat a wide range of foods, but again what it is sensible for any individual to eat will depend on their individual circumstances.

All this sort of advice, in its attempt to provide rules for all, finishes up as being a bit silly. Those pushing it out would be better employed explaining the issues and providing the information that would allow individuals to work out what is best for them.

 

[Beardyrich]

It is true that There's nothing you cannot eat if you have type 2 diabetes, but the follow up should be something like you will have to limit certain foods but what and by how much will vary from individual to individual and case to case. It is true that you should eat a wide range of foods, but again what it is sensible for any individual to eat will depend on their individual circumstances.

All this sort of advice, in its attempt to provide rules for all, finishes up as being a bit silly. Those pushing it out would be better employed explaining the issues and providing the information that would allow individuals to work out what is best for them.

Hi Docb, thanks for your reply. I do find it frustrating though, as I'm sure most of us do, to try and work out what we should be eating.
Someone reading the NHS advice might think it OK to eat the wrong foods, that's what I wanted to highlight. I think the NHS ought to modify the guidelines on their website.
I'd be pretty well peeved off if I had followed this advice only to later find that it's not all correct.

 

[Docb]

For me the bigger problem is that the advice is open to a such wide variety of interpretations. This means that when it is passed on by HCP's different messages can be given depending on the prejudices of the individual passing it on. To that end you are right, it is more confusing than enlightening.

 

[Eddy Edson]

For me the bigger problem is that the advice is open to a such wide variety of interpretations. This means that when it is passed on by HCP's different messages can be given depending on the prejudices of the individual passing it on. To that end you are right, it is more confusing than enlightening.

As you say, the problem is that there are no valid rules except for: eat in the same healthy fashion as for anybody, and within that, adjust carbs etc to your own personal requirements from time to time. But for that to be useful advice, it needs to be in association with SMBG in some form - because otherwise how do you tell what your "personal requirements" are, of course? And SMBG for most T2's is officially deprecated in the UK.

And newbies generally want detailed rules. So you get this confluence of agendas which delivers a clueless outcome: outdated approach to guidelines which operates just at a population level and averages, ignoring individual variability; the inability of the peak bodies to deliver meaningful advice for individualisation in an anti-SMBG context; and patients' desire for hard and fast rules.

The latest American Diabetes Association guidelines are better than this. At least in the sense that they refuse to propose specific rules for diabetics, instead just saying that dietary advice needs to be tailored to the individual within generally healthy eating patterns. Which is advice which makes sense in the US context, where SMBG is generally supported by insurers.

 

[Drummer]

Well - of course you can eat anything - it is the high blood glucose which you might well see as a consequence that is the problem - but the NHS advise us not to test our levels, so following their advice leaves us in ignorance of what might be dangerously high levels of glucose in our blood until we get tested and see that Hba1c has not gone down. Presumably we are then told we need more medication and should exercise more.
Are you sure that the non white flour option is working for you?
There are the same sort of carbs in the brown as the white option - I could not see any benefit from brown carbs - but I checked, testing after eating - same whoosh, possibly just a tad slower, but still whoosh.
I avoid grain, sugary foods, starchy foods, anything low fat, seed oils, and I eat morning and evening, as I need just two meals a day, and not large ones, but I never did eat a lot, despite the hollow laughter as my weight and size increased following the low fat low calorie but high carb advice.

 

[Beardyrich]

Hi Drummer, yes we can eat anything that we like but, I think most diabetics are constantly trying to keep their blood sugars at a reasonable level aren't they? In doing so, we need to eat the 'right' foods, which is why I originally posted about the NHS advice. I suspect that this advice would be more useful to 'newbies' (like myself) who need dietary advice rather than those who have already had time to modify their diet to suit them. I do realise that we're all different and that some of us can enjoy some foods without hesitation that others would steer clear of but people seeking advice need the right guidelines to start them on the road to a healthier lifestyle. Confusing and conflicting advice doesn't help.
You ask if I've tried white bread. Well I haven't tried it, nor wholemeal. I now eat Burgen which is lower in carbs than 'normal' bread. This suits me as my blood sugars don't spike after eating this. I could monitor after eating white bread but I'm happy with the Burgen now so don't see the need to change.
I was only diagnosed a couple of months ago and I didn't fully realise the implications. I was told to change my diet but it was a real struggle to find the 'right' foods to buy.
I have more of an idea of what types of food to buy now but still find it a bit of a struggle to buy different foods as I don't want to become bored with the same old things week in week out. I have some cook books that feature low GI recipes and another by Dr Clare Bailey which I am hoping to make use of this weekend.

 

[Drummer]

I think you got the wrong end of the stick, what with me being sarky about the NHS advice - I asked if you'd checked that the NON white bread was OK - which seems to be the case.
You'll need to check the low GI recipes, as I wrote, low GI means nothing to my powers of digestion - I spike a little slower perhaps, but spike I do.

 

[Ljc]

Hello @Beardyrich . Apologies if you already know this, we have a great recipe section on this forum, it where members put their own creations
https://forum.diabetes.org.uk/boards/forums/recipes.21/

This long running thread might be helpful too
https://forum.diabetes.org.uk/boards/threads/what-did-you-eat-yesterday.30349/

 

[Beardyrich]

Hi Lin, thanks for the info. I’ll take a look at those links later. This is such a great website for all sorts of reasons. Take care, Rich.

 

[karloc]

I think the NHS advice is so general that it probably fits no one plus "but you'll have to limit certain foods" is correct but ends up being meaningless without extremely complex explanation.
We are all different in diet needs in general plus with Diabetes I am sure we have very different stages / conditions etc.
There are lots of good advice / ideas on this forum but you still need to take it in context.

I am lucky because my Doctor is supportive of my ideas / plan. He is also happy I test my BG.
My plan.
I am overweight, unfit, almost 4 weeks into being diabetic.
My aim is put diabetes (if possible) into remission, loose weight, become fitter (I put this last because as an ex rugby player / very active 30 years ago I carry a lot of unfit leg muscles which I would like to tone down, but even walking carrying extra weight would build those muscles.)

In order to put my diabetes into remission:
After a lot of research into it all, of which there is much conflicting information I have come to the conclusion that firstly I might not be producing enough Insulin (which is what its all about really) now this I hope (no way of knowing for sure) is because a bad diet and being overweight. This means my body needs to produce far more than 'normal'. Secondly my body has probably become insulin resistant so it wont work as its meant to so the bodies response is to produce more insulin which will also increase the insulin resistance in a vicious circle.
So in order to control my insulin levels I have to stop my body producing so much insulin and by keeping my insulin levels down it should (In my mind and my doctor agrees) it should help my body become less insulin resistant. Insulin is produced as a result of Glucose in the blood (Glucose comes from Carbs, stored glucose in the liver and glucose produced by the body from fat stores - simple explanation). It also appears that insulin may also block the body from using stored fat.
I have reduced my carbs intake to probably 10-20g per day, this keeping my BG reading down to 4s-5s. A couple of times I have had a few more carbs pushing my BG into high 5s but mostly in 4s when I am being good.
It took about 1 week of drastic changes to get rid of all the glucose stored around my body and actually bring my BGs down which had an instant change to my eye sight.
I was also very careful for the first few weeks to make sure that I only had coffee (with milk as my main carbs source) only at meal times with only water in between to make sure my body had longer periods of as low insulin as possible, now my BGs are much lower I am a little bit more flexible on this but not much.
I am also eating very little to take advantage of low insulin to make my body use stored fat and loose weight. Mostly only eating eggs, bacon, chicken, tuna, salmon and mushrooms. I boil up a load of eggs and if I feel really hungry just have an egg or 2. I have had a few slightly more small 'proper' meals - like some spag bol but salad instead of the pasta when I have been really hungry or mushroom and bacon omelette.

Side effects of my extreme diet:
With such a restricted 'diet' I am at danger of being short of certain vitamins and minerals, so I do have a few supplements that I take from time to time, I don't normally believe in these but on such extreme diet I need to be careful. The only 'major' issue I have had so far was a potassium shortage (missing heart beats, which is sign of extra beats strangely) at the time I had some salmon and peanut butter to boost potassium and then got some supplements (electrolyte plus) that have potassium, magnesium, sodium etc.

After weight loss (1st down, 3-5 more to go) and keeping my insulin down during the weight loss I intend to try and adopt a better diet than previous - I think it will involve lots of test with trying foods and watching BGs etc to work out whats 'good' for me. The issue about good / bad carbs is complex as always, from a pure insulin point of view carbs are carbs but they will have different spike effects and things like high fibre carbs are meant to help the body not become insulin resistant so are better. I am not convinced that will be much help if you are already insulin resistant or failing to produce quite enough insulin atm - I think this is partly where a lot of confusion comes from.

Getting a BG tester was the best thing that I did in my mind as I can get a clear view of what certain foods are doing to my BG. I suspect the NHS don't recommend them because not everyone would find them useful I guess, some might need more NHS time to help them and if recommended they would probably have to supply them - that they can't afford.

Well this went on longer than I thought

 

[Felinia]

I may be repeating another post I made about the generalised nature of diabetes advice given by the various medical professionals in the UK, so please forgive me! It puts me very much in mind of the Pete Seeger song "Little Boxes" where we are "all made out of ticky-tacky and all look just the same". Of course everyone is different and instead what we get is just so bland and vague, trying (and failing) to cover all bases. Like many other newbies I really struggled at first to find the real gems of information in the vast amount of conflicting, confusing and sometimes downright weird information. But I think the real issue for newbies is that you get a vast amount of information flung at you in a very short space of time, then left to get on with it, with no idea how you are doing. This causes worry and stress which you don't need. I'm supposed to have follow up tests but still waiting to hear. The GP surgery has staff shortages, the annual flu jab campaign, and a 6 week wait for even a simple appointment like a blood test. So I really value my monitor, despite being told the NHS didn't supply for Type 2, as some people became obsessed with monitoring (OK I suspect it really is a cost issue). Without it I would have had no idea of what foods affect me badly, and have been able to modify my diet suitably. Shame there's not a picture of a soapbox to tack on!!!

 

[Ralph-YK]

But I think the real issue for newbies is that you get a vast amount of information flung at you in a very short space of time...

My experience is no information at all ever.

... then left to get on with it, with no idea how you are doing.

Defineately!