Advice from dietician

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lordburnside

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I have just had a call from an NHS dietician as my name had got to the top of the list.
I have been managing my BG and it went from 55 to 42 and lst time it was 44 as I had lapsed a bit. Alcohol and lack of exercise!

I have been doing without rice, pasta, bread and potatoes for 6 months 99% of the time. The dietician says I should eat between 100g and 200g of carbs. He said I should eat wholemeal bread, wholegrain rice and pasta and some grains. As I recall these raise my BG somewhat!

I discussed the various advice I had received, from Diabetes uk, from You Tube, books and NHS and I was advised to follow the NHS requirements. I am not sure that I should. I think the people on this site have their own experiences. If I go back to bread, 2 Weetabix etc I will put on weight and I feel sure my BG will rise.

My current diet seems to work except for portion size, lack of regular exercise (weather related!) and I like alcohol.

Anyone on here follow NHS guidelines only and find that it works?
 
The way I see it, you have two options.....

Continue to follow what you have been doing which you know works for you and you have had fantastic success with...
or
Follow the NHS advice and keep testing and if it doesn't work, revert back to what you know does work.

Even if the NHS advice works for some people, it doesn't guarantee it will work for you which is why, here on the forum, we recommend people test and see what works for them as an individual and adjust their diet accordingly.

It is sad and frustrating that the NHS continue to churn out this "one size fits all "Eatwell Plate" dietary advice and that Diabetes UK continues to follow their lead.

Let us know how you get on if you decide to follow their advice please.
 
I follow my own guidelines in order to keep it under control. That does mean sometimes having some potato or a banana (Like today) and the odd ice cream, but if I have 100g-200g of carbs a day I'd be permanently elevated and back to where I was in 2021. Which was in a very, very bad place.

So I ignore all this guff about '130g' allowance a day. It's complete nonsense, in my opinion.
 
We are all different. Some people need to do their own research. Some people hate doing research and find it easier to follow guidance from others. Some people can eat wholemeal breads and pasta while others find it spikes their BG. Some people use exercise to reduce their BG while others are unable to exercise.

I think this is summed up beautifully at the top of every page on this forum:

everyone manages their health differently.
Click to expand...

If you find something that works for you, that you can maintain, that fits with your lifestyle, that suits your personality, that gives the best health results for all of you, not just the diabetes, go for it.
 
NICE guidelines:-

Encourage adults with type 2 diabetes to follow the same healthy eating advice as the general population.

Really....??
 
If you're generally low-carb/keto, then adding carbs back in will cause some weight-gain. This will initially be from water-weight, and likely very closely mirrors the water-weight you lost when initially going low-carb. Carbs attract water.
Whether you continue to gain fat after that will come down to how much energy you take in compared to what you burn.

Which protocol you follow is up to you. The best one is the one you most enjoy as it's the one you're most likely to stick to. The recommendations they give absolutely can work. But if you don't want to work them you aren't obligated.
 
beating_my_betes said:
Carbs attract water.
Click to expand...
Only to a small degree.
Some of the carbs you consume are stored in the form of glycogen. Glycogen is stored in your liver and muscles, where it can quickly turn into glucose to provide energy when you need it. Molecules of glycogen contain water. The American Council on Exercise reports that every gram of glycogen retains about 3 grams of water.
Click to expand...
The amount of water retained from carbohydrate is restricted because your body has limited space for glycogen storage. If you consume more carbs than usual, or you're carb-loading to prepare for an athletic activity, you may gain 3 pounds to 5 pounds of water from glycogen, reports the American Council on Exercise.
Click to expand...
 
Sigh
From the age of 20 to when diagnosed in my mid 60s I was pressured to eat those healthy carbs - I was not far off spherical, and a very bad diabetic, I was informed.
You just can't get through to some people, it isn't working, it can't work, it has never worked - but they tell you it's you doing it wrong -
After diagnosis I went to what I knew works for me - they almost patted me on the head but they were not interested in low carb information....
 
Thanks for your input one and all.
I could do with a change so I will give try a bit of wholemeal bread/weetabix/ potatoes for a week. I have my blood glucose monitor for another week (as they are too expensive to use permanently if you are paying yourself). I will weigh myself on Saturday 27th and again a week later and monitor my BG until my monitor runs out of time.
 
Many/most NHS dieticians haven't a clue about diet and neither do most of the associations that these 'experts' are members of (have a look at their websites). Be careful about the advice you receive.
 
helli said:
you may gain 3 pounds to 5 pounds of water from glycogen
Click to expand...
Yes! This is what I meant when I said that the gain likely mirrored what was lost when initially transitioning to a low-carb/keto diet i.e the water leaving along with the glycogen. I think we're on the same page, no?
 
As regards the 100g to 200g grams of carbs per day thing - increasing to those levels will raise your BG, but lower your protein and/or fat intake. So long as you're getting all the vitamins, minerals and fibre you need from your existing diet - the primary effects from the change would be due to the lower levels of fat and protein. How are your cholesterol levels? Are your kidney function tests normal? Is there any indication at all, other than the faith a nutritionist has in one-size-fits-all NHS dietary advice, that what you're already eating is doing you any harm?
 
I have a cunning plan! I know what some meals do to my BG so as I have a monitor at the moment I will test my existing meals properly and write it down. Next week I will try some new things like wholemeal bread etc and compare.
My existing diet seems to be breakfast and lunch practically no carbs then dinner is about 40-80 carbs (usually beans/lentils with chicken/fish!) Sometimes I have fruit with yoghurt too. So I think I probably average 100g of carbs a day. NHS say 100 to 200g is OK.
So if I have a couple of slices of bread and maybe a couple of potatoes that will get me to 150g of carbs and with NHS range. I will then compare this week and next week.
Gives me something to do!
 
lordburnside said:
I have a cunning plan! I know what some meals do to my BG so as I have a monitor at the moment I will test my existing meals properly and write it down. Next week I will try some new things like wholemeal bread etc and compare.
My existing diet seems to be breakfast and lunch practically no carbs then dinner is about 40-80 carbs (usually beans/lentils with chicken/fish!) Sometimes I have fruit with yoghurt too. So I think I probably average 100g of carbs a day. NHS say 100 to 200g is OK.
So if I have a couple of slices of bread and maybe a couple of potatoes that will get me to 150g of carbs and with NHS range. I will then compare this week and next week.
Gives me something to do!
Click to expand...
It can be a great thing to get more information and insight. However, I'm not sure your plan is going to give you results that will give clarity. If anything, I think it might just confirm your expectations.
 
lordburnside said:
I have a cunning plan! I know what some meals do to my BG so as I have a monitor at the moment I will test my existing meals properly and write it down. Next week I will try some new things like wholemeal bread etc and compare.
My existing diet seems to be breakfast and lunch practically no carbs then dinner is about 40-80 carbs (usually beans/lentils with chicken/fish!) Sometimes I have fruit with yoghurt too. So I think I probably average 100g of carbs a day. NHS say 100 to 200g is OK.
So if I have a couple of slices of bread and maybe a couple of potatoes that will get me to 150g of carbs and with NHS range. I will then compare this week and next week.
Gives me something to do!
Click to expand...
I do tend to look upon it as carbs per meal rather than the day as a whole as I know that by eating nearly all my carbs in one meal would push my blood glucose too high but spreading it more evenly I keep below that 8mmol/l 2 hours post meal. Having said that I try to keep around 70 -80g carbs per day (15, 20, 30 plus drinks)
 
Today bacon and egg and two small tomatoes 3 cups green tea 8.6 before 8.5 after two hours peaked at 9.6
Lunch salad 7.7 before and after peaked at 8.2. Ate 5 aniseed balls in the office 7.9 before 8 after - peaked at 9.5. Sweets in the office is a sin.

My BG is higher this week because of gin and tonics and chocolate at the weekend!
 
lordburnside said:
Anyone on here follow NHS guidelines only and find that it works?
Click to expand...
More or less and got diagnosed type 2. Went keto got remission and lost the weight I needed to, lasted 4 yrs. Then life got in the way and I slid backwards closer back to the carbs they recommend (about 100-150g) and ended back where I started.

So no it doesn’t work for me. It’s a starting point with the assumption you are having more currently. That’s a false assumption for a few number.
lordburnside said:
So I think I probably average 100g of carbs a day. NHS say 100 to 200g is OK.
Click to expand...
So you are already doing what they say. Did this magician, sorry dietician, give any reason why you should have more carbs than currently or how they would benefit you ir what was wrong with your solution that was working?
 
Dragonheart said:
More or less and got diagnosed type 2. Went keto got remission and lost the weight I needed to, lasted 4 yrs. Then life got in the way and I slid backwards closer back to the carbs they recommend (about 100-150g) and ended back where I started.

So no it doesn’t work for me. It’s a starting point with the assumption you are having more currently. That’s a false assumption for a few number.

So you are already doing what they say. Did this magician, sorry dietician, give any reason why you should have more carbs than currently or how they would benefit you ir what was wrong with your solution that was working?
Click to expand...
The consultation was done over the phone and the dietitian will follow it up with a letter.
During the short discussion I said I am aiming for an HbA1C of 40mmols/mol as I would rather not be prediabetic either. He suggested that I was being too strict and that a reading of say 50 was not really too bad. My latest reading was 44 so I had slipped from 42 but after a week in London on holiday eating cheesecake and supping beer in excess I wasnt too worried.

I had my usual breakfast this morning of bacon and egg with 2 little tomatoes but with two medium slices of brown wholemeal bread . The results were that after two hours my BG was half a point higher (than without the bread) but the biggest difference was that the spike was 14.6 as opposed to 9.6. So as we know bread is not a good idea! The bread can go in the freezer or the birds can have it.

Tomorrow going to try two weetabix for breakfast. Whoopie. Just get bored with bacon and egg and fruit and yoghurt with nuts for breakfast.
 
lordburnside said:
I have just had a call from an NHS dietician as my name had got to the top of the list.
I have been managing my BG and it went from 55 to 42 and lst time it was 44 as I had lapsed a bit. Alcohol and lack of exercise!

I have been doing without rice, pasta, bread and potatoes for 6 months 99% of the time. The dietician says I should eat between 100g and 200g of carbs. He said I should eat wholemeal bread, wholegrain rice and pasta and some grains. As I recall these raise my BG somewhat!

I discussed the various advice I had received, from Diabetes uk, from You Tube, books and NHS and I was advised to follow the NHS requirements. I am not sure that I should. I think the people on this site have their own experiences. If I go back to bread, 2 Weetabix etc I will put on weight and I feel sure my BG will rise.

My current diet seems to work except for portion size, lack of regular exercise (weather related!) and I like alcohol.

Anyone on here follow NHS guidelines only and find that it works?
Click to expand...
i asked my DN why she hadn’t sent me to an NHS class and she said its because all her patients were being given incorrect information and she had to re-educate them, so just a waste of time. She told me to eat around 60g of carbs. I couldn’t possibly eat the amount of carbs you’ve been advised, without taking huge amounts of insulin. I didn’t even eat 130 carbs a day before I was diagnosed. Just carry on with what works for you.
 
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