DiABETES UK Nutritional Guidelines

[Hamrag]

Source?
(I agree with much of what it says, I’d just like to know who has produced it).

I think the major reason why everyone tiptoes round this subject, is that because the NHS is still recommending the starchy carbs route, and this is what a lot of people have come away from their doctors with, nobody wants to say outright 'your doctor is wrong' in case a dogmatic approach which contradicts the NHS frightens people away. (Also, as we have seen on this thread, there is a huge variation in the amount of carbs different people can tolerate, some report doing well on 100, others have gone for 50, etc). So we tend to take the 'test, and eat to your meter' approach, and hope the penny will drop.

Agree, However the problem with the NHS Nutritional guidelines is mainly the fact that they are aimed at everyone, Diabetic or not! and certainly in my GP Practice both my Doctor and Diabetic nurse acknowledge that however you try to reduce your sugar Intake be that Low carb, Keto, Moderate carb. If it works for you they are supportive. The Guidelines need to have a clearly written subsection for both T1 AND T2, Then both the Doctors , Nurses and Patients would be clearer about the advice that works for these/ their condition.

 

[Hamrag]

I never said you were.

But I do suggest you read what you have written above.
"MCNF, moderate carbs normal fats", was the reply to you.
And you spin somehow needs to be "moderate low carbs natural fats"

Just saying.

100g Carbs (in my opinion) is Moderate. and the Fats described are all natural! Its no spin, just an opinion!

 

[Eddy Edson]

At Last someone who is willing to share what works for them as a T2 Moderate low carbs and natural fats.

I'm mainly plant-based, moderate carbs (by which I mean something like 150g - 180g, sometimes higher), "Mediterranean" (so lots of unsaturated & not much saturated fats).

In other words, 100% consistent with the major international dietary guidelines & recommendations from credible nutrition experts, which contrary to the propaganda from "gurus", don't get their knickers in a twist about going higher or lower on particular macronutrient ratios, apart from capping proteins.

EDIT: Oh, and 30g+ fibre. For me, that's important for BG control and once again consistent with all the recs.

I think the most important reason why you see targets like 45% - 60% carbs is because nutritionist want you to be eating lots of fibre & lots of whole grains, and they don't want you to replace them with saturated fats. It's a bit ham-fisted (so to speak), but I can see the point when I read posts from LCHF-types saying things like "healthy fats like butter and bacon" (!).

I think it's a point of dissonance for diabetics, because grains are often tough for BG control, but there's a wealth of evidence that fibre & whole-grains are Good Things. My solution: eat seeds. Lots of fibre, very beneficial for BG control, hopefully similar nutritional benefits to whole grains.

And then also: nowhere do I see those 45%-60% carb levels etched in stone & in all the major national guidelines from the US, the UK, Canada, Australia etc etc there is no objection to going lower-carb than that so long as you replace them with mainly plant-based fats and keep the fibre levels up.

 

[Hamrag]

I'm mainly plant-based, moderate carbs (by which I mean something like 150g - 180g, sometimes higher), "Mediterranean" (so lots of unsaturated & not much saturated fats).

In other words, 100% consistent with the major international dietary guidelines & recommendations from credible nutrition experts, which contrary to the propaganda from "gurus", don't get their knickers in a twist about going higher or lower on particular macronutrient ratios, apart from capping proteins.

Can you point me towards the Major International guidelines please.

 

[Deleted member 21371]

100g Carbs (in my opinion) is Moderate. and the Fats described are all natural! Its no spin, just an opinion!

Can you point me towards guidelines that define low carb, so we can see how you formed that definition please.

 

[Eddy Edson]

Can you point me towards the Major International guidelines please.

The FAO has a convenient portal: http://www.fao.org/nutrition/educat...egions/countries/united-states-of-america/en/

 

[Hamrag]

Can you point me towards guidelines that define low carb, so we can see how you formed that definition please.

I formed that Opinion based on Diabetes.uk Quote :
"What is a low-carb diet?
Currently, there is no agreement about the definition of a low-carb diet - but, anything providing less than 130g/day of a 2000kcal diet (26 per cent of energy) is considered 'low-carb'. Anything less than 30g/day of 2000kcal diet (6 per cent energy) is considered very low-carbohydrate ketogenic and is not recommended as research suggests this is not sustainable even in the medium term." So from that, In my opinion A low carb Diet can range between 130 Grams a day to 30 Grams a day. Therefore in my opinion (50- 30 is low carb/ Keto) (50- 130) is Moderate low Carb, and I am aware that some people can return good blood results up to 200 Grams a day, (this will also be influenced by medication, and other conditions that may effect there health)

 

[Deleted member 21371]

I formed that Opinion based on Diabetes.uk Quote :
"What is a low-carb diet?
Currently, there is no agreement about the definition of a low-carb diet - but, anything providing less than 130g/day of a 2000kcal diet (26 per cent of energy) is considered 'low-carb'. Anything less than 30g/day of 2000kcal diet (6 per cent energy) is considered very low-carbohydrate ketogenic and is not recommended as research suggests this is not sustainable even in the medium term." So from that, In my opinion A low carb Diet can range between 130 Grams a day to 30 Grams a day. Therefore in my opinion (50- 30 is low carb/ Keto) (50- 130) is Moderate low Carb, and I am aware that some people can return good blood results up to 200 Grams a day, (this will also be influenced by medication, and other conditions that may effect there health)

So, no real recognised definition then
I prefer the term "moderate" carb, as it was originally stated to be.

 

[Hamrag]

Can you explain, "as it was originally stated to be"

 

[grovesy]

I have found over the years that what works changes and it has to have been readjusted. Also that what ever way you manage it has to be maintained long term.

 

[Hamrag]

I have found over the years that what works changes and it has to have been readjusted. Also that what ever way you manage it has to be maintained long term.

I agree and I have had to reduce my Carb intake and Increase Medication further (after a 50%reduction 2 years ago) to maintain A1c below 41

 

[Deleted member 21371]

I have found over the years that what works changes and it has to have been readjusted. Also that what ever way you manage it has to be maintained long term.

True, healthy meditranean diet, came off meds, and can now eat a bit more than when I was on the low fat diet.

But I keep my eye on it, I reckon weight will go back on if I drop my guard, and that'll take my hba1c back up again.

 

[Benny G]

True, healthy meditranean diet, came off meds, and can now eat a bit more than when I was on the low fat diet.

But I keep my eye on it, I reckon weight will go back on if I drop my guard, and that'll take my hba1c back up again.

So you have found a way of eating and living that works for you. Well done.
I know you like your analogies, there's more than one way to skin a cat.

 

[Deleted member 21371]

So you have found a way of eating and living that works for you. Well done.
I know you like your analogies, there's more than one way to skin a cat.

Indeed there is, it does seem that the more of us that say it, the better choices people will have.

 

[Hamrag]

So, no real recognised definition then
I prefer the term "moderate" carb, as it was originally stated to be.

Not sure what you mean by this? " I prefer ---------------"

 

[Hamrag]

True, healthy meditranean diet, came off meds, and can now eat a bit more than when I was on the low fat diet.

But I keep my eye on it, I reckon weight will go back on if I drop my guard, and that'll take my hba1c back up again.

When you say Healthy Mediterranean diet do you mean Healthy fats, Oily Fish etc, and do you eat refined carbs- Bread, Pasta Rice etc? And as you have been able to come off your Meds, and maintain weight Is this through Calorie restriction? How long since Diagnosis?

 

[Deleted member 21371]

When you say Healthy Mediterranean diet do you mean Healthy fats, Oily Fish etc, and do you eat refined carbs- Bread, Pasta Rice etc? And as you have been able to come off your Meds, and maintain weight Is this through Calorie restriction? How long since Diagnosis?

No, I never mentioned fats, I just said a healthy Mediterranean diet.

Certainly low fat, if you really need to put the word into my diet, so let's call it a healthy LOW fat Mediterranean diet if you need to.
I reversed my diabetics through a low fat diet, no reason to put the weight back on eating fat again.

 

[Hamrag]

No, I never mentioned fats, I just said a healthy Mediterranean diet.

Certainly low fat, if you really need to put the word into my diet, so let's call it a healthy LOW fat Mediterranean diet if you need to.
I reversed my diabetics through a low fat diet, no reason to put the weight back on eating fat again.

No I wasn't putting the word Fat into your diet ! As a Mediterranean Diet as far as I am aware, and having lived in Crete for some time in the past includes oily Fish, Lamb, Goats cheese, Olives, Salads with Olive oil dressings, and Olive oil for cooking, I simply was asking when you Say Healthy Med diet do you include these fats/oils. But it seams not, and I was asking do you eat Pasta, Bread, and Rice, which are foods that I would avoid in order to keep my Blood Glucose down. Also the reason I asked how long since Diagnosis was because I have been diagnosed now for around 12 years and although I have now successfully managed my T2 through a combination of Low carb and reduced medication, like many people with long standing T2 I still have to take Meds.

 

[Deleted member 21371]

No I wasn't putting the word Fat into your diet ! As a Mediterranean Diet as far as I am aware, and having lived in Crete for some time in the past includes oily Fish, Lamb, Goats cheese, Olives, Salads with Olive oil dressings, and Olive oil for cooking, I simply was asking when you Say Healthy Med diet do you include these fats/oils. But it seams not, and I was asking do you eat Pasta, Bread, and Rice, which are foods that I would avoid in order to keep my Blood Glucose down. Also the reason I asked how long since Diagnosis was because I have been diagnosed now for around 12 years and although I have now successfully managed my T2 through a combination of Low carb and reduced medication, like many people with long standing T2 I still have to take Meds.

Diagnosed 7 years ago.
Originally prescribed metformin, then Januvia added.
It took me two years to bring it back down to normal levels.
I was then took off Januvia, and reduced to 500g of metformin.
I resisted being taken off metformin for a long time, but as my Hba1c has been stable at 34 for 5 years, I was taken off it last year.

At the risk of boring everyone.....
When I was diagnosed, I was morbidly obese.
I also got fat through overeating, that was down to me.
I realised losing weight was something I needed to do then.
I looked at different diets, and decided I wanted a non restrictive diet eventually, as I didn't want to be tied into a diet for life, so it was fairly obvious to myself then I wanted a choice that meant reversing diabetes, not simply avoiding the food group the raised BG.
(To me that was simply like someone with a pollen allergy choosing to live in a plastic bubble for life, and that wasn't for me)
Also, no one could admit they still portion control on HF, I had had several decades of overeating, because I chose to, so I could easily eat several thousands calories of fat in a meal. And I know fat makes me fat. (Yes, I did try LCHF initially, so that was based on experience, the bit about not stuffing your face still often gets overlooked)

So, working with the NHS, I lost about 4 stone in the year, using my meter and their dietitian tuning their low fat diet to suit.
All carbs aren't equal, all carbs don't turn to sugar at the same rate, so if you do produce insulin, as I still did, it's simply a question of finding foods that release slower, and there is no issue keeping up with it.
I still wasn't quite reversed, so I then finished with the Newcastle Diet, which did that for me.
I had read all the comments on "starvation mode", maybe it does exist for some, it doesn't for me.
(Very similar to Fungs fasting, eating normally, then fasting, so overall low calorie, but I don't think he had invented that until after the Newcastle diet, so I found Prof Taylors results and they had a good track record.)

Then I moved to a much healthier diet then previously, concentrated on the calories, and dropped the overeating. Which isn't to say it's utterly rigid, I can still eat a BugerKing, or a Domino's.
I have lost my sweet tooth through.
I don't eat cakes or donuts anymore, mainly as they are too sweet, and I have the mindset now of thinking about empty calories.

As to insulin resistance, I worked with the NHS there too, attended the courses, and got referred to an NHS gym, very good for me, graded exercise, and then I realised exercise greatly reduced insulin resistance, as your muscles work, (I had been sedentary) and start to break down the glucose again.

Yes, there may be spikes initially, there may be liver dumps, there may be odd things happening for a while, but I decided I wasn't going to spend my life trying to avoid any odd reading on my meter, as that's as bad as being diabetic still. Maybe I spiked during exercise, maybe I rose more than 2, maybe I had a dawn phenomenon, but that passes. It don't vanish entirely, but it happens to normal people too.
And I'm happy with normal.
I don't need the "gold standard" of BG control.
Normal people don't suffer diabetic complications, that's enough for me.

 

[Hamrag]

Diagnosed 7 years ago.
Originally prescribed metformin, then Januvia added.
It took me two years to bring it back down to normal levels.
I was then took off Januvia, and reduced to 500g of metformin.
I resisted being taken off metformin for a long time, but as my Hba1c has been stable at 34 for 5 years, I was taken off it last year.

At the risk of boring everyone.....
When I was diagnosed, I was morbidly obese.
I also got fat through overeating, that was down to me.
I realised losing weight was something I needed to do then.
I looked at different diets, and decided I wanted a non restrictive diet eventually, as I didn't want to be tied into a diet for life, so it was fairly obvious to myself then I wanted a choice that meant reversing diabetes, not simply avoiding the food group the raised BG.
(To me that was simply like someone with a pollen allergy choosing to live in a plastic bubble for life, and that wasn't for me)
Also, no one could admit they still portion control on HF, I had had several decades of overeating, because I chose to, so I could easily eat several thousands calories of fat in a meal. And I know fat makes me fat. (Yes, I did try LCHF initially, so that was based on experience, the bit about not stuffing your face still often gets overlooked)

So, working with the NHS, I lost about 4 stone in the year, using my meter and their dietitian tuning their low fat diet to suit.
All carbs aren't equal, all carbs don't turn to sugar at the same rate, so if you do produce insulin, as I still did, it's simply a question of finding foods that release slower, and there is no issue keeping up with it.
I still wasn't quite reversed, so I then finished with the Newcastle Diet, which did that for me.
I had read all the comments on "starvation mode", maybe it does exist for some, it doesn't for me.
(Very similar to Fungs fasting, eating normally, then fasting, so overall low calorie, but I don't think he had invented that until after the Newcastle diet, so I found Prof Taylors results and they had a good track record.)

Then I moved to a much healthier diet then previously, concentrated on the calories, and dropped the overeating. Which isn't to say it's utterly rigid, I can still eat a BugerKing, or a Domino's.
I have lost my sweet tooth through.
I don't eat cakes or donuts anymore, mainly as they are too sweet, and I have the mindset now of thinking about empty calories.

As to insulin resistance, I worked with the NHS there too, attended the courses, and got referred to an NHS gym, very good for me, graded exercise, and then I realised exercise greatly reduced insulin resistance, as your muscles work, (I had been sedentary) and start to break down the glucose again.

Yes, there may be spikes initially, there may be liver dumps, there may be odd things happening for a while, but I decided I wasn't going to spend my life trying to avoid any odd reading on my meter, as that's as bad as being diabetic still. Maybe I spiked during exercise, maybe I rose more than 2, maybe I had a dawn phenomenon, but that passes. It don't vanish entirely, but it happens to normal people too.
And I'm happy with normal.
I don't need the "gold standard" of BG control.
Normal people don't suffer diabetic complications, that's enough for me.

Now put into perspective, I am understanding more where you are coming from. I looked into the Newcastle diet some two years ago and can appreciate how people get good results from the diet both in terms of weight loss and BS control / reversal of Insulin Resistance. I chose to go down the road of LCHF as I didn't think I could cope with just 600 cal restriction, even for just 8 weeks. However I did practice Intermittent Fasting 1-2 days a week for around 6 weeks which help me shed my 3 stone overweight. Your History is interesting and I can now appreciate your point of view.