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Saturated fat or Sugar?

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Terry Burge

New Member
Relationship to Diabetes
Type 1
Hi all,
After suffering a heart attack which was diagnosed as a complication of type 1 diabetes, the dietician in cardio rehab said that the NHS guidelines were that I should stay away from saturated fat & salt as well as trying to keep my blood sugars under control?
I am now totally confused because I now see in the media that Saturated fat is not the culprit to Heart Disease but Sugar is! How can I now stay away from sugar as well if I need carbohydrate for my energy when I inject insulin? Any ideas?
Thanks
 
Hi all,
After suffering a heart attack which was diagnosed as a complication of type 1 diabetes, the dietician in cardio rehab said that the NHS guidelines were that I should stay away from saturated fat & salt as well as trying to keep my blood sugars under control?
I am now totally confused because I now see in the media that Saturated fat is not the culprit to Heart Disease but Sugar is! How can I now stay away from sugar as well if I need carbohydrate for my energy when I inject insulin? Any ideas?
Thanks

Sorry to hear about your heart attack Terry. Saturated fats have always been harmful to the heart and it’s best to try and limit them in your diet. This may help explain;

https://www.cardiosmart.org/~/media/Documents/Fact Sheets/en/abk6292.ashx
 
Hi. You only need to inject insulin to cover the carbs you eat and not the other way round. Your body can normally get all the energy it needs from the fats and proteins you eat; don't be mis-led by food industry adverts encouraging you to eat carbs for energy. Do have some carbs and match the insulin to those (carb-counting) but don't feel you need to have them 'for energy'. Note that it's the liver that makes the fat that is deposited in the arteries and my understanding is that little of that comes from the fats you eat - mainly from the carbs you eat. It's up to you to decide whether you believe the NHS and BHF fat advice is valid - I know where I stand on that and my personal view is that salt is only an issue if you do have high blood pressure already.
 
The salt thing is to do with BP generally - if you overdose on it, like the sat fat - it's never been good. So - don't snack on a whole family sized bag of salty anything - but a couple of Pringles with a sandwich sometimes is OK. A whole tube of them instead of decent, varied food choices, isn't.

The body can obtain enough energy from all food groups and in fact never actually needs stodge in the form of either starchy carbs or sugary ones. The ONLY exception for anyone on hypo inducing meds, is glucose (not any old sugary stuff) (though of course that's a useful fallback if you're out of glucose to use) when we go low and specially when we are actually hypo.

We only inject just enough insulin before a meal or snack, to cover whatever carbs are going to be eaten that time. Please - don't use 'using insulin' as a convenient excuse to eat rubbish.
 
Hi. You only need to inject insulin to cover the carbs you eat and not the other way round. Your body can normally get all the energy it needs from the fats and proteins you eat; don't be mis-led by food industry adverts encouraging you to eat carbs for energy. Do have some carbs and match the insulin to those (carb-counting) but don't feel you need to have them 'for energy'. Note that it's the liver that makes the fat that is deposited in the arteries and my understanding is that little of that comes from the fats you eat - mainly from the carbs you eat. It's up to you to decide whether you believe the NHS and BHF fat advice is valid - I know where I stand on that and my personal view is that salt is only an issue if you do have high blood pressure already.

Thanks, DaveB, exactly my point! Who do I believe? I understand everything that you say but apparently there has been a new publication in the BMJ that is saying that it is not saturated fat that causes heart disease but sugar! So how do I stay away from sugar being a type 1? Surely I cannot stop taking insulin? Salt causes high blood pressure in the first place if you consume too much of it so if you have heart disease already I have to stay away from processed foods & not consume no more than 0.01 gms of salt in any 100gms which is quite difficult in this day & age?
 
The salt thing is to do with BP generally - if you overdose on it, like the sat fat - it's never been good. So - don't snack on a whole family sized bag of salty anything - but a couple of Pringles with a sandwich sometimes is OK. A whole tube of them instead of decent, varied food choices, isn't.

The body can obtain enough energy from all food groups and in fact never actually needs stodge in the form of either starchy carbs or sugary ones. The ONLY exception for anyone on hypo inducing meds, is glucose (not any old sugary stuff) (though of course that's a useful fallback if you're out of glucose to use) when we go low and specially when we are actually hypo.

We only inject just enough insulin before a meal or snack, to cover whatever carbs are going to be eaten that time. Please - don't use 'using insulin' as a convenient excuse to eat rubbish.
Thanks Jenny, but I don't actually eat anything sugary at all unless I'm having a hypo but then follow that up with some carbohydrate. I was just trying to understand what is right? I have diabetes which I have to control but I now have to look after my heart as well now. I follow the mediterranean diet & stay away from all unhealthy fats as much as possible. I only eat wholegrain foods high in fibre & lots of fruit & vegetables. I don't eat any cheese, butter or any fatty meats at all. I was just trying to establish that after reading an article that apparently suggested that it was ok to eat the bad saturated fat like butter & cheese & stay away from all forms of sugar whether that be refined sugar or starch? How do I do that if I have to inject insulin to convert the glucose into energy?
Who do I believe the NHS or the media?
 
Hello Terry

I think quite a lot of people share your confusion and frustration. I know I do.

This is what I have picked up and filtered over the years, I have no idea whether it is right, but it is the composite of reading lots of stuff from both ends of the spectrum.

First off - many people have already made up their minds that EITHER saturated fat is bad, or that saturated fat is fine.

I get the feeling that research and articles are written and published to back an idea/position more than going in with an open mind

There is a good deal of scientific evidence against ‘saturated fat’. Much of it dating from some time ago, however new thinking casts doubt on the conclusions (and funding sources of that research) and there have been several, high profile recent meta-analyses of very large populations have found no evidence that saturated fat, per se, associates with heart disease. Saturated fat does raise cholesterol, but in these meta analyses, that raised cholesterol did not necessarily increase CHD/CVD. Which is interesting in itself.

The food industry has devoted a significant amount of money into formulating ‘low fat’ foods, and is likely to want to protect this investment.

As far as I am aware, there has never been a single study which looks at saturated fat in isolation (probably because it would be impossible to do one). People don’t eat just saturated fat - in any product that contains fat there are varying proportions of mono/poly unsaturated fats too, along with a host of other things. What caught my eye when I first began looking at some of the early studies was that saturated fat got the blame where diets included more things like higher proportions of sausage rolls or biscuits. These do often have a high proportion of saturated fat, but it makes me wonder if it wasn’t something else in there that was doing the damage.

There are some substances in processed foods, takeaways and the like which have clear associations with heart disease. Most of us have heard about ‘trans fats’ which are pretty nasty, and have been removed from many products, but there are other compounds in processed foods (which may also contain high levels of saturated fat) which are probably best avoided and/or minimised.

I’ve read some interesting stuff about heart disease which points the finger at ‘arterial inflammation’ rather than ‘sat fat clogging’ as the method by which processed foods may negatively impact heart and CV health. And again it is the processed foods which contain these inflammatory compounds, which damage the blood vessels and which circulating cholesterol then tries to cover over and repair.

If you keep barking your shins on a coffee table, having plasters in your bathroom cabinet is not necessarily a problem (as long as you don’t have a ridiculous amount blocking up the whole thing). What you need to do is remove or reduce the size of the coffee table to keep your shins undamaged.

I am much more relaxed these days about saturated fat in proper meat, cheese and so on. I am still cautious of high fat, highly processed foods, and probably eat more takeaways and other stuff than I should, but I check labels for some of the chemical nasties that are rather similar to trans fats) to try to minimise those. I am generally avoiding anything labelled ‘low fat’ now as the labels on those generally read like a chemist’s dictionary.
 
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Hello Terry

I think quite a lot of people share your confusion and frustration. I know I do.

This is what I have picked up and filtered over the years, I have no idea whether it is right, but it is the composite of reading lots of stuff from both ends of the spectrum.

First off - many people have already made up their minds that EITHER saturated fat is bad, or that saturated fat is fine.

I get the feeling that research and articles are written and published to back an idea/position more than going in with an open mind

There is a good deal of scientific evidence against ‘saturated fat’. Much of it dating from some time ago, however new thinking casts doubt on the conclusions (and funding sources of that research)and there have been several, high profile recent meta-analyses of very large populations have found no evidence that saturated fat, per se, associates with heart disease. Saturated fat does raise cholesterol, but in these meta analyses, that raised cholesterol did not necessarily increase CHD/CVD. Which is interesting in itself.

The food industry has devoted a significant amount of money into formulating ‘low fat’ foods, and is likely to want to protect this investment.

As far as I am aware, there has never been a single study which looks at saturated fat in isolation (probably because it would be impossible to do one). People don’t eat just saturated fat - in any product that contains data there are varying proportions of mono/poly unsaturated fats too, along with a host of other things. What caught my eye when I first began looking at some of the early studies was that saturated fat got the blame where diets included more things like higher proportions of sausage rolls or biscuits. These do often have a high proportion of saturated fat, but it makes me wonder if it wasn’t something else in there that was doing the damage.

There are some substances in processed foods, takeaways and the line which have clear associations with heart disease. Most of us have heard about ‘trans fats’ which are pretty nasty, and have been removed from many products, but there are other compounds in processed foods (which may also contain high levels of saturated fat) which are probably best avoided and/or minimised.

I’ve read some interesting stuff about heart disease which points the finger at ‘arterial inflammation’ rather than ‘sat fat clogging’ as the method by which processed foods may negatively impact heart and CV health. And again it is the processed foods which contain these inflammatory compounds, which damage the blood vessels and which circulating cholesterol then tries to cover over and repair.

If you keep barking your shins on a coffee table, having plasters in your bathroom cabinet is not necessarily a problem (as long as you don’t have a ridiculous amount blocking up the whole thing). What you need to do is remove or reduce the size of the coffee table to keep your shins undamaged.

I am much more relaxed these days about saturated fat in proper meat, cheese and so on. I am still cautious of high fat, highly processed foods, and probably eat more takeaways and other stuff than I should, but I check labels for some of the chemical nasties that are rather similar to trans fats) to try to minimise those. I am generally avoiding anything labelled ‘low fat’ now as the labels on those generally read like a chemist’s dictionary.
Excellent Mike.
 
I actually believe Alan Shanley's 'Tag' line - and always did (cos that's how I was brought up) and still do -

All things in moderation - except laughter!
 
Thanks, DaveB, exactly my point! Who do I believe? I understand everything that you say but apparently there has been a new publication in the BMJ that is saying that it is not saturated fat that causes heart disease but sugar! So how do I stay away from sugar being a type 1? Surely I cannot stop taking insulin? Salt causes high blood pressure in the first place if you consume too much of it so if you have heart disease already I have to stay away from processed foods & not consume no more than 0.01 gms of salt in any 100gms which is quite difficult in this day & age?
Hi again. In principle you can reduce your insulin if you reduce your carb intake. You only need to take meal-time Bolus for any carbs you eat and the 24 hr Basal is to balance the liver's continuous glucose output. You don't need to have much sugar (or carbs) as long as you reduce the Bolus to match. You only ever need to take enough insulin to keep your blood sugar in range and no more. You mention you have hypos and I wonder whether you are carb-counting i.e. matching the Bolus to the carbs in that meal? Also note that keeping the carbs and insulin down will reduce blood sugar swings and the risk of hypos. It sounds like you have quite a good diet and you must follow the advice of your heart consultant, but be aware that there are now strong arguments for the traditional sat fats such as butter as the research that said they were 'bad' is a bit suspect and as I mentioned earlier the fat you eat goes thru a very complex metabolic process in the body and doesn't go straight into the blood stream; it's the liver that determines that. The arguments will continue!
 
Just because we are told something over and over again doesn't make it true - bad bad saturated fat - an essential food we can't live without.
Lovely lovely whole grain - something invented recently and not part of our requirements.
High cholesterol will kill you - despite people with lower cholesterol after a heart attack being more likely to die.
So much accepted truth is just something someone made up and no one bothered to check because it was so plausible, or they were in a position of authority or something -
 
I think the trouble is there are so many different view points it is difficult to know what to believe. I had to cut my carbs as I was pre-diabetic and I try to have a mix of low fat and full fat produce. I do my best to keep the processed foods to a minimum and do my best to keep to the Med diet. I love cheese and that is one of my downfalls so I try not to have more than about 1 oz at a time.

My understanding is it is the trans fats that are the worst and all the stuff in processed foods, take aways etc.

A friend of mine was on statins and did not feel at all well so was taken off them some time ago. His cholesterol is now down to 3.6. He told me he follows the Med diet.
 
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