Type 2 and insulin resistance - what I don't understand is...

[bulkbiker]

Isn't the general point that it does seem that there are more than one way to tackle T2, and it can be individual according to that individual's personal metabolism, and, too, what they can cope with and manage long term?

I'm sure it is individual to a point .. the problem however is when people are only given one option and if they fail then they get blamed.
Very few doctors recommend following low carb although many people who try it find it works well for them.
Pushing crash diets on people and then being surprised when the weight comes back or their symptoms don't improve shouldn't really be all that surprising for many of us. Yet now the NHS is piloting it is many areas. A few are trying low carb too but without being informed of the options how can patients choose?

 

[Callista]

"Very few doctors recommend following low carb"

That seems surprising. Is it because they are concerned we'll swap carb for fat, and as the UK (and the developed world) has a general obesity problem, docs regard fat as a bigger enemy than carbs?

 

[Burylancs]

"Very few doctors recommend following low carb"

That seems surprising. Is it because they are concerned we'll swap carb for fat, and as the UK (and the developed world) has a general obesity problem, docs regard fat as a bigger enemy than carbs?

It's because its traditionally associated with cardio problems, kidney problems, thyroid problems and such things as adrenal fatigue. The Atkins Diet had to upgrade its maintenance diet in about 2012 to 130g a day because of Ckass Actions threatening on those issues. It's only recently that low carb zealots have been allowed to seize the agenda at DiabeteUk and are pushing a very wooden one-size-fits-all figure of 130g irrespective of job, age, stage and duration of diabetes

 

[bulkbiker]

"Very few doctors recommend following low carb"

That seems surprising. Is it because they are concerned we'll swap carb for fat, and as the UK (and the developed world) has a general obesity problem, docs regard fat as a bigger enemy than carbs?

If you cut carbs to a minimum then yes you have to replace it with something which is fats and protein.

Most doctors know very little about nutrition so have no idea what to recommend people eat to put T2 into remission.

They simply hand out copies of the "Eatwell Guide" which doesn't help anyone to lose weight.

 

[bulkbiker]

It's only recently that low carb zealots have been allowed to seize the agenda at DiabeteUk and are pushing a very wooden one-size-fits-all figure of 130g irrespective of job, age, stage and duration of diabetes

I'd really love to see that happen but so far I haven't noticed a huge following of low carb here. Are you on a different forum to me maybe?

associated with cardio problems, kidney problems, thyroid problems and such things as adrenal fatigue.

"Associations" though not causal proof which can be rather problematic.
Has ViRTA been shut down yet?
They go for full on dietary ketosis and have better results than Taylor...

 

[Callista]

Hmm, lots to ponder! I wonder if another factor should play into this? That Homo sap didn't get much access to large amounts of starch easily (or at all?) until about 8-10k years ago with the Neolithic Agricultural revolution, ie, planting cereals of various kinds. So for most of our evolution we were of necessity 'low-carb' (or, at least, 'low starch' as I guess we probably scoffed all the edible fruit/berries we could forage).

I wonder, therefore, whether our 'ancestral physiology' (for want of a better term) is more geared to a low carb (low starch) diet?

Just pondering!

 

[Burylancs]

Hmm, lots to ponder! I wonder if another factor should play into this? That Homo sap didn't get much access to large amounts of starch easily (or at all?) until about 8-10k years ago with the Neolithic Agricultural revolution, ie, planting cereals of various kinds. So for most of our evolution we were of necessity 'low-carb' (or, at least, 'low starch' as I guess we probably scoffed all the edible fruit/berries we could forage).

I wonder, therefore, whether our 'ancestral physiology' (for want of a better term) is more geared to a low carb (low starch) diet?

Just pondering!

Our ancestors were Hunter Gatherers. The gatherer part suggesting they got upto 50% of their calories from carbs. Diabetes was first diagnosed 4 and a half thousand years ago in Ancient Egypt. Perhaps no surprise, since they had a grain based diet based on the Nile. The genes for Type 2 Diabetes are so widespread and well conserved that they might have been beneficial at one point some authorities suggest. In periods of famine for example or older age. The official name Diabetes Mellitus, 'sweet p@ss' , is Greek of course because they sipped the urine to diagnose it.

 

[Deleted member 21371]

Hmm, lots to ponder! I wonder if another factor should play into this? That Homo sap didn't get much access to large amounts of starch easily (or at all?) until about 8-10k years ago with the Neolithic Agricultural revolution, ie, planting cereals of various kinds. So for most of our evolution we were of necessity 'low-carb' (or, at least, 'low starch' as I guess we probably scoffed all the edible fruit/berries we could forage).

I wonder, therefore, whether our 'ancestral physiology' (for want of a better term) is more geared to a low carb (low starch) diet?

Just pondering!

Mostly roots and berries

 

[bulkbiker]

I wonder, therefore, whether our 'ancestral physiology' (for want of a better term) is more geared to a low carb (low starch) diet?

Indeed that's pretty likely... quite a few studies suggest precisely that

How diet shaped human evolution: The Neanderthal rib-cage and pelvis expanded to adapt to a high-protein diet in Ice-Age Europe

A new study finds that the Ice-Age diet -- a high-protein intake of large animals -- triggered physical changes in Neanderthals, namely a larger ribcage and a wider pelvis.

www.sciencedaily.com

The evolution of the human trophic level during the Pleistocene - PubMed

The human trophic level (HTL) during the Pleistocene and its degree of variability serve, explicitly or tacitly, as the basis of many explanations for human evolution, behavior, and culture. Previous attempts to reconstruct the HTL have relied heavily on an analogy with recent hunter-gatherer...

pubmed.ncbi.nlm.nih.gov

As an ex archaeologist I find it quite fascinating plus of course it's supportive of my mainy animal based food diet.

 

[Callista]

All fascinating!!! I wonder if the 50% from carbs stat indicates more sugar sources than starch sources though? And then the starch mostly from rooty veg?

I know there are precious few hunter gatherers still around (the surviving Bushmen/San?) (if that's the correct term?) (and maybe some remaining Amazonian Amerindians?), but I wonder what their contemporary food intake shows (ie, whatever is 'not' modern/western yet)

Also interesting that the D2 genes are so well conserved, indicating, as you say, that they might provide some useful function as well? (Perhaps the ability to make the most/wring the last damn calorie (!) out of every bit of relatively 'scarce' starch/sugar?)(which, of course, in an environment where carbs are not plentiful, would be a useful trait.)

As ever, in general, it's only really the post-WWII (Never had it so good!) 'mass prosperity' that has caused this huge, huge availability of vast amounts of food for western-based humanity, and we are just not 'designed' to cope well with it...and, worse, we are 'designed' to crave stuffing our faces whenever the food is around, as in 'olden times' (!) most of us lived if not hungry, then certainly never with much certainty of the next meal....



Also interesting
I know there are precious few hunter gatherers still around (the surviving Bushmen/San?) (if that's the correct term?) (and maybe some remaining Amazonian Amerindians?), but I wonder what their contemporary food intake shows (ie, whatever is 'not' modern/western yet)

 

[Burylancs]

All fascinating!!! I wonder if the 50% from carbs stat indicates more sugar sources than starch sources though? And then the starch mostly from rooty veg?

I know there are precious few hunter gatherers still around (the surviving Bushmen/San?) (if that's the correct term?) (and maybe some remaining Amazonian Amerindians?), but I wonder what their contemporary food intake shows (ie, whatever is 'not' modern/western yet)

Also interesting that the D2 genes are so well conserved, indicating, as you say, that they might provide some useful function as well? (Perhaps the ability to make the most/wring the last damn calorie (!) out of every bit of relatively 'scarce' starch/sugar?)(which, of course, in an environment where carbs are not plentiful, would be a useful trait.)

As ever, in general, it's only really the post-WWII (Never had it so good!) 'mass prosperity' that has caused this huge, huge availability of vast amounts of food for western-based humanity, and we are just not 'designed' to cope well with it...and, worse, we are 'designed' to crave stuffing our faces whenever the food is around, as in 'olden times' (!) most of us lived if not hungry, then certainly never with much certainty of the next meal....



Also interesting
I know there are precious few hunter gatherers still around (the surviving Bushmen/San?) (if that's the correct term?) (and maybe some remaining Amazonian Amerindians?), but I wonder what their contemporary food intake shows (ie, whatever is 'not' modern/western yet)

There sre still some Hunter Gatherers around. Their cholesterol levels are 2.25 to 2.75 which shows how far we are from healthy levels.

 

[Callista]

I hope the medics are studying them well before they become extinct (or their lifestyle does...)

What's always impressed me about the HG lifestyle is how little work they do, relative to their food hunting/gathering effort. It's the downside of the neolithic farming revolution - condemned us to endless toil. And, sadly, has fuelled the bloated human population currently destroying the earth (sigh).

 

[bulkbiker]

There sre still some Hunter Gatherers around. Their cholesterol levels are 2.25 to 2.75 which shows how far we are from healthy levels.

Not sure that's quite correct .. at least not for all hunter gatherers..?

Serum Cholesterol Among Hunter-Gatherers: Conclusion - Perfect Health Diet | Perfect Health Diet

 

[everydayupsanddowns]

Very few doctors recommend following low carb although many people who try it find it works well for them.

I think the landscape is changing.

From my years of forum dwelling, I can certainly remember a time when that was the case. About 10 year ago low carb was viewed with quite a lot of suspicion, and many newbies were being actively discouraged from the approach. Around 5 years ago, to my recollection, the tide began to turn, and with the likes of Dr Unwin, and Freshwell, along with multiple conference presentations, low carb approaches are increasingly advocated and recommended to those who are newly diagnosed. Diabetes UK's dietary recommendations have changed substantially over the past 10-15 years too from what I've seen. From 'base all meals on starchy carbs' to multiple approaches including low carb, mediterranean, Newcastle and more.

A newbie thread I replied to earlier had been recommended to stick to 3 meals totalling no more than 20g of carbs each, which seemed on the verge of keto to me.

I haven't done a review of suggestions this week, but my feeling it that perhaps 40-50% of newcomers who share the dietary suggestions they have been given use phrases like, "nurse/GP told me to avoid bread, pasta, potatoes, rice etc"

So while low carb has never quite been able to prove itself in an analysis of all available research as the only way, it certainly seem to be actively on the table on currently recommended options?

 

[Deleted member 21371]

I think the landscape is changing.

From my years of forum dwelling, I can certainly remember a time when that was the case. About 10 year ago low carb was viewed with quite a lot of suspicion, and many newbies were being actively discouraged from the approach. Around 5 years ago, to my recollection, the tide began to turn, and with the likes of Dr Unwin, and Freshwell, along with multiple conference presentations, low carb approaches are increasingly advocated and recommended to those who are newly diagnosed. Diabetes UK's dietary recommendations have changed substantially over the past 10-15 years too from what I've seen. From 'base all meals on starchy carbs' to multiple approaches including low carb, mediterranean, Newcastle and more.

A newbie thread I replied to earlier had been recommended to stick to 3 meals totalling no more than 20g of carbs each, which seemed on the verge of keto to me.

I haven't done a review of suggestions this week, but my feeling it that perhaps 40-50% of newcomers who share the dietary suggestions they have been given use phrases like, "nurse/GP told me to avoid bread, pasta, potatoes, rice etc"

So while low carb has never quite been able to prove itself in an analysis of all available research as the only way, it certainly seem to be actively on the table on currently recommended options?

I guess the choice is reverse the illness, or control the symptoms?

If I go south, I'll go for diet control one day, perhaps.
I'm keeping everything on the table.

 

[everydayupsanddowns]

I guess the choice is reverse the illness, or control the symptoms?

Many of our low or moderate carb members meet the generally accepted criteria for remission (2x HbA1c of 48 or below with no meds), and with a way of eating that they find enjoyable and sustainable. I think it's about finding an approach that works for each person as an individual.

To my mind it's not very helpful to suggest that people who chose a different route somehow were wrong or made a mistake. Particularly since not all approaches work equally for everyone - so there's no guarantee that a different option (eg one that worked for an individual) would be equally effective for someone else.

Everyone is just trying to find their way through the maze, and find the set of strategies that work for them. 🙂

 

[bulkbiker]

it certainly seem to be actively on the table on currently recommended options?

Except that many doctors or, far more importantly diabetes nurses, seem either ignorant or sceptical of it as a likely successful treatment. If people aren't made aware of it as a possibility then it won't be of any help to them.

 

[everydayupsanddowns]

Except that many doctors or, far more importantly diabetes nurses, seem either ignorant or sceptical of it as a likely successful treatment. If people aren't made aware of it as a possibility then it won't be of any help to them.

I think that is far far less the case than now than was when you were diagnosed. Just look at the number of newbies arriving who have been told to go low carb by their nurse or GP 🙂

 

[bulkbiker]

I think that is far far less the case than now than was when you were diagnosed. Just look at the number of newbies arriving who have been told to go low carb by their nurse or GP 🙂

I can only vouch for the experience at my surgery and the T2 Sussex NHS group I am a member of...it is still very rare worse luck for the poor patients. In fact we had a rep from Diabetes UK at our last video call who was very anti any dietary advice!

 

[Deleted member 21371]

Many of our low or moderate carb members meet the generally accepted criteria for remission (2x HbA1c of 48 or below with no meds), and with a way of eating that they find enjoyable and sustainable. I think it's about finding an approach that works for each person as an individual.

To my mind it's not very helpful to suggest that people who chose a different route somehow were wrong or made a mistake. Particularly since not all approaches work equally for everyone - so there's no guarantee that a different option (eg one that worked for an individual) would be equally effective for someone else.

Everyone is just trying to find their way through the maze, and find the set of strategies that work for them. 🙂

I suppose the focus of my HCP team wasn't solely on hba1c.

Directly, or indirectly, the focus was mostly on weight loss I guess, and improving my diet, which was needed generally.

The Newcastle diet hit the news after I'd lost most of the weight I had needed to, I decided it wouldn't hurt to try it, to actually specifically address the type 2.

Even now, my focus, like many others, is simply to stay fit, and not gain weight, and still look ok on the beach in summer.

Things may change, other health issues may come along, apart from diabetes, my options are still there for them as well.

And I entirely agree, it's vital to find the method that works for you.
There is no "one size fits all" answer.