Why do we need to go to the USA to learn what is achievable?

[wallycorker]

I have been a Type 2 diabetic for around nine years. Yet only recently have I learnt what improvements in control can be achieved using diet. I only came to understand the true power of diet by reading material from the USA - initially a book by Dr Neal D. Barnard ("The Reverse Diabetes Diet: Control Your Blood Sugar, Repair Insulin Function and Minimise Your Medication") and later another by Dr Richard K. Bernstein ("Dr Bernstein's Diabetes Solution: Complete Guide to Achieving Normal Blood Sugars") plus works by other authors.

Two years ago, my Hba1c was 9.4%. After having found such books relating to the "reversal" of diabetes by searching on Amazon, I have brought my last four quarterly Hba1c results down from 8.5% to 6.8% to 5.7% and the last reading was as low as 5.5% and dropping.

It seems to me that all the educational messages received from the NHS - whether it be from GPs, nurses or dietitians - are diluted compromises. Is the reason for this that the information provided in this country needs to be adjusted to take account of what the NHS is willing to fund?

Why do we need to go to the USA for such information on how to bring our blood sugars under control? Why is it that UK diabetics are not educated about such dietary possibilities from NHS sources? Anyone got any views on this matter?

 

[VBH]

You don't actually have to go the US at all. The US is not that far removed from the advice that the NHS gives since the ADA is broadly in line with the NHS and DUK. What you are looking at is the rebels and it seems to be easier in the US for the rebels to be heard.

There are groups in the UK and internationally particularly on the web who knew most of this before those books came along, but it all helps.

But you also have to bear in mind that its not just the good people, particularly in the US who get heard. There's also the nutters and the totally misleading. For years, Cherewatenko has been publishing books claiming a cure for diabetes through the use of chromium, based on a tiny study in an isolated region of china where people have a chromium deficiency to a level which is never experienced anywhere else.

Off the back of this he has sold a lot of books claiming that chromium is a cure for diabetes when it clearly isnt - unless it was caused by a chromium deficiency. And the chances of it being caused by a chromium deficiency in the west are virtually nil. And then there is a danger of poisoning from the use of chromium supplements.

So you do have to be a little selective with books to avoid to kooks, but you seem to have found some of the better ones so far.

 

[C*5_Dodger]

I have been a Type 2 diabetic for around nine years. Yet only recently have I learnt what improvements in control can be achieved using diet. I only came to understand the true power of diet by reading material from the USA - initially a book by Dr Neal D. Barnard ("The Reverse Diabetes Diet: Control Your Blood Sugar, Repair Insulin Function and Minimise Your Medication") and later another by Dr Richard K. Bernstein ("Dr Bernstein's Diabetes Solution: Complete Guide to Achieving Normal Blood Sugars") plus works by other authors.

Two years ago, my Hba1c was 9.4%. After having found such books relating to the "reversal" of diabetes by searching on Amazon, I have brought my last four quarterly Hba1c results down from 8.5% to 6.8% to 5.7% and the last reading was as low as 5.5% and dropping.

It seems to me that all the educational messages received from the NHS - whether it be from GPs, nurses or dietitians - are diluted compromises. Is the reason for this that the information provided in this country needs to be adjusted to take account of what the NHS is willing to fund?

Why do we need to go to the USA for such information on how to bring our blood sugars under control? Why is it that UK diabetics are not educated about such dietary possibilities from NHS sources? Anyone got any views on this matter?

There is certainly a number of books in the USA that put the alternate view, i.e. that it is carbohydrates - particularly refined carbohydrates - that are the cause of all our nutritional woes. There is one you may like to read by Jenny Ruhl (see the books thread of this forum). The problem with the "Establishment" both in the USA and here is that they believe that fat - saturated fat in particular - is bad for us. Hence low fat and thus high carbohydrate diets. The only trouble is the science behind, "the fat is bad for you" theory is not well founded. It all started with Ancel Keyes and his 6 countries study but this was flawed. Have a look at this site for a critique of Keys http://high-fat-nutrition.blogspot.com/search/label/Cholesterol%20presentation%3A%20Between%20countries There's lots more if you are interested!

Regards Dodger

 

[wallycorker]

There is certainly a number of books in the USA that put the alternate view, i.e. that it is carbohydrates - particularly refined carbohydrates - that are the cause of all our nutritional woes. There is one you may like to read by Jenny Ruhl (see the books thread of this forum). The problem with the "Establishment" both in the USA and here is that they believe that fat - saturated fat in particular - is bad for us. Hence low fat and thus high carbohydrate diets. The only trouble is the science behind, "the fat is bad for you" theory is not well founded. It all started with Ancel Keyes and his 6 countries study but this was flawed. Have a look at this site for a critique of Keys http://high-fat-nutrition.blogspot.com/search/label/Cholesterol%20presentation%3A%20Between%20countries There's lots more if you are interested!

Regards Dodger

Hi Dodger - Thanks for your comments.

I have read the Jenny Ruhl "Blood Sugar 101" book - also the one by Vern S. Cherewatenko mentioned by VBH - also, I've read many others. I've never read so much in my life!

However, as a Type 2 diabetic, the book that has stimulated me most and got me moving in the right direction is Dr Neal D. Barnard's book.

As regards fat, at this stage, I too consider fat is bad for me and I moved initially to a very low-fat diet - almost vegetarian or even vegan. After reading other US books, I have come to the conclusion that it is very likely that animal products and saturated fat also plays a big part in heart disease, cancer and other diseases too. Being a survivor of colon cancer seven years ago, I am surprised that I was never given any dietary advice as to how I might possibly prevent a recurrence. I found Dr Dean Ornish's book on the reversal of heart disease very convincing too.

I really do not know exactly what has led to my very significant recovery in blood glucose levels. I have said elsewhere that at the same time that I moved to a low-fat diet, as a separate exercise, I started to diet to lose weight and I'm still doing that with an average caloric intake of around 1,300 calories. I'm fairly convinced that the lower caloric intake played a major part in my diabetic improvement. Why? Because the improvement began almost as soon as I started and that seems to happen in all the case studies in the books that I have read.

It was later on that I started playing around with changing the types of carbohydrate (i.e. from refined carbs to low G.I. types) and, also, starting to move towards a lower-carbohydrate intake but only a little bit (I can't call it a low-carb diet). In fact, I consider that I'm still at an early stage with that. I thought Dr Bernstein's book was stimulating too but I didn't dive straight into his programme because - as others have said - it seemed a little bit difficult and drastic. Moreover, I was doing OK - and still am - with the low fat/low caloric intake approach. However, if things start to get more difficult then it is something that I will certainly take on board.

I suppose you could say that I'm on a low-fat, reduced-carbohydrate diet with restricted calories. However, I tend to think of my current diet as being very low-fat (with almost no animal fat/cholesterol), wholefood - with lots of fruit and vegetables (quite a lot more than the five-a-day) - with very low alcohol intake. I'm far from ceratin as to what is causing my improvement in blood glucose levels and blood pressure - and I expect also in cholesterol numbers when I have my annual check in the near future.

Whatever is causing my improvement, I am a very happy man - not least for the 25kg weight loss that has occured so far.

I took a quick look at the literature via your link but found it very confusing and difficult to understand. I'll try to take it in at a later date. Thanks for sending it.

Best Wishes - John

 

[wallycorker]

You don't actually have to go the US at all. The US is not that far removed from the advice that the NHS gives since the ADA is broadly in line with the NHS and DUK. What you are looking at is the rebels and it seems to be easier in the US for the rebels to be heard.

There are groups in the UK and internationally particularly on the web who knew most of this before those books came along, but it all helps.

But you also have to bear in mind that its not just the good people, particularly in the US who get heard. There's also the nutters and the totally misleading. For years, Cherewatenko has been publishing books claiming a cure for diabetes through the use of chromium, based on a tiny study in an isolated region of china where people have a chromium deficiency to a level which is never experienced anywhere else.

Off the back of this he has sold a lot of books claiming that chromium is a cure for diabetes when it clearly isnt - unless it was caused by a chromium deficiency. And the chances of it being caused by a chromium deficiency in the west are virtually nil. And then there is a danger of poisoning from the use of chromium supplements.

So you do have to be a little selective with books to avoid to kooks, but you seem to have found some of the better ones so far.

Hi again VBH,

I wasn't saying that the ADA is any better than the NHS or Diabetes UK. From what I have read they all give a similar message - i.e. broadly speaking have a bit less fat and five-a-day. I was referring to the books by various different authors - in particular, by Drs Neal D. Barnard and Richard Bernstein - but also by others too. I've never read so much in my life!

Certainly, I do not consider that I've read anything by any "nutters" - even the book by Cherewatenko which I have read. However, reading his book didn't send me out looking to buy chromium in any form whatsoever.

As far as I am concerned, reading material on any subject is always the same. There are things that you will agree with and embrace - even if it is only to see what happens - and there are things that you will be unable to relate to.

You say "There are groups in the UK and internationally particularly on the web who knew most of this before those books came along" and I'm certain that there are. That is my main criticism of the information that I have been receiving from the NHS and Diabetes UK for nine years. There must be people at the top of these organisations who have read and understood the various literature that is out there showing how our type of problem can be effectively improved by diet. However, for some reason unknown to me they do not give us that information. Instead, they pump us full of different drugs and operate on us when things get bad.

Personally, I suspect that the real reason for this will turn out to be financial - such as the influence that pharmaceutical companies and food organisations and such like have on our health system. Perhaps, we would manage to understand why things are so far from ideal if we were able to understand how medical conferences, research and our health service provision in general are being funded and by who.

In the meantime, it is quite obvious from my short time visiting this forum that we are all being given different and conflicting advice, also we are all being dealt with extremely differently by the PCTs and GPs despite the fact that all these medical authorities fall under the same governmental and NHS umbrella. Why should that be the case?

 

[C*5_Dodger]

I suppose you could say that I'm on a low-fat, reduced-carbohydrate diet with restricted calories. However, I tend to think of my current diet as being very low-fat (with almost no animal fat/cholesterol), wholefood - with lots of fruit and vegetables (quite a lot more than the five-a-day) - with very low alcohol intake. I'm far from ceratin as to what is causing my improvement in blood glucose levels and blood pressure - and I expect also in cholesterol numbers when I have my annual check in the near future.

Dear John,

I think that what you are doing is great, I am a great believer in "If it works for you - go for it!". I think that any diet can be made to work by restricting the calorie intake. For me a controlled carb approach works because it makes sense physiologically. I keep saying this, but "If you don't put glucose ( carbohydrate) into your body - how can you have high blood sugar." Regarding the post about Ancel Keys what is being demonstated is that you can "prove" just about anything you want if you select 6 counties from 22 that suit your purpose. In effect Ancel keys fudged it!

Warmest Regards Dodger

 

[Caroline Wilson]

I think there is a lot we can do for ourselves, and to help ourselves. Knowledge is power.

I'm sure there are some good studies in USA and the UK. One thing to remember is in the USA there is not an NHS as there is here, so if people don't have good insurance they can't always afford medical advice or treatment.

I agree some GPs are reluctant to share knowledge here because it means they are in control of the power, but it is worth doing research and finding out for ourselves.

 

[wallycorker]

Dear John,

I think that what you are doing is great, I am a great believer in "If it works for you - go for it!". I think that any diet can be made to work by restricting the calorie intake. For me a controlled carb approach works because it makes sense physiologically. I keep saying this, but "If you don't put glucose ( carbohydrate) into your body - how can you have high blood sugar."

Warmest Regards Dodger

Dear Dodger,

Yes - I agree with that.

I think what I'm trying to say is that my restricted calorie diet is the main reason that my blood glucose levels have become so well (and easily) under control. It's quite possible that my dramatic improvement is less a matter of the type of food that I'm eating at this stage. However, I do not know that for certain.

I'm quite prepared that somewhere further down the line I will encounter more difficulties. It is already my intention that if - or when - that occurs then I will be adopting Dr Bernstein's low-carb approach at least to some degree.

By the way, I read another book last week "Healthy at 100" in which he says that the societies with greatest longevity - e.g. the Okinawans - have tended to have a lower caloric intake but with full nutrition. By the way, another great book that one by John Robbins.

Best Wishes - John

 

[mikep1979]

we dont need to go to the usa to learn what is achievable at all!!! if you listen to what people have to say then you would understand this fact. i for one have a great team of professionals around me who give me all the latest up to date info and equipment. they also are 10x better than my first doctor who was a yank and couldnt have organized a p***up in a brewery!!!! he was useless and he was supposedly a diabetes specialist. i am now under a very very experienced team who like to be at the cutting edge of treatment.

i understand that type 2's have slightly different needs to type 1's, but i have 2 family members who are type 2 and they are both under the same team as me and follow a standard healthy eating diet, including carbs etc and they are in the 5% club. they have both been on a carb counting course and also told about hidden sugars etc. i think the problems you are having come down to a) your care team.......and b) the pct.

 

[wallycorker]

I think there is a lot we can do for ourselves, and to help ourselves. Knowledge is power.

I'm sure there are some good studies in USA and the UK. One thing to remember is in the USA there is not an NHS as there is here, so if people don't have good insurance they can't always afford medical advice or treatment.

I agree some GPs are reluctant to share knowledge here because it means they are in control of the power, but it is worth doing research and finding out for ourselves.

Hello Caroline,

Yes - we should all be grateful for the NHS - I agree with that. But our system is certain to have weaknesses and drawbacks that we ought to push to improve.

There is one major drawback to the NHS system that has only just hit me after 65 years and that is that doctors are very likely only going to give advice that is fully funded by the NHS - or the PCT. In my case, as a Type 2 diabetic, I recently asked to be allowed to start testing because I was changing my lifestyle dramatically to try to get my blood glucose levels under control. My GP said he wasn't willing to do that because it was sufficient to wait for the three-monthly HbA1c test to see how good - or, more likely how bad - things were before deciding what to do next.

Only afterwards did it strike me that in a private health situation his advice would almost certainly have been very different if we were operating outside the NHS. In such a case, he would almost certainly have been recommending testing.

What would he be doing if he was a Type 2 diabetic? What would he be recommending to his own family members and friends if they were in my situation? I think that I know the answer to that question!

What I'm saying is that being in the NHS does not always work necessarily to our advantage and good health. I consider that the health authorities ought to give us both funded and non-funded advice.

 

[mikep1979]

wally it has nothing to do with the gp and has everything to do with the pct thinking they can save some money and implement it in maybe cutting waiting times for operations etc. all pcts have a budget and have to stick to it. they forcast at least a year in advance how much they will spend and have to then stick to the budget given to them. some services suffer and others flourish. i know my local pct has nothing to do with cancer treatments at all, but only because they have an agreement with another pct local to us to use their facilities and for the other pct to use our pct's diabetes facilities. it is a case of the post code lottery again. i understand what your saying about the usa having good studies etc, but like has bee stated they have no nhs, so think how much you would have spent on health care till this point as your premiums for insurance would be on the high side as a diabetic.

 

[wallycorker]

I think there is a lot we can do for ourselves, and to help ourselves. Knowledge is power.

I'm sure there are some good studies in USA and the UK. One thing to remember is in the USA there is not an NHS as there is here, so if people don't have good insurance they can't always afford medical advice or treatment.

I agree some GPs are reluctant to share knowledge here because it means they are in control of the power, but it is worth doing research and finding out for ourselves.

Hello Caroline,

Yes - we should all be grateful for the NHS - I agree with that. But our system is certain to have weaknesses and drawbacks that we ought to push to improve.

There is one major drawback to the NHS system that has only just hit me after 65 years and that is that doctors are very likely only going to give advice that is fully funded by the NHS - or the PCT. In my case, as a Type 2 diabetic, I recently asked to be allowed to start testing because I was changing my lifestyle dramatically to try to get my blood glucose levels under control. My GP said he wasn't willing to do that because it was sufficient to wait for the three-monthly HbA1c test to see how good - or, more likely how bad - things were before deciding what to do next.

Only afterwards did it strike me that in a private health situation his advice would almost certainly have been very different if we were operating outside the NHS. In such a case, he would almost certainly have been recommending testing.

What would he be doing if he was a Type 2 diabetic? What would he be recommending to his own family members and friends if they were in my situation? I think that I know the answer to that question!

What I'm saying is that being in the NHS does not always work necessarily to our advantage and good health. I consider that the health authorities ought to give us both funded and non-funded advice.

 

[mikep1979]

Hello Caroline,

Yes - we should all be grateful for the NHS - I agree with that. But our system is certain to have weaknesses and drawbacks that we ought to push to improve.

There is one major drawback to the NHS system that has only just hit me after 65 years and that is that doctors are very likely only going to give advice that is fully funded by the NHS - or the PCT. In my case, as a Type 2 diabetic, I recently asked to be allowed to start testing because I was changing my lifestyle dramatically to try to get my blood glucose levels under control. My GP said he wasn't willing to do that because it was sufficient to wait for the three-monthly HbA1c test to see how good - or, more likely how bad - things were before deciding what to do next.

Only afterwards did it strike me that in a private health situation his advice would almost certainly have been very different if we were operating outside the NHS. In such a case, he would almost certainly have been recommending testing.

What would he be doing if he was a Type 2 diabetic? What would he be recommending to his own family members and friends if they were in my situation? I think that I know the answer to that question!

What I'm saying is that being in the NHS does not always work necessarily to our advantage and good health. I consider that the health authorities ought to give us both funded and non-funded advice.

as my message above pointed out it isnt the gp but the pct

 

[aymes]

I've lived in both the US and the UK and so within both health systems and I have to say I am extrememly grateful to have access to the NHS. In my experience I have always had excellent service from the NHS as a whole and have personally never felt that I've been given bad (or rather minimised) advice based on financial considerations. The US certainly has some advantages (for those with good insurance!) and access to excellent expertise but there are also some parts of that system that really do not sit well with me, TV advertising of drugs encouraging the public to ask their physician for them to name but one!
Anyone interested on the topic I really would recommend watching the Michael Moore film Sicko. I'm not generally a fan of Michael Moore films as I can find him to be quited biased and one sided in his explorations but I did think Sicko worked very well as a comparison between different health care systems (chiefly US, Canadian, UK, France and I think Germany) and the advantages and limitations of each. I'd be interested what anyone else who has seen it thought?

 

[wallycorker]

as my message above pointed out it isnt the gp but the pct

Hi mikep1979,

You keep saying that "it isnt the gp but the pct" but I think that you might be quite a way off the mark with your statement.

Certainly, I am aware of a great difference across our PCT. I know of some GPs who prescribe strips and others such as mine that don't. Moreover, I am aware that some GPs in the same practice have different attitudes to such things.

You may be right that PCTs will have some sort of a policy on such issues but GPs certainly seem to have a great deal of autonomy as to what they actually do.

Best Wishes - John

 

[VBH]

I have to agree with John. Although Mikep has had good experiences of medics (after a shaky start), there are many who do not and its a bit of a lottery. Theres also a difference between T1 and T2 in that T1s generally have access to a specialist while T2s see GPs and nurses for the most part and they can be highly variable.

I know of one individual in the Isle of Man who has a doc who appears to have very little knowledge, has the patient down as a T2 despite it being very obvious that its T1 (or T1.5) and has taken months to get around to the idea that metformin is not going to do the job. Its extremely difficult for this patient to go elsewhere.

Some patients do get stuck with inadequate care and have a hard time getting any change, particularly those misdiagnosed as T2.

With regard to strips, despite PCT policy there are docs at the same surgery who are more willing to prescribe strips than others depending on how the patient intends to use them. Its just down to how much knowledge the GP has about diabetes generally and putting the patient's best interests above the pressure from the PCT.

Aymes - Seen it. Liked it. But I knew most of what he was saying already from talking to various people around the world, particularly the appalling inequality in the US. I was rather glad he tried to bring more attention to it.

 

[wallycorker]

I've lived in both the US and the UK and so within both health systems and I have to say I am extrememly grateful to have access to the NHS. In my experience I have always had excellent service from the NHS as a whole and have personally never felt that I've been given bad (or rather minimised) advice based on financial considerations. The US certainly has some advantages (for those with good insurance!) and access to excellent expertise but there are also some parts of that system that really do not sit well with me, TV advertising of drugs encouraging the public to ask their physician for them to name but one!
Anyone interested on the topic I really would recommend watching the Michael Moore film Sicko. I'm not generally a fan of Michael Moore films as I can find him to be quited biased and one sided in his explorations but I did think Sicko worked very well as a comparison between different health care systems (chiefly US, Canadian, UK, France and I think Germany) and the advantages and limitations of each. I'd be interested what anyone else who has seen it thought?

Hi Aymes,

People seem to have misunderstood me a bit because I never intended to say that I believed that the US health systems were better than the UK's NHS. Neither was I saying that all US doctors are better than UK doctors. In fact, I'm a deep-seated Labour supporter and a massive supporter of our NHS. However, it is important that all of us at least try to recognise any weaknesses in the NHS and - even more importantly - try to get changes made to get rid of the weaknesses.

Advertising is something that I am aware of - and the possibility of how it might influence on what happens in our societies - even in our charities. For example, the Diabetes UK magazine Balance - which I receive - contains many full-page adverts by the pharmaceutical companies advertising meters and strips (giving meters away even so that we get hooked onto using their strips) - I wonder how much of an influence that has on decisions by Diabetes UK? Might the magazine's content have a totally different slant if the main advertisers were organisations representing healthy eating foods - e.g. vegetables, fruit, beans, nuts and suchlike? I suspect that it would! Moreover, might the advice that we get from the NHS and Diabetes UK be different too if that was the way things happened?

I suspect that GPs surgeries are the same - i.e. being bombarded with stuff by the pharmaceutical companies so that people get hooked onto using their equipment - and even more importantly their medications and drugs. When was the last time you saw a vegetable company making deliveries to your local GP surgery?

Sorry! I didn't see the film.

Best Wishes - John

 

[aymes]

Hi Aymes,

People seem to have misunderstood me a bit because I never intended to say that I believed that the US health systems were better than the UK's NHS. Neither was I saying that all US doctors are better than UK doctors. In fact, I'm a deep-seated Labour supporter and a massive supporter of our NHS. However, it is important that all of us at least try to recognise any weaknesses in the NHS and - even more importantly - try to get changes made to get rid of the weaknesses.

Advertising is something that I am aware of - and the possibility of how it might influence on what happens in our societies - even in our charities. For example, the Diabetes UK magazine Balance - which I receive - contains many full-page adverts by the pharmaceutical companies advertising meters and strips (giving meters away even so that we get hooked onto using their strips) - I wonder how much of an influence that has on decisions by Diabetes UK? Might the magazine's content have a totally different slant if the main advertisers were organisations representing healthy eating foods - e.g. vegetables, fruit, beans, nuts and suchlike? I suspect that it would! Moreover, might the advice that we get from the NHS and Diabetes UK be different too if that was the way things happened?

I suspect that GPs surgeries are the same - i.e. being bombarded with stuff by the pharmaceutical companies so that people get hooked onto using their equipment - and even more importantly their medications and drugs. When was the last time you saw a vegetable company making deliveries to your local GP surgery?

Sorry! I didn't see the film.

Best Wishes - John

Oh no, I do appreciate that you weren't suggesting one system was superior to the other, I do find comparisons very interesting though and there certainly are plus and minus points with each.
Regarding advertising, what I was specifically referring to was the use of advertising in the US along the lines of 'do you suffer from these symptoms.... then our drug will help you...speak to your doctor and ask for it'. That kind of advertising really scares me.
I do agree that there is a concern regarding advertising and donations to charities and the impact that may have on the direction of the organisation. For what it's worth I do work for a charity, and have spent all my working life in the sector and in my experience it is something that those working in the organisations are very aware of and conscious to ensure that funders do not have an undue influence on their workings, of course the success of these strategies is open to debate! From my perspective I don't think Diabetes UK does too bad a job on this and I'm happy with the balance (no pun intended) that they get between medical and lifestyle advice.
Interestingly enough last time I visited my GP surgery they were do a large healthy eating promotion with the support of local fruit and veg businesses, we now have some very elaborate paintings of fruit and veg (from interesting angles of course!) on display throughout the place. But I do appreciate that this is just a strange coincidence to you comment and certainly not the experience of all so I do get your point regarding the influence of companies on these places.

 

[wallycorker]

Interestingly enough last time I visited my GP surgery they were do a large healthy eating promotion with the support of local fruit and veg businesses, we now have some very elaborate paintings of fruit and veg (from interesting angles of course!) on display throughout the place.

Wow!!! Now there is something that I hadn't expected to read.

Well done that surgery!!!!!

Where is it? If it's near enough I might try getting in. 🙂

Best Wishes - John

 

[katie]

Im thinking about making myself go on a low carb diet. One reason is because at the moment I just eat what I want and my levels go high. I can't snack between meals without my blood glucose rising either. Another is because I really want to lose the love handles 😛

Can anyone recommend a good book that will give me ideas of what to eat instead of my current Carby meals? I want to cut down a lot on bread because I eat far too much. I cant think of enough alternatives to all the carbohydrate I consume! I only eat white meat and fish.

I hope I can make myself do this! I'm kinda stressed at the moment so I keep grazing, but I really want to get good levels and feel fitter 🙂