Many of you will know that I have been a Type 1 diabetic since the 1960s. Besides this site I keep a watching brief on a few diabetes sites. One thing being very much pushed is a low carb, high fat (LCHF) diet. Claims include that it achieves better diabetic ciontrol and despite being high in saturated fats colesterol is unaffected. I have always been rather dubious about the claims with some of the research looking questionable. Already being on lowish carb, ~120gm CHO, I decided to give it a short trial but not dropping my daily carbs below 100gm. Recently I had some blood tests done and the results were:
HbA1c - no real change (-1 mmol/mol)
Cholesterol - total increased from 3.2 to 4.1 with most of the increase being LDL (bad) cholesterol.
So it's back to how I was and tonight as penance I had pickled herring with a hard boiled egg, a few small new potatoes and salad.
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MichaelJH
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Hello Michael. I'm only familiar with low carb diets for Type 2 diabetes, not Type 1.
I was diagnosed as borderline "insulin resistant" with an HbA1c score that was right on the edge, blood tests carried out across a twenty year period showed it had been steadily climbing so I was clearly on my way towards a not very good outcome.
No medication was prescribed but I went on a Mediterranean diet with a reduced carb bias (about 100g or less of carbs per day), I started restricted hours eating (so I only ate between 1.00pm and 9.00pm), I stopped all snacking between meals, I cut out nearly all processed and sugary foods, and I exercised to at least the NHS recommended level of 150 minutes per week.
Bottom line was I lost two stones and achieved a healthy BMI (which I've now maintained for nearly five years), and my HbA1c scores have come crashing down and are back well into the safe zone.
Inspired by my experience my sister, who was medicated for full blown T2 Diabetes, went on her own low carb diet. But because she was much farther along the T2D road her's was far tougher. Only 30g of carbs per day and repeated cycles of 24 and even 48 hour fasts. It took her a few months of a pretty brutal regime, but she lost a lot of weight and is now T2D medication free.
I appreciate this won't necessarily work for everyone, but it seems to work for a sizeable percentage, and when it does work it's truly life changing!
Hi Michael, Sorry this didn't seem to work for you. My wife had a completely different experience for Type 2 diabetes. Going on strict Keto, <20g carbs per day, she reversed her blood sugars and insulin resistance completely. For her, it was just a matter of cutting out junk foods and highly processed foods, and returning to whole fresh foods. Yes, that includes lots of meat and dairy, eggs, and above ground veges, berries, but she loves it after being told all her life that high fat was bad. Oh, and she has lost over 13 Kgs in 7 months. It's horses for courses no doubt. The thing she liked also about Keto was you didn't have to buy anything special to try it. No one is selling anything, it's just a change in what you decide to eat.
Hi Michael My Hba1c has been within normal range thus far but I have family history of type 1 diabetes and several with borderline type 2. Heart disease also rampant from grandfathers right through to now..... I'm very interested in the whole subject of eating for health. You mention that some of the recent research on HFLC diets was a bit iffy......can we know which you were concerned about?
It is very noticeable how many people come on this forum utterly astonished with what has befallen them with heart problems who state they have always eaten healthily and exercised regularly.
What eating healthily actually means has changed over the years with once foods said to be unhealthy-cheese eggs coffee wine etc-then promoted as being something you need every day. Its worth reading this book which looks at all types of foods and the evidence surrounding them that decides whether they are god bad or neutral.
I bought it originally having been fed up with activist vegans believing they are saving the planet despite the evidence to the contrary (soya, Avocados and almond milk saving the planet?) It has lots of references and basically the LCHF diet seems on the whole a good one although those already predisposed to diabetes might need to adjust things a bit. But worth a read.
Please be careful of promoting a book that has such bad reviews , unfortunately being a human { regardless of being vegan/vegetarian or meat eater } is bad for this planet, end of story
It is quite scary when you read of some natural disaster to then examine the population growth in that country. Deforestation and vast population increases often spell famine or flooding disasters.,
I am not 'promoting' anything. It had very good reviews in many quarters except amongst the vegan community who ran a deliberate campaign to vilify it due to it pointing out some home truths about nutrition and the provenance of many vegan foods. . It is full of references on all types of foods. Incidentally I am a life long vegetarian so am sympathetic to the notion of alternative styles of eating.
I tried LCHF back in 2020 when I was told I was borderline type 2. It was recommended by many on the diabetic forums. I loved it. No more carb cravings, I lost over two and a half stone and my blood sugar levels back into normal zone in a short space of time. I maintained my weight loss with ease for over 2 years. Then I had a heart attack and when my cholesterol levels were checked, the bad cholesterol was 5.2, massively above where it should be. Whilst I believe an acutely stressful period was the ultimate trigger for my HA, the high cholesterol was a certainly a large contributing factor. Since the HA I have been trying to follow the Mediterranean diet, but by reintroducing bread and pasta etc, I find I’m getting huge carb cravings which I don’t always successfully ignore. My weight is creeping up along with my blood sugar levels and I hate it. I want to regain control of my blood sugar levels and weight, without increasing my cholesterol levels. If anyone has any suggestions please let me know! The exercise part is working well. I walk briskly for 5 hours each week.
"My weight is creeping up along with my blood sugar levels and I hate it. I want to regain control of my blood sugar levels and weight, without increasing my cholesterol levels. If anyone has any suggestions please let me know! The exercise part is working well. I walk briskly for 5 hours each week."
Walking is wonderful, but I found that for me at least it doesn't actually meet the NHS criteria for exercise. Even when walking quickly my heart rate won't get up to the minimum recommended level. I'd need to be going consistently up a fairly steep hill for at least 30 minutes before walking would qualify as exercise, and here in the New Forest there just aren't any big enough hills! But nothing works faster than exercise for moving glucose out of our bloodstreams and into our muscles where it belongs. Consequently, as well as lots of lovely walks, I also visit a gym five times a week.
I do wonder why the UK didn't have a weight problem in the 1970's? Obesity then was only about 2%, where as now obesity is over 30% (with another 30% overweight). Unfortunately there's no consensus on an answer, so it's all just hypothesis. However, I suspect it might be as much about what we eat and when we eat it, rather than how much we eat (the total calories we each consumed in the 70"s isn't that different to today). We ate much less processed food back then, and we didn't snack between meals. Today we're far more likely to "graze" on highly processed packaged food throughout the day. Maybe that's something to explore? Certainly my weight has fallen (and even more importantly it's now stayed down for nearly five years) since I stopped eating between meals (in fact I go further, and I only eat between 1.00pm and 9.00pm) and removed nearly all processed foods from my diet. However, I'm under no illusions, my diet isn't cheap and it's certainly not convenient, so for many people it just wouldn't be practical.
One last thought. When I first found my HbA1c scores were uncomfortably high, I invested in a Freestyle Libre device to measure my blood sugar in real time. Instead of the snapshot you get from a finger prick test this gives you a constant report for every minute of the day and night across a two week period. What I discovered during the month I wore it, which is the same as very many people report, is that it's just not as simple as "all carbs are bad and all carbs will spike blood sugar". We're different, with different gut flora and different DNA, so we all process foods differently. So for me I found the real killers were things like beer, fruit juices, white rice, pizza crusts, and biscuits. All these caused an immediate blood sugar spike. However, moderate quantities of sourdough bread, boiled new potatoes, most root vegetables, low sugar red wine, 70% plus dark chocolate, and wholemeal brown rice hardly affected me at all. But let me emphasise other people report very different results, for them red wine, carrots or potatoes may be a serious problem, but they can get away with the occasional biscuit or glass of beer. Given that I'll be living this way for the rest of my life and still want a social life, I found it very useful to establish where I can get a small amount of flexibility. I should emphasise, small amount of flexibility, I'm talking no more than one slice of sourdough bread per day for example, not guzzling an entire loaf.
"We're different, with different gut flora and different DNA, so we all process foods differently."
There is a longitudinal study of Twins taking place. Led by Prof Tim Spector ar Kings College London. He was one of the developers of the Zoe app which was used to track the pandemic.
Our biome matters and can be nutured. We are inoculated with our mother's gut flora at birth.
How we are born either by caesarean section or vaginally means we acquire a different biome, as well as whether we were breastfed, or have had antibiotics in our life.
There is even research into using microbiota transplant in the treatment of obesity and diabetes! ncbi.nlm.nih.gov/pmc/articl...
Yes, I've read most of Tim Spector's books. In fact it was his recommendation for the Freestyle Libre that made me try it, and I discovered exactly what he said. Namely that how we each process food is so highly individual that we need to guard against overly broad conclusions.
So it's true that radically reducing carbs will reduce blood sugar spikes, but it's also true that many people will be able to re-introduce modest quantities of some carbs (the precise ones will vary person to person) and still avoid damaging blood sugar spikes.
Thank you, you have some useful info there. I do have a blood sugar monitor which I haven’t used in a while, but it is only the finger prick one which I would use immediately before eating and then 2 hours after. I did see a pattern develop. Eg. Lasagne was a definite no-no. Perhaps the monitor you mention would be worth looking into.
Re the exercise, I was given parameters by cardiac rehab as to my heart rate and intensity level to work at, so I stick with that.
Yes, atorvastatin 80mg and Ezetimibe 10mg. Atorvastatin alone didn’t reduce my bad cholesterol levels to target (1.4). So lipid clinic added in Ezetimibe alongside it. I will find out in a month or two if this has helped.
Maybe there is a healthy /unhealthy way to do low carb high fat. Eating loads of bacon and red meat and high fat dairy maybe making things worse whereas if you ate more fatty fish eggs nuts avocados and lots of low carb vegetables perhaps you would get better results. I have no idea however since my cholesterol was 5.6 last time it was checked. I dont know what it is now since I have also been doing HCLF for awhile now ( with the occasional bit of rice or noodle) I generally eat about 80 grams a day (including fruit). I have lost some weight and feel it is more satisfying to eat more fat and protein.
What is healthy when it comes to food? UK guidelines suggest a minimum 5 fruit and veg a day. This recommendation is not backed up by any science, and is also open to interpretation. Eating 5 portions of sweet fruits will have a profoundly different effect on the body than eating 5 portions of cruciferous vegetables.
Then we look at the recommendation of basing meals around starchy carbohydrates - bread, pasta, rice, potatoes, suggesting that a third of our food intake be made up of this. Our ancestors almost certainly didn't evolve with this sort of ready access to carbohydrates, and physiologically we are much the same as them. So is this really the basis of a healthy meal? People like to point out the difference between simple carbs (sugars) and complex carbs, but those complex carbs are very quickly broken down into simple carbs, this can happen while the food is still in your mouth!
Then there is the demonisation of saturated fat - it'll clog up your arteries! Yet there is not even an accepted theory as to how this is supposed to happen. The closest we have is Ancel Key's studies, which selectively picked data to support the hypothesis he had already decided upon. The reality is that science has moved on from this, yet the medical profession is slow to catch up. Over 50 years went by between science proving the harms of smoking, and the medical profession adopting it as fact.
I think if we measure the healthiness of a diet on the effect it has on a lipids panel, then in my belief, we are doing ourselves a disservice.
I could go on about this with far more depth and detail, but I just wanted to highlight some of the problems with established thinking.
I've seen more recent studies (which unfortunately I don't have to hand), that show that it is primarly compounds in plants that are likely to lead to endothelial dysfunction. Notably omega 6 fats when oxidised (which happens far easier than with saturated fats, expecially when accompanied by a generous carbohydrate intake), and plant sterols and stenols which can be incorporated into cell membranes in place of our own cholesterol, and cause dysfunction.
I think what you highlight is that science is an ever moving set of goalposts, and even at any one time, there can be wide disagreement amongst scientists.
Edit: I'll do some further research into this and feedback, with references where possible.
"I just wanted to highlight some of the problems with established thinking."
I agree that we're still a long way from diet and nutrition being settled science. But unfortunately none of us on this forum have the luxury of waiting until there's a scientific consensus. We need to eat today, at the same time as managing serious health problems. So we have to do the best we can with the information available.
Personally I think there's merit in coming at this from the other end. Given that many authoritaties disagree, is there any part of the discussion where there's at least some broad agreement?
Fortunately I think that there is. Pretty much everyone says highly processed foods damage our health.
So for me this is the starting point, the foundations upon which I build my diet choices.
I recognise however that there's a problem. Not with the science, but with the social realities.
Highly processed foods tend to be cheap, tasty and incredibly convenient. So even though the weight of evidence is that were digging our graves with our teeth, it's unlikely most people will be able to significantly reduce their intake.
I agree. A few obvious issues with processed foods:
1/ Every process tends to reduce the nutrient content, while typically having no effect on the calorific content. This results in lower satiety and the need to take on more calories to feel nourished.
2/ Questionable ingredients. If you don't know what it is, you probably shouldn't be eating it.
3/ Nutrients added back in. Often these nutrients are synthetic. One may ask what the problem with that is. Well, for example, naturally occuring vitamin c and ascorbic acid are not the same thing. Ascorbic acid is just part of the vitamin c complex, but they are allowed to call it vitamin c on the label. B6 is another problematic synthetic vitamin, whereby the synthetic version is actually capable of causing a B6 deficiency!
As a general rule of thumb, when I have doubt I think "what do I believe our ancestors did?" and if I am deviating far from this, I do it consciously.
I can't comment on the above debate about what a good diet represents , but can thoroughly recommend Dill Mustard to go with your pickled herring. Yum
Based upon that study data, they would class you as an extra low carb candidate and are shortening your life by 4 years. With my target of around 20-50 grams of carbs per day I should probably be dead already.
Of course, reading between the lines of that study it is quite clear that it is another one of those "meat is bad, plants are good" pieces, and should be weighted accordingly.
But Michael, as AlfredV has pointed out, that means you're actually on a low carb diet! The NHS recommends that 50% of your calories should come from carbs, which translates to at least 260g of carbs per day.
Having reached my target weight I'm also now on a maintenance diet of 130g carbs per day. Luckily I don't think we have to worry!
Once we get past the lurid headline in the article you linked to, we discover that the low carb group in the study included obese, serial dieters. In other words what was killing the low carb group probably wasn't the lack of carbs, it was more likely to be the terrible toll that extra fat exerts on our health.
Hi Michael hope you are ok. Now it has been proved by you that saturated fats can increase cholesterol. But well done for trying a different approach. We can all only make our own decisions of what we eat based on the specialist medical advice we are given and information we read ourselves. We can never have too much information and can choose what to accept and what to reject. I find this site invaluable for the useful information given by people like yourself, which I would never have otherwise known. I cannot think of anything worse than pickled Herrings, I am sure there will be no shortage of them in the supermarkets but we are all different so enjoy. Best wishes.
When I was pre diabetic a few years ago (HbA1c now back in normal range for a few years) I joined a diabetes forum. I have to admit I was bemused by the HFLC diet so never tried it just sticking to low carb and limited saturated fats in a Mediterranean style diet. All the HFLC and Keto diets seem to be promoted by dubious medics IMHO!
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Low carb confusion
My high fat diet reduced my cholesterol by 50%.
Returning to work, well sort of.
Ftom low blood pressure to too high
High, rising Lp(a) and CAC but low LDL
