The NHS is planning to feed diabetics... - Low-Carb High-Fat...

Low-Carb High-Fat (LCHF)

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The NHS is planning to feed diabetics sugar.

Subtle_badger profile image
33 Replies

bbc.co.uk/news/health-53983095

As someone (non-diabetic) who did a month on whole food, low calorie and did fine, I thought maybe that's not a bad thing.

Then I saw this..

twitter.com/SamFeltham/stat...

Above is the soup ingredients. 3 out of 4 have maltodextrin as the main ingredient. It's a sugar, and shockingly it's got a higher price glycemic index than glucose, and much higher than table sugar.

I can't imagine they could design a worse drink for diabetics. It only won't kill them because they can't eat much of it.

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Cosmo501 profile image
Cosmo501

😱😱😱

Cosmo501 profile image
Cosmo501

I just don't understand it. -- I read the links, and one person had commented that they had found it gave them a break from food, and so gave an opportunity to break bad habits with food.. so that sort of covers an idea of why shakes and soups, not whole food.... but why can't the soups and shakes be with whole food ingredients? I really just can't get my head around this one...

Subtle_badger profile image
Subtle_badger in reply toCosmo501

Exactly. Sugar water flavoured to taste like tomato, or chicken and mushrooms. It is just insane.

I just looked up Bachelors tomato soup: mostly tomatoes, and 104kcal. Wouldn't that be better? I mean, not as good as food, but better.

slipstick profile image
slipstick

Maybe it's because tests have shown that many people will tolerate those things for a few weeks and can then get weaned onto a low carb diet. Whereas starting them off with "You need to eat all these foods you've never heard of and not very much of them. Oh and you must cook them all yourselves, you can't get them from KFC or even McDonald's" would not get nearly such a good take up.

Prof Roy Taylor has proved fairly conclusively that it is just the losing weight that helps/causes diabetic remission. Once people have done that and feel they've achieved something is the time to talk them onto a long-term healthy diet. It's the planned follow-up to the (proven) fast weight loss that's important. No-one expects that diabetics (ex-diabetics?) will be on 800 kcal of soups and shakes for life.

OTOH I wouldn't fancy them either.

TheAwfulToad profile image
TheAwfulToadAmbassador in reply toslipstick

>> Prof Roy Taylor has proved fairly conclusively that it is just the losing weight that helps/causes diabetic remission.

There's an entire oligarchy of Professors dedicated to obfuscation of the science. After all, if they actually admitted that the cause of T2D is pretty straightforward, and the cure equally straightforward, they'd get no more research grants and presumably would end up working as shelf-stackers in Tesco.

Taylor's statement can't possibly be true, for the simple reason that not all diabetics are obese. Or even most diabetics. Nor are all fat people diabetic. Less flippantly, it can't be true because of the way insulin resistance works (and subsequently falls over, as in the case of T2D). I did a long rant about this a couple of weeks ago.

Even if we assume for a moment that it is true, then the simplest way for a diabetic to lose weight is to stop eating carbs (and concurrently "cure" his diabetes). I really don't see how this is any more painful than drinking ultra-low-calorie shakes full of chemicals and sugar. I'm pretty sure most people have heard of steaks and cauliflower. And there's no requirement to eat "not very much".

Incidentally ... I reckon you actually could do a low-carb diet based on McDolans and KFC.

slipstick profile image
slipstick in reply toTheAwfulToad

We're talking about Type2 diabetics. The majority of T2 diabetics are overweight or obese. The vast majority (85%+) of recently diagnosed T2 diabetics are overweight or obese. If these lose weight in any way many, but not all, of them can get into remission (which is NOT a cure nor is it claimed to be). A lot of controlled trials have demonstrated this.

Arguing against these facts by pointing to the small minority of T2 diabetics that were never overweight is about as useful as the tobacco lobby pointing to the tiny number of smokers who reach old age as proof that smoking does no harm.

I don't know to what extent the weight loss regime was chosen for social reasons, that was my speculation. I imagine control is the most important reason. Keeping to 800 kcal/day works and a controlled diet is the simplest way to achieve that. There certainly other ways to lose weight but they are far more difficult to control and to provision.

I'm sure if someone else wants to do a series of controlled trials of some other methods and they work the NHS might listen to them too. But it's likely to take a good hypothesis and controlled trials and several years, anecdotal "evidence" won't cut it.

TheAwfulToad profile image
TheAwfulToadAmbassador in reply toslipstick

If these people lose weight in any way many, but not all, of them can get into remission (which is NOT a cure nor is it claimed to be). A lot of controlled trials have demonstrated this.

I won't get into the remission vs. cure debate because I don't believe T2 is even a disease as such. It's one possible feature of Metabolic Syndrome. It's also predictable from physical principles and a basic understanding of physiology.

lose weight in any way

The problem is that if you are diabetic, then the only viable way to lose weight is to stop eating carbohydrates. You can do that either by, erm, not eating carbohydrates, or by not eating. I don't see any particular advantage in advising people to do the latter when the former gives almost identical results. People like Virta Health and David Unwin are reporting ~60% success rate, although they have somewhat different approaches, a different client base, and use different metrics. The NHS studies on Very Low Calorie Diets using proprietary shakes report the same thing (58%, IIRC). It's a bit hard to compare different treatments because they use different measures of "success", but if you look at the detailed results it's clear that there's not much to choose between them in terms of short-term outcome.

I will agree that VLCD diets might be useful in one particular case: where the patient believes that medicine must taste bad in order for it to work (this is a universal feature of shamanism - because superstitious people universally hold this belief). The quality of science education in the UK is now so disastrously bad that many people do in fact view medicine in terms of magic potions and woo-woo, because they don't understand how their bodies work or what drugs/surgery actually do.

LCHF has one major advantage over the VLCD approach : if people stick with LCHF for life (which is perfectly possible) then the existence of their diabetes - even if not "cured" - becomes moot, because such a light demand is placed upon their carbohydrate-handling mechanisms. There is no equivalent advantage associated with VLCD. In fact there's no obvious pathway forward once the meal-replacement shakes are stopped other than calorie-counting ... which has a huge attrition rate. Lifelong adherence to caloric restriction is a few percent.

Arguing against these facts by pointing to the small minority of T2 diabetics that were never overweight is about as useful as the tobacco lobby pointing to the tiny number of smokers who reach old age as proof that smoking does no harm.

I don't see the equivalence. The facts are what they are. I'm arguing about interpretation - specifically, I'm arguing about proximate cause. The Experts are saying that being obese, in and of itself, is the cause of diabetes, ergo losing weight will reverse diabetes.

- Even if you want to take 15% as the number of "normal" people who develop T2D, the existence of those people disproves the hypothesis. If it were 1 or 2% you might reasonably dismiss them as outliers. But 15% isn't a "small minority". It's a statistically- and clinically-significant number.

- If being fat is the proximate cause of diabetes then (a) being massively fat should nearly always result in diabetes (b) losing weight should reverse the problem in almost every case and (c) reversal should occur only when the patient has lost weight. None of these predictions align with empirical observations. For example, fat people tend to be less prone to diabetes (this is the origin of the "fat people are healthier than skinny people" myth). And in both low-carb and low-calorie studies, normal blood sugar control is achieved long before any significant weight is lost (sometimes within a matter of days).

The theory must explain reality. If it doesn't, it's wrong.

The LCHF approach is based on the hypothesis that T2D is an adaptation failure, caused by a long-term mismatch between incoming power flow from carbohydrates and the body's ability to deal with that power flow. Removing the carbohydrates allows recalibration.

This hypothesis explains all the available facts. It is also supported by known physical mechanisms. It is therefore better than the hypothesis that obesity causes diabetes.

I'm sure if someone else wants to do a series of controlled trials of some other methods and they work the NHS might listen to them too.

You sure have a lot of faith in human nature :)

Virta Health are making money out of curing diabetics. It's quite hard to do this (at least long term) if your purported cure is a sham.

Gary Fettke was hauled through the legal system for telling people to stop eating junk food and eat proper meals.

David Unwin is an embarrassment to the NHS, and NICE have done a U-turn on their initial support for his approach. His diet is barely even low-carb: all he's telling people to do is to lose the stodge and eat normal meals with meat and two veg. It's not radically different from "Mediterranean":

dietdoctor.com/wp-content/u...

But apparently "more reseach is needed" to prove that this doesn't do people harm. If it weren't so tragic it'd be hilarious.

S11m profile image
S11m in reply toTheAwfulToad

"normal blood sugar control is achieved long before any significant weight is lost (sometimes within a matter of days)"

Yes, diabetes can be reversed long before obesity is cured.

Excess (refined) carbohydrate causes increased blood sugar

which causes seretion of insulin

(which makes the body store fat)

In diabetics, insulin resistance eventually prevents the insulin controlling the blood glucose level

The body then produces more insulin

Diabetes is measured and defined in terms of blood sugar, but it is really insulin resistance, and excess insulin - the cure is less carbohydrate = LCHF

"The Experts are saying that being obese, in and of itself, is the cause of diabetes"

I think that theses are the "experts" that have been led astray by the junk food manufacturers (who seem to be able to control governments, education ...)

Should we blame doctors for believing what they are taught?

Subtle_badger profile image
Subtle_badger in reply toslipstick

"I'm sure if someone else wants to do a series of controlled trials of some other methods and they work the NHS might listen to them too."

Do you think Dr Taylor self funded? The NHS paid for this study. We won't get this sort of studies into low carb, until the powers that be decide to fund them (Virta Health being a notable exception).

What we can get is cohort studies like David Unwin's, which is very convincing. So convincing, that you don't RCTs to prove it, the results are so vastly better than standardised care we don't need a control group to prove it works.

slipstick profile image
slipstick in reply toSubtle_badger

No, I think Roy Taylor has been working on this for at least 15 years and it's only this one latest project that is NHS funded. Even the immediate precursor DiRECT was funded by a charity (Diabetes UK). A fair bit of his early funding was from what is often called "Big Pharma". I'm not sure how keen they were on his results though.

And unfortunately talking about not needing controlled trials because your results are "obviously" so good is what cranks and charlatans have been doing for years. Now I happen to think that David Unwin is genuinely onto something so I'm by no means accusing him of anything like that. I would like more information about how his participants were chosen and what the conditions were that caused about 50% not to do well. But to be fair DiRECT and similar programs tend to be a bit shy about that last point too.

Subtle_badger profile image
Subtle_badger in reply toslipstick

None of this explains why they are telling diabetics to drink sugar water. There are alternatives between maltodextrin (the definition of a non-food, it's an additive that can only be created industrially) and - I don't know - pork rillettes and cavalo nero served on a bed of spiralised daikon. There could be much healthier premade shakes, for example.

I don't know why you think they will transition to a low carb diet. There is nothing in the DiRECT study description that indicates they used a low carb diet for maintenance. The followed standard care, so low fat. They even explicitly say that low carb has been proven to be no more effective than high carb. 🤨

directclinicaltrial.org.uk/

TheAwfulToad profile image
TheAwfulToadAmbassador

>> It only won't kill them because they can't eat much of it.

The general plan for the NHS seems to be as follows: keep people as sick as possible without actually killing them, thus ensuring that the entire population of the UK can be prescribed pills for life.

I'm not sure why this is the plan, but I imagine the simple answer is "money".

BrynGlas profile image
BrynGlas in reply toTheAwfulToad

Agreed

Fruitandnutcase profile image
Fruitandnutcase

I don’t get it - I make mushroom soup with onions fried off in some olive oil, then add chopped mushrooms and some fresh or if I haven’t got fresh, some dried parsley, and some additive free vegetable stock I treated myself to a soup maker a couple of years ago, I could cook off the onions to start but I use a pan on the hob.

That’s it - there’s nothing I can’t pronounce in it and definitely no sugar.

Same with other soups I make, sometimes I make and freeze extra so it’s simple to bring it out, defrost and microwave it. All pure and healthy and I know exactly what I’m eating.

As for LCHF putting T2 into remission which it undoubtedly does, I think in the past many scientists have staked their life’s work and reputations on other theories and along comes Professor Taylor’s very simple ‘lose weight’ approach has totally upset the apple cart.

Where will big pharmacy and big business be when there is no need for their products if people get wise to how simple it is or it could be. I blame whoever came up with that ‘healthy plate’ and the food pyramid. I still can’t believe that in spite of lots of evidence to the contrary, people who should know better are still pushing carbs as the basis of every meal. It’s totally mad.

Subtle_badger profile image
Subtle_badger in reply toFruitandnutcase

Here's a crazy thing from the DiRECT study

"However, meta-analyses of the controlled trial evidence show no important differences between high and low carbohydrate diets for weight control or HbA1c."

Even if that is true, why is that is only ever put forward as an argument against low carb, not - as it should be - an argument for dismantling the whole EatWell/Food Pyramid nonsense?

Fruitandnutcase profile image
Fruitandnutcase in reply toSubtle_badger

I noticed that somewhere last week - I’m afraid I didn’t even bother to read any more because I absolutely refuse to believe it - I know from testing my bloods before and after meals that it’s total rubbish.

If I want a nice high blood glucose reading then all I have to do is eat a nice carby meal or snack.

It would be laughable if it wasn’t alarming. On the other hand if you walk round any supermarket and look at the stock on the shelves and in the chilled food cabinets - if LCHF caught on in a big way what would happen to the producers of all that stuff - look at all the different varieties of crisps and snacks, sugar laden cakes, puddings, biscuits, sweets and all the other carbohydrate rich goodies that are on the shelves and that you see people piling into their trollies.

Soap box alert!

The other thing that gets me is when you see people on TV programmes such as the one by that chef Tom Kerridge or Michael Moseley (who was interesting to begin with but now pops up everywhere like a rash) where overweight people are having to alter their diets before they kill themselves and they all say they ‘need to have cakes, biscuits, sweets etc in the house for the children!’

It doesn’t seem to dawn on them that by having all that high carb stuff available their children are only going to have the same problems when they grow up. I feel like shouting at the TV ‘Why???’ Why do you have to give your kids the same stuff that is ruining your health? Do the kids a favour too and cut their carbs as well.

Subtle_badger profile image
Subtle_badger in reply toFruitandnutcase

I see that on here all the time. people who slip up and have biscuits after dinner. Why do you have them???

slipstick profile image
slipstick in reply toSubtle_badger

Personally I've had an unopened packet of my old favourite chocolate biscuits in the cupboard for weeks. I like the fact that they're still unopened because it means that my "new" way of eating is really turning into a "lifestyle change" and not just a quick weight-loss diet.

You might be surprised to realise that not everyone thinks or behaves in the way that you imagine they're going to.

BrynGlas profile image
BrynGlas in reply toFruitandnutcase

Yes!! I have very often bored my family to tears complaining about the whole aisles full of what I call 'non-food'. Sweets, biscuits, bread, crackers, ready meals, rice, noodles, pot noodles etc, booze and cakes. Well - non-food items to me at any rate.

Those aisles are often bigger in total than basic food items, the stuff we can all use to make a meal any day of the week and I find that the more economic the supermarket/shop, the more sweets, chocolate, high carb items it seems to sell.

But then, so many people have no idea how to produce a meal from scratch these days.

I was in Scotland 15/18 years ago now I suppose and the friends I was staying with were gobsmacked when I cooked things like spaghetti bolognese and meat and potato pie, 'from scratch!' Basic everyday meals, with 2 teenage boys needing feeding up (bottomless pits) but they couldn't get over the fact that I didn't need a packet or a jar to make parsley, cheese, onion sauces, even cottage pie was produced with the aid of a jar, or instant gravy granules etc. It is a shame. Even my own mother still makes sauces with a packet - 'just add milk' for different things. Birds trifle in a box!!! LoL

And no, I was not eating such things even then - which was another thing they couldn't understand. I had my salads, but was eating such things as cottage cheese (which I still miss to this day) etc, etc with it!

I am convinced that stopping cookery lessons was the beginning of the slippery slope. I loved cookery and my Nan taught me a lot too. Sadly many children don't have that sort of experience these days.

Fruitandnutcase profile image
Fruitandnutcase in reply toBrynGlas

“I am convinced that stopping cookery lessons was the beginning of the slippery slope. I loved cookery and my Nan taught me a lot too. Sadly many children don't have that sort of experience these days.”

Couldn’t agree more, I say exactly that myself. . My sons are in their forties and I can remember when the younger one did home economics. The sessions were too short to cook anything other than cakes and biscuits. Then most of the time was spent designing a box to put the biscuits in to ‘market’. Once they started spending more time on marketing that was the end of the cooking. Such a shame because I always found kids loved cooking.

School cookery sessions also meant that children whose parents didn’t cook, no longer came in contact with anyone who did.

Saying that I remember back in the sixties my mother went up to my high school to complain (she was SUCH an embarrassing mother) that she had seen children in the local co-op buying tinned beef to use in Domestic Science as a filling for a meat pie. My mother was shocked at that.

BrynGlas profile image
BrynGlas in reply toFruitandnutcase

LoL Yes that is exactly what I mean. And then we have children who don't know what a carrot is, does it grow on trees? Where does milk come from?

When my ex and I bought this house with 4 acres in 1991 I discussed with him having chickens, pigs and a goat for milk. I said something like can goat's have artificial insemination so we didn't need a Billy goat?

I said that I would find it very difficult to part with the kids!

He asked why we would want to have any kids ????????????

He had know idea that the goat would have to have a baby before it produced milk!!

THEN he asked why couldn't we have a cow instead then because then we wouldn't have to find a home for the kids - ???

He was born in 1938, lived in the country AND went to a grammar school would you believe, zero common sense.

Fruitandnutcase profile image
Fruitandnutcase in reply toBrynGlas

Just goes to show - you can learn as much from the university of life as you can from a grammar school.

Like the sound of your four acres. Did you go for cows or goats in the end and did he discover how you got milk?

Have to say I read a while back that kids thought you got cheese from trees - I blame all those Swiss cheese plants for that 😉

BrynGlas profile image
BrynGlas in reply toFruitandnutcase

Neither, he wouldn't wear either in the end. I did have 2 saddleback pigs called Bootsie and Snudge though. But he didn't like them rooting the field up and made me have them rung, which I was very much against. In the end I gave them back to the breeder because he did nothing but complain about them.

I did do a lot of rare breed chicken breeding at one time, but that got too much in the end when the Fox was sitting on the walls watching new pullets being put out! There is no such thing as a good fox. They killed 20 odd chickens one night alone and left them lying around. So decided to stop it all.

Fruitandnutcase profile image
Fruitandnutcase in reply toBrynGlas

Foxes are so destructive aren’t they, like you say they can clean out a whole hen house in a night.

Clearly your ex wasn’t meant for the farming life.

BrynGlas profile image
BrynGlas in reply toFruitandnutcase

Too right!

BrynGlas profile image
BrynGlas in reply toFruitandnutcase

LoL I hadn't heard that one before, but suppose it makes sense! I could never get my Swiss Cheese plant to grow, never mind to bear cheese!!!!

bigleg profile image
bigleg

Sam did well to illustrate what junk these shakes are. They do not teach patients how to eat real food but rather remain addicted to chemical concoctions!!! and they have to stay on those junk shakes for 3 months, where as using LCHF principles they can put their diabetes into remission within a couple of weeks. We see regular patient graphs posted on Twitter and FB by their proud health care professionals. Did you know that NICE and dropped their endorsement of Dr Unwin's Sugar Infographics? There is an appeal lodged and there is a petition running: change.org/p/national-insti...

We have a National Sickness Service, not a National Health Service. Dr Unwin thanks Prof Roy Taylor for reaching out to him when he first started on his Low Carb journey to offer introductions to the publisherss. Did any of you see the speach of RFK Jr and Dr Heiko Schöning on stage in Berlin last weekend? Reports are that there were about 1.5million people from around Europe and I picked up a photo yesterday of the police taking their helmets off in solidarity for the movement.

PandQs profile image
PandQs in reply tobigleg

petition signed thanks for the link

BrynGlas profile image
BrynGlas in reply tobigleg

Me too

BrynGlas profile image
BrynGlas

Not my idea of where to go how to get there and I don't understand why that lot is thought to be healthy. Insulin must be going up and down like a yoyo.

Subtle_badger profile image
Subtle_badger in reply toBrynGlas

That's a good point. Hba1c is an average. You lower your carbs and you get a continuous lower blood sugar, or you eat sugar followed by long periods of being hungry, where your blood glucose goes through the roof then plummets: you are miserable most of the time, and you often have dangerous blood glucose levels, but the average might be roughly the same as the lower carb diet.

Maybe they need CGM on the trial participants to see what is really happening.

BrynGlas profile image
BrynGlas in reply toSubtle_badger

I suppose we might find that one of these days, but I am not holding my breath yet.

TheAwfulToad profile image
TheAwfulToadAmbassador in reply toSubtle_badger

A CGM would be a completely obvious monitoring method. But they don't want to know what's happening. This sort of thing is pure superstition, and the last thing superstitious people want is facts that contradict their views.

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