Low carb rebel (inspired by Rosina1871's question of yesterday)

[Marijo1951]

This was originally going to be a response to Rosina1871, but I then decided to make it a separate post as I would like to see other people's comments on my own experience.

I too understood that 'a low carb diet is necessary when on steroids to avoid weight gain', so for a time I diligently followed the low carb way of life. I did lose some weight (though it plateaued) but felt increasingly unwell and became nauseated firstly by cheese, then by fish, eggs and meat. Eventually last December I adopted a vegan diet, assuming I'd gain weight but maybe feel better. Since then I've lost more weight, slowly but steadily at about 0.5-1 lb per week, and more importantly I've lost the constant sick feeling. My HbA1c level is 32.

In some important ways my new diet - commonly described as 'low fat plant-based' - is similar to the low carb one in that I still avoid sugar and simple 'white' carbs and processed foods and I eat plenty of vegetables, salads and fruit. However there's no doubt that with all the grains and pulses, I take in far more carbs and being oil-free I have a low fat intake, so for me at least the orthodox advice evidently doesn't apply. I was already on a low-ish dose of pred when I started, 6.5 mg in December, 5.5 mg now, so I can't say how it would have worked when I was on a high dose.

One other advantage is that I'm now spending far less money on food. Obviously a vegan diet that includes a lot of plant-based processed food can be expensive, but I eat very few of those things. Plant-based milks can also be expensive, but I've found that Aldi's soya milk, oat milk and almond milk are fine and less then half the price of the branded ones.

[PMRpro Ambassador]

It's what works for you - but above all, what you can do and stick to long term. Both my daughter and grandaughter are vegan and I enjoy (proper) vegan food. But I couldn't do it long term and until relatively recently most people wouldn't manage it easily - and even now it is difficult to do it if you don't fall for the vegan aisle in the supermarket!! A study some years ago showed that a strict vegan diet relieved joint pain for half of the subjects with RA - even the smallest amount of animal protein, a yoghurt for example, was enough to reverse the effect. And at the end of the study few of them remained on the diet despite the incentive of pain relief because they couldn't cope when it wasn't handed to them on the proverbial plate.

I suppose I am biased because I'm also allergic to something in the structure of the starch in commercially grown wheat - I'm fine with the so-called ancient wheats like spelt and kamut and other grains. But that means I have other concerns with my diet - and cutting carbs, which does work if I get low enough, is a lot simpler to cope with.

[Marijo1951 in reply to PMRpro]

I've mentioned before that my second daughter was diagnosed with RA when she was 14 and became vegan a couple of years later for ethical rather than health reasons. However there's no doubt that one of the main outcomes was a huge reduction in her RA symptoms, and for the last 30 plus years she's suffered symptoms only intermittently and fairly mildly. Frankly she was so ill as a teenager, I was expecting her to become wheelchair-bound . My 20-year old granddaughter (daughter of my eldest daughter) also became vegan about 3 years ago and is evidently thriving on it. I'm just sorry that I didn't follow these family examples much sooner.

[PMRpro Ambassador in reply to Marijo1951]

And I think you know that my granddaughter's health improved dramatically as a vegan - her asthma is "normal" now which is a lot less scary. My daughter's skin has improved a lot too but she, unlike her daughter, cooks and eats well. The other - a lot of junk!!!

[Marijo1951 in reply to PMRpro]

Yes, it is important to acknowledge that it's possible to eat very unhealthily as a vegan. I visited a vegan café in Manchester with my daughter, but we left very quickly. It was all stodgy US-style pizzas and imitation burgers, ribs and sausages, with cakes and vegan ice cream to follow. The only veg were chips, some very dodgy-looking coleslaw and deep-fried onion rings in batter. I suppose if youngsters have been brought up on standard fast food, this stuff is what seems familiar and acceptable, but it does seem sad not to explore the world of delicious plant-based food, especially when there are so many vegan cooks who blog and make YouTube videos.

[DogAgilityObsessed]

How interesting. I have been vegetarian for about 35 years (apart from a couple of years when I ate meat and fish if out) and haven’t eaten a cake since starting pred on 13th June last summer. I do eat carbs but generally complex ones. I’ve put on weight around my waist and on my face but not so much I don’t think I can lose it. I test my blood sugar regularly and it hasn’t changed.

Incidentally my husband has put on even more weight over lockdown and he isn’t on pred so it’s entirely possible we both just eat too much.

I’m actually trending towards a more vegan/plant based diet having been reading about links to Alzheimer’s. Both my parents have just been diagnosed so it’s very much in my thoughts at the moment.

[PMRpro Ambassador in reply to DogAgilityObsessed]

Sorry to hear that - it still amazes me to hear people our age having parents still alive! I struggle to imagine it.

I now eat a lot of veggies and dairy and really not a lot of fish and meat - 4 oz of meat or 6oz of fish is a massive portion for me, The meat is all local, grass fed, produced on small farms up mountains , or UK lamb which definitely grows up outside on mountains. A lot of the cheese is the same and all the milk.

[JanetRosslyn in reply to PMRpro]

Bit off subject, but the bit about having parents still alive... Im 65 and I struggle to accept that my father was born two centuries ago! 1895. (Mum was born 1912)

[PMRpro Ambassador in reply to JanetRosslyn]

Golly! I have to confess to not having any idea what year either of my parents were born - mum must have been early 1920s, dad was a bit older. My MIL would be about 110 now so similar to your mother.

[Marijo1951 in reply to DogAgilityObsessed]

I think it's important to stick to the complex carbs and especially to avoid added sugar. I did research the possibility of a low carb vegan diet, but it included huge quantities of avocados and coconut cream which, apart from seeming very unbalanced, would hardly be good for the planet.

My initial pred dose was 60 mg per day because I had GCA as well as PMR. I became ravenously hungry and simply gave in to it, comfort eating for England. This only lasted a while but my weight shot up. I tried Slimming World but with very limited success, then lost a stone on the low carb approach and have lost another stone since I started the vegan diet in December.