I've long had an interest in how the foods we eat affect inflammation and weight and generally follow low -carb eating, although I often lapse and am not as diciplined as Id like to be. So this sounds fascinating to me, especially as I'm also interested in gut-health science. Taking part starts by wearing a continuous blood sugar monitor for a few weeks, and they send you various muffins to see the effect on your blood sugar levels and advise what your best diet should be. For me the most interesting thing will be to find out more about my blood sugar levels as they have gone up due tosteroids and I'm being threatened with having to take diabetes meds, which I have so far turned down because I want more info than going on just HbA1c tests. What we have is steroid induced hyperglaecemia, which I wonder perhaps ought to be treated in a different way to Type 2 diabetes, which is a metabollic disorder? here is so little info or research on ths area
It will cost me about £50 a month for 6 months, a price I'm very willing to pay for the info and support it will give. They also sent me a refereal code which gives a discount if anybody is interested I can PM it to you
I have heard quite a few people say it is just an expensive diet very similar to all other diets, even though Tim Spector insists he is against diets!
Having been very recently diagnosed with steroid induced diabetes, I have been learning a lot about it and understand that, although the cause is different, the treatment is pretty much the same.There is a bit more reluctance to diagnose diabetes in case you are going to reduce or come off the steroids reasonably quickly and your blood sugar might revert to normal. I think that that is not likely for either of us?
The current treatment is the same but that is possibly because so little is known about how to treat it. On the ZOE study you wear a blood sugar monitor and an App can track the bs levels. So I'd be interested to know if I get a big spike shortly after taking the Pred but then my body successful brings the levels down. in which case a low sugar diet might work better than meds. I want the facts before making a decision what to do. My GP i getting jittery because my HbA1c is about 50, yet a friend who has had T2D fo about 30 years and on metformin is told she is doing well if she keeps her levels below 65! The blood tests that we currently have availanle only show bs at a point in time or a 3 month average, so the constant info the monitor provides will be very useful. Dr Mackie is also interested in how I get on with it. It's not a diet as such, it's designed to educate and help you work out the best foods for you. By chance I got talking to someone in a cafe recently who was training to be a diabetes nurse and she was wearing one of these monitors as thy are commonly used to treat patients with Type 1 diabetes so she needed to understand them. She took a measurement whch was about 5 then said watch this, ate a few chips and showed me how quickly her blood sugar level shot up to 8. Even though I know a lot about how carbs have such a rapid effect I was shocked. I'm quite excited about learning more
I've been researching low carb eating, fasting etc for years so can't think there will be anything that will surprise me. I know even 'good' things like oats and brown rice and fruit affect bs. It'll be interesting to learn about timings (koalajane wroked out when the Pred kicks in and how long it lasts for example) to be able to have useful discussion with doctors. For me there is the additional factor that anything high histamine causes inflammatory reactions, again even good things like ginger, garlic, yoghert, raw tomatoes, fresh fish. I agree with others this ought to be available on the NHS.
this is why I believe all type 2 diabetics should be given glucose monitoring kits because what spikes someone doesn’t spike another and the only way to find out is by testing before and after
Absolutely. I do think Tim's work may well revolutionise diabetes and obesity management since they are finally getting the message that diet is very significant in both.
Oats, fruit, yoghurt, fresh fish, all form a large part of my diet and I have just bought brown rice instead of white. Would be good to know if these foods really are beneficial for me.
I was diagnosed type 2 and put on gliclazide and given a glucose monitor. I went low carb and was taken off gliclazide 6 months later. With my monitor I discovered my sugars shot up about 4 hours after taking pred for about 5 hours. I also discovedr I can get them down by going on an energetic walk. Although my sugars still shoot up with pred (on 5mg) my last hna1c was 36
Very interesting , thanks, especially the timings. I remember you posting about low carb eating in the past, you are an inspiration. Also interesting what you say about the energetic walking after eating. A friend who is trying to fight cancer is keeping sugars and carbs low and going running about 20 mins after eating and swears it has helped shrink the tumour
I went for a walk today and my sugars before were 5.2. After my walk they were down to 4.7 but up I have also had bigger drops. I am happy then to have my meal and then go for the next walk to bring them down. I also believe a glass of red wine brings mine down a bit.
Most diabetics are not given glucose monitors so can’t find out which foods do cause their sugars to go up. I really think they should have the chance to find out. Most are put on metformin whereas because of the steroids I was put on gliclazide which really worked quickly for me and because they can make sugars drop you get the monitor
That’s interesting. The brisk walking worked for me too. One day I went for a long energetic walk with a friend and as we were out all day we’d taken cheese sandwiches to eat. I ate 4! She was even more fascinated by the monitor than I was I think so we kept checking it. Nice rounded bumps within appropriate levels with no spikes. There was one sandwich left which I had for lunch the next day. No exercise this time and just one but I got a massive spike. Quite a contrast.
There was a diabetic on the patient.info PMRGCA forum who did a lot of careful monitoring of his levels after food and found he would get a nighttime peak that he could stop by exercising after dinner.
Interesting. I tried one of their early challenges which was to go a brisk walk straight after your normal breakfast (having had that breakfast the previous day with no exercise). My BS level headed so low I was in the red area for a short while while walking in my local park. Exercise obviously is a major factor for some people anyway.
That's the main reason I'm doing this. My GP wants to put me on diabetes meds because my HbA1c is high, but I'm saying hang on a minute, let's get the facts first, see what's actually going on. I'm also looking forward to seeing what effect some complex carbs have. I generally eat a low-carb lifestyle, and am wondering whether I can add a few more things in occasionally that are supposedly good for your guts, like the odd slice of rye bread, brown rice, oats, and kartoffelsalat (I've heard eating cold potatoes is lower GI), we can but hope!
This may sound like a dumb question but how does the blood sugar monitor work? My Dad was diabetic and he had to keep using a finger prick thingybob to extract a drop of blood for testing.
I don't know how the ZOE one works, haven't looked yet, but in general most will be based on measuring light - my husband developed an optical monitor for continuous measurement of oxygen and it was based on looking at the peak in the spectrum for oxygenated haemoglobin so I assume the glucose ones are based on the peak for the form of haemoglobin measured in Hba1c
Not a "diet" - it is finding out how YOUR body reacts to different foods so you can eliminate what sends your BS into orbit. He found that healthy porridge was his downfall - despite it being sold, even by doctors, as a healthy breakfast.
I don’t think many doctors understand about low carbs. I was so lucky my diabetic nurse was really knowledgeable about the LCHF way of eating and exercise
The diabetes nurse at my GP practice knew NOTHING, she told me I shoudl eat more fruit and brown bread so I bought her a copy of Michael Mosley's Blood sugar diet. One of the reasons I'm doing the ZOE study is that if I come across people who don't know about recent research I can educate them with evidence.
I remember seeing his YouTube video some time ago when he explained how his 'healthy breakfast cereal' caused massive spikes for him and noticed his slight indignation about his wife not being affected at all when eating the same stuff. Well, it turns out that I seem to be exactly the same as Tim! My similarly 'healthy' breakfast caused similar massive spikes and subsequent massive drops in my BS so I have now adopted eating breakfast like Tim! Like him I was very surprised but on reflection it explains a few things.
I have to say I was a bit taken aback at how surprised he claimed to be. To me as a physiologist by trade it is blatantly obvious that the mueslis could send some people's BS up and it all depends on how the porridge oats are milled, plus I doubt he was making it "proper" with pinhead oats, salt and water, soaking it overnight. No doubt the practice of making a big pot and saving the rest for later helped the GI!!!
I suspect porridge does the same for me - if I have porridge for breakfast I'm hungry long before lunchtime where bacon and egg or NO breakfast means I'm not hungry until after lunchtime, Don't need a monitor for that ...
Like you I was initially surprised at his surprise! But I think he was maybe most surprised at the contrast with his wife who could eat exactly the same breakfast with no peaks whereas he couldn’t.
Dear Suzy. I too have steroid-induced diabetes. I was pre-diabetic before. Now on Metformin and Jardiance. Do you have any mental tricks to help you avoid sugar, starch, booze, red meat? Esp sweets and starch.
Yup. I grocery-shop on line and quite often entertain myself adding things like coffee cake and eclairs I then delete before submitting the order. A girl can dream!
I dread needing to go to the baker to get milk - the little supermarket in the village occasionally either runs out of semi-skimmed or the sell-by date is a bit short since it takes me 4 days to get through a litre. Too much temptation at the baker! Though I am very restrained with a piece of cake, cut into 3 usually, today, tomorrow and freeze one.
Since I rarely eat out - I allow that!!! But apart from pizza - no way you can de-carb THAT, I do get them to swap the carby stuff for salad or more veg. And mostly I haven't room for dessert ...
I’ve been doing it for a few weeks now and have found it fascinating. Seeing what made my blood glucose spike on the app on my phone while using the monitor (for two weeks) and learning how the spikes could be moderated by e.g. eating something else beforehand or exercising afterwards was so interesting.
It's a continous blood sugar monitor, now being used on diabetes patients, esp Type 1. On the Zoe study I've signed up for, you wear a monitor on your arm for 2 weeks and then using an App on yur phone can take readings wheever you want to see the effects of eating different foods.
It’s what tangocharlie says but actually a bit better as you don’t have to take readings. I think you needed to do that with the previous version of the monitor but with the one I got your blood glucose is monitored constantly and you see a graph on the monitor app which shows how it has gone up and down during the day. You can just look at the app and see what is happening at any time of the day. It does get a bit compulsive! You will also have logged what you have eaten on the Zoe app so you can see there what you have eaten at what time and can see what has caused the BS peaks and troughs. So there are two separate apps.
I could bore for Scotland about it! I'll happily PM you with my (many) thoughts if you like but I’m away in Edinburgh for the weekend (not for the Beyoncé concert!) so it will be next week I think. It will become clear to you when you do the programme but you get tests you can try out which show that you might find your blood sugar response to carby food can be reduced if e.g. you pair it with another food which is rich in protein, fat or fibre, or you go for a brisk walk after eating it or you eat another food rich in protein, fat or fibre before eating the carby food. I should emphasise that it’s very personalised so what worked for me may not work for you.
I have nearly completed the Zoe course and have found it not only very interesting but beneficial. I thought I had a healthy high fibre diet and I managed to control weight and avoid diabetes while on higher doses of pred but my cholesterol is now below 5, first time in many years. I have also lost weight without difficulty. Much of it is discovering the right food combinations. I hope you have as much success as I did.
That is interesting. My doctor wants me, after my holiday, to discuss starting statins to bring down my cholesterol level. She said I currently have a 17.5% chance of a heart attack in the next 10 years. My recent HbA1c has shot up to the top level of 41. The nurse said the only way to change things is with drugs and that diet doesn’t alter things significantly. Obviously I don’t want to start taking more drugs if I don’t need to.
I’m currently on 12mg of pred. Out of interested what dose are you taking doodle?
I'm now down to 1mg and currently trying 1/2 every third day . I still get the dreaded fatigue early afternoon, this has been a constant from the beginning. I am into my 7th year. The lovely Polly seems to have gone into submission. I have seen an endrocologist consultant at Barts, in London, also a consultant rheumatologist and none ,along with my GP, are interested in doing any cortisol testing!! I was almost 9 stone when Polly arrived and I managed to sustain that weight but I'm now 7stone 10Ibs, some will be due to my careful eating while on pred and then the slow reduction, but the Zoe programme has also undoubtly had an impact. I tried taking statins but didn't tolerate them, took a much lower dose for awhile which seem to have no impact and gave up. As an added bonus I no longer have any heart burn though it was mostly quite mild. If you have anymore questions please feel free to message me.
Many thanks for your reply. I will probably give the statins a try when I’m back from holiday and reduced pred to 11mg. I’m reluctant though as my Dad had so much muscle pain whilst taking them. I’m really struggling to keep my weight in check and am just about where I was after the Christmas binge and pre PMR diagnosis.
Thanks for your offer. I’m sure I’ll be back for more info later!
I was one of the first to do the Zoe programme in the UK over a year ago as I'd put my name down years ago when it was only available in the US. It's not really a diet, more a way of healthy eating, first finding out what actually is healthy for you as everyone responds differently to different foods. You can lose weight on it if you want to but equally put it on too. When I follow the principles I've learnt from it, I feel much better and vice versa. I've learnt a heck of a lot from it. I hope one day in the future that this is available to everyone for free as I'm sure it's the way to go to educate everyone about a healthy way of eating.
I think you have made an astute move to join Zoe and understand your sugar spikes. We are all different and get different level of sugar spikes from different foods… Doctors (on the NHS) cannot officially recommend diets or food restrictions that have not been scientifically proven to be beneficial or detrimental, but since PMR caught me I have adopted a zero sugar, low salt, no alcohol and anti inflammatory diet and feel quite good about it despite the occasional longing for a good pasta dish washed down with some quality claret!
Can I just stick in a cautionary tale here. It happens I never got the hang of salt, turned up my infant nose at salted butter. Later I found it was fun on crisps and chips, but never ate much of either or anything processed. Later still when I wasn't even occasionally dropping in for fish and chips on my way home or buying a packet of crisps in the office canteen I had an almost totally - pinch in boiling veggies and whatever natural salt is in fresh foods - salt-free diet. So there I was about a year into PMR developing a craving for the stuff. Hi, Google. I didn't think I had Addison's. Problem solved by munching my way through a couple of multi-packs of crisps. It happened again about a year later. Nowadays I keep salted peanuts around. You do need some of the stuff. With me this may be something to do with the Na:K ratio because I drink quads of milk before even starting on the oranges and lentils and sometime a meal replacement shake which contains potassium .
I find this all very interesting. I am currently reading Tim Spector’s book, “Food for Life” and have learnt so much from it. The whole subject is fascinating. I am considering registering for the Zoe programme although my blood and cholesterol levels are always low and I don’t need to lose weight. However, I’m sure you can learn an awful lot about blood sugar spikes etc.
Thanks for posting this, TC. I think that it is going to become a very important tool in improving an individual's health. I, too, will be starting the course next month. My wife completed hers last autumn and, as well as being able to lose weight easily, has been free of the migraines that have affected her since she had our first child in 1984, which is truly remarkable and life-changing for her. In her case, it was her gut microbiome's reaction to fat intake that surprised her. Now she commonly has a breakfast of sweetcorn, peas, edamame beans and scrambled egg, while I'm eating my muesli, fruit and yoghurt concoction.I suppose that I ought to add that I am a Zöe shareholder after its recent crowdfunding effort.
I went through it a couple years ago. It was very interesting information from the monitor but it didn’t tell me much I didn’t already know. I do best with high protein low carb. And my body didn’t like intermittent fasting (blood sugar fell way too low over night). However, none of the info helped with my gut issues (eventually diagnosed woth colotis and celiac) and years later, have finally landed on Weight Watchers for weight loss. 15 pounds in 8 weeks. The actual process was fascinating though, and I don’t regret doing it.
So high protein low carb didn't help you lose weight? I wonder why? It works for me, provided I eat good fats too eg avocados and buttr on the veg. My trouble is I'm not self-disciplined in the long run, so I hope the monitor will help me realise I can't fool myself. I joine dSlimming world and try and follow their Sp plan as things like potatoes and pasta make me gain weight
The Zoe program specifically didn’t help. In the past I lost weight… quite a lot, but once I was diagnosed with colitis and celiac and fight chronic diarrhea, I can no longer eat high veg, low carb. The Zoe program didn’t help heal my gut either.
Oh I see. I've been working on gut health for a few years as I thoguht it might help lower inflammation. My problem is if I eat anythng high histamine it causes mast cell reactions, and a lot of foods that are good for your gut are high histamine eg yoghert, kefir, pickled and fermented things, bone broth. But despite that I have improved my guts - I pay for annual tests from chuckling goat. Did the coeliac come on in later life then? That must be difficult to live with. Do you have Crohns too as that seems to go with collitis?
Yes. Celiac came on after several years of low carb and weight loss followed by Covid baking and relaxed eating. I don’t have Crohns, but do have microscopic collagenous colitis. I have adjusted to the gluten free diet but wish there was something I could do for the colitis. So far the one medication that worked caused me leg numbness and I had to come off it. Fun stuff.
I've just completed 6 months on the Zoe programme and would like to endorse the generally positive comments here. I thought I had a fairly healthy diet beforehand and wasn't too concerned about weight etc, but wanted to see whether doing the Zoe thing would help with the underlying inflammatory stuff and therefore PMR. (I am lucky that I have a 'mild' case of PMR, probably triggered by 2nd Astra Zeneca jab in April 2021 - but I've had all the offered jabs since without incident, and am NOT anti-vaxx! I hope that it will eventually resolve without pred - it does seem to be going in the right direction, though I still have some shoulder pain.)
Anyway, the individual testing done by Zoe is a revelation and I now know a lot more about what foods work best for me, how to avoid blood sugar spikes, what different kinds of hunger signals mean, even how to check my poo - it's a hugely educational experience, reinforcing your learning with daily mini-lessons. The daily log where you can enter your planned meals and check their score against your individual health benefit targets is very useful, and they have meal planners, links to tested recipes, a barcode scanner you can use to get scores while shopping - the lot. You can also chat to a coach any time you want to ask a question. So yes, it's expensive, but I feel I have very much benefited from the knowledge gained and have permanently changed the way I eat. Even if it's not a 'magic bullet' for PMR, a personalised anti-inflammatory diet ('diet' in the sense of permanent food regime, not a short-term diet to lose weight) can only be helpful IMO. I wish it could be made widely available to all at no cost - probably save the NHS millions in the long term.
Thanks everyone for your ideas and encourgement. One of my worries is that they might not let me do it on high steroids or know how to take into account the blood sugar spikes caused by Pred rather than food
Well, you won't know until you try - or maybe ask the question before you sign up... knowing ZOE would be surprised if there isn't a FAQs or a way to contact beforehand.
They've let me sign up without asking about meds or health conditions, which I was surprised about. Maybe because I answered the health questionnair rather than the weight loss one. I'm not bothered if I lose weight or not, I probably will lose if I keep blood sugars low as I have done in the past. My main focus is avoiding having to take diabetes meds. Do I remember right you were on the ZOE Covid study?
The fact you are on steroids doesn’t matter. From memory I think they may have said you shouldn’t do it if diabetic but pre diabetes is ok. There’s a questionnaire that you complete at the start.
I should have said that as I learnt my blood sugars spike due to the steroids between 12 and 5 pm I don’t eat in that time to try to keep the sugars lower. My diabetic nurse is happy with this and your body soon gets used to it.
Hi a question please for those who have already done the ZOE nutrition study. I've now finally got my kit and will start in a day or two. But it says you have to fast 8 hours before the first tests (muffins etc) on the morning of Day 1. But I know if I take my Pred it will cause a blood sugar spike, probably a few hours after, which I guess could skew my results. So what did you do, take your Pred as normal, or wait after the breakfast muffins, or wait until after lunch? I can't find the answer on the FAQs.
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Newly diagnosed but don’t want to take pred
Hba1c now 43 - Prediabetic?
Plant sterols for cholesterol and continuous glucose monitor for blood sugar - good results
Wish Me Luck! Update #1
