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Tuesday 4 September 2012

My experience with a low carbohydrate diet.

I was diagnosed type 2 diabetic about 12 years ago when I was 61. My Dr warned me of the consequences of uncontrolled diabetes & referred me to the local hospital for a basic course. There I was told to base my diet around whole grain carbohydrates & general follow a low sugar; low fat; low salt diet & maintain an active lifestyle. That diet was basically as recommended by Diabetes UK. I was also told that diabetes was progressive, & I would progress from diet to tablets to insulin, while suffering health deterioration.

My principle diabetes symptom was a numb sensation in my right thigh, which my Dr thought was diabetic neuropathy. At diagnosis, my HbA1c was 8.7, cholesterol 7.6 & weight 13 st 7 lb (86 Kg)

On diagnosis in November 2000, the Dr. told me all the complications could expect – foot amputation, blindness, stroke, heart attack, etc, & helpfully computed my heart attack probability as 25% within 10 years. She also advised me of the NHS help available. I went to the one-day course at West Middlesex Hospital for talks by nurse, dietitian, pharmacist & podiatrist. At first control by diet & exercise was recommended, before use of sugar control drugs is considered. I was assured that however good my control, diabetes was progressive through medication & insulin.

I was in a state of shock for some months, & was careful to comply with the advice. I was already playing tennis & getting plenty of exercise, & was have been health conscious all my adult life. I included cholesterol reducing margarine & oat bran to help reduce cholesterol.

I got on well at first, & after two years I felt I had diabetes under control. My HbA1c was 6.5, cholesterol 5.4 & weight 12 st 5 lb. (78.5 Kg.) My heart attack risk dropped to 15%. I was very happy with Diabetes UK diet recommendations which I understood as:Low sugar, low fat/oil, low salt ;
30-40% in the diet of carbohydrates, particularly multigrain bread, basmati rice, pasta;Plenty of vegetables & fruit.

I recommended the D UK diet in a radio phone-in in 2003. However, the condition progressed slowly, as predicted. After about 4 years I started taking metformin & then they wanted to reduce my cholesterol below 4.0 so I was given simvastatin. Simvastatin caused serious muscle pain & I have been unable to take any cholesterol medication.

Complications began to set in: chronic tiredness, muscle pain & the beginning of retina damage.

In April 2008 muscle pain was so serious I feared becoming disabled. It could take 5 minutes to get out of bed. Stairs were a struggle. My active life seemed to be over. My HbA1c was considered acceptable at 6.7. My overnight BG averaged about 7.

At that time I joined the forum. Thousands of people with diabetes ask questions, note news items & contribute from experience. Many contributors had found from experience that a low carbohydrate diet was very beneficial. I had nothing to lose, so immediately cut right down on carbs. My overnight BG dropped to an average less than 6. Within 3 months I was playing tennis again & I was completely out of pain. My weight dropped to about 12 st (76 Kg.)

I have continued a low carb diet ever since. Four years on, I am well & active, playing tennis & table tennis at club standard. I have cooperated with several heart/diabetes research projects, including a long term Imperial College's SABRE & Ealing Hospital's LOLIPOP. There is no indication from these projects that my low carb diet is causing any adverse effects.

One blood measurement that my Dr is watching is kidney function, which is completely stable since before my change of diet.

What do I eat? Is it complicated or straightforward? Are there problems with eating out, or with friends?

Basically all I do is avoid the obvious carbs – bread, potato, rice, pasta. I have developed some special low-carb recipes. Also I make a bread/cake & a porridge based on ground almonds. I snack on cheese & nuts. My friends are used to me refusing biscuits & cakes & savouries. Sweet dishes include jelly flavoured with NAS squash & topped with yoghurt or cream.This chart shows a breakfast experiment:

Roughly the same weight showed striking differences in composition & performance. My almond porridge sustains me until lunch - & on occasions when I play tennis during the morning while consuming only water. After the 1 hour spike up to 7.4, my BG stayed at about 5.5.

The Tesco fruit/fibre cereal gave a massive spike to 14.3 & by 11 o'clock had dropped to 4.1 & I was beginning to feel shaky. Happily at that point my reserves came into use & raised the BG to 4.7.

A further point of interest is that the Tesco data is for a suggested amount of 30 g, with 125 ml milk. That provides only 183 kcals, or 10% of the daily requirement - which does not amount to a substantial or even adequate breakfast.

A very serious question for D UK is raised by their booklet “Eating well with Type 2 Diabetes” where they assert: Why is carbohydrate important?

All carbohydrate is converted into glucose and will have an impact on blood glucose levels. As this is the case, some people with diabetes wonder if it would be better not to have any carbohydrate in their diet to keep their glucose levels under control. This is not recommended as:
• glucose from carbohydrate is essential to the body, especially the brain
• high fibre carbohydrates, such as wholegrains and fruit, also play an important role in the health of the gut
• some carbohydrates may help you to feel fuller for longer after eating.

How much do I need?

The actual amount of carbohydrate that the body needs varies depending on your age, weight and activity levels, but it should make up about half of what you eat and drink. For good health most of this should be from starchy carbohydrate, fruits and some dairy foods, with no more than one fifth of your total carbohydrate to come from added sugar or table sugar.

These assertions by D UK appear to be totally without foundation. I have reported the benefits to me of low carbohydrate diet & asked for research references. All I get is “if it works for you, keep it up, but we cannot change our diet recommendations.”

I came across the July/August 2003 “Balance”, which had an article "investigating the truth behind a low carb diet."

I won't bore you with warnings of the dangers of "breakdown of vital muscle & body tissues" or "increased risk of heart disease, cancers & bowel disorders" or "the risk of kidney disease." Such a diet may be "suitable ... with medical supervision & with guidance from a state-registered dietitian."

A key paragraph is: 
"Research into the long-term effects of low-carb diets is now required. And in response to this, Diabetes UK is funding such research."

Eight years on we have the 2011 D UK “Position Statement” where we read:
"More research is needed to assess the effectiveness of varying degrees of low-carbohydrate diet on weight, glycaemic control, hypertension and lipid profile in people with Type 2 diabetes as well as to investigate the long term effects of these diets."

I can't wait for yet more long term studies - I've too much to lose. I followed their "healthy diet" for 7 years & was crippled by the complications. My low-carb diet started in May 2008. The complications disappeared in 3 months. Four years on I am well & active. There is no hint of any adverse effects in my experience, nor in the SABRE & LOLIPOP studies. My Drs are happy with my level of health & all my blood test results.

D uk state in their “Position Statement” on low carb diets, warn that “there is a lack of evidence related to long-term safety and benefit of following this diet.”

I know of two long term studies:

A 44 month Swedish study, (citation 13 in D UK Position Statement) which states:

“ the present high-carbohydrate dietary advice resulting in unnecessary hyperglycemia and insulin resistance seems difficult to support and for diabetes patients, current dietary recommendations seem to be a major part of their problem rather than being part of the solution. Carbohydrate restriction, however, reverses or neutralises all aspects of the metabolic syndrome.”

Mark Daly, Consultant diabetologist, the MacLeod Diabetes and Endocrine Centre, Exeter responded to my query:

We have presented our results at 3 national and 1 international meetings. We found no serious adverse effects over 2 years but not everyone is as good at sticking to low carbohydrate diets as you.”

I challenge Diabetes uk to produce ANY evidence to (a) support their warnings of the dangers of low carbohydrate diets, & (b) to justify their recommendation for T1 & T2 diabetics that carbohydrate should make up about half of what you eat and drink.

A guest post by Ian Day


Anonymous said...

This is a lovely article Ian, many thanks for sharing it with us.


Anonymous said...

@ I challenge Diabetes uk to produce ANY evidence to (a) support their warnings of the dangers of low carbohydrate diets, &

(b) to justify their recommendation for T1 & T2 diabetics that carbohydrate should make up about half of what you eat and drink.

Good luck with that!

Would you like an appointment to a Cryogenic centre so that you can be frozen today and arrangements made for you to be defrosted when they finally get around to doing so?

Anonymous said...

A very good post Ian-As always.Thankyou.


Lowcarb team member said...


Thank you for allowing us to post your story. It will inspire others. Your hard work away from forums is much appreciated.

We must never stop spreading the good news.


Suzie_B said...

These numbers were posted on this blog the other day:

Percentage of registered Type 2 patients in England
HbA1c >= 6.5% (48 mmol/mol = 72.5%
HbA1c > 7.5% (58 mmol/mol) = 32.6%
HbA1c >10.0% (86 mmol/mol) = 6.8%

I wonder how much these numbers would change if all the low-carbers were removed from these statistics? Too bad they don't keep track of people separately who low-carb to see the difference.

Lowcarb team member said...

Hi Suzie

If the lowcarbers numbers were taken out of the stats the numbers would be even more gruesome.

They could list the HbA1c numbers for lowcarbers, but that would highlight how bad their treatment truly is.

Year in and year out, zero progress is being made, in fact the situation is getting worse.


Philippa said...

Sigh. The Diabetes UK party line is very similar to the Canadian one.

They even post nonsensical things like claiming they are committed to the latest research etc, yet their position papers are more than 10 years old and most certainly don't support current research.

fibreclaireUK said...

Very helpful and inspiring article. Thank you Ian for sharing your experience.

Lowcarb team member said...

Philippa said...
"Sigh. The Diabetes UK party line is very similar to the Canadian one.

They even post nonsensical things like claiming they are committed to the latest research etc, yet their position papers are more than 10 years old and most certainly don't support current research."

Hi Philippa, your right the NHS and DUK are still pushing dietary advise based on old research, low fat high carb is the recommended diet for Type2 diabetics.

like Ian we have been following a LC diet for over four years with no adverse effects, the fact we are still getting safe A1c levels on minimal or no medications and with no evidence of progression shows to us at least LC is safe.

We do have a Canadian friend in Dr Jay Wortman who I'm sure you will be aware of, he has published a comment about Ian's post.


Jan J. said...

Great to see this post! I had toyed with low carb in the past and done well but didn't stick to it. I tried going low carb again when diagnosed with diabetes with a blood sugar of well over 500 (USA measurement). I was almost put on insulin. I did well with stopping sugar but was told I needed those whole complex grains so kept whole wheat and brown rice. And also kept high BS. A few weeks ago dropped wheat/grains, staying very low carb and even without meds my blood sugar has been normal or barely above already and I have so much more energy - just feel better! With almond flour, I will be able to stick to it this time, particularly with such drastic results. Other health issues are better as well - reflux, asthma, allergies, hypertension. So happy to see the word spread more and more! (I recommend the Wheat Belly book by Dr. William Davis - it inspired me to get going again)

IanD said...

That was a talk given to the Hounslow Diabetes/Cardio Support Group last May. Over 50 people were present & the organisers sent my talk to all the email subscribers, & printed it for others to pick up at the next meeting.

How do I post the JPGs - my LC diet plate & my b'fast experiment?

At the next meeting two dietitians spoke.

After all that, no-one has contacted me about my diet, & AFAIK no-one has joined the forum.

Anonymous said...

Very good post and thank you for sharing this with us, it spurs others on I'm sure and spreads the word.

Thank you


Anonymous said...

This is really inspiring stuff but also frustrating for me. I have been strict low carbing for about 2 months now and cannot get my fasting BS below 7. I test all the time and mostly, it is between 8 and 12 even tho I don't eat more than about 40 carbs a day. I read so many success stories but it just doesn't happen for me. Maybe my pancreas is just fried and insulin is the only way?

Pharmajobs-India said...

Good article and thanks for sharing your experiance on low carb diet.

Lowcarb team member said...

“This is really inspiring stuff but also frustrating for me. I have been strict low carbing for about 2 months now and cannot get my fasting BS below 7. I test all the time and mostly, it is between 8 and 12 even tho I don't eat more than about 40 carbs a day. I read so many success stories but it just doesn't happen for me. Maybe my pancreas is just fried and insulin is the only way?”

Thanks for your comment. I have said for a long time diabetes goes not have to be progressive, not in the sense we will go on to suffer serious complications. However, type two diabetics at diagnosis usually have a damaged pancreas. Some reports state around 50% of beta cells have died. This the reason I am alarmed when some type two non insulin using diabetics state they can eat up to 200 carbs a day and hold good BG numbers. The question is how long will they hold safe BG numbers on that sort of carb intake ?

My guess is not for very long. I have talked to diabetics in that situation, and they find within a few years, they have to reduce carbs to keep good numbers. I believe the advice eat to your meter is sound for the newly diagnosed, but in the long term, a type two should go for the minimum amount of carbs they can tolerate. Most real low carbers find 30 to 50 easy to live with.

Complete beta cell burn out maybe down the road for many of us diabetics. When a lowcarb diet does not keep BG safe, insulin is the only med I will use. Far too many type two meds have ether been banned, or in my opinion not very effective, or are downright dangerous.

A well controlled lowcarbing type two, should have minimal grief trying to hold safe BG numbers on a very small amount of injected insulin. That’s my theory, who knows, I may have to go down that route myself. I respect insulin but do not fear it, it’s pretty easy to make a decision when you have no choice.

Good luck and health to you and yours.


Lowcarb team member said...

Hi Ian

Your post has caused a lot of interest, people from all over the world are reading it. We get stats on this blog shown below after around 24 hours. For a small blog like ours these are very high numbers for one post. Well done, if you have helped one person go lowcarb it is all worth while. I suspect you have helped many with your story. Thanks again for posting it here.

Kind regards Eddie

Entry Pageviews
My experience with a low carbohydrate diet.
4 Sep 2012, 15 comments
213 pageviews.

Anonymous said...

Ian this is an amazing article, I can only thank you for sharing this with us. I'm sure it will go towards helping others.


Anonymous said...

"After all that, no-one has contacted me about my diet"

Somehow I'm not surprised they just don't seem to want to know that for so many low carbing is the way forward. We must keep spreading the word.

Your article was excellent thanks

Lowcarb team member said...

You can view Ian's LC diet plate here


IanD said...

A diabetic friend asked me for my almond cake-bread recipe.

I took him a sample & he had it with chips!!!

It raises the question, "should we eat the low carb diet before or after or with our meals....????

When I gave that talk, some refused my samples because they "know" that low carb food is bad for diabetics.

Anonymous said...

Ian thank you so much for sharing this excellent article with us, I enjoyed reading it. I am a strong believer in the low carb way and think it very important that we should all spread the word as much as we can. Your sentence, which I have copied below, goes to show we still have a lot of work to do.
As the saying goes from little acorns oak trees grow. I hope the low carb oak tree keeps growing over the years and matures into a magnificent learning tree, it is needed perhaps more than ever these days with some of the nonsense shown on television, written in articles in magazines, and also bad information given on some forums etc.

'When I gave that talk, some refused my samples because they "know" that low carb food is bad for diabetics.'


IanD said...

With my final cup of tea with that diabetic friend I was offered a "healthy" Special K bar. I looked at the small print.

Only 90 kcals - you'd need 4 for a calorie sufficient b'fast - & more or a Mars bar mid-morning.

78% carb of which 38% sugar
5% fat.

I explained why I declined ....

In the olden days they used to talk about "food value." What food value is in such "pseudo-foods?"

Anonymous said...

Ian this should be unbelievable and unforgiveable but unfortunately I've seen this for myself, this is why I for one do all that I can to spread the good low carb news, even if only one or two take it up they will be another success story to continue the good news.

When I was young type 2 diabetes only affected middle aged or older people. Now to my horror children are being diagnosed as type 2 diabetics.

Also when I was young sweets and bottles of sugary fizzy type drinks was a once a week treat. Now the younger generation seem to live on it. These drinks often appear in their school lunch boxes together with the seemingly mandatory crisps and chocolate bars.

If things don't change it's only going to get worse.