Brett picks up the gauntlet.

Hi Brett as you can see your comment has been posted unedited, I hope your comment will kick off an interesting debate. Graham will no doubt have input later. Feel free to comment on my comments, post your comments in the usual way and I will place them up on this thread. Anyone else reading this thread please feel free to comment.

From Brett today.

"Thanks for your reply graham and yes it was rather late, had a new coffee machine and had a few too many espressos.

Any way, as I've said before any diet is individual to the person, what we all choose for ourselves to do is individual for our needs. I appreciate the differences between types but feel harsh restriction of any food group is not beneficial for either type, maybe why you are underweight or struggle to put on weight. Nothing wrong in reducing a particular food group. Someone eating 100 carbs a day would be consuming roughly 400 cals a day from them, thats alot to make up in fat, protein, unless in a short term calorie restricted diet for a short period. What would have to be eaten to make up 2100 to 2600 cals from other food groups. Are all people aware about the effects on kidneys of extra protein, especially those who have kidney problems and low carb. Why does even the atkins diet state that its not a diet to be done forever. If it is a healthy way to go why isn't the while nation doing it. I know of many low carbers who are actually overweight. I know of some low carbers who have lost weight but accompanied with exercise which, will work with any diet. I do.wonder how many type 2s actually stick to a proper Diet with exercise.

Edit Graham

Hi Brett

Actually restriction of carbs has proven beneficial to me, besides the obvious reduction in blood glucose my lipid panel is good and my eGFR is >90, all my other blood tests have come back within lab ranges. The only slight hiccup was low serum sodium level which was put down to my BP meds, I was put on a different medication and increased my dietary salt intake now that is in range. Recently had my annual retinal scan which showed no retinopathy changes, also podiatry checks showed no problems.

Kidney problems on a LC/HF diet is a myth, renal function has been shown to improve not deteriorate on a LC diet. There is a new study in Renal & Urology News which unfortunately can only be accessed by HCPs, which given the title looks like more good news for us Lowcarbers.

“High Fat, Low Carb Diet Beneficial for CKD Patients”

http://www.renalandurologynews.com/high-fat-low-carb-diet-beneficial-for-ckd-patients/article/314032/

A bit stereotypical yes but, true. If a type 2 reduced carbs to 200g (not the junk carbs) and have reduced fat, wouldn't that improve insulin sensitivity by itself. This would reduce external fat and also the internal hidden fat in a person of normal weight. If weight isn't an issue, and a person is following that with raised levels I believe there would be a lack of insulin (growth hormone) in the first place as indicated by the struggle to gain weight whilst consuming carbs .that would then need injecting. many thanks, brett"

Brett I would like to debunk some of the myths stated in your post. "we all choose for ourselves to do is individual for our needs" We did not choose to become low carbers, we had no other choice. Low carbing is the only way we can hold non diabetic BG numbers year after year. Type two medications do not bring down BG by a significant amount. At diagnosis my HbA1c was almost twelve, no type two drugs would have reduced my HbA1c to the mid fives. Multi drug regimes were proved so dangerous the ACCORD trial ended early because too many people died.

You said "Are all people aware about the effects on kidneys of extra protein, especially those who have kidney problems and low carb" We have never advocated increasing protein to replace the calories lost from carb reduction, having said that a high protein diet has no effect on healthy kidneys my GFR is >90. Protein can produce excess glucose and may raise BG. I am using close to the same amount I have ate all my adult life.

"Why does even the atkins diet state that its not a diet to be done forever." Our diet is not the atkins diet. It is my understanding that the Atkins diet induction period is based on high fat and protein. My diet is based on non starchy vegetables such as swede, cabbage, cauliflower, celeriac, broccoli, sprouts, spinach, kale, peppers, the list is long. I then add proteins such as lean meat, chicken, fish and eggs. My calorie shortfall is made up of healthy fats such as coconut oil, cream, butter, olive oil, avocado and fat from nuts and seeds. Also a small amount of low carb fruits such as strawberries, blueberries, blackberries and rhubarb. Does that sound like a highly restricted diet to you? Remember we have only left out foods that are low in nutrients and raise BG to dangerous levels. Foods such as white bread, pasta, rice, potatoes, cakes,biscuits, crisps etc. I reckon I am eating the healthiest food of my life, and my weight, BG control, blood tests  and lipid profiles confirms this is the case.

“If a type 2 reduced carbs to 200g (not the junk carbs) and have reduced fat, wouldn't that improve insulin sensitivity by itself.”

Almost all non insulin using type two diabetics cannot consume anywhere near that amount of carbs. Most would be running double figure BG numbers 24/7, in my case BG numbers close to or even above 20mmol. For most type two’s 50 carbs is about the optimum, some a little higher. The superstar diabetics I know with long term HbA1c in the mid fours use around 30 carbs per day. What about us using insulin you may think, well insulin is not available on prescription on demand, also 93% of type one diabetics, obviously insulin users fail to get to a safe HbA1c, so insulin is not a get out of jail free card. Remember many type two diabetics at diagnosis are awash with plasma insulin, more insulin is the last thing they need.

From Fred

"let us not forget that protein also kicks up insulin, so we can overdo protein. I do not understand why "lean meat" is even suggested. We need fats, and only 1gm/kg or so of protein."

Agree Eddie

From Brett

Agree, type 2 drugs does not reduce bg levels enough by itself, but, along with regular exercise may be enough for some, not all. Alot of lc I have seen do very little if any exercise expecting to still see weight loss whilst consuming same amount of cals. Also, does consuming high fat for an extended period of time impair sensitivity in the long run.

As indicated by many lc, unless you lc it is assumed there must be poor control,poor hba1c, even in type 1 and get referred to as idiots.

And if someone is lc and they do prolonged excercise whilst taking tabs, or in some cases insulin, they are at risk of hypos, maybe not enough to pass out but enough to require assistance and there goes the driving licence (thats whole other matter for debate). so, before an extended activity do they then eat carbs to avoid this situation. Could digest a reduction or stop of said meds which may then lead to higher levels at times of rest.

I just think some people go into low carbing.not understanding the full entirety of the diet. Regards, brett

Edit Graham

 I agree regular exercise is good but will not make much impact on a NHS/DUK diet high in carbs.
Nearly 6 years on since diagnosis most of that time on LC/HF I haven’t seen any difference in insulin  sensitivity.

In our time as DCUK members Eddie and I never ventured in to the T1 forums, on the other hand a certain few T1s felt the need to meddle in the T2 discussions.  One was Jopar who even told me she knew better than me on how to treat my diabetes; another was phoenix who constantly posted misleading links to supposedly LC studies which turned out to be nothing of the sort. There were others who jumped on the band wagon but and I stress the majority we had no problems with.

Having said that our main inspiration who set us on the right track was Fergus a T1 on a LC/HF diet, though he does not do forums these days we still keep in touch.  He’s held A1c’s in the fours for over ten years and is a keen cyclist and runner he’s also a drummer in a band, not bad considering his carbs are <30g a day.

Fergus is the author of LOW CARB DIET - A NEWBIES GUIDE at DCUK

http://www.diabetes.co.uk/forum/threads/low-carb-diet-a-newbies-guide.9427/

Regards
Graham

Hi Brett

Well we agree type two meds do not reduce BG numbers by themselves. Remember many type two diabetics cannot set up a rigorous exercise regime they may be overweight and many are 50, 60 or 70 years of age. High dietary fat (the right fats) do no one any harm.

I don’t assume people that do not low carb are idiots, or have poor control. The NHS stats state 93% of type  ones and a very large number of type two’s have very poor control of BG numbers. They are not fools, they have been very poorly advised.

“I just think some people go into low carbing not understanding the full entirety of the diet” The way I eat has been the way people have ate since the beginning of the human race. Meat, fat and whole vegetables. If there is one area the boffins and experts do not argue about, is mothers feeding their babies with breast milk is best, very high in saturated fat. When low fat formula milk was tried, it was a disaster and swiftly dropped. Makes you think eh.

Eddie

From Galina

" Are all people aware about the effects on kidneys of extra protein, especially those who have kidney problems and low carb."

A diet which is low in carbohydrates is not necessary high in protein or low in fiber or whatever, that is why the abbreviation LCHF is often used - low-carb-high-fat diet.

From Jean

Hello and thanks for this excellent post. To me following a low carb high fat regime is now a lifestyle. It suits me it keeps my bg numbers in the mid fives.

From Paul

I'd agree Galina,my experience of the low carb nay-sayers arguments always seems to involve something along the lines of "Low carb-high protein diet" or "A zero carb diet is not sustainable" and I don't know anyone in my low carb circles,including myself who does zero carb or high protein only as a regime,only low carb-high fat...I have renal issues so high protein is off limits and I DO eat carbs in the form of non starchy vegetables and berries so none of the studies quoted and linked by the nay-sayers have any clout-especially the ones that demonise sat fats in the context of a trial that consisted of a high carb-high fat diet...I don't know any LCHF'ers that would entertain such a diet as high carb-high fat,as we know,is a quick fire road to ruin.

From Brett

Alot of people have mentioned the diet of our ancestors, they had a life expectancy of how many years? As to the reference of mothers milk, basis have alot of growing to do and that milk also passed other nutrients from the mothers diet. Would it be recommended for a mother whom is breastfeeding to have a lc diet, I honestly don't know but common sense would say not. besides, adults have done all their growing. The reference made to most type 2s being overweight and in 50s,6os. plus would love to.know their diet pre diagnosis.

As for those able to exercise w on blood lowering meds well, we will just ignore that one.

No matter how long the debate continues pros and cons will be argued with no. progress made on either pary. Regards brett

From Eddie

“Would it be recommended for a mother whom is breastfeeding to have a lc diet, I honestly don't know but common sense would say not.”

My friend Dr. Jay Wortman is a type two diabetic and low carb expert. His wife carried their daughter on a low carb diet. Hard to imagine a more beautiful child. I know people who have met Izzy and report a highly intelligent child with perfect manners and behavior way above her years.

From Tess

Everyone seems to think "Atkins" is ONLY the induction-period diet, and although Dr A suggested not staying on it indefinitely, there's no evidence there's anything wrong with it. There's also no evidence that a higher-protein diet WITH its naturally-occurring fat is deleterious to health for those with normal kidney function.

Under ideal circumstances, I eat ultra-low carbs, and it has improved my health immeasurably.

It IS possible to do a low-carb diet wrong (not enough animal fats), and that goes double for zero-carb. But if you do your homework and "eat nose-to-tail," it's perfectly healthy. If your idea of a low-carb diet is one that's full of treats instead of whole foods, it IS far from optimal ... but that's not a "low-carb diet" but a "low-carb JUNK FOOD diet."

From Jill

Brett said "A lot of people have mentioned the diet of our ancestors, they had a life expectancy of how many years?"

This has to be the most misleading non-argument ever. Adjusted for infant mortality and death by traumatic injury, our Paleolithic ancestors lived just as long as us - they didn't die of heart disease, cancer, autoimmune diseases and diabetes though. They were also taller and had much better dentition than the agriculturalists that came after them. Paleontologists can tell the difference between hunter gatherer and Neolithic populations immediately because of the pathologies caused by diets based on grain.

From Galina

Actually, Paleo diet is not necessary the same as LCHF diet. I guess,on a diabetic blog people are discussing a diet with a certain macro-composition. May be the conference in London decided that Paleo diet was a joke, however it is a growing trend among athletes to the disadvantage of some sport teams from England.

http://thelowcarbdiabetic.blogspot.com/2013/12/australian-cricket-team-thrash-england.html.