X-pert Diabetes course in Warrington

Have YOU recently been diagnosed with

Type 2 Diabetes or Pre-Diabetes?

Would you like to have an opportunity to see if you can reverse the diagnosis?
It was previously believed that Type 2 diabetes was a progressive condition that deteriorated over time but research has now shown that it can be halted and even reversed with a low carb lifestyle.

Consists of a 6 Session X-PERT Health Low Carbohydrate Programme.

Designed to provide information and guidance on a Low Carbohydrate Solution.

The Programme is run by a registered X-PERT Health educator and supported by the Natural & Low Carb Kitchen, experts in low carb cooking & foods.
Blood Glucose Test Meters to be provided (free of charge).

Initial information meeting on Thursday 26th January 2017 at 6pm. Patient families also welcome to attend information meeting.
Programme commences on Thursday 2nd February 2017 at 6pm for 6 Thursday evenings Cost of programme £5 per session (total £30).
Venue Grappenhall Ex-Servicemen’s Club, Chester Rd. Grappenhall.
For further information please contact Keith Rathbone 01925 824999

Find Your Own Carbohydrate Level

Carbohydrates are in many foods we eat and are classified into sugars and starches. When I started on this low carb way of life I found it a bit confusing. What level of carbohydrate was needed?

There are no essential carbohydrates

so what was to stop me choosing zero? You don’t you need carbs for energy( they are not necessary as your body can make glucose) so why do dietitians advise them? Is the advice itself just a habit?
People eat a lot of carbohydrate containing foods like bread, cakes, cereal, fruit and vegetables, and regard them as healthy in moderation, but as you know they are habit forming.
I was 50 years of age but I still found it hard to believe that staple everyday foods like this could harm me in any way.
It was my sister’s and, separately, a patient’s, marvelous recovery from a rare arthritic disorder that set me thinking. Why would they get so much better just by cutting out the starches from their food? The theory is to do with bacteria in the gut feeding off starches and causing an overgrowth of a bug called klebsiella, which then triggers a reaction whereby the body starts to attack itself. The particular diet they used is called the London AS diet.
Then Dr David Perlmutter’s book Grain Brain set me thinking about whether sugars and starches could lead to diabetes, dementia and other chronic inflammatory conditions. This could happen through the insulin hormone getting too high, too often, causing weight to go up and causing Type 2 diabetes.
Then I had the surprise of seeing the zerocarbers on www.zerocarbzen.com, www.myzerocarblife.com and the Principia Carnivora Facebook group. One of these zerocarbers was a retired doctor who wrote to me from the USA and told me about his zerocarb journey- and very well he did too. Obesity and hypertension resolved and off all his medication. Many of these people had morbid obesity and through a zerocarb lifestyle became a normal weight and were able to stop all their medication.
The Masai and the Inuit people were zero carbers and while many dietitians say that no one can stick to zero carb diets, I am told that 10-20k people in the USA do exactly that today.

How can you decide? It starts with what you want to achieve and what you like to eat.
Would you like to write down your goals?

People say things like…
Running about with the grandchildren
Looking good for a son’s wedding
Weight loss
Resolution of type 2 diabetes
Coming off drugs
I am a keen exerciser and feel I need to eat some carbs. If so what is the minimum you can get away with?

Are you veggie or vegan? That makes it impossible to get down to zero without nutrient deficiencies, so I often suggest cutting out sugars and following recipes on www.authoritynutrition.com or www.dietdoctor.com

Decide how low you want to go and whether you reduce them gradually or all of a sudden. My plan, which came from Dr Perlmutter is flexible, and you could do it with or without any grains, sweet fruit, or starchy vegetables if you wanted quicker results.

If you want to reduce your risk of diabetes and dementia, Dr Perlmutter suggests 30g a day is about right. I got too thin after 4 months on this so decided to raise it a little but I still eat under 50g a day.

Butter Bob Briggs and Jeff Cyr eat the lowest level they need to feel well, keep their weight down,their blood glucose normal and keep them off medication.

Once you achieve your goal you can decide if your want to raise your carb level a little and see if that still works for you.

Should we turn the sugar tap off?

sugar
I was at a diabetes meeting the other day and the expert speaker was telling us a sad story of how his wife had developed insulin dependent diabetes and how she and the family had very little structured diabetes education. This meant that she and her son did not know how to prevent complications like hypos. He also described the standard way of managing diabetes with a variety of drugs and insulin. Lifestyle measures were in there, but without any detailed explanation.
When the talk was over a patient stood up and said:

If I had a flood in my house, I would not spend day after day, week after week & year after year buying buckets, mops and towels. I would not be inventing different types of buckets and more efficient mops or drainage systems to ensure the water drained away quickly. I would find the source of the water and turn it off.

If you are prediabetic or diabetic, would you like to find the source of your sugar and turn it off? Look at www.diabetes.co.uk or www.dietdoctor.com for more information. Discuss with your nurse or doctor if you are on medication, as this will need to be reduced.

If you are a doctor or nurse, find out how you can teach patients about cutting down their sugar sources, and give them information on they can reduce their drugs.

sugar-taps

Diabetes 1983 vs 2016

1983 Medical school, I learnt that diabetics had a problem with processing sugar and carbohydrates. They either lacked insulin(type 1), or their insulin did not work properly(type 2)which meant that foods high in sugar and/or carbs( which all convert to sugar in the body) were the worst foods for their metabolism. Fast forward to 2016, and many of us are

under the illusion

that diabetics can eat what they want and match the carb load with insulin without any consequences. This works very badly for many. Eating more and more carbs means insulin requirements go up and up, weight increases, and, for type 2s,

insulin works less well over time

, a bit like giving increasing doses of morphine to a drug addict. They may then be more prone to hypos and to complications. Our local dietitians appreciate this and I have been working with them to get the word out to local doctors and nurses, as well as patients, that a low carbohydrate diet is the first step. Eggs & bacon vs porridge? Eggs & bacon gives a much lower blood sugar level( just skip the bread!). Cholesterol? The cholesterol in food does not cause a high cholesterol in the blood. That’s a longer story and you can read it here.

Diabetes.co.uk

I was talking to our chief dietitian about a time long ago when it was universally accepted that diabetics should not eat much in the way of sweet and starchy food. They did something called carb counting and limited their carbs. This was back in the day when we were both young, and newly qualified as GP and dietitian. Somewhere along the way the world forgot this helpful approach. Just to make it clear, Type 2 diabetics have an inability to process starches and sugars properly due to a problem called insulin resistance. It makes them overweight. It makes them have more inflammation in their bodies and this is a bad thing. They have high levels of circulating insulin and it does not bring their blood glucose down enough. If we doctors give them insulin, it may bring their blood glucose down, but they get fatter and fatter and need more insulin over time. Their control does not really improve. There is only one solution. Cut carbs, count carbs, and accept that your body just cannot tolerate them. Try the low carb plan on www.diabetes.co.uk. It has only been going a few months and already has had over 120,000 members!

Diabetes – a Tale of 2 Diets

Last night I saw a stoical and charming lady of 89 who had diabetes and uncontrolled high blood pressure. Her diabetes was managed but uncontrolled on a fairly standard British diet and you can probably guess what it was. Porridge for breakfast with semi skimmed milk, a whole wheat bread sandwich for lunch with paste or cheese, and a cooked meal from one of those companies that supplies the multitude of old people up and down our country because it can be easily popped in the microwave. When she is hungry in between meals she has a biscuit or a little piece of cake. The standard approach, after advising less cake and biscuits, is to tell this lady to take more and more medications to bring down her blood pressure and glucose. These drugs cause increasing side effects, and sometimes admissions to hospital. Indeed, there is a study that shows that if you take a group of elderly people and split them in half, and half of them have their medication reduced, and half have it unchanged, that after one year more people are alive in the group that have had their medication reduced.

I asked her what she would like to do.

Would you rather take more tablets for your blood pressure (she was already on 5 medications) and diabetes?
Or would you rather try something a bit different?

Even at 89 she wanted to hear about a different approach.

This is what I told her. Your body cannot control its own glucose properly and that has a knock on effect on how your body works. The easiest way to help it is to avoid eating sugary and starchy foods. These foods are moreish (addictive) and it is important to give them up. It is a choice you can make instead of adding in more medications.

If you want to do this I suggest the following:

Base breakfasts around eggs, or bacon, maybe with some tomatoes or spinach
Base lunches around meat/cheese/poultry/fish salads- e.g. a slice of beef and salad or a tin of tuna /salmon and salad
Base evening meals around meat/cheese/poultry/fish with vegetables and/or salad.
For snacks I suggest olives, or hard-boiled eggs, or slices of cooked meats, but these snacks should not be necessary as time goes on.

Talk to your family and carers about how you can do this and bring them back in a couple of weeks to discuss further.
Here is my card with a list of helpful websites.
I suggest you gradually withdraw and change over a 6-week period, because if you do it all at once you will get low carb flu and that is a bit much at your age.

I am pleased to say she is going to try that.
In a few weeks I will see if her blood pressure and HBA1c have improved. I will need to help her further with the diet- people often have many questions once they get going with it.