10 things I have learned since 2013

1. Sugar, particularly fructose is the problem. Ultra-processed food is the problem

In 2013 I first heard about excess carbs rather than Fat being the problem from Professor Robert Lustig. It was a chance radio interview and his You Tube post told me more.

2.Many people do not want you to change and may undermine you openly or covertly.

There are many reasons for this. They like what they do, and your change of lifestyle and your new shape throws the focus on their eating and drinking. Which they like, and feel a bit guilty about, and do not want to change. Or maybe think they do not need to change. It happens with your family, at work, and between organisations.

3.Carb Creep

You will probably get drawn back to processed carbs in a process called carb creep- be vigilant, and cut it out. That tablespoon of ketchup, or that half a piece of cake may be the slippery slope.

4. Processed Food Addiction

Most people have processed food addiction and this may be the reason for 2. above. It also makes it harder for you to change your lifestyle as you probably have it too, or have had it too. Look at Fork in the Road by Dr Jen Unwin to find your own way forward.

5. Intermittent fasting

Also known as time-restricted eating is very important. I have seen a 21 stone man become a 10 stone man through this with my own eyes, not just on the internet. I think we all benefit from having large gaps where we are not grazing. It reduces our appetites, it reduces our blood glucose and insulin. So if you don’t want to eat OMAD (one meal a day), try not eating between meals, or just have two meals a day and no snacks.

6. Community

There is a great low carb, real food community out here and it is massive. Look at Facebook and Twitter for the biggest groups and follow people like Dr Zoe Harcombe, Dr David Unwin, Dr Tro, Dr Jason Fung and more.

7. All good food movements are infiltrated eventually

Big Food are already here with their processed Keto , low carb and high protein snacks- avoid them as they are not what I am talking about here. They are not real food. Real minimally processed food does exist- think dried meats, tinned fish, packaged minimally processed cheeses, olives. Big food- what we need are real food ready meals, without processed carbs, and where the real carbs are low enough for overweight and diabetic people.

8. Somebody wants a fight between vegans and low carbers, but we can easily be on the same side.

Divide and conquer may be their game, but I say you can be a real food vegan, a real food meat eater, a real food pescatarian and it will give you greater health benefits, than eating ultra processed food. Stick to minimally processed or totally unprocessed real food for best results.

9. The dietary guidelines of the western world are still wrong for those that fatten easily.

We still haven’t managed to change the dietary guidelines, but we will need to do that in order to reverse the obesity crisis.The first step will be to get a truly independent SACN in the UK.

10.Alcohol and soft drinks

Alcohol is not quite the last word, but it is the hardest thing for some people to tackle. If you do not drink alcohol, you may drink fruit squashes, or diet drinks and these can also be an issue. All of these things affect your hormone insulin, and when this goes up, your fat gets stored. They also may give you the “munchies”, or weaken your resolve about your new lifestyle. Soberistas are a great online community that can help.

A year from now and you are a lot “healthier”, what does “healthier” mean to you?

I have been asking this question for a few years now, and the answers I get are as varied as the people I meet. At first however, people are stumped by the question, and give me stock answers like losing weight, or having more energy, and is it when I dig deeper that they give more meaningful answers. For one person it meant enjoying dancing again, and saving hundreds of pounds on new dancing dresses, as she was able to fit into her original, beautiful ones again.
My colleague Jen Unwin taught me this method, and said that losing weight is a “So, what? What difference will it make to your life?”
She also taught me that it helps to GRIN!
Set your Goals
Use your Resources
Make changes in Increments
Notice your improvements

Outings and birthdays- shifting the focus away from sugar

As a society, we have got into the way of outings and birthdays involving a lot of sugar, whether for the outing itself (e.g. a trip to the chocolate factory, Pizza hut or similar restaurant, or the cinema with sweets and popcorn added in), the meal within the outing(full of junk food like burgers, crisps, popcorn, sweets), the sugary cake, or the party bags (sweets and more cake). When I was a child parties were rare- most parents could not afford to invite that many kids and most parties were in our own homes with mum or dad. Party food was a few sandwiches and sausages, and party bags had a little toy and a single piece of cake. I expect I only went to three or four a year, whereas these days some kids can get invited to one a week.

Can you think of doing other sorts of outings for your kids’ birthdays or days out?

Here are a few of my ideas, and with all of these consider just having 2-6 kids rather than the whole class. This saves on the cost and also means you can have a proper meal afterwards, maybe back in your own home.

A picnic in the park or forest
The climbing wall
Go karting
Quad biking
Local National Trust place for something to do with farming or history
Pottery party
Go Ape

You could bring your own food or take them back to your house after the main event.
Food could be like any main meal and have a protein source- meat, fish, eggs, chicken, some good carbs like veggies and berries, and some good fats- like cheese, or added mayonnaise, olive oil dressing, or avocados

Cakes- how about a proper “cheese” cake, or a cake made with a lot less sugar, or individual low sugar muffins?

This is a good one from the PHCuk cookbook:

Chocolate cake with chocolate ganache- by my friend Dr Jen Unwin
5 eggs
2-tablespoon coconut oil
1 teaspoons vanilla powder
1 banana
2 tablespoons coconut flour and almond flour
2 tablespoons ground flax
Blend up eggs, oil and banana
Add dry ingredients and stir gently
Should be of “cake consistency” if too runny add almond flour. Pour the mixture into a medium lined loaf tin and bake at 180 degrees c fan for about 30 minutes.
Ganache topping
200g plain over 70% chocolate
600ml double cream
Break the chocolate into pieces and place in a bowl. Gently heat the cream in a pan and when it just comes up to a simmer pour it over the chocolate and keep stirring till it melts. Keep stirring and as it cools it will thicken. Then spread it over the cooled cake in the tin. Place in a cool place till needed.

A “cheese cake” is often used for weddings, but I bet you could make a fun one for kids if you wanted.
Below is an adult version ☺

Treats and rewards
Try to give kids treats and rewards that are nothing to do with food. I am often told by older people that the most important thing you can give children is your time and attention. You could listen to them reading, you could sit down and watch a film together, turning off your mobile phone, you could play together by making things (models or puzzles), or you could go for a walk( (and add in an “I spy”), you could go to the swings, or an art gallery or museum, you could go and visit a relative or help the old couple down your street. Think of nice things to do that do not involve sugar or even food, and ask your child to do the same. The aim is that you, your child and your family more activity centred and less food centred.

Medication, Measuring & Carb Counting

Your medication Before starting the low carbohydrate way of eating you may need to adjust your medication for lowering your blood glucose.

Metformin- no change needed

Other drugs:
Sitagliptin- halve your dose
Gliclazide- halve your dose
Canagliflozin, dapagliflozin, or andempagliflozin- stop them before you start low carb.

Insulin- consult your doctor first- but dose usually goes down to half or even to a third of what it is on a higher carbohydrate way of eating, depending on your blood glucose.
Any other medication like BP drugs – please ask your GP. Your BP may well go down.

Your blood glucose testing Get a machine from your practice nurse or the Internet.

If on any drug above, apart from metformin, you will need to check your blood sugar every 2 hours and even in the middle of the night at first to ensure it is stable. Don’t forget to check 1-2 hours after meals, and especially if you deviate from the recommended foods – see what happens so you know-and go easy on yourself, you are learning. Here is a video clip that shows you how to do it:

Learn what happens with different foods, so you can make further changes as needed. Write the blood glucose results and foods/meals down in a book or spreadsheet to help you see what happens over time. Alter what you do to keep your blood glucose between 4 and 7( 4 ‘is the floor’)

Your carbs I recommend no more than 30g carbs a day, which you can work out from the Carbs and Cals book or app. Carbs are best divided 6/12/12, but could be 15, 15, or 10,10,10. Don’t forget to count and adjust for any snacks or drinks.

Introduction to the 8 week course

This is an 8 week course that helps you change your eating and drinking habits permanently. I get emails from people many months and years down the line telling me they are still doing it and that could be you!

It’s not just about what you eat and drink, but also about sleep, movement and exercise, relaxation and stress management and getting over processed food addiction. Addressing these things will help you achieve your goals and so become much healthier.

First up, what does “healthier” mean to you…. think of YOUR hopes, dreams and goals and write them down- how would you like to feel a year from now, what would better look like? Build up a detailed picture in your mind of the things you would like to be doing, who you will be with, and how you will look & feel as this new healthier you.

Ask yourself what you eat and drink now meal by meal, drink by drink, snack by snack? If you eat bread, rice, pasta, potatoes, cakes, biscuits or sweets and are ready for change there is a brilliant chance of success. If you secretly eat a lot of junk, you are not alone, and can change with the right approaches.Look here.

What is low carb/ low GI food and drink? What do you know about it? This link will show you. Look at the plate and click through the dots.. 🍽

Clearing your cupboard of processed food is an important first step, so do it with your partner, friend or family and maybe one of them will join you on the 8 week plan. All that sugary and starchy stuff has to go- so pile it up and give it away.

1 recipe- breakfast– and food samples to taste

Breakfast ideas

Set YOUR quit day

and if you try and don’t succeed , try again. It is much easier if you have none of that rubbish food in the house, and you avoid places where you are tempted.

Can you involve the rest of your family- like who does shopping and cooking? Get them on board if you can, and bring them to the group, but if they are not ready, just get on with it yourself.

If you are diabetic, get a blood glucose meter from your practice nurse or online, and check your blood glucose 1-2h after meals and learn what happens. We are aiming for 4-7 and 4 is the floor! Write down your results so you can avoid foods that raise your blood glucose too high- it will vary day to day so try things with & without exercise and learn how your body responds. See your GP with one of my medication letters if you are on medication for diabetes before you start.

Move more- do what do you enjoy, think of what would you like to do that is fun. If you have a lot of weight to lose, start with chair or floor based exercise or walking and build it up gradually. Would you consider giving yoga a go?

Mindful eating– what does it mean to you? To me, it means taking my time, enjoying the tastes and textures, and turning off the TV.

Habit releaser of the week: For one week sit in a different chair when you watch TV or eat a meal. A little habit change like this enables bigger habit changes!

Sleep– try to go to bed and get up at the same time each day from now on as this reduces your stress hormones and improves your health.

Blood requests and record charts- would you like to get your blood tests and measurements done before you start? These can include…. weight, height, waist, HBA1C, lipids, liver function and kidney function. Do you want to do BEFORE photos, to compare with your AFTER ones?

Website list, books, social media links Look to the bottom of the page.

Week 8-How to Change Your Eating in 8 weeks

Remind yourself of your hopes and goals- one year from now, what will “healthier” look like to you, and what will you be able to do as a result?

How have you been getting on with low carb? Tell us about your challenges and successes in the group or- email me at joannemccormack@nhs.net

Your questions- on the night or email me and I will discuss with the group if you want.

Food to try- email me with suggestions, or bring something along

By special request here are some low carb ideas for those of you who are on the road or in the air, and wonder what you can eat as a low carber.

Schools and workplace challenges- packed lunch ideas

Family challenges- do your family do low carb, or how do you adapt to people eating different ways in your family? How can you help reduce the sugar intake of your children or grandchildren? Make them recipes from this site!

Have a look at these FAQ – I will also provide a laminated list at the meeting.

This is the last meeting of the cycle- please do give me some feedback before we start on the next one.

Week 7 How to Change your Eating in 8 weeks

Remind us of your hopes and goals and share them with me if you like!

How have you been getting on? Let me know your challenges and successes on the night, or by email to joannemccormack@nhs.net

Have you any questions?

Have any of you eaten out yet? What happened?

How do you find eating out with low carb either on the hop and for a sit-down meal?

Local menus have been provided thanks to Ayesha Wooler, our public health champion.

If you have not started low carb yet, would you like to stop eating out for first 6w or longer, or would you like to try eating out right away? The choice is yours.

How do you feel asking for something different?

What is the reaction of your partners and friends?

Website of a cafe offering low carb choices.

In this meeting I discuss mindful movement or chair yoga to help us relax and I do a short mindfulness exercise. If you are registered with Stockton Heath you can see Dr Hemma Mistry about it as she is a trained yoga teacher as well as a doctor!

Recipe and if you fancy mini cheese and onion muffins here you are

Week 6 How to Change your Eating in 8 weeks

Remind us, and yourselves, of your hopes and goals Imagine a healthier, happier new you, one year from now. How will you look, how will you feel, what will you be doing differently? The more detailed your picture the better.
How have you been getting on? What have been your challenges and successes, and would you like to share them with us?

Have you heard of mindful eating? It can help you develop a better relationship with your food.
I will be doing a mindfulness exercise tonight to give you a taster.

Mindfulness books can be very useful so here are two to think about- Mindfull-ness by Elaine Hillides and Mindfulness- a practical guide to finding peace in a frantic world by Mark Williams & Danny Penman.
Stress increases cortisol, adrenaline and noradrenaline, which make it harder for some people to eat healthily, so it makes sense to reduce your stress via mindfulness or other methods like yoga. You can try yoga in St Thomas Church Hall 5-6pm on Mondays with Dr Hemma, or at many places round the country.

How can you eat bread on the low carb diet? Here is a recipe to try.
You could also try some ‘Non bread” from the Real Food Cookbook by Ellen Picton and Zoe Harcombe. It is great with curries!
Exercise- what’s gone well and what not so well?

I do recommend using a blood glucose meter, so that you remain safe, and so you know the effects of different meals and foods. Look up your meter on YouTube for a demonstration of your particular meter.
Do check your readings 1 to 1 and a half hours after your meals and after any deviation from the low carb plan. It is important learn the effects of foods that raise your glucose significantly . Be kind to yourself, and accept that you are human and cannot be perfect 🙂 Learn what happens when you eat what your body cannot tolerate. Learn what happens when you eat your favourite meals and alter them so they are lower in carbohydrate. Take note of the readings so you have a record.
Remember you are aiming for between 4 and 7, so change the foods to lower carb ones if you are getting higher than that. I advise 30g a day of carbohydrate, but lower or higher if that is what works for you. Use Carbs and cals as a guide

You will see how the blood glucose readings vary according to how much sleep you have and how much exercise you get, as well as what you eat.
Do you have any questions? – write to me at joannemccormack@nhs.net

Week 5: How to Change your Eating in 8 weeks

Remind us of your hopes and goals- I will to add them to our flip chart as a visual memory.

How have you been getting on? What are your challenges and your successes? Would you like to share them with me or the group?

Give me your questions on the night or email me at joannemccormack@nhs.net

Moving and exercise- where are you now, and what would you like to build up to? Remember you cannot outrun a bad diet.

Recipe- easy granola

Your recipes and how we can adapt them- I will pick some of my favourites and ask you for yours. Don’t forget to bring your recipe books. There are now many vegetable noodles or zoodles around like courgetti or spaghetti squash, and rice substitutes like cauliflower rice and broccoli rice. Many of you make them, with all sorts added like garlic, onions, and spices, but others want it in a packet. If it’s fresh and low in carbs, that’s fine.

Let’s talk about birthdays and treats this week, and email me with your favourite tips with lower sugar living..

The national dietary guidance of Brazil! something to set you thinking..

Week 4 How to Change your Eating in 8 weeks

Here is a link to Suzy Glaskie, health coach, of Peppermint Wellness. Suzy came along to one of our groups and I was very impressed. She connected with each of us about processed food addiction, and how we can leave it behind us! Follow the link and think about how you can address your addiction to processed food. Most of us have it to a certain extent- I know I did.

Do remind yourself of your hopes and goals! Recently, one of my group shared that she dreamed of running with her dog. She also has managed to get on her bike for the first time in 10years, so I’m sure she will do the run. I look forward to getting a photo.
How have you been getting on? Challenges and successes are very good to share, plus photos and stories. Send them to me or share on social media and tag me.
Your questions? email me joannemccormack@nhs.net
How are you involving your family, friends and workmates?
1 recipe- “fathead pizza” if you like pizza & want something lowcarb this is very tasty.

Habit change and addiction, and cravings?
Don’t give up on giving up!
Many of you ask about sweeteners so here is a 4 minute video from Dr David Perlmutter