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.
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.

Measure and get measured

HB
Hba1c
Lipids, liver function, kidney function
Weight
Height, & waist or hip
Photo before and after
BP

Dr McCormack 14.8.2018

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 food 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….would 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 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 will be traveling this summer.

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 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

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 we do mindful movement or chair yoga to help us relax- feel free to ask Dr Hemma Mistry about it as she is a trained yoga teacher as well as a doctor!

Recipe and food to try 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, which we will be trying next week.

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 1 hour 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 they 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?

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

Food to try

Your recipes and how we can adapt them- I will pick some of my favourites and ask you for yours.

Let’s talk about birthdays and treats

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.

Remind yourself of your hopes and goals
How have you been getting on? Challenges and successes
Your questions? email me joannemccormack@nhs.net
How are you involving your family, friends and workmates?
1 recipe- fathead pizza- if you like cooking
Food to try if you come along tonight..

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

Week 3- How to Change your Eating in 8 weeks

Remind us of YOUR hopes and goals. Mine were, and are, to reduce my risk of dementia. My dad and grandmother had dementia, and it is associated with diabetes.
How have you been getting on? What are your challenges and successes?
Your questions? Email me if you like on joannemccormack@nhs.net
Low carb snacks and fermented foods– examples are provided on the night.
Recipe for sauerkraut
Exercise chat- what have you been doing? You cannot exercise enough to compensate for eating the wrong sort of food. Sumo wrestlers eat lots of rice and drink lots of beer and despite doing lots of exercise they maintain a high weight.
Non food treats
Not to forget:
Set your quit day– processed food addiction affects many of us, don’t give up on giving up!
Get your measurements and/or photos done. The tests to be done now and in 3 months are HBA1C, liver, kidney, lipids, thyroid, weight, height, and waist measurements.
Be mindful
Habit releaser of the week- have a night- or a week- off TV, and see what else you can enjoy.
See me or your GP for advice about your diabetes medication before your quit day.

Week 2- How To Change your Eating in 8 weeks

Week 2
Remind us of YOUR hopes and goals. Lose weight? Come off medication? What will that enable you to do? E.g. run after grandchildren, run a marathon, get into a new dress, climb a mountain, walk round the supermarket? Last week someone told me she wanted to spend a full day on roller-coasters!
How have YOU been getting on? What are your challenges and successes?

Main meal recipe Chilli-covered Salmon with Spinach from www.dietdoctor.com

Food to try- tonight I am bringing in liver paté with celery, and other low carb foods from our local supermarket.

Bring in your recipe books, or favourite recipes and I will show you how you can make them lower carb, and still very tasty.
Exercise idea- did you know you cannot outrun a bad diet? Exercise is good for you, it brings out the happy hormones, so think of what you enjoy doing. Move more for fun!
Here is a great low carb website list.

Not to forget….

Mindful eating- plan your meals, and your shopping, take your time over eating this week, and enjoy every mouthful.
Habit releaser of the week– could you travel a different way to work this week, or if you are retired travel a different way to somewhere you go regularly. Take in your new surroundings and take your time.
Sleep– getting up and going to sleep at the same time every day.
Food addiction– are we all junk food/processed food addicts? Thinking of giving up processed food like giving up smoking- setting a quit day, not giving up on giving up.
Checking your measurements and/or doing your photos before you start. Ask your nurse or HCA to check your weight, height, waist, HBA1C, liver test, HB, kidney test. Some people prefer to use just photos to show their progress- it is up to you!
Have you any questions? If so email me on joannemccormack@nhs.net

Week 1- How to Change your Eating in 8 weeks

Week 1

Remind yourself of YOUR hopes and goals- what will better look like to you, one year from now? Build up a detailed picture of that healthier new you.

How have YOU been getting on? Do share your challenges and successes with your friends & family and me at joannemccormack@nhs.net. I love to hear about your progress!

These are some of the questions you have asked..

What is a low carb shopping list? Which are the best low carb websites www.dietdoctor.com www.diabetes.co.uk

Have you got any good lunch ideas? for packed lunches and mid day meals.

Lunch recipes and food to buy from supermarkets.

Lunch links

What sort of food can you buy from the supermarket that is ready to eat- mackerel pate, olives, celery, hummus

Quit days– have you set yours yet?

Diabetes blood test 1 hour after meals- set your blood glucose goals and take note of the results of different foods.

Moving more and having fun- our ideas as a group.

Becoming less food centred– ideas for going out- what else do we like to do?

Alcohol laminated card -show and link
Soft drinks laminated card-show and link

Not to forget….

Mindful eating- plan your meals, and your shopping, take your time over eating this week, and enjoy every mouthful.
Habit releaser of the week– could you travel a different way to work this week, or if you are retired travel a different way to somewhere you go regularly. Take in your new surroundings and take your time.
Sleep– getting up and going to sleep at the same time every day.

Checking your measurements and/or doing your photos before you start. Ask your nurse or HCA to check your weight, height, waist, HBA1C, liver test, HB, kidney test. Some people prefer to use just photos to show their progress- it is up to you!