Why Low-Carb

by Jenny Phillips, our LowCarbTogether Nutritionist

Diabetes is a condition where blood sugar levels are elevated – there is simply too much glucose in your system. Type 2 diabetes develops over a long period of time and, at the time of diagnosis, you may or may not have symptoms. These might include:

  • Increased frequency of urination
  • Increased thirst
  • Feeling hungry a lot of the time
  • Feeling tired, particularly after meals or in the afternoon
  • Slow healing of wounds
  • Thrush or yeast infections
  • Blurred vision
How is Type 2 diabetes diagnosed?

By blood test. Initially an elevated fasting blood glucose may prompt your doctor to run an HbA1C test – this is more representative of your longer-term glucose levels and assesses how ‘sugar crusted’ your red blood cells are. As the lifespan of a red blood cell is 12 weeks this is a more robust measure than glucose, which changes throughout the day.

You can also assess your own blood sugar levels throughout the day by using a Freestyle Libre device, available at chemists and online. This is a continuous blood glucose monitor (CGM) which gives you real time feedback. It is a device which is attached (painlessly!) to your arm for a 14 day period. You download an app on your phone which enables you to scan the device and record you blood glucose as a chart.

The feedback is extremely valuable and helps you to identify which foods are spiking your blood sugar levels so that you can adjust your diet. In this example you can see that a ‘healthy’ looking cereal bar spikes my blood sugar levels – I am not diabetic:

Why are high sugar levels a problem?

High blood sugar levels can be catastrophic in terms of your health. Over time it can lead to damage to the internal organs such as the heart and circulatory system, kidneys, nerves and eyes.

Because of this, a healthy body very tightly controls the amount of sugar in your blood. However, in uncontrolled diabetes, where blood sugar is too high, the sugar reacts with proteins and lipids which are part of your internal organs and forms Advanced Glycation End products (AGEs). In addition to diabetes Type 2 this also increases risk of chronic degenerative conditions like atherosclerosis, Alzheimer’s and chronic kidney disease. The cellular damage caused by glycation can extend to the feet, causing peripheral neuropathy or a loss of sensation. In extreme cases a loss of circulation to the feet can lead to amputation, and blindness when AGEs form in the eyes.

How are blood glucose levels normally regulated?

Via the hormone insulin. This essential hormone manages the flow of glucose which enters your blood stream when you eat sugars AND starchy carbs. When your digestion breaks these foods down, glucose molecules are released, and blood sugar levels rise. This triggers the pancreas to release insulin which then shuttles the glucose into the cells where it is used to make energy.

However, we are eating more sugars and starchy carbs than is good for us! The current ‘healthy eating’ deadlines do not help here. In their efforts to (wrongly) demonise fats, we are in the crazy situation where the public are advised to eat 55% of their calories as starch which is a whopping 250g a day for an average female.

This means that many of us are triggering insulin too often and trying to remove more glucose than the cells can use. In this case the excess glucose is shuttled to the liver where it is converted into saturated fat and stored around your middle. Insulin is also the fat storage hormone.

Why do I feel tired all the time?

One of the big downsides of high insulin levels (in response to eating sugary and starchy foods) is that the fat becomes ‘locked in’ to the fat cells and can’t be released easily. So effectively the cells are deprived of their energy source and you feel flat.
This is why many people gain weight on a high carb intake, even when they are trying to diet.

What if I'm not overweight

by Jenny Phillips, our Low Carb Together Nutritionist

The first place that fat accumulates is around the middle ie: close to the liver. You don’t need to be overweight to have high levels of internal fat – so some people can be slim and diabetic. This group is known as TOFI – thin on the outside, fat on the inside.

Take Our Simple Test

ADD UP YOUR SCORES:

Below 18 = Liberal low carb

Congratulations – you are doing a great job! Your metabolism is generally working well and you are feeling pretty good. Low carb is still right for you because it is a fantastic way to achieve a varied and nutritious diet, but you can afford a little more flexibility, particularly if you have high levels of exercise.

19–47 = Moderate low carb

Generally life is treating you well, but you still have some health goals to accomplish. Your metabolism may benefit from some fine tuning so thatyou feel more energized and focused. As you start to include some of the low carb and nutritious recipes on this site and in our books, monitor how you feel to keep yourself on track.

48+ = Strict low carb

You may have health issues that you are trying to work through. It is likely that your metabolism has slowed down and you may be finding it hard to achieve all you need to in the day. Chances are that you have a degree of carbohydrate intolerance, and foods like breads, rice, and pasta will cause rapid swings in your blood sugars. Try to focus on excluding high carbohydrate foods.

Breakthrough thinking to reverse Type 2 diabetes

by Jenny Phillips, our LowCarbTogether Nutritionist

There is now a growing group of doctors influenced by the successes of Dr David Unwin, a GP from Stockport near Manchester. Dr Unwin has been using a low carb approach to reverse diabetes, achieving normal blood sugars in one in four of his patients and reducing medications for all of them.

However, the side effects are equally impressive. Low carb results in patients losing weight, becoming happier and having hope that they are, to a large extent, in control of their health destiny. One in four comes off of blood pressure medications and blood markers improve.

Astonishingly, when patients switch from a high carb diet to a low carb diet with generous healthy fats, the fats in their blood (triglycerides) almost halve. As does Gamma GT, a marker which indicates fatty liver. This is because low carb eaters learn to become a fat burner, not a fat storer.

Why doesn’t the NHS recommend low carb for diabetics?

Actually, the NICE guidelines which should inform the advice you are given does support low carb:

The latest guidelines (Dec 2017) for type 2 diabetes recommend that GPs “individualise recommendations for carbohydrate and alcohol intake” while ensuring “high fibre, low Glycaemic Index sources of carbohydrate in the diet for people with T2D”. In other words, avoid not just sugar but the carbs that digest down into a lot of sugar.

In fact, Dr Unwin’s sugar infographics, a helpful way of assessing the sugar impact of foods, are endorsed by NICE and available for clinicians via the NICE website. See www.nice.org.uk/guidance/ng28/resources

The reality is though that many GPs are still influenced by the current eating guidelines aka the Eatwell plate. This is why many doctors, unlike Dr Unwin and his followers, still believe Type 2 diabetes to be a progressive disease requiring lifelong (and ever increasing) medication.

Dr David Unwin and Type 2 Diabetes?

by Dr David Unwin

Essentially people with Type 2 Diabetes have a problem dealing with a sugar, glucose. This is why it builds up in the blood stream, resulting in higher than normal blood sugars which over time damage small blood vessels in vital organs. From this it would seem obvious to cut sugar out of the diet –if possible completely! Particularly as we don’t actually need any dietary sugar at all. In many cases this simple first step can create a huge difference and may make the use of lifelong drugs for diabetes quite unnecessary. Many times I have seen the total elimination of sugar improve not just diabetes but also blood pressure and mood. I have heard it said that sugar may be OK ‘in moderation’. This worries me for two reasons: Firstly if we don’t need to eat any sugar at all in the diet, eating a moderate amount of sugar could leave someone with Type 2 diabetes ‘moderately’ poisoned quite unnecessarily. Secondly I find in practice sugar addiction is a serious problem. If you are a sugar addict it may be very difficult to have just one biscuit, or you may find a single square of milk chocolate generates powerful cravings for more!

Often I come across patients who are mystified by their diabetes, saying they have already cut all the sugar out so how come they still have diabetes? Most people understandably only think of the obvious sources of sugar like sweetened drinks or chocolate bars, missing the important fact that starchy carbohydrates like bread, rice or potato digest down into surprising amounts of glucose. For example a 30g slice of brown bread affects blood glucose to the same extent as three teaspoons of sugar or a 150g baked potato as much as eight spoonful’s of sugar. This explains why the latest English diabetes guidelines (NICE May 2017) state:

1.3.3 Encourage high fibre, low glycaemic index sources of carbohydrate in the diet
1.3.6 Individualise recommendations for carbohydrate and alcohol intake.

The challenges are how to implement these guidelines in practice? And how best to explain what ‘low-glycaemic index carbohydrates’ means? I have spent five years looking into this very question.
The glycaemic index ranks the carbohydrates in our foods to give us an idea of just how much sugar starchy carbs produce as they are digested down compared to a meal of pure glucose. Nearly all breads and cereals have a high glycaemic index compared to green veg, most nuts or eggs. Many people with T2D find it helps to ‘turn the white part of your meal green.’ So that instead of steak and chips have steak and loads of coleslaw, salad or broccoli. Another example is replace the rice in your curry with green beans, asparagus or cauliflower –pouring the curry sauce over a big pile of veg instead of rice.

 

How much sugar do you think there is in your blood stream at any point in time? It may surprise you to know that there are less than 2 teaspoons! Consider then that a can of coke (330ml) delivers a whopping 9 teaspoons of sugar, and even starchy foods break down quickly have a massive sugar impact on your system – two slices of brown bread toast releases 6 teaspoons of glucose…

Dr Unwin has calculated the sugar equivalent of popular starchy foods to drive home the point that these foods are lethal for someone with blood sugar issues:

 

 

What can I eat?

by Jenny Phillips, our LowCarbTogether Nutritionist

Here are tips to help you adopt a healthy low carb diet. Please do consider purchasing The Diabetes Weight-loss cookbook and/or The Reverse Your Diabetes Cookbook, which I have written with Dr Unwin and the cookery writers, Katie & Giancarlo Caldesi:

Reduce or eliminate starchy carbohydrate foods and sugars -both of which cause a rapid rise in blood sugar. These include breakfast cereals, bread, pasta, white potato, rice, cous cous, crackers including ryvita, oat cakes, rice cakes and also cakes, biscuits, sweets, chocolate, fruit juice, fizzy drinks & cordials.

Protein is a very important part of each meal, it is used by your body for growth and repair. If you are vegetarian then choose carefully to ensure adequate protein intake from pulses, cheese, nuts, seeds and eggs. Omnivores also have the advantage of meat and fish, which are incredibly nutritious and good sources of vitamin B12, iron and essential fats. Red meat can be enjoyed 2-3 times per week.

Here’s the good news – you can include good fats within your diet – these are essential for your metabolism and help you to feel fuller for longer. Oily fish such as salmon, mackerel, sardines & anchovies contain omega 3 which helps to reduce inflammation and keep brains healthy. Olive oil can be used as a salad dressing and very light frying. Butter and coconut oil are both tasty saturated fats which are safe to heat in roasting and frying. Avoid margarines and vegetable oils which oxidise when heated. Also avoid low fat products which tend to include sugars and sweeteners to improve flavour. Full fat yoghurt is a good choice.

Focus on lots of vegetables with each meal. Non starchy and salad vegetables should be eaten generously so that you feel full at each meal. You can still use gravy, curry and other sauces over your vegetables. Some popular replacement for the starch include shredded cabbage cooked in butter (replaces tagliettelle), cauliflower rice and courgette spaghetti, but you can also just include more varieties of veg  on your plate.

Starchy veg are allowed with each meal but in a modest portion – these tend to be veg that grow underground such as carrots, parsnips, butternut squash, sweet potato, sweetcorn and beetroot. Just have a small portion and only one of these per meal alongside plentiful non-starchy veg.

Nuts and cheese can be added in moderation, they are nutritious and tasty but also highly calorific so go slow if you want to lose weight and have them within a meal instead of snacking on them.

When it comes to fruit, berries are a good choice as they are naturally low in sugar. Other fruits depend on how you react to the sugars. Certainly modest portions of fruit within a salad or alongside a main course can add flavour and interest. Try to avoid high sugar tropical fruits such as mango, pineapple and banana.

A word on snacking. Fasting between meals and overnight can really help to improve insulin resistance – we are not designed to eat constantly! Aim for three good meals and then stop. Whilst fasting your digestive system gets a rest and your body can concentrate on other vital jobs such as keeping your immune system strong, balancing hormones and spring cleaning (detoxification!).

Finally, avoid diet & low calorie drinks. There are studies showing that these create hunger which leaves you vulnerable to poor food choices. Instead enjoy fresh water, teas including green, herbal and red bush, and moderate cups of coffee (2-3 per day, unless coffee makes you jittery).

How do I start a low-carb diet?

by Jenny Phillips, our LowCarbTogether Nutritionist

Here’s our Meal Plan for your first week.

Wine glass is 175ml, keep within guidelines of max 14 units per week

Site Disclaimer

The information we have collated on this page is advisory only and is based on differing levels of research.LowCarbTogether.com provide this resource for information purposes and does not in any way endorse any third party statements. Remember if you are taking medication or have been diagnosed with a specific illness always check with your healthcare professional before changing your diet in any way.