# What do we want?



## Lurch (Jan 18, 2014)

...Less carb!

As a new convert to the ketogenic diet, growing more fanatical about the blindness of official guidelines regarding carbs. 

Just found this short extract video by a doctor with newly diagnosed Type 1 from the 2013 Low Carb Downunder Seminar, Melbourne, Australia.  Video posted in December 2013...

"Troy Stapleton - I Manage My Type 1 Diabetes By Eating LCHF"

http://www.youtube.com/watch?v=TR8rc_AF6XU

Best one I've seen for its clarity, tone and factual illumination on the topic of the ketogenic diet for diabetes.

The doctor (Troy Stapleton) recounts following the same personal research path I've just recently followed myself, like most on here, with the same books as often get mentioned here, and he's now successfully managing his  T1 on a low carb/high fat diet with reduced insulin.  Even shows the same 1917 Diabetic Cookery book as his own proof of concept, which is cool.

It's bizarre how we're all cast adrift round the world by our health care professionals to do our own research on managing this thing.  Surely can't be long before the official control guidelines will reflect the overwhelming evidence and we can return to the wisdom that existed before the mid-twentieth century. 

When do we want it?  Now.


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## Northerner (Jan 18, 2014)

There have been a few programmes on TV over the past year or so that have started to question the notion that fat is bad, and pointing the finger at carbs (especially high GI) as being the real problem - docs like 'The Men Who Made us Fat', for example. I also had my eyes opened about the myths surrounding cholesterol. The problem is that most people don't have our incentive/motivation to examine these things more critically and conduct our own personal experiments.


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## Redkite (Jan 18, 2014)

I have to say I don't like to see people advocating excluding any food group from everyone's diet.  Yes, there are certainly benefits to be had by reducing excessive carbohydrate intake, but cutting them out altogether is not appropriate for most people.  In fact they are essential to the diet of a growing child, and also essential to people taking part in energetic sport.

The arguments will go back and forth, and eventually come back full circle to the realisation that people should eat a balanced diet, with everything in moderation.  This is the diet followed by my Grandparents' generation, who probably ironically benefitted from all the years of rationing during and after the war, and grew their own veg and prepared their own meals.  Mine lived well into their 90's, yet the following generation seem less healthy.


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## Northerner (Jan 18, 2014)

We also need to bear in mind that human beings are incredibly varied and complex beings, so there is never going to be a simple set of rules - you need to find out what works best for you as an individual, and that best accommodates your tastes, lifestyle and needs


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## Redkite (Jan 18, 2014)

Northerner said:


> We also need to bear in mind that human beings are incredibly varied and complex beings, so there is never going to be a simple set of rules - you need to find out what works best for you as an individual, and that best accommodates your tastes, lifestyle and needs



Yes I agree completely . I suppose what I'm trying to say is that there's a danger of people who are recent converts to a new diet that works for them as an individual assuming that the same diet will be appropriate for everyone, and giving out this as gospel!  Sorry for bad grammar!


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## HOBIE (Jan 18, 2014)

Looks good & makes sence to me lurch    Will try it out on a weekend when not at work. & then if it works will do for longer


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## Lurch (Jan 18, 2014)

Redkite said:


> there's a danger of people who are recent converts to a new diet that works for them as an individual assuming that the same diet will be appropriate for everyone, and giving out this as gospel!:



I think I haven't best explained my self-confessed 'fanaticism'.   What angers me, looking at the past few months since dx, is that the official guidelines gave me a 'gospel' to go away and eat lots of starchy carbs etc and don't bother testing myself. I could expect to go on meds.  There was no mention of carb intolerance or finding out what diet worked for me...just do what we tell you.  The one-size-fits-all health plate is, to me, the real bad gospel.

From what I've researched in a few months from knowing little about diets to now knowing a great deal, is that people were never force-fed advice to eat high carb diets, let alone diabetics,  until the mid-twentieth century.  

And it isn't just the carbs.  We're force-fed advice that fat is bad.  That 'science' was plain wrong, but is still official advice to scare folk into eating more carbs.  Because of course too much protein destroys the kidneys, doesn't it, so what's left (other than hitting the drink)?  But how much protein is too much?  The official purveyors of the dietary guidelines don't say.  Our RDA is 55g protein a day for men and, I think, 45g for women.  Why these amounts?  Science exists to say we need at least .8g per kilo weight just for  body maintenance.  Others say we should have 1g per kilo, and there's even recent science that older folk should take up to 1.6g per kilo ( gram ratios here are not food weight).  

Quote: 'Most adults would benefit from eating more than the recommended daily intake of 56 grams, says Donald Layman, Ph.D., a professor emeritus of nutrition at the University of Illinois.'

http://www.menshealth.com/mhlists/guide-to-protein/recommended-protein-intake.php

So who decided we should take 45 - 55g grams and what science is this based upon?   A sedentary male of around 69 kilos might just maintain lean body mass on 55g (nutritional) protein a day.  If that's his maximum healthy BMI weight, he's 166 cms (5ft 5inches) tall. [ BMI 25 = 69 / 1.66 squared].  How come all UK males are advised to eat the level of protein that'll keep only a sedentary 5ft 5 inch male going?  Why?

I'd never proselytise anyone to follow a particular diet. That's actually my point.  I'm angry I was left to "Diet and Exercise" and find out for myself that the official dietary advice is completely inappropriate to me to manage my disease and, it seems, very probably many others. 

My intention is to break down the fortress of the official 'high carb' gospel and free folk up to feel able to try a different diet that may well help them.  Due to the dogmatic official guidelines I still feel scared I'm skiing 'off piste' despite the evidence of my meter, my blood pressure (117/76  - levels I haven't seen in many years), and my waist line. I might drop dead tomorrow, but at least I'm going down on my own terms.


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## Northerner (Jan 18, 2014)

Lurch said:


> ...My intention is to break down the fortress of the official 'high carb' gospel and free folk up to feel able to try a different diet that may well help them.  Due to the dogmatic official guidelines I still feel scared I'm skiing 'off piste' despite the evidence of my meter, my blood pressure (117/76  - levels I haven't seen in many years), and my waist line. I might drop dead tomorrow, but at least I'm going down on my own terms.



I totally concur. The 'official' advice is completely illogical and I am astounded it is still propogated. No wonder we are spending (wasting!) so much money on treating diabetes and its complications


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## happydog (Jan 18, 2014)

I totally agree with Lurch and Northerner.  I am still getting flack over reducing carbs and not going on the medication at my surgery.  I will be into battle again this week.  The doctors and DN regard complications as inevitable, medication as essential and deteriorating health as normal with diabetes.  One would think that they might be supportive when they see the reduction in HbA1c but it is certainly not the case for me.  Don't know how we change things.  I met someone last weekend who has a sister and two brothers both with T2 and she looks like a possible candidate herself, but she said "Oh there is not much that you can do if it is in your genes so we don't bother with diets and things we eat what we like and just enjoy our food".  Tough on the medical profession too if people won't listen.


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## Redkite (Jan 18, 2014)

My intention is to break down the fortress of the official 'high carb' gospel and free folk up to feel able to try a different diet that may well help them.  Due to the dogmatic official guidelines I still feel scared I'm skiing 'off piste' despite the evidence of my meter said:


> !!!  Don't get me wrong, it's great that you're finding a low carb diet works for you, and I don't agree with the official one-size-fits-all advice either.  But I still firmly believe that no food group should be completely excluded from a person's diet, otherwise key nutrients may be lost, e.g. B vitamins from wholegrains if these are excluded, or vit D if whole milk is replaced with skimmed.


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## Northerner (Jan 18, 2014)

Redkite said:


> !!!  Don't get me wrong, it's great that you're finding a low carb diet works for you, and I don't agree with the official one-size-fits-all advice either.  But I still firmly believe that no food group should be completely excluded from a person's diet, otherwise key nutrients may be lost, e.g. B vitamins from wholegrains if these are excluded, or vit D if whole milk is replaced with skimmed.



I've been drinking skimmed milk for years - even 1% milk tastes horrible to me! However, I do get my share of oily fish and lots of eggs, plus plenty of sunshine when it puts in an appearance 

Oh oily fish! Dear oily fish!
By far and away my favourite dish!
Infuse me with your Omega 3,
Please oily fish, come dine with me!

Oh, take away my chicken bhuna!
Replace it with a slab of tuna!
And though I love the taste of gammon,
I'd much prefer some Scottish salmon!

Imagine eating with every course
Some pilchards in tomato sauce!
If every herring could be mine,
Then life on Earth would be divine!

So, fill me up with oily fish!
Believe me, it?s my dearest wish!
My heart?s desire, where have you been?
Embrace me now, oh plump sardine!


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## Redkite (Jan 18, 2014)

Lol that's brilliant!

No use relying on the sun for our vit D in this dreary country! I can hardly remember what it looks like!


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## HOBIE (Jan 18, 2014)

The sun  Whats that ?  Is it that big bright thing in the sky  Also love fish


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## Maryanne29 (Jan 19, 2014)

I found Lurch's posts very interesting. I have been trying to find info on the amount of carbs an 'average?' person needs each day and everything I read is different. Since having my pump I have reduced my carbs a lot, improved control and lost some (not enough!) weight. My DSN says I need more to 'provide fuel for the brain'. The dietitian's view is that low carbs are better. I know it's not an exact science but who is approx right? I will still do what feels right for me (low carbs) but given my advanced age I think my brain needs regular 'feeding'!

It would also be good to have some carb quantity guidelines because I think my non diabetic partner eats far too many each day...


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## AlisonM (Jan 19, 2014)

I've been doing the low carb thing almost since diagnosis, in spite of opposition from my medical team who seem fixated on the idea that plenty of carbs is required for good control and despite the clear evidence that my diet works for me. I do have some support from my consultant at the clinic, he at least seems to own a bit of sense.

I was doing the low fat/low sodium thing too but, sticking with the low sodium, have recently added butter (and occasionally cream) back onto the list without any impact on my cholesterol levels. I've lost two kilos since Christmas and gone down another dress size.


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## Northerner (Jan 19, 2014)

I regard myself as a 'medium carb' person, and eat between 100-140g per day. Official guidelines say 250g. I am generally a very active person, doing a lot of running, walking and other things and find this intake is perfectly adequate. After my recent illness I have been trying to regain some of the weight I lost, and the other night I had a pizza containing 160g carbs - more than my usual entire day's intake! It felt like far too much and I won't be repeating it any time soon!


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## cherrypie (Jan 19, 2014)

Thinking back, I have always eaten what can be described as a low carb diet but that was never my intention, it's just the way I have always eaten.
I  eat normal fat products and would not give you a thank
you for light and lite products.  Why spoil the taste of the real thing?  These products seem to me to come under the heading of junk food when you look at the labels.  It is always butter and cream for me, olive oil on salads, oily fish.  I do not select lean cuts of meat but like the flavour of ones with a fat content but I prefer chicken overall with the skin on.
Moderation is how I eat except when it comes to green vegetables.  I love them.  
Have never eaten a burger or a pizza and a takeaway maybe once a year.
I have a job to keep weight on never mind trying to take it off.
I read amazing stories in the press of how people have lost weight following a particular diet, sometimes several stone but I think the proof that diets work is to see how the subject is doing 10,15, 20 years later.


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## Bloden (Jan 27, 2014)

My head's spinning! When first diagnosed, I read that I should have between 200 and 250g carb every day in order to "exercise" my insulin and improve its efficiency. And now I keep reading about low carb diets for type 1ers. Aah! I like my carbs, hands off!

I've just remembered - I had a look at a ketogenic diet website, aimed at epilepsy sufferers, and it stated the aim of the diet is to keep the body in a state of ketosis. But isn't that dangerous, especially for diabetics?


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## DeusXM (Jan 28, 2014)

> the aim of the diet is to keep the body in a state of ketosis. But isn't that dangerous, especially for diabetics?



Simply, no.

Everyone who ever loses weight, ever, goes through ketosis. People on SW or WW will be going through ketosis.

Ketosis is simply the process of metabolising fat and should not be confused with diabetic ketoacedosis, which is a related but entirely separate situation.

When your body is in ketosis, it produces ketone bodies from fat, which are metabolised for energy. If you want less body fat, you will have to break down that fat into ketones ie. enter ketosis.

DKA is where your body does not have enough insulin to meet its basic metabolic needs, causing an uncontrolled production of ketones that build up in the blood.

To use a metaphor, ketones are the equivalent of smoke. They tell you something is on fire. What smoke can't tell you is whether the fire is from a BBQ with delicious burgers and sausages, or your house burning down! 

If you are taking a basal insulin, then generally you can consider your basal metabolic insulin needs met. But you can't go on ketone testing alone to check whether you're in ketosis or DKA - you'll need top do blood sugar testing as well to verify. 



> I read that I should have between 200 and 250g carb every day in order to "exercise" my insulin and improve its efficiency.



Unfortunately this is nonsense. The more carbs you eat, the more insulin you need. The more insulin you have circulating, the more resistant to insulin your muscles become.



> I like my carbs, hands off!



And as T1s, both you and I have a significant advantage in that we can alter our insulin levels according to our carb intake. But here's another dodgy metaphor for you. Managing blood sugar is a bit like a car. The more carbs you eat, the faster your car is going. Then when you need to manage your blood sugar, you take insulin. That's the equivalent of steering.

When you're bombing it down the M1 at 100mph, it's much easier to over or understeer and potentially put yourself in danger. It's the same principle with diabetes - the more glucose and insulin you've got on board, the more likely it is that you're going to make a quite serious mistake, certainly compared to the person who's pootling along at 10mph!

Another factor to bear in mind is of course, excess blood sugar is removed from your blood by insulin turning it into fat, so every time your blood sugar spikes, you effectively put on weight. Plus, insulin also stimulates cholesterol production in your liver.

It's up to individuals to work out what fits best for them. All I'm going to say is generally I eat less than 50g of carbs a day (although I have plenty of days when I just do what I like), my last A1C was 6.1%, my cholesterol was a nice and low 4.3 with a great HDL/LDL split and some of the lowest trigs (the markers for heart disease) that my consultant has ever seen on anyone, diabetes or not. 

In other words, it certainly works for me. Based on my numbers, I'm not convinced what I'm doing is dangerous.


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## Bloden (Jan 28, 2014)

Thanks for the info, DeusXM. I like the house on fire analogy!

My basic daily carb intake is 170g, I'm 8 stone, and my cholesterol/trigs/BP etc are fine like yours...so I think I'll stick to my current diet.

One more question - why is ketosis beneficial to epileptic youngsters? (got a friend whose teenager struggles with her epilepsy).

Ciao fnow


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## DeusXM (Jan 28, 2014)

No-one knows for definite why a ketogenic diet seems to help some people with epilepsy - it's just that anecdotally, it seems to work.

Possibly it's because a ketogenic diet alters the fuel on which your brain runs - instead of glucose, a ketogenic diet causes your brain to run on ketone bodies (β-hydroxybutyrate, acetoacetate and acetone, according to Wikipedia). The method by which these reduce seizures isn't known, but it seems to work, apparently.

You'll also note that this completely disproves the constantly reiterated assertion that your brain needs glucose. It doesn't. It can run on ketone bodies without any problems at least as well as it can on glucose. Therefore there is no need for someone to actually ever eat carbohydrates for the most part, although personally I wouldn't advocate that. And if you are eating 170g carbs and enjoying good cardiovascular health and glucose control, I see no reason to 'fix' what clearly isn't broken!


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## Bloden (Jan 28, 2014)

Thanks again. I'll let my friend know.


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## DeusXM (Jan 28, 2014)

Be sure to let them know they should discuss any dietary approach to epilepsy with the doc, dietician etc. first - it's quite easy to do a ketogenic diet "wrong" (everyone always seems to think it's just fried breakfasts all the time) and for children it's very important they get enough fat, protein and veg to support their growth..


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## Bloden (Jan 28, 2014)

To be honest, I don't think they'll go for it, but I just thought they should know about it.


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## Pattidevans (Feb 8, 2014)

Maryanne





> My DSN says I need more to 'provide fuel for the brain'. The dietitian's view is that low carbs are better. I know it's not an exact science but who is approx right?


the brain needs either glucose or ketones to run efficiently, not carbpohydrates.  Having said that, carbs convert to glucose most readily, but in their absence the body is adept at converting protein and fat into brain food!  So actually your dietitian is probably a bit more on the correct side.


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