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Hippocrates
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Welcome to the Low Carb
Diabetic. The authors of this site are all diabetics, none are
Doctors or Healthcare Professionals, some of us are type one’s and
some type two’s. All believe in the low carb lifestyle, and minimal
or no medication for the good control of diabetes. Through the
correct diet, and regular exercise, we have all achieved safe
control, and non diabetic blood glucose numbers. This has been very
easy to achieve ! Would you treat an alcoholic with more booze, or a
drug addict with more heroin ? Starchy carbs, are poison to all
diabetics.
So often at diagnosis, a diabetic is advised to eat normally, or
base their diet on starchy carbohydrates, this is totally ludicrous.
That diet was recommended to us, by our healthcare teams, and is the
type of diet promoted by DUK, the largest diabetes charity in the
UK. After trying the recommended diet, and trying to control our
blood glucose, we started to become concerned. Through basic
research, we quickly learned that high blood glucose numbers are
dangerous. We decided it was time to look harder for an alternative,
an alternative to the eat starchy foods with every meal advice. An
alternative to chasing highly elevated blood glucose numbers, with
ever increasing medication. We discovered low carb.
A low carbohydrate diet, has given us many health benefits. Safe
blood glucose numbers, stable weight reduction when required, vastly
improved lipids, reduced blood pressure. In short, it has totally
transformed our lives and outlook. We
truly believe a reduced or low carbohydrate diet will benefit all
diabetics. Try the diet for seven days, watch your blood glucose
levels fall, very often dramatically, and you will prove to
yourself, diabetes does not have to be progressive. You have nothing
to lose, and so very much to gain. The best of luck and health to
you and yours.
Why low carb?
The chief symptom of diabetes is an elevated blood glucose level.
While some medications can help to reduce blood glucose, a reduction
of foods in the diet which significantly raise levels in the first
place can itself be sufficient to normalise them. Medications can
therefore often be reduced (in consultation with healthcare
professionals) and in some cases (type 2 diabetics only) eliminated
altogether.
Which foods are restricted?
Lowering the intake of obvious sugars is clearly beneficial in
controlling blood glucose. However, starchy carbohydrates such as
bread, pasta, rice and potatoes and foods containing processed
flours are also metabolised by the body to produce large amounts of
glucose. As they contain very few micronutrients (vitamins and
minerals) low carb diets often reduce or eliminate only these foods.
Which foods are included?
A low carb diet is not necessarily low in all carbohydrate foods,
simply those which disrupt blood glucose and insulin levels. Many
contain large quantities of vegetables, with the exception of some
starchy root vegetables. Typically, they also include nuts and some
fruits. Generally, they include the healthy natural and unprocessed
foods similar to those eaten in populations where diabetes and heart
disease are rarely found. In this category comes meat, fish, eggs
and dairy foods including butter and cream. Vegetarian protein
sources such as tofu,quorn and TVP can also be included .
The impact of particular foods on blood glucose can vary greatly
between individuals and testing after meals is recommended to figure
out which foods to safely include in your diet.
In broad terms, carbohydrates have a large impact on blood glucose
levels, protein much less, and fats have little if any effect.
How low is low?
An effective low carb diet is one which maintains, most of the time,
a healthy blood glucose level. The amount of carbs it contains will
vary between individuals.
What is a healthy blood glucose
level?
A healthy non-diabetic will typically have a blood glucose level
within a tightly controlled range, usually below 5mmol/l for the
majority of the time. This equates to a glycated haemoglobin (HbA1c)
of below 5%. The current health service NICE ‘target’ HbA1c of 7.5 % is
roughly equivalent to an average blood glucose approximately 50%
higher than that of a non-diabetic.
What about cholesterol?
Diabetics are right to be fearful of the risks of heart disease,
since rates are many times higher than those of non-diabetics.
Since around 80% of the cholesterol in the body is actually
manufactured by the liver and the cells, relatively little comes
directly from the diet. Total cholesterol is however now widely
recognised as a very poor indicator of heart disease risk.
Far more meaningful are the individual components of total
cholesterol, known as high density lipoprotein (HDL) and
triglycerides. Trig. / HDL ratio is perhaps the single most
significant measure of heart disease risk.The lower the
triglycerides and the higher the HDL, the better.
Insulin and glucose combine to raise triglycerides and lower HDL,
which is why a low fat, high carbohydrate diet may actually increase
heart disease risk. It’s commonly reported that those on low carb
diets have lower cholesterol levels and certainly much improved
trig. / HDL ratios.
What about weight loss?
Insulin is often referred to by biochemists as the fat building
hormone. In fact, the body cannot make body fat without insulin. It
is very unusual to find an overweight individual who doesn’t also
have elevated insulin levels. Type 2 diabetics, at diagnosis, will
often be overproducing insulin.
Insulin also inhibits the body’s use of stored fat as a source of
fuel. Lowering insulin levels is extremely important, perhaps
essential, for weight loss to succeed. This is one reason why low
carb diets are particularly successful in weight loss since the
fewer the carbs, the less insulin is required. Some may also find
that they consume fewer calories without feeling hungry because
their fat metabolism begins to work properly once more, allowing the
body access to energy reserves in fat stores which were previously
inaccessible.
Ketosis/Ketoacidosis
Diabetics, and even some health professionals, often confuse two
quite distinct metabolic processes - ketosis and ketoacidosis.
Ketosis is a perfectly natural and healthy state during which the
body uses stored or dietary fat for fuel. In order to enter this
state, carbohydrate intake needs to fall below a certain level.
Ideally, a healthy metabolism should regularly use ketosis, while
fasting overnight for example, to fuel the body's processes and
utilise stored fat reserves. Most of the body's organs, the heart
for example, in fact run very efficiently on ketones.
Ketoacidosis is quite different and is typically the result of a
chronic lack of insulin, not a lack of carbohydrate. With
insufficient insulin, the body attempts to fuel itself by breaking
down fat and protein stores in an uncontrolled way, a process which
results in the blood becoming dangerously acidic. In short, ketosis
usually occurs when blood sugars are at the lower end of the normal
range, and ketoacidosis occurs when blood sugars are dangerously
elevated. Ketosis is a result of low carbohydrate intake,
ketoacidosis is a result of inaquate insulin levels.
What about physical energy?
Strictly speaking, we burn neither glucose nor fat for physical
energy. Energy within our cells actually comes from a molecule
called adenosine triphosphate, or ATP. When its molecular bonds are
broken, energy is released in the mitochondria, the power plants of
our cells. A glucose molecule will generate 36 ATP molecules. A 6
carbon fatty acid molecule will generate 48 ATP molecules.
Therefore, when insulin levels are low and the body can access fatty
acids as a fuel source, physical energy levels can actually increase
on a low carb diet.
Anecdotally, many on low carb diets often report feeling
considerably more energetic, without the peaks and troughs of energy
which appear to come with a diet high in carbohydrates.
Is it suitable for type 1
diabetics?
The benefits of reduced insulin levels also apply to type 1’s.
Insulin has a measureable impact on blood vessels by narrowing them,
with increased cardiovascular risks. Smaller doses can also make
blood glucose fluctuations far more predictable, resulting in fewer
highs and lows. It is not true to say that type 1’s need
carbohydrates to feed their insulin. They may simply need less
insulin.
Why doesn’t the NHS recommend
low-carb diets?
Great question. Largely because it was once thought that dietary fat
caused heart disease and dietary protein caused kidney damage, so
without carbs there’d be nothing left to eat. Subsequent research
has revealed that neither of these hypotheses was correct and that
the finger of suspicion ought to be pointed at glucose, but changes
to established mindsets are very slow to happen.
Isn’t low carb just another diet
fad?
Since the emergence of the human species in the Rift Valley around
3-4 million years ago, we have been meat eaters. Fruit and
vegetables were a rare treat during their short growing seasons. We
only began cultivating crops during the agricultural revolution
10,000 years ago. Refined sugars and starches became our staples
around 200 years ago.
In the context of our evolutionary history, perhaps it’s the
‘healthy balanced diet’ which is the real diet fad? “No one has ever explained to me how you can
ask someone to lower their blood sugar level and yet recommend a
diet based on sugar.” Dr Charles Clark, Diabetes expert.
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