It might be a delicious, steaming bowl of spaghetti or toast in the morning. Perhaps it is a jacket potato for lunch, a few cookies, or a banana and a glass of milk before bed. They are all basic products for the diet of millions of Britons.
But would you give them all up if it could cure your # 2 diabetes & # 39; or prevent it from being the first place?
The answer may be yes. Or at least: "I'll try." And some experts recommend this precisely as part of a so-called low-carbohydrate diet.
It might be a delicious, steaming bowl of spaghetti or toast in the morning. Perhaps it is a jacket potato for lunch, a few cookies, or a banana and a glass of milk before bed. They are all basic products for the diet of millions of Britons
Those who use medication for life, with the threat of illness, disabilities and early death due to the blood sugar situation, are convincing of the promise – whether or not it means giving up a few pleasures of life.
In April it was announced that such a nutrition plan, the Low Carb program, had received approval to be prescribed by NHS GPs to people with type 2 diabetes and also those with pre-diabetes.
Half a typical meal would be vegetables, while carbohydrates (preference for whole grain, instead of & # 39; white & # 39; carbohydrates) and protein would each make up a quarter.
But the program also provides advice to those who may want to cut carbohydrates drastically – sometimes called the ketogenic or keto diet approach – to just 30 g per day. That is less than two medium-sized slices of whole-grain bread from Hovis.
Low-carb diets such as the Atkins, Dukan and South Beach diet have long been popular. Generally there is a spectrum – officially low carbohydrates can range from 130 g per day to just 30 g. And a whole range of diet books and trendy websites now recommend the best way to beat diabetes and control blood sugar by swapping pasta for zucchini strings, rice for finely torn cauliflower and bread for lettuce leaves. When it comes to pudding, don't even think about it.
It is restrictive, no doubt. Some may say that the lowest point of the scale is extreme. But are such measures absolutely necessary? Not so, according to the experts who have devoted decades of research into blood sugar levels and their effects on the body. In fact, you can beat diabetes – or stop before it strikes – with just a few adjustments.
Do pounds & # 39; s … without missing the food you love
At present, the only proven way to get diabetes under control is to lose and lose pounds. And as long as you stick to a low-calorie diet, it doesn't matter – whether it's for reasons – whether or not those calories come from carbohydrates.
This message underlines the exclusive recipes in today's Mail on Sunday. They are designed to help you lose weight and improve your health – meaning you have to eat less. But it is not about removing pasta, bread, rice or potatoes, and you can even get a pudding.
Dr. Michael Mosley has developed a series of recipes – including this steak and carrot dish – that contains less than 450 calories per serving and can promote weight loss
If you could do with losing a few pounds, then you are not the only one. A third of British adults are overweight – and another 25 percent of the population is obese, which is a medical term for very overweight.
Public Health England says that the average adult consumes up to 300 extra calories per day than recommended – that's 2,500 a day for men and 2,000 for women.
Type 2 diabetes and pre-diabetes are mainly linked to weight gain.
But, as one of the UK's leading nutritionists states, it's not what you eat, it's just eating too much of everything that makes you arrive.
Professor Michael Lean, president of human nutrition at the University of Glasgow, says: & The scientific evidence is extensive, consistent and very clear. The cause of type 2 diabetes, in sensitive individuals, is weight gain and specifically the waist size increase – which indicates fat accumulation in the vital organs and in particular fat in the liver.
& # 39; The specific diet has little influence. It's weight gain that matters, and you don't have to be very obese or obese to be affected. & # 39;
The exact way the diet reverses type 2 diabetes and pre-diabetes is just as simple, he adds. & # 39; It happens when there is weight loss from 10 kg to 15 kg – or from 1 to 2 lbs to 5 lb – regardless of the starting point. This leads to loss of the excess fat in the liver. & # 39;
It's the age-old comparison – consume fewer calories than you burn. & # 39; The composition of the diet does not matter as long as there is weight loss & # 39 ;, says Prof. Lean.
Bust the myths of going low-carb
The idea that diets with a very low carbohydrate content are good for type 2 diabetics – or those with an increased risk – comes from the theory that carbohydrates increase the amount of insulin produced by the body.
Increasing insulin increases appetite and reduces the body's natural ability to burn fat, as is often claimed. If we believe the theory, it means that eating less carbohydrates causes us to lose weight. However, the problem is that it has never been proven.
Professor Gary Frost, president of nutrition and dietetics at Imperial College London, says: & # 39; There is no good scientific evidence that increased carbohydrate intake leads to high levels of insulin that in turn induce appetite. & # 39;
And according to Prof. Lean believes that low carbohydrate diets have a magical advantage over other weight loss methods, a myth. Individual studies have suggested that going low in carbohydrates quickly shifts weight, and significantly lowers blood sugar levels.
Current healthy eating guidelines suggest that carbohydrates should make up about a third of the meal – about 260 g of carbohydrates per day
But in the longer term, there is no benefit to addressing many other diets, according to the best evidence. & # 39; There is no unique effect of low-carbohydrate diets on body fat, diabetes, blood pressure or cholesterol & # 39 ;, Prof. Lean adds.
Current healthy eating guidelines suggest that carbohydrates should make up about a third of the meal – about 260 g of carbohydrates per day.
The new Low Carb program initially suggests limiting carbohydrates to between 130g and 150g per day. This is not so restrictive when you consider that a bowl of porridge contains around 35 g of carbohydrates and a Tesco chicken sandwich 42 g. & # 39; If you follow such a & # 39; n diet, that could very well result in weight loss & # 39 ;, says Prof Frost. & # 39; But that is because you can limit calories by limiting carbohydrate consumption. & # 39;
The Low Carb program also offers advice on further reducing carbohydrates, up to 30 grams per day. However, Prof Frost points to studies suggesting that low carbohydrate diets can raise cholesterol – and therefore the risk of heart disease – because people eat a larger proportion of their calories from fat. A large study in April found that people who ate the least amount of carbohydrates were at highest risk of dying from cancer, heart disease, and stroke. And according to the upcoming data from Prof Lean and his team, low carbohydrate diets can lead to nutritional deficiencies that increase the risk of type 2 diabetes.
Why is it important to keep weight?
The evidence that weight loss can reverse type 2 diabetes comes from a long-term trial led by Prof Lean and his colleague, Professor Roy Taylor.
They found that a diet of just over 800 calories a day, followed for 12 to 20 weeks, can lead to rapid weight loss and bring the disease in remission. But weight loss alone is not enough to combat type 2 diabetes. The crucial part, the researchers discovered, is keeping the weight low.
After the volunteers in the trial had completed the first, very low-calorie phase of the diet, they no longer needed to count calories. Instead, it simply followed the government's EatWell plate – which can use a third of the diet as carbohydrates – and consumed a lot of whole-grain, fruits and vegetables, lean meats, and legumes.
After two years, one third of the volunteers had kept a healthy weight and were still in remission of diabetes. Studies have since found a similar approach for pre-diabetes.
Finding a diet that you enjoy makes it easier to hold than a regimen that is quite a job
In the study by Prof. Lean and Prof. Taylor, participants were given low-cal shakes to make it easy for people to lose weight. Prof. Taylor told The Mail on Sunday that the diet would have the same results as people could cut back on regular foods – carbohydrates or otherwise.
& # 39; Some people go well with low-carb diets and find it a very good way to lose weight & # 39 ;, says Prof. Taylor. & # 39; But it is not something that fits everyone. & # 39;
Browsing online does not make it difficult to find Facebook groups and websites dedicated to carbohydrate-restricted diets, and even in the most extreme cases, those who claim to eat only meat – the so-called carnivore diet – are a way to gain weight to lose health.
And there are dozens of anecdotes posted by those who claim that such a diet worked for them.
But this method has not stopped for scientific research until now.
Prof Taylor adds: & # 39; Losing weight is important for people with pre-diabetes. This can be done by a moderately low-carbohydrate animal or a relatively higher low-carbohydrate diet. This would result in long-term prevention of type 2 and appear safe. So I wouldn't jump on a soapbox and say that low carb is the only way to go. & # 39;
Find a diet that you like – and stick to it
Prof. Taylor advises that it is actually better to make as few changes as possible when trying to lose weight. & # 39; If keeping track of some carbohydrates in your diet means that you are making less radical changes, you run the risk of continuing with the plan in the longer term, "he says. & # 39; So do everything that works for you, whether it's carbohydrates, carbohydrates or low in fat. Replacing the meal is very useful for the initial weight loss. & # 39;
Compliance with low carbohydrate diets is & # 39; pretty horrible & # 39; and the failure rates are usually & # 39; huge & # 39 ;, according to Prof Frost. Studies comparing groups compared to low-carb, low-fat and Mediterranean diets initially found that those who followed a carbohydrate-restricted approach were more likely to stick to it. But after two years, the low-carb group had the highest percentage of dropouts because it limited their diet more severely.
Another study found that 42 percent of those on a low-carb diet dropped out in two years compared to 32 percent after a low-fat approach. & # 39; Many people find carbohydrate-restricted diets very difficult, so they are not a long-term answer & # 39 ;, says Prof Taylor. He adds: & # 39; In general, the message for maintaining weight is about controlling our portion sizes and reducing snacks with a lot of calories and therefore unhealthy. Adhering to a diet rich in fruits and vegetables, lean meats, and whole-grain carbohydrates such as oats and lentils will keep you stable and healthy without counting calories. & # 39;
So what about puddings and sweet treats – they are definitely off the menu if no pre-diabetes or type 2 diabetes is diagnosed? Not so, according to Thomas Sanders, professor of nutrition and dietetics at King & # 39; s College in London.
Contrary to what many people think, studies have shown that people with type 2 diabetes can actually tolerate sugar as part of their diet. & # 39; You just have to control calorie intake & # 39 ;, says Prof. Sanders.
& # 39; It doesn't matter if it goes through refined sugar or complex carbohydrates.
& # 39; Of course, eating fudge bars and chips is not good for you, and it won't fill you up. But a little chocolate if you desire is fine as long as it is not every day. The rule of thumb is to stick to 100 calories for a snack. & # 39;
Carbohydrates are not your enemy
Carbohydrates are a collective term for the sugars, starches and fibers found in fruits, grains, vegetables and dairy products.
The body needs them for digestion, for energy, growth and a whole host of other functions.
Carbohydrates are generally broken down in the digestive system into separate sugar molecules – usually glucose, sucrose and fructose.
Carbohydrates are generally broken down in the digestive system into individual sugar molecules – usually glucose, sucrose and fructose
So, whether you eat white bread, brown rice or a banana, the digestible carbohydrates in this food end up in the blood as the same: sugars.
Some low carb advocates have claimed that since all carbohydrate-containing foods end up as sugar molecules, eating them has a & # 39; equivalent effect & # 39; on the body as consuming pure sugar.
But how exactly is this?
Professor Gary Frost says: & # 39; That's not it. The problem is that you don't compare like with because table sugar is chemically different from white bread or rice, and therefore the effect on the body is different.
& # 39; The carbohydrates in bread or rice are broken down to 100 percent glucose. But table sugar is 50 percent glucose and 50 percent fructose – a type of fruit sugar.
& # 39; There are indications that fructose can increase the amount of fat in the blood and that fat is then stored in the liver. If you have diabetes, the effects can be harmful. & # 39;
It is also worth knowing that the rate at which carbohydrates are digested varies depending on what else is in the food, such as fiber – which is also a carbohydrate, just an indigestible – fat and protein. Fats in a meal slow the digestion of carbohydrates.
More complex carbohydrates such as pasta, wholemeal bread, lentils and porridge also give you a full feeling for longer. But there are also other factors, such as how food is cooked – baked potatoes digest faster than chips, for example – and what else is eaten. If you choose a very low carbohydrate restriction, this often means that you have to cut away bread, potatoes, rice and also legumes, fruit and many vegetables. If you do this, you risk removing important sources of fiber – essential for bowel and cardiovascular health – from the diet.
Further evidence that diabetic patients do not need to remove carbohydrates came from a review in which 56 studies with nearly 4,000 people were analyzed. It concluded that a Mediterranean diet with a moderate amount of carbohydrates, rich in dietary fiber, & # 39; was the most effective diet method & # 39; in controlling blood sugar levels.
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