PHC: How low carbing can help the NHS, meeting in Edinburgh

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The Public Health Collaboration is hosting a morning meeting on Saturday 18th March in Edinburgh from 9 am till 1pm.

The morning speakers will be explaining the role low carbing has on:

Improving mental health and particularly the results with bipolar disorder.

Improving weight and glycaemic control in type two diabetes.

Reducing the costs of managing type two diabetes.

Public education and group coaching initiatives in Scotland.

The PHC Ambassadors are having an afternoon meeting to discuss their projects.

The meeting is at the Quaker Meeting House in the old part of Edinburgh at the bottom of the castle and the fee is £15.

Please contact Sam Feltham at the Public Health Collaboration for more details and to register for the event.

Metabolic Multiplier: Help for type two diabetics who want to adopt a low carb diet

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The site Metabolic Multiplier have compiled a toolkit that you can use to educate yourself about the low carb diet and have included information that you can give to your doctor or other health care professional so that they will be more likely to help you monitor your condition.

I was part of the development group last year.

The dietician Adele Hite was extremely active in the group and always seemed so full of energy and enthusiasm. She put in many hours into the project as well as her day job. Little did I know that she had a returning cancer and that she was to die from it in less than a year. In retrospect, I think that this is what drove her. She was determined to leave a legacy to help others.

If you know of any newly diagnosed diabetics or any who are experiencing friction with their GPs or health care providers, please let them know about the Metabolic Multiplier site. It is organised by the highly efficient and versatile Cecile Seth.

Low carb diets are beneficial for weight normalisation after childbirth

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Everyone knows how hard it is to shift body fat after having a baby. A recent study suggests that adopting a low carb diet featuring plentiful meat/poultry/fish and animal fats was more successful than having a low carb diet based mainly around plant foods.

Readers who are keen to shed their post holiday season weight gain may also find this information useful.

Low-carbohydrate diets (LCD) have been considered a popular dietary strategy for weight loss. However, the association of the low-carbohydrate dietary pattern with postpartum weight retention (PPWR) in women remains unknown.

The present study involved 426 women from a prospective mother-infant cohort study.

Overall, animal or plant LCD scores, which represent adherence to different low-carbohydrate dietary patterns, were calculated using diet intake information assessed by three consecutive 24 h dietary surveys.

PPWR was assessed by the difference of weight at 1 year postpartum minus the pre-pregnancy weight. After adjusting for potential confounding variables, women in higher quartiles of total and animal-based LCD scores had a significantly lower body weight and weight retention at 1 year postpartum (P < 0.05). The multivariable-adjusted ORs of substantial PPWR (≥5 kg), comparing the highest with the lowest quartile, were 0.47 (95% confidence interval 0.23–0.96) for the total LCD score (P = 0.021 for trend) and 0.38 (95% confidence interval 0.19–0.77) for the animal-based LCD score (P = 0.019 for trend), while this association was significantly attenuated by rice, glycemic load, fish, poultry, animal fat and animal protein (P for trend <0.05).

A high score for plant-based LCD was not significantly associated with the risk of PPWR (P > 0.05). The findings suggested that a low-carbohydrate dietary pattern, particularly with high protein and fat intake from animal-source foods, is associated with a decreased risk of weight retention at 1 year postpartum. This association was mainly due to low intake of glycemic load and high intake of fish and poultry.

https://pubs.rsc.org/en/content/articlelanding/2021/fo/d1fo00935d

Diabetes UK and British Dietetic Association finally recognise value of low carb diets for diabetics

I have personally been campaigning for low carbing for diabetics since 2003. I’m pleased to say that FINALLY Diabetes UK and the BDA have accepted low carbing as a valid option for management of type two diabetes. Presumably they will catch up with Type 1 diabetes in another 20 years or so.

Here are the main points from a paper that they issued on the subject in 2021.

Dietary strategies for remission of type 2 diabetes: A narrative review

Adrian Brown,Paul McArdle,Julie Taplin,David Unwin,Jennifer Unwin,Trudi Deakin,Sean Wheatley,Campbell Murdoch,Aseem Malhotra,Duane Mellor

First published: 29 July 2021

https://doi.org/10.1111/jhn.12938

Abstract

Type 2 diabetes (T2DM) is a growing health issue globally, which, until recently, was considered to be both chronic and progressive. Although having lifestyle and dietary changes as core components, treatments have focused on optimising glycaemic control using pharmaceutical agents. With data from bariatric surgery and, more recently, total diet replacement (TDR) studies that have set out to achieve remission, remission of T2DM has emerged as a treatment goal. A group of specialist dietitians and medical practitioners was convened, supported by the British Dietetic Association and Diabetes UK, to discuss dietary approaches to T2DM and consequently undertook a review of the available clinical trial and practice audit data regarding dietary approaches to remission of T2DM. Current available evidence suggests that a range of dietary approaches, including low energy diets (mostly using TDR) and low carbohydrate diets, can be used to support the achievement of euglycaemia and potentially remission. The most significant predictor of remission is weight loss and, although euglycaemia may occur on a low carbohydrate diet without weight loss, which does not meet some definitions of remission, it may rather constitute a ‘state of mitigation’ of T2DM. This technical point may not be considered as important for people living with T2DM, aside from that it may only last as long as the carbohydrate restriction is maintained. The possibility of actively treating T2DM along with the possibility of achieving remission should be discussed by healthcare professionals with people living with T2DM, along with a range of different dietary approaches that can help to achieve this.

Practice points

  • Type 2 diabetes (T2DM) remission should be considered as a treatment goal for people living with T2DM (especially for those within 6 years from being diagnosed). The ability to achieve this may be influenced by duration of diabetes, weight loss and gender. Therefore, it should be positively discussed with this in mind.
  • Based on the evidence from clinical trials weight loss (typically 15 kg or greater) is the main driver and predictor of remission. However, more data are needed so that it is more reflective of an ethnically diverse population.
  • Based on evidence from clinical trials, maintenance of weight loss appears to be the main driver of continued remission, and this therefore needs to be a key focus of the planning and delivery of all services designed to achieve remission. If a diet low in carbohydrate is sustainable to the individual, normoglycaemia may be maintained in the absence of weight loss, although evidence is limited and loss of remission is likely to occur if carbohydrate restriction ceases.
  • Total dietary replacements (TDR) and low carbohydrate diets have been demonstrated as being effective in facilitating weight loss and remission of T2DM. Evidence of effectiveness beyond 2 years is limited. The dietary approach should be one which the individual can maintain for the long term.
  • TDR and low carbohydrate diets, if appropriately supported, are considered safe and should not be avoided in suitable individuals who find these approaches acceptable. Clinicians should therefore aim to support their use within clinical practice as part of person-centred diabetes care.
  • Programmes supporting people toward achieving remission need to be structured and offer continued, regular support, including the involvement of dietitians (mandated by the National Health Service England).

Tim Noakes: Nutrition Network Courses for Health Professionals

Homepage | Nutrition Network (nutrition-network.org)

Tim Noakes shot to fame in the low carb community by being accused of malpractice by two South African dieticians for giving dietary advice when he was not a registered dietician. After five long miserable years and the support of international colleagues he won the case. Anna Dahlquist, a Swedish GP had gone through the same thing a few years before this, and not only won her case, but managed to get the Swedish food guidelines for people with diabetes changed.

Professor Noakes has established online training for health professionals covering a variety of useful topics. Participants can be from all over the world and will receive accreditation. The full list of topics can be found by clicking on the homepage in BOLD above.

Public health collaboration online conference 2021

Sam Feltham has done it again. This year’s conference is now available on you tube right now.

Last weekend there were many contributors from diverse fields including members of the public, doctors, academics, and the scientific journalist Gary Taubes who gave the opening talk about ketogenic diets.

The courses that particularly interested me were about the experiences of type one diabetics who had adopted the low carb approach, how to achieve change, and how to increase your happiness.

There are talks about eating addiction and eating disorders, statins, and vegetable oil consumption.

Much of the material will be familiar to readers of this blog. There are some new speakers and topics which do indicate that a grassroots movement in changing our dietary guidelines is gaining ground.

CrossFit: exercise, diet and research

CrossFit is a website which you may enjoy visiting.

In one site you can find detailed exercise advice, often in the form of videos, for strength training, recipes, and research findings related to health and dietary composition.

There is information on the low carb diet, which is particularly helpful for those with diabetes, who wish to lose body fat, or who wish to reduce their cardiovascular risk.

Lectures by a wide variety of speakers are also included.

https://www.crossfit.com/essentials

Your brain needs 50g of glucose a day

Adapted from Richard Feinman’s Nutrition in Crisis 

We have all heard NHS dieticians and diabetologists telling us that we will die of brain failure or get severe brain damage when we go on low carb diets because the brain needs 130g of glucose a day.

We will typically remind them that the glucose does not need to be ingested since our livers are perfectly able to manufacture well over 130g of glucose a day, the process called gluconeogenesis.

Richard Feinman is a cell biologist and he has an even finer retort.

The 130g of glucose a day necessity was discovered by George Cahill. This was the amount of glucose that a brain uses in normal nutritional states. It is indeed the case that this glucose can be ingested or manufactured in the liver or both.

Under starvation conditions however, the brain will only use 50g of glucose a day.  In starvation, the utilisation of ketone bodies becomes more important for brain function.

Unfortunately, nutritionists picked up on the 130g of glucose a day message and have been repeating it ever since. Cahill is reported to have said that by the time he was aware of the simplified but inaccurate message, it was too late to stop it.

Thus, it is not always true that you need 130g of glucose a day for brain function and it is never true that this must be from dietary carbohydrate.

So, if you get the old chestnut thrown at you, you know what to say now!

 

 

 

 

 

Dr Chris Palmer: Ketogenic diet now being used in mental health

Dr Chris Palmer from Harvard has been using the low-carbohydrate and ketogenic diets in practice for over 15 years now mostly for weight loss. Recently, he has found an anti-psychotic and mood stabilizing effect from specific types of the ketogenic diet. Now he is pursuing clinical research in this area to better understand the topic. As a result, he has also been speaking at national and international conferences.

Here area few of his podcasts/interviews:

http://lowcarbmd.com/episode-49-dr-chris-palmer-treating-schizophrenia-with-lifestyle

https://www.chrispalmermd.com/ketogenic-diet-psychology…/ and keto putting schizophrenia into remission.

https://www.chrispalmermd.com/ketogenic-diet-remission…/

https://www.chrispalmermd.com/keto-naturopath-by-karl-goldcamp-interview-christopher-palmer/

My comment: It is a very good idea for those people with schizophrenia to be on a low carb diet, mainly due to the side effects of the anti-psychotics which give people metabolic syndrome and diabetes. It is even better to hear that there conditions are improved so they are less reliant on these drugs.

Diet doctor: free online course with credit for medical professionals

This is a message from dietician Adele Hite:

I am thrilled to announce that Diet Doctor is now offering a free CME activity to all interested clinicians, patients and carers: Treating metabolic syndrome, type 2 diabetes, and obesity with therapeutic carbohydrate restriction.

Thanks to the support of our members, we can offer this CME at no cost to clinicians.

This fully referenced, evidence-based CME activity is certified for three AMA PRA Category 1 Credit(s)™. It is jointly provided by Postgraduate Institute for Medicine (PIM) and Diet Doctor and is intended for physicians, physician assistants, registered nurses, and dietitians engaged in the care of patients with metabolic syndrome, type 2 diabetes, and obesity.

The course was designed by clinicians for clinicians. As this course outline shows, it covers all clinicians need to know about dietary carbohydrate restriction and how to implement it safely and effectively with patients for whom it is appropriate. In keeping with Diet Doctor’s mission to “make low carb simple,” the course also comes with supplemental materials for clinicians and their patients to make it easy to translate evidence into practice.

We hope that this course will help reaffirm the scientific and clinical support for this approach and — along with other efforts by LowCarbUSA and expert clinicians — act as another step in solidifying a standard of care around low-carb nutrition. We would love it if you would share the news about this course with colleagues. You can forward this email to them or use this flyer to share or post.

Diet Doctor also has some new resources to help make low carb simple for patients and clinicians alike. For patients, we have:
‒ a sample menu
‒ shopping list
‒ a meal planning guide
‒ a substitutes for favorite foods handout
‒ simple meals and planned leftovers, and
‒ information about target protein ranges

For clinicians, we have handy one-pagers on:
‒ monitoring ketones
‒ fasting insulin and HOMA-IR ranges
‒ lab tests and follow-up schedule
‒ type 2 diabetes medication reduction, and
‒ a 5-day food diary for patients who need to monitor their intake

Of course, for those on the list who are not clinicians, anyone can register for and view the course. You just won’t be eligible for CME credits.

For clinicians, please let us know if we can help you help your patients in other ways. And if you are interested in supporting us as we continue to develop materials to make low carb easy for clinicians and patients, please think about becoming a Diet Doctor member yourself.

Finally, we are happy to hear suggestions for improvements moving forward. If you take the time to view the course, we’d love to hear what you think.

Best regards,
Adele