Is anyone up for questioning the NHS on carbohydrates?

(Sarah Sim) #1

I was going to ask questions about this page:

Anyone up for asking questions about these quotes:
“Carbohydrates should be the body’s main source of energy in a healthy, balanced diet, providing about 4kcal (17kJ) per gram.”

“Research shows diets high in fibre are associated with a lower risk of cardiovascular disease, type 2 diabetes and bowel cancer.”

“Significantly reducing carbohydrates from your diet in the long term could put you at increased risk of insufficient intakes of certain nutrients, potentially leading to health problems.”

“Replacing carbohydrates with fats and higher fat sources of protein could increase your intake of saturated fat, which can raise the amount of cholesterol in your blood – a risk factor for heart disease.”

"When you’re low on glucose, the body breaks down stored fat to convert it into energy. This process causes a build-up of ketones in the blood, resulting in ketosis.

Ketosis as a result of a low-carbohydrate diet can be linked, at least in the short term, to headaches, weakness, nausea, dehydration, dizziness and irritability."

(Is this a bad thing? Because it is written like it is, what are the long term effects.)

“In the absence of carbohydrates in the diet, your body will convert protein (or other non-carbohydrate substances) into glucose, so it’s not just carbohydrates that can raise your blood sugar and insulin levels.”

"But there’s not enough evidence that foods that contain wheat are any more likely to cause weight gain than any other food.

Unless you have a diagnosed health condition, such as wheat allergy, wheat sensitivity or coeliac disease, there’s little evidence that cutting out wheat and other grains from your diet would benefit your health.

Grains, especially wholegrains, are an important part of a healthy, balanced diet."

"There’s some evidence that suggests low-carbohydrate diets can lead to weight loss and improvements in blood glucose control in people with type 2 diabetes in the short term.

But it’s not clear whether the diet is a safe and effective way to manage type 2 diabetes in the long term.

Weight loss from a low-carbohydrate diet may be because of a reduced intake of calories overall and not specifically as a result of eating less carbohydrate.

There also isn’t enough evidence to support the use of low-carbohydrate diets in people with type 1 diabetes."

"Douglas Twenefour, Diabetes UK clinical adviser, says: "When considering a low-carbohydrate diet as an option, people with diabetes should be made aware of possible side effects, such as the risk of hypoglycaemia (low blood sugar).

"We also advise that people with diabetes discuss the amount of carbohydrate to be restricted with their healthcare team.

“The best way to manage diabetes is by taking prescribed medications and by maintaining a healthy lifestyle that includes plenty of physical activity, and a balanced diet that is low in saturated fat, salt and sugar and rich in fruit and vegetables, without completely cutting out any particular food groups.”"

“It’s recommended that you base all your meals around starchy carbohydrate foods and you try to choose higher fibre wholegrain varieties when you can.”

When I can find the right email address I was going to ask for the scientific evidence for the quotes above to see what they reply. Anyone up for joining me? I don’t think they will take any notice, but we can ask.

(bulkbiker) #2

Happy to stick my name onto anything that you send but the NHS seems decidedly conflicted on this issue.
There are number of areas where they are starting to look at Low Carb.
There is a new online module for GP training written by Dr David Unwin (who tweets as @lowcarbGP).
The low carb program is available for prescription by doctors (although I’m not sure how many of them are aware of this).
At the most recent All Part Parliamentary Group on diabetes there was quite a big push by Aseem Malhotra, Zoe Harcombe and Tom Watson for a low carb approach.

However, the antis are the established “experts”. Idiots like Twenefour who seems the most ill-informed but is from DUK which gives him more influence than he deserves.
Then you get Public Health England with Alison Tedstone and Louis Levy who are very anti low carb let alone keto.

The NHS are stuck in the middle so I almost feel a bit sorry for them… Note the “almost”…

(Jules) #3

Makes my blood boil no one is ever held accountable for bad advice. My father was given very strict advice on what to eat and what not to eat. I can still see him sticking to the advisory “healthy” margarine in my mind now. Died at 68. I’ll gladly support.

(Carl Keller) #4

Why is it that only erythrocytes are the only cells in the human body that requires glucose? Why is it that our livers are so proficient at producing glycogen (gluconeogenesis) from protein? How is that our hunter/gatherer ancestors survived for hundreds of thousands of years on predominately low carb menus?

Why omit the word “Correlation” before “Reseach”? Why not consider that the importance of fiber is amplified in a diet high in processed foods and that fiber simply acts as a sponge to slow the effect of processed foods on our bodies?

Why am I getting 75-85% of my RDA in vitamins and minerals while eating single item whole foods that are low in carbs now while I was lucky to get 50% while eating a SAD based diet?

Why is there no unbiased research to confirm this assessment? Why are there so many studies that contradict it?

Why not consider the sodium variable and its amplified importance in a low carb setting?

Why try to demonize gluconeogenesis when it’s simply a natural, demand-driven process to maintain a homeostatic blood glucose level?

Why is wheat’s effect on blood glucose without consequence? Does it have some magical property that allows it to resist the effect of insulin?

Why not try to prevent T2D instead of address the need to treat or manage it? Why is T2D currently epidemic while recommendations for the past 50 years have suggested high carb diets, low sodium, eat more, move less are the answers to good health?

Why are we not extinct? Why did our ancestors not die before the advent of farming due to the inability to regulate their blood glucose levels?

Why not focus on prevention instead of treatment or reversal instead of regulation?

It’s recommended by whom? The organization that cuts your check?

(Sarah Sim) #5

I may use some of your questions (with your permission), although “I feel like I am kicking a girl (NHS)when she is down”. Not having to cut off limbs must save the NHS money though.

(Carl Keller) #6

Permission granted. Imagine NHS is male if that makes it easier. Give him a stiff kick to the groin. :wink:

I would like to change this one answer because I didn’t answer in the context of someone with diabetes:

Why is the current (ineffective) treatment for T2D prescribing insulin which is a direct attempt to lower blood glucose levels and how is this better than consuming low glycemic food that keep BG levels and insulin levels closer to normalized?

(Scott) #7

I just love the way they cherry pick the one week of “possible” keto discomfort in the first week as if it is a constant.

(Jules) #8

I’m guessing because insulin companies make billions of pound/dollars every single year.

(Mollyann Hesser) #9

“Carbohydrates are the body’s main source of energy. In their absence, your body will use protein and fat for energy.” Ummm… that’s why we cut the carbs.

(A fool and his bacon are soon parted) #10

You’ve got such people as Aseem Malhotra, David Unwin, Malcom McKendrick, Zoë Harcombe, Petro Dombromylskij, and Sam Feltham on your side, but then there are chaps like Rory Collins and others of his ilk doing their best to fight back. Swiss Re and Crédit Suisse both get it and will help fight, I’m sure, since it’s clearly in their financial interest. But then you’ve got Monsanto, Archer Daniels Midland, Glaxo Smith Kline and other powerful financial interests lined up against them. Talk to that MP, what his name, Watson, or something? and see what he advises. I’ll bet he’d appreciate some support from the voters, and he knows the players at the Parliamentary and Ministerial levels. Any truth to the rumour that H.M. is keto?


It is a great mental exercise to work through each point and list one’s best current knowledge response.

In so doing it becomes a self test to see where personal curiosity may lead. And it keeps an individual (individual now being represented by the shorthand ‘n=1’) evolving in the knowledge that best helps them self.

Changing the advice of a massive bureaucracy like the NHS is no small task. But doing it as a side project to improving one’s own knowledge is a worthy distribution of effort.

Many flea bites will itch a bear.

(bulkbiker) #12

She certainly seems to low carb most of the time.
The MP is Tom Watson he hosted this recently

(Sarah Sim) #13

I just picked up on this yesterday and I haven’t had time to watch it yet as it is about 30 minutes long. But I am very excited to watch it.

('Jackie P') #14

I would like to know why the NHS awarded Dr David Unwin the NHS Innovator of the Year Award in 2016 for his outstanding work recommending low carbohydrate diets to his diabetic patients. And then publish this outdated drivel as dietary guidelines with no review date until 2021!?

(Alec) #15

Very likely a left hand and right hand problem. The NHS is a behemoth with thousands of “leaders” driving policy. Some may be sympathetic to low carb diets, and others (probably most) will think it is utter bunk.

('Jackie P') #16

Yes Im so frustrated, I have worked in the NHS since 1976 and they often fail to respond to emerging research and trends/feedback. We are training less and less doctors and nurses, cutting back on vital services and yet the answer is staring them in the face! How great would it be to be a world leader in innovation rather than sitting around waiting for the next SAD guidelines.

(Alec) #17

Change of this sort seems to take forever, it is highly political… but it will happen. I think we know some of the truth (not all yet), and it is righter than the current guidelines.

The question we should ask ourselves is how do we move the ball in the right direction? Talk to your Dr about it, write to your MP about it, support Nina T in her crusade (if the US changes its guidelines, the UK will follow), talk about it at your work, write an email to your biggest boss you dare at your work. Is there a CEO of the NHS these days?

This change is already happening from the grass roots. Once the leaders get the idea that they will get support from below if they start changing direction, that is when it will all change very suddenly.

(charlie3) #18

Institutions that get their feet stuck in cement and turn out to be wrong get marginalized. Their funding shrinks. They wither away. The internet and social media, like this forum, accelerate the grass roots. How fast is low carb catching on? Does anybody really know? Probably a LOT faster than would have happened in the past.

(Alec) #19

Alas, I am not sure this is true for govt agencies. They are still given the money come what may.

(charlie3) #20

Government agencies can get bloated and find their funding rises and falls with public opinion and political changes like a new President. I’ve grown weary of the FDA. They have been given too much to regulate and too much discretion. Among so many other things, they enable drug companies to sell treatments that don’t work while that money might be better spent on finding/promoting cures. The low carb movement is a counterpoint to pharma drugs that leave the perception that taking a pill is equilivent to the lifestyle changes that would make the pill irrelevent. Increasingly the FDA acts with apparently good intentions but, for too many citizens, end up promoting the wrong solution. They would regulate what we do in our private kitchens if they could figure out a way. Another example, I switched from smoking to vaping 4 1/2 years ago. Without that I wouldn’t be eating low carb, exercising, and enjoying the best health in many years. The FDA intends to interfere with my access to vaping products. That makes them a dangerous enemy of my health. I fear them. The government’s influence over diet is a much more serious and epic disaster as most of us would agree. (Mr. President! You promised to drain the swamp.)