To think the NHS’ dietary advice is wrong?

[Breakingmad]

Specifically this part? Surely we shouldn’t be basing our meals on starch?

Here’s the link to the full article. I really disagree with the ‘fat is the enemy’ message too re full fat milk, fatty cuts of meat etc.

www.nhs.uk/live-well/eat-well/

The NHS bases it's information on evidence.

There is also a significant lag between new evidence coming to light and adoption across the NHS.

Added to which , a lot of peer reviewed studies are funded by food manufacturers and their associates. The temptation for people with skin in the game to suppress any evidence which does not support their case and only publish ones which suit their purposes.

Journalists find that reporting simple results make much better headlines than the equivocation of 'under these circumstances...'

Evidence is not just so easy to find.

DH was diagnosed as TII diabetic in 2006. The NHS advice at the time was that it was not reversible , that way of eating had very little impact and to resign oneself that the pills available would eventually become ineffective and insulin injections would become routine.

Fortunately, we found lots of evidence for alternative approaches. Using MN's own low carb high fat bootcamp, which includes really helpful resources, DH lost lots of weight and regularly delivered blood test results in the low, not diabetic range.

At his GP's insistence, he continued the metformin medicine for a full year after the blood tests, before finally (sic) accepting that he was no longer TII diabetic.

They insist on annual blood tests so we know the results have been maintained.

In the time that we have known about the impact of eating low carb high fat on blood sugar, https://www.diabetes.co.uk has started to recommend low carb high fat for diabetics. NHS still has not made any change to their advice. Many more practitioners now agree that the high fat low carb is the way forward and say that we should not expect the NHS to update their advice any time soon.

We are in touch with many, many others diagnosed TII who have followed the same way of eating with the same results.

This is only one area that we know about. There may be others where the NHS lags best practice.

Yep, carbs between 20-50g per day and higher (good) fat for 15 months lowered my Hba1c bloods from 103 (very high type 2) to 36 (normal).
Also practice intermittent fasting (never have breakfast and sometimes just one meal a day). Great weight control, great energy levels and improved mental clarity!
I think many people have insulin resistance caused by years of spiking their insulin response many times a day and this is why so many struggle to lose weight.
Slower release carbs still spike blood sugars and corresponding insulin response albeit a lower spike but sustaining over a longer period (proved with 12 months personal data from finger prick tests before and 2 hours after anything I ate).

I don't understand how people have the time to eat 3-4 times a day, especially at work.
I skip brekky and lunch most of the time. Just don't have the time. I just think NHS advice is waaaay out of date, sounds like something from the 20s when everyone was working the docks.
75% of the population is a dietary mess most of it from eating crap.

NHS data is 'safe' data. It isn't often updated.

Yes, I do have a certificate and experience working with NHS dieticians. They give that info a decent shape. No food is bad, excess is bad, balance is an paramount.

Every article about any micro or macro nutrient tends to forget the holistic reality... none of the data is incorrect but most of it in is unusable for the majority of people, most if whom would misunderstand and misapply what they have read, especially when what they read was written by an enthusiastic but clueless journalist.

It isn't the food you eat that most people need to change it is the amount, timing and variety that needs to change.

I'm at risk of diabetes.
I recently massively cut down on processed carbs (bread/ pasta/ noodles/ white rice only a few a week now - was previously every meal and my blood sugar levels are much more stable and I'm losing weight much more easily. My appetite is manageable as opposed to being starving and craving sugar all the time.
Eating lots more protein and "healthy" fats - yoghurt, avo, nuts etc

I looked at shifting some post baby weight by seeing an NHS Dietician some years back. I dutifully kept a food diary for her to review, so she could tell me where I was going wrong.

The list of things I was told I shouldn't ever have included pretty much every single food that would be regarded as being part of a Mediterranean Diet other than pasta - I could have 'vast amounts of pasta, pile your plate high with it' as long as it wasn't seasoned and I was supposed to eliminate all oily fish, seafood, all but a matchbox sized amount of fresh meat with no fat/seasoning/flavour, strong cheeses, preserved meat, preserved vegetables, olive oil, nuts and salt, whilst purchasing ready meals and sauces because they had the red/amber/green symbols on the packaging - and eating a bowl of cereal with skimmed milk every morning.

I wasn't convinced (or particularly enthusiastic about eating ultraprocessed food and sugary stuff I didn't like), but she was adamant that I would lose weight as soon as I did that, cut out all fat and salt and piled my plate high with pasta in the evening. Oh, and if I bought 'diet' biscuits, I could have two of those every day - apparently that was some sort of reward.

Let's just say it didn't work out well.

The eatwell plate was invented without any evidence base to say it is the right way. Newer emerging studies are coming forward all the time. Full fat, low carb and to eat like a cave man are showing to be more beneficial in some ways

Hahha every dietician I've met has been morbidly obese.

So what's the advice if LDL cholesterol is high and needs to be lowered? No sat fats I thought. If pre diabetic also, that complicates things right?

This thread is a zombie… and just goes to show how much we don’t progress past thinking we know despite never having actually put the work in to study a subject.

"Eat food. Not too much. Mostly plants."

So eat less processed food including refined carbohydrates - you may have to eat nearly none at all.

Plus move more.

Govt guideline of 2000 calories per day for an average woman is bonkers.
If I go over 1900 p/d regularly I start piling it on. Moderately active and 5’6.5” so average height.
I think it the guideline should be 1600 p/d with 12-1300 for weightloss.

Agreed. Especially true for older women. I exercise a lot, definitely a lot, but if I ate 2000 calories every day I'd put on weight.

Agreed, the NHS dietary advice is outdated and not evidence based.

Sugar is worse than fat. We needs fat in our diet for cell function, as we do with ca4bs etc. It's the conflicting messages about the type and amount that are confusing!

Carbs are sugar more or less.

I know that's popular to say on MN.
DS is doing GCSE catering.
I put that statement to DS & asked if he agrees.
He critically evaluated & immediately said No.
He has a whole set of reasons why it's not accurate thing to say. It's a bad understanding of chemistry, molecular structures, and how the human body responds to different types of carbohydrates.

I mean, he's only 14. But he's talking chemistry, biochemistry, nutrition. He isn't interested in food puritanism. He sounds a lot more informed than simplistic things said on MN.

• ZOMBIE

Exactly. I find it quite scary that so many people are so willing to defer to experts rather than seeing what effects certain foods have on their health and well being.

Starch is sugar. FIbre is not sugar. High fibre starchy food is an oxymoron.

YANBU. It’s horribly misleading and wouldn’t help anyone who needed to lose weight. Nhs also gave advice for diabetics to eat lots of fruit…

You don't need a 4 year degree to be able to see with your own eyes the evidence walking around in front of you. Or - shocking, I know - actually eat food and be honest with yourself about how it makes you feel.

With very few exceptions the obese / overweight people I know love carbs, demonise fat, and chose 'diet' versions laden with sweeteners every single time.

Other common beliefs which usually hint that someone is either overweight or not actually practicing what they preach include the 3 meals a day rule and the not eating enough calories 'starvation mode' rule.

Harsh? Sure. But we're on track for 42m overweight adults by 2040. Why is anyone still listening to the dieticians or the NHS or the companies who have a vested interest in keeping us fat when we can all see and feel the effects on ourselves and all around us?

To those superiorly calling it a zombie thread it's only from last November and hardly a topic which is irrelevant a few months later is it?

Starch is not sugar. Fibre is no less sugar than starch is.

Sugar is a simple carbohydrate. Starch is a complex carbohydrate, which breaks down into sugar molecules as part of the process of digestion. That's why starch is a slower-release form of energy than sugar is. Fibre is also complex carbohydrate but (by definition) is not digested.

Yes, you read that correctly. Fibre is a carbohydrate. This obsession with "carbs" is seriously pissing me off.