So confused by different dieting theories

[HeadShoulderHipsandCalves]

I listen to various podcasts (such as Tim Spector's, and Michael Mosely) but I end up more confused when their analysis of the research contradicts other things I see and hear. My diabetic nurse is still saying 'reduce animal fat' but other research suggests it is not as bad as previously thought. Listened to something else this week and it was suggesting whole milk is not the worse option but that milk won't necessarily be great for bone strength.

It's so hard to pick out what's what and separate decent research from media doctors looking for headlines.

Does anyone understand all the research thoroughly, and if so, what approach would you recommend for a pre- diabetic 50 year old with high cholesterol please?

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I would cut down on high fat such as butter, cheese and full fat milk. To improve cholesterol levels. Also certainly cut right down on cakes biscuits and sweets. Eat more veg and lower fat protein foods such as beans, fish. Chicken and so on.

Given you are prediabetic and have high cholesterol I would prioritise getting the prediabetes under control. Research suggests you can do this in a very short time period. Look at Michael Moseley fast 800, or the Newcastle diet. I'm surprised at your diabetic nurse. DH was recently diagnosed and his nurse has recommended low carb and he's now in the pre-diabetic range.

The research for people with diabetes or prediabetic is to reduce the unhealthy carbs. Try and reduce or eliminate bread, pasta, rice, flour and sugar. Try and eat a lot more veggies that grow above ground. You also need protein for satiety. You are currently insulin resistant. This means your body is having to produce a lot of insulin in an attempt to keep your blood sugars normal. High blood sugar is very bad for the body. You also can't lose weight when insulin is high.

To reduce insulin you need to intermittent fasting if you can, I skip breakfast and only eat between 12-7pm. You can also reduce your intake of carbohydrates. Exercise also helps reduce insulin. Once insulin is lower your body can access the stored fat in your cells. This really helps with your appetite because you will feel much less hungry once burning fat because you likely have lots to burn.

Focus on getting your blood sugars under control. Then look at the cholesterol. You might find it sorts itself out when you get your blood sugars under proper control.

If you want more information Dr Unwin is an excellent source of advice, he's a GP who has been helping patients reverse diabetes using low carb.

Low carb and fasting are both evidence based approaches to reducing insulin resistance.

I started the 16:8 intermittent fasting and I’ve already lost a stone. It works brilliantly for me. Check out the Fasting topic on here.

A GP or endocrinologist or dietitian should be able to give you advice. They might put you on an 800 cal diet as mentioned above for two weeks or so. I was diabetic and managed to go into remission. Most reasonable diets (low carb, low fat, fasting) will work, but the key is to choose something sustainable for you.

Whatever you do, try and limit the carbs. I focus on whole foods (not completely), high protein (I’m vegetarian but I think lean meats, poultry and fish should be fine just not everyday), I have moderate carbs in the day and generally have a lower carb dinner. I’ll use a little oil in dressings but to cook with I use a spray oils generally. The more protein you have the less hungry you will be. Make sure a third of your plate is non starchy vegetables. I find it quite difficult, but if you can try and track your calories. An example day might be:

Breakfast: Spinach and Ricotta Omelette, homemade beans, seasoned tomatoes, mushrooms and carrot
Lunch: Tofu and mango stir fry with half a pouch of brown rice. Mindful Chef has a good recipe, skip the maple syrup or swap for sweetener and I usually drizzle some sriracha on top. The veg is usually just a stir fry pack from the supermarket.
Dinner: Is usually a salad of some sort. For example Baked Halloumi (Seasoned with jerk sauce, Tikka paste, peri peri or something), or Falafel, some salad leaves, avocado and whatever veg I have in the fridge. Dressing will usually be something simple. A combination of some of the following: teaspoon of olive oil or sesame oil, lemon or lime, balsamic, hummus, garlic salt and pepper.
I have protein shakes, fruit (only one portion) or Alpro yoghurt in between. Usually I eat the same thing for two days in a row. Eat slowly and off small plates. You can always take a bit more if you feel hungry. When I’m finding it difficult, don’t have as much time as I do now or I think I’m slipping up then I will eat the same thing all week just to eliminate choice. Rome wasn’t built in a day though. It was small changes over a long time. I try and eat like this 80% of the time.

Do not drink your calories, water, infused water, herbal teas, and occasionally a sugar free drink. I had to quit tea because I couldn’t help putting sugar in it. Sugar is not your friend and I’m not successful with this, but you should try and avoid sweeteners because I find they lead to sugar cravings. I lost around 25 kg but still have quite a bit more to lose so I’ve started Wegovy as well, but obviously this isn’t for everyone.

I truly hate exercise, so I started small. I started walking, did some of couch to 5k and then got a PT because I’m ridiculous and I need someone to force me.

Which Quack told you that weight loss is impossible with high insulin levels?

@Vegetus probably some chiropractor on YouTube .
@SweepforAssassins do you how ozempic works? It raises insulin and it is the most effective weight loss drug ever. You might need to review your pseudo-science.

It baffles me how people can spout nonsense on here with the confidence they do.

Hi
Please don't do anything drastic like 800 calories a day etc. I am slim but have inherited high cholesterol- I already had a healthy ish diet so didn't have much leeway. I got my cholesterol down from the heights of 7.9 to under 5 by doing these things: massively reducing daily biscuits, cakes etc, tracking calories daily so you are seeing how much you eat, eating red meat only at weekends if at all, eating lots of oily fish and plants, having oats most days for brekkie and allowing myself one pastry breakfast per week, having alcohol in small amounts only at weekends and those Benecol drinks, doing a bit of cardio alongside my usual weight training. Personally these were not big changes for me as I was already quite healthy so I've kept to them.
Put your height, weight and how much you want to lose into a realistic portal such as james smith academy or the fitness chef and they will give you an amount of calories to lose weight slowly. Stick to those. If you give yourself a calorie target that's too low the likelihood is that you'll starve and go for a binge.

I’ve heard this from a diabetic nurse, she didn’t say impossible but she said harder. Something about your cells won’t go into fat burning mode while insulin is high. So she was advocating having lengthy breaks between food to allow insulin to come down. That if you keep snacking your insulin is permanently high.

no idea what’s right and I can understand why people are confused.

I would say less starchy carbs (pasta, bread), obviously less cakes, sweets, biscuits, avoid fizzy pop and for me that includes diet soda as the diet soda makes me hungry. Eat more veg, more protein, so meat, chicken, beans, lentils.

I am confused as to whether low fat or high fat is better, low fat is less calories but some people say you need fat to help make you feel fuller.

I definitely lost weight easier when intermittent fasting and not eating till midday.

Biology.

Insulin is putting sugar inside cells so you can use it in respiration and convert it to carbon dioxide and water. In the process releasing energy.

In weight loss you want your body to use fat in respiration. To do this your fat cells must release fatty acids into the blood where they can be taken up by your muscle cells and used in respiration. This process is inhibited by insulin.

If the body already has a lot of sugar or the stored form of sugar glycogen it will use them in respiration. Whereas if insulin is low then it will use fat.

Looks like op is getting exactly the same mixed messaging on here as she complained about in the OP.

Some people respond better to different diets. This is because their bodies are different and because of their physchology.

As you are prediabetic this mixed messaging is particularly bad in your case. It used to be that a typical low fat diet was recommended for diabetes but many people including doctors (like Micheal Mosely) found that this wasn't effective for diabetes. As a result the mind set is slowly changing to one of lowering carbs. This makes sense medically as diabetes is a problem with insulin which is the blood sugar regulation hormone. Less sugar, less insulin needed, less blood sugar issues. Some health professionals have not transitioned to the new thinking however for whatever reason likely because it's still considered faddy.

Cholesterol is produced by the body in response to sugar in the blood (or as pp said it can be bad luck with genetics) and you may well find reducing carbs will help that too.

I would recommend trying a strict keto type diet for 2-4 weeks and see if it improves anything.

This isn't a meat and eggs diet. Include tonnes of salad and green veggies, olive oil, cream, cheese, quality cuts of meat etc. it is a hard diet to do if you aren't used to it, I would research some menus and stick to them. Alternatively, greenchef do low carb now I think if you can throw money at the issue.

Absolute nonsense. The insulin model of obesity is pseudo science and has been disproven time and time again.

I’d see a dietitian (not a nutritionist). They’re the experts in evidence based nutrition advice.

Are you overweight? If so, getting your weight down should be the first priority. Do whatever works for you to do that - calorie counting, weight watchers, low carb, whatever.

And to correct some dangerous info on here. Ozempic is not insulin. It helps to CONTROL insulin i.e. so your body uses it at the correct time rather then too much. A cursery Google reveals this.

@Vegetus

So why does it work? Why has the diabetes society added it to their acceptable options for their patients?

The irony is that modern dieting that demonises fat is a recent fad, only been around for 40 years and what happened? People reduced their fat and obesity skyrocketed. Fat is essential nutrition for the body, carbs are not.

Processed anything is bad though (carbs or fats) food culture is awful at the moment.

The studies on insulin and weight gain/loss never prove this theory to be correct.

High fat low carb Vs low fat is pretty comparable when calories are equated. Low carb has a quicker lowering of hb1ac levels but these seem to rise back to near baseline again as adherence is hard as with all diets!

There's no magic bullet you just need to find a way of eating that enables you restrict intake and still enjoy your diet long term. Once this is accomplished and fat is lost all the blood markers will improve.

I'd recommend figuring out her energy expenditure, then having a high protein diet so upwards of a gram per pound of lean bodyweight, enough healthy fats for adequate hormone control and this leaves enough room for some fun stuff if she wants or needs it to get her through the slog of dieting. Sprinkle in some exercise a mixture of resistance training and some steady state cardio and you've got a recipe for success in eyes.

It works but not for the reasons peddled by the book sellers and YouTubers. Simple fact is they consumed less calories than they expended. They haven't magically unlocked some mechanism inside the body that can do away with the laws of thermodynamics.

It performs no better or sometimes worse in every study where calories are equated.

Obesity has sky rocketed due to the abundance of cheap, delicious and readily available calories. No one got obese due to the advent of low fat yoghurt they got fat because you can get a pizza and tub of ice cream for 5 quid and people are more sedentary than before.

For sound advice and reliable information, I would look up Dr Jason Fung and Dr Rangan Chatterjee (the latter has a great podcast).

Jason Fung is a nephrologist. Do not follow his advice, buy his book or buy his supplements.

In fact search on YouTube for any qualified dietitian my favourite person in this space is Layne Norton breaking down his absurd claims.

Eat food, mostly plants and move more.

Agree with vegetus that our diets and lifestyle are hugely affected by the fast availability of food and people not realising how much they are putting into their bodies. If someone is overweight or obese the first thing they need to do is look at how much they are eating and then put themselves in a calorie deficit. Tracking calories lets you see if you are over fuelling yourself.

Are people still promoting Jason Fung? Wasn't he all against insulin. Guess that theory is in the toilets now with Ozempic.
Layne Norton debunked Fung. Herman Pontzer's book is quite a good read too. Also totally debunks the low carb crusaders.

What I posted previously is not being argued. It is the biological pathways fat and sugar take. Doesn't matter what diet you are on.

In a low calorie diet you will reduce insulin and burn fat.

In a prediabetic or diabetic though it is important to reduce blood sugars because if they are abnormally high they are causing damage to the body. Hence why a low carb diet can be healthier than a low fat one.

The body is not a calories in calories out machine because you ignore entirely the body's ability to reduce or increase metabolism.

You're way overstating the effect of metabolic adaptation. It's not spontaneous as the quacks like to preach, the body is always a calories in calories out machine. The calories required to maintain homeostasis change depending on the size of the body. If you're fatter it requires more to keep the engine running than when you're slimmer.

It's not if you start eating less calories your body will automatically stop burning calories to compensate for this.

TLDR metabolic adaptation is a slow gradual process over time.