1/11 Many people cut out sugar + carbs as a way of reversing type 2 diabetes, pre-diabetes or improving their health #LCHF
At a recent group consultation many of my patients shared worries about how to avoid carbs in restaurants as 🇬🇧emerges from lockdown
Here are my top tips👇
2/11 Think carefully about your choice of restaurant - some may be easier to manage than others
3/11 Put aside time to think about the meal in advance
It's hard to think clearly when arriving in a busy restaurant
"If you fail to plan, you plan to fail"
Try looking at the menu online before you go and have a think about your food and drink choices before you arrive
4/11 Think carefully about what you'll drink
Beer has a lot of carbs, wine/spirits far less BUT watch the mixers
A small can of tonic water has about 4 tsp sugar - even diet tonic has 1 tsp
Diet Coke is better than Coke but I wouldn't put either in my body!
Soda water = no sugar
5/11 And remember that alcohol lowers your inhibitions and can affect your decision making
6/11 Watch out for those pre-dinner nibbles. How about some olives?
7/11 Don't worry about being a bit awkward when ordering, it's OK - you're the one that's paying the bill
Think about asking for a salad instead of chips or potatoes or ask for a burger but without the bun
8/11 Swap out the starchy carbs, potatoes, sweet potatoes, pasta and rice for vegetables grown above ground like cauliflower, courgette, peas, broccoli, cabbage, spouts etc
9/11 If you're eating Asian food/curry, Thai etc watch out for the rice and the naan bread. Instead think about having another meat/fish curry or a vegetable side dish (without potatoes) instead. Chickpeas (chana) and lentils (dhal) are good alternatives for many people
10/11 Desserts are always tricky. Options for me include cheese (but no biscuits) but I often simply order a different starter rather than a dessert - I don't mind if the person serving thinks I'm weird! 🤪
11/11 Lastly, don't worry if you fall off the wagon and are disappointed with yourself
Take it as an opportunity to learn how to handle it better next time, put it behind you and move on
It's not a catastrophe, just a bump in the road to better health
Enjoy your meal out 🍽️😋
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This patient of mine is 55 and has mysteriously reversed her type 2 diabetes with a huge drop of HbA1c from 77➡️32mmol/mol (9.2-5.1%) in only 3 months
She is not on any new medications for her diabetes..
2/4 She swears she has NOT made any dietary changes EXCEPT cutting out all sources of sugar like sweets🍬, biscuits🍪, chocolate, cake🧁, fruit juice🧃 + avoiding starchy carbs such as bread🍞, cereals🥣, potatoes🥔, rice🍚+ pasta🍝
I really believe she is telling me the truth🤔
3/4 It's particularly spooky👻because she's the 88th person at my practice to whom this has happened
2/10 Pre-diabetes has many names, often with subtle differences in definition
It's often called:
Impaired glucose tolerence, IGT
Impaired fasting glycaemia
Intermediate hyperglycaemia (preferred by @WHO )
High Risk State of Developing Diabetes (preferred by @AmDiabetesAssn )
3/10 Pre-diabetes is *NOT A DISEASE*
This is really important
It's a *RISK FACTOR* for developing type 2 diabetes
Other risk factors include:
Age >40 (>25 if S Asian)
Family History
Being overweight
People of Asian, African-Caribbean or black African origin, even if born in🇬🇧
2/11 The study is by @lowcarbGP@jen_unwin + others and looks at reversing T2DM and pre-diabetes by lifestyle change, in particular by ⬇️sugar and starchy carbs
3/11 The study builds on the work of Prof Roy Taylor's DiRECT Study which found that *severe* calorie restriction could put T2DM into remission👍
More info here 👇 directclinicaltrial.org.uk
This was great news but SO many people find calorie restriction IMPOSSIBLE TO SUSTAIN 🤔🤷♂️
I've spent the last 10 years wondering about this. A TED Talk and paper by @segal_eran (refs at end) has completely blown my mind 🤯
He provides some of the answers - but they may not be what you think
Here goes....
2/11 The incidence of diet-related disease has ⬆️⬆️ in last 30 years
In 🇺🇸 70% of population are overweight, diabetic or have NAFLD (fatty liver)
38% are obese 😲
10% have type 2 diabetes 😲
Diet and lifestyle are the major drivers
3/11 So why don't we know what is the best diet for humans?
It's because we are asking the wrong question
Much of what constitutes the best diet depends on the individual human every bit as much the food
Nutrition needs to be personally tailored to each individual
2/8 I've been prompted to tweet about this after hearing some wonderful news today. A year ago @DrPaulaPowell1 and I assisted at a cardiac arrest on the beautiful but remote Isle of Lewis. David survived and posted a really moving video on FaceBook