the blood sugar diet in practice - issues & answers 2020 · •19 type 2 diabetics and pre-...

The Blood Sugar Diet in Practice

Dr Clare Bailey

GP, Burnham, Bucks

claremosley@gmail.com

Prof Roy Taylor, Newcastle, 2015 • Demonstrating that

weight loss reverses diabetes

• Problem is central obesity – fat infiltrates liver & pancreas

Obesity & abdominal fat – significant risk factor

Insulin Resistance/metabolic syndrome • Type 2 diabetes is caused by

abnormal fat storage, particularly in liver & pancreas (Specialised MRI)

• Failure of muscle glycogen storage and abnormal storage of fat in muscle after eating.

• Insulin resistance

Changes in liver fat over 8 weeks

Prof Roy Taylor’s results: Average weight loss 15kg short (< 4 years) = 87% long (> 8 years) = 50%

Dr David Unwin, LCHF 2014

• 19 type 2 diabetics and pre-diabetics • low carbohydrate diet • ten minute one-to-one sessions with a GP or practice nurse + regular group

education. • At 7 months only one had dropped out RESULTS; • all had significant weight loss (average 8.63 Kg) • Av. HbA1c dropped from 50.68 to 39.9. • Despite higher fat intake, average cholesterol dropped from 5.5 to 4.7 • Waist measurement waist circumference from 120cm to 105cm • liver function improved for nearly all participants

Tale of two trials 1. Women’s Health Initiative Dieting Modification Trial, 1992. 49,000 women randomly allocated to low fat v continue as normal. Followed for 8 years. Fat consumption fell from 39% to 29% After 8 years weight difference was..

0.4 kg No differences in rates of heart disease, stroke, breast cancer or colorectal cancer risk

2. Predimed study 2013

7000 Spaniards randomly allocated to low fat diet or Mediterranean diet.

Results of Predimed? Those on the Mediterranean diet were; • 30% less likely to die from a MI or stroke • Cut risk of developing diabetes by 52% • Women on Mediterranean diet, but supplemented with extra-

virgin olive oil, had 68 percent lower risk of getting breast cancer

• Less decline in cognitive function than low fat

Weight loss with Low-fat, Mediterranean or Low-carb Diet. New England Journal of Medicine, 2008.

What is a Mediterranean diet?

Nuts An essential part of the Mediterranean diet.

Olive oil and fats • Monounsaturated fatty

acids and antioxidants • Reduced risk of heart

disease • Can fry with it

Oily fish (eg salmon or mackerel)

• source of protein • omega 3, a particularly

healthy form of fat

Saturated Fat?

American Journal of Nutrition, Meta-analysis - association of saturated fat with cardiovascular disease; “Across the entire range of disease, heart disease and stroke, there was absolutely zero effect”.

Annals of Internal Medicine, 2014; Looking at the association of dietary, circulating and supplement fatty acids with coronary risk; • 80 studies, 520,000 people • No evidence of increased heart disease

Dairy products Higher levels of some saturated fats, in particular margaric acid, were associated with a lower risk of heart disease. (Especially Full Fat Greek style yoghurt)

Eat eggs - especially for breakfast

Moderate meat consumption

Always include some protein (at least 40-50g). (Grass fed beef also contains omega 3)

EPIC Study on meat consumption and mortality - 500,000 participants from ten European countries

• Lowest mortality: eating up to 100 gms (3 oz/day)

• Highest mortality: in non-meat eaters or eating more than 140 gms a day (4 oz/day)

Non-starchy Veg

• Low in calories (eg 17 calories in 100 gms of courgette)

• High in fibre, vitamins and other nutrients

• High in phytonutrients protect against a range of diseases.

Some fruit But ideally not more than 1-2 portions of fruit daily – ideally non-tropical

Slow-release Carbohydrates Seeds, Lentils, Pulses, Whole grains Avoid “just going brown”

The Blood Sugar Diet (BSD) 1. BSD Fast 800: Fast and effective.

2. The 5:2 BSD: More flexible, involves intermittent fasting.

3. The BSD Med Style Way of Life: Gentler, no fasting, no counting, portion control.

Tips for fasting • Drink more fluids at least 1 l extra • Expect first week to be tough • Appetite settles after 1-2 weeks • Important to emphasise increase in fat intake • Reduce or stop insulin & Gliclazide along with BP

medication • It doesn’t suit everyone & is not appropriate for others

Cassie

24 year old insulin dependent diabetic Developed gestational diabetes during pregnancy. Remained on insulin & BMI increased to 50.

lost 6½st in ten weeks and conceived twins. ‘After the birth of my daughter, Gracie, now five, my weight crept up to 28st. 'It had taken us four years and four miscarriages to conceived Gracie

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HbA1C (Mmol/mol) change in 26 consecutive patients 2016

HbA1C change

Go Mediterranean & enjoy!

claremosley@gmail.com, www.thebloodsugardiet.com (a well informed forum available online)

Avoid fasting if • Underweight and/or have a history of an eating disorder • Under 18 years of age • Breastfeeding or pregnant • Diagnosed with a significant psychiatric disorder • Frail or recovering from surgery • Under active investigation or treatment or have a significant

medical condition affecting ability to comply with diet • On certain medications; eg Warfarin, reduce antihypertensives • Type 1 diabetic • Unwell or have a fever