Daily Mail

TASTIEST TOBEAT WAY DIABETES

Nine out of ten of all Covid deaths are in the world’s most obese countries – and Britain is one. Boris has got the message ... he’s slashed his carbs. Now we’ll show how YOU can too!

- by Dr DAVID UNWIN

LET me start with an embarrassi­ng confession: for years, patients with a weight problem were among my least favourite cases to deal with as a doctor. Back then they filled me with despair, because despite giving them the suggestion­s set out in official guidelines, they rarely — if ever — lost weight, and the health of those with type 2 diabetes so often just got worse.

When I look back, I see now that it was my fault: I gave poor advice, then blamed my patients when it didn’t work.

But now I’ve found a proven way to help them. And these days I actually enjoy helping people lose weight because we’re seeing such great results with this in my GP practice.

As I have revealed previously in the Mail, the secrets of that success lie in a low-carb diet that is both delicious and effective — one that helps you maintain your energy levels and lose weight without feeling hungry!

And you, too, can reap the benefits with the unique eat to Beat Diabetes series being launched in the Mail today, with four-page recipe pull-outs all next week.

In this series I will show you how cutting the carbs could transform your health — backed by the latest evidence and supported by delicious low- carb recipes developed exclusivel­y for Mail readers by food writer, Katie Caldesi. And the recipes have the added bonus of all being superquick, taking just 30 minutes or under to prepare from fridge to fork, using everyday ingredient­s!

LOWER BLOOD PRESSURE AND IMPROVED SLEEP

KATIE and her husband, renowned Italian chef Giancarlo, have used the low- carb approach to transform their own health — Giancarlo losing 3 st, putting his type 2 into remission — and now even banishing his gout, so that he’s able to exercise ( as Katie reveals in Weekend magazine today).

type 2 diabetes and obesity are life-shortening problems that can raise your risk of dying from heart disease, stroke and several different types of cancer.

But they have taken on particular significan­ce in the past year, with evidence even early on in the pandemic that both are significan­t risk factors for serious complicati­ons from Covid-19 if you catch it.

Indeed a shocking report published this week showed that Covid deaths have been ten times higher in countries with high levels of people who are overweight — such as the UK, Italy and the U.S., where this describes over 50 per cent of the adult population.

the impact of this was graphicall­y highlighte­d by what happened to Prime Minister Boris Johnson, who end up being hospitalis­ed with Covid and who’s since made it clear that his excessive weight had been a factor (at 5 ft 9 in he weighed 17 st 7 lb).

He’s now lost ‘quite a lot of weight’, he revealed on twitter this week, by going on runs, cutting out cheese late at night — and ‘eating less carbs’. It was gratifying to hear, because as I know from my patients, a low-carb approach can successful­ly tackle weight gain and type 2.

Not only that, it can also help reduce high blood pressure and fatty liver disease, a serious condition thought to affect one in five people. And as I have witnessed in my patients, the weight loss it triggers can lead to improved sleep and improved mood, too.

It’s not just my GP practice, either. As well as transformi­ng my patients’ health and lives, one of the most exciting recent developmen­ts for me has been the way low carb is being embraced by my medical peers. In March 2013, six months after I started on this, I knew of just one other doctor using the approach.

Imagine my delight to hear from the Royal College of General Practition­ers (where I am a clinical expert in diabetes) that 2,690 doctors have now accessed my low-carb e-learning module! One of these was the energetic Dr Ruth tapsell, a GP in the village of Hartland in Devon, featured in Good Health last tuesday. She said that my published results and success with low carb ‘was the most exciting medical discovery’ that she and her husband, Sam, also a GP, ‘had come across in years’.

In January, the most recent audit of all 161 patients with type 2 at her surgery showed that 32 per cent had reduced their blood sugars to below the threshold for type 2 after going low carb.

‘ Most have reduced the medication they are taking and some are drug free,’ said Dr tapsell. ‘ We’re now one of the lowest prescribin­g GP practices for type 2 diabetes drugs in our region.’

In the meantime, the evidence in support of low carb mounts — recently the BMJ published a major review of 23 studies that concluded with the good news that type 2 patients adhering to a lowby

carb diet for six months ‘ may experience remission . . . without adverse consequenc­es’. I’ve seen the benefits in my own practice. Some of you may remember from previous series I’ve published in the Mail that I have helped care for the same population of 9,500 patients since 1986 when we had just 57 patients with type 2 diabetes; now there are 473, an eightfold increase.

until 2012, I prescribed everincrea­sing amounts of drugs for type 2, but the medication seemed to be more of a sticking plaster than a real cure.

Then came my lightbulb moment: a patient walked in, having lost stones in weight and come off her type 2 diabetes medication. her secret? Going low carb.

That was the beginning and, as I sit at my desk today, nine years later, 93 of my patients have reversed their type 2 diabetes and are no longer on medication.

on top of this, 333 of my patients have lost an average of 11 kg (22 lb) in weight with improvemen­ts in their blood pressure, liver function and cholestero­l levels — results I’ve published in peer-reviewed journals, most recently in BMJ nutrition, Prevention & health last october. And despite concerns that people can’t stick to low carb, I know plenty of patients who have — for many, eating low-carb is now a lifestyle, rather than a diet they are on for a few weeks.

one of those in my low carb type 2 remission group has been doing it for eight years and this isn’t the record: my longest low- carb patient started years before me in 2003, and he is still on it, and in type 2 diabetes remission after 17 years!

PATIENTS NO LONGER NEED THEIR PLLS

AS LAURA Scruton, a low- carb success story, explains on the next page, she’s been doing it for nearly a decade and says she’ll ‘never go back’ to her old way of eating’. now in remission from her type 2, the 59-year- old says she’s feeling ‘ stronger, fitter, healthier and happier than ever’.

Thanks to success stories like this, against all national trends our GP practice now needs to prescribe fewer drugs for diabetes, saving us roughly £50,000 a year.

This is a small but exciting beacon of hope in a world grappling with the twin epidemics of diabetes and obesity. So what’s going wrong with our diets? essentiall­y, they are full of sugar and refined carbs, with the addition of poorqualit­y fats and a cocktail of preservati­ves, flavouring­s and emulsifier­s to give these foods a long shelf-life and make them tastier, so moderation becomes nearly impossible.

often the actual nutritiona­l value of these foods is so poor the manufactur­ers add vitamins to make them seem healthy. Breakfast cereals are a classic example.

These foods are designed to be moreish and for some people this can be a problem, as they essentiall­y become ‘addicted’ to sugar and carbs (I will explain this perhaps controvers­ial idea next week — but to see if this describes you, try the quiz here, which was developed at Yale university).

These types of foods are packed with ‘empty’ calories, and people are piling on the weight, and developing type 2 as a result.

So how does going low carb help? essentiall­y, people with type 2 have a problem dealing with sugar. our bodies respond to a sugary meal by producing the hormone insulin, which pushes the extra sugar into muscle cells for energy. excess sugar is also pushed into belly fat and the liver where it’s converted into fat, contributi­ng to obesity and fatty liver.

This can result in weight gain and the insulin the body produces becoming less effective. As a result, sugar builds up in the blood over time, damaging small blood vessels in vital organs, such as the kidneys, eyes and even the heart.

YOU BURN FAT AND FEEL LESS HUNGRY

So IT makes sense to avoid sugar. Yet many people don’t realise that this isn’t just about sugar in your tea or biscuits — it includes starchy carbohydra­tes such as pasta, rice and bread.

That’s because starch is actually made up of glucose molecules ‘holding hands’; so when your body digests these carbs, this produces sugar — sometimes in surprising­ly large quantities. For example, a small bowl of boiled rice (150g) can raise your blood sugar by approximat­ely the same extent as ten teaspoons of table sugar.

now carbs are not inherently ‘bad’ but if you have type 2 and a problem metabolisi­ng sugar, then it makes sense to cut down or avoid these as much as possible.

Some people worry that without sugar or carbs they won’t have enough energy — it’s true, the body does need a small amount of sugar, but this can be made out of protein or fat by the liver (and note, low carb does not mean no carb — there are carbs in the berries, pulses and vegetables that you eat on low carb).

But, also, rather like hybrid cars, we have a dual-fuel engine and can burn either glucose or fat for

TURN OVER TO SEE THE INCREDIBLE RESULTS

energy. Fat is actually a more concentrat­ed energy source than sugar, providing nine calories per gram compared to four. Knowing this, you might wonder why an obese person is still hungry?

My average patient with type 2 diabetes weighs nearly 16 st (100 kg) and despite having more than a month’s supply of energy on board as fat, they are hungry for every meal and snack.

This is due to insulin. Because of its imperative to reduce blood-sugar levels, when you eat a high-carb diet insulin blocks your ability to burn fat, preferring sugar for fuel. This explains why for decades I was always hungry, no matter how many biscuits I ate and despite the fat stored in my ‘middle-aged spread’. Going low carb meant I was able to become a ‘fat burner’, burning both the fat stored in my belly and from my food.

For so many of my patients, a low-carb diet has resulted in less hunger as they start burning their own fat.

Luckily even after cutting carbs there are lots of delicious ingredient­s left, such as the foods you find in the recipes in today’s Mail, continued all next week. For going low carb doesn’t mean you miss out, you can still enjoy meat, fish (including smoked salmon), eggs, full-fat dairy (such as Greek yoghurt, cheese and even cream), nuts, green veg, and lower sugar fruits such as raspberrie­s or strawberri­es. And the beauty of low carb is that it can help other health problems, too.

In the early days I worried that advising my patients to enjoy butter, eggs, meat, and full-fat dairy might have adverse effects, so I measured all the factors I could think of related to both metabolic and heart health — weight, waist circumfere­nce, cholestero­l (‘bad’ LDL and ‘good’ HDL cholestero­l) and particular­ly triglyceri­de (a fat produced in the liver), liver function and blood pressure. I was astonished (and relieved) to find significan­t improvemen­ts in all these. An important review of studies, by researcher­s from John Moores University in Liverpool in 2019, published in Nutrition Reviews, concluded: ‘Large randomised controlled trials of at least six months duration with carbohydra­te restrictio­n appear superior in improving lipid markers when compared with low-fat diets’. In other words, people on a low-carb diet had improved cholestero­l and triglyceri­de levels.

And then there’s high blood pressure, sometimes known as a silent killer because you don’t notice its effects until too late. I have seen improvemen­ts in blood pressure

in 196 low-carb patients as their average blood pressure improved from an average reading of 143/84 (‘high’) to 130/77 — which is a normal level (our results were published in the Internatio­nal Journal of Environmen­tal Research and Public Health in 2019).

I have also been surprised by how many of my patients have noticed an improvemen­t in mood and levels of anxiety as their diet improves. Now of course, low carb is not by any means the only effective approach and it may not suit everyone, but it is a viable approach and organisati­ons such as the American Diabetes Associatio­n are acknowledg­ing this fact.

There are other ways to improve your type 2 diabetes, such as regular exercise — and very low-calorie diets as devised by Professor Roy Taylor at Newcastle University. For some, stomach-reducing surgery is effective. The point is to find the bestoption for your needs to help you lose weight effectivel­y.

For me there is no doubt about the potential health benefits that cutting sugar and starchy foods can offer. And if you’d like to lose weight and improve your health while still eating the most delicious food, then this is the series for you. DiSCLAiMer: Always consult your GP if you have any health concerns, and particular­ly if you are on prescribed medication­s, before embarking on any diet.

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