Scottish Daily Mail

EAT TO BEAT DIABETES

Mouth-watering 4-page pullout that could transform your health

- by Dr DAVID UNWIN NHS DIABETES EXPERT

TODAY, in the third part of our groundbrea­king series, NHS GP Dr David Unwin reveals how going low-carb can have surprising health benefits, such as cutting your blood pressure, while chef and food writer Katie Caldesi offers more exclusive recipes.

WHEN I first started offering a low-carb approach to my patients with type 2 diabetes, my wife, Dr Jen Unwin, who is an NHS psychologi­st, and I also went on the diet. We were both possibly carrying a bit too much middle-aged spread and wanted to trim down. I also wanted to keep my blood sugar levels at a healthy level.

Every Monday night, Jen and I met the patients — there were 18 to begin with — to share our experience­s, support each other and try out simple low-carb recipes we prepared together.

On average the group lost one-and-a-half stone in weight, and four inches off our waists (I myself lost three) but there were some other surprises too. I started noticing that if I stood up too quickly, I felt dizzy.

One day on checking my blood pressure — which had previously been high — I was astonished to find it was now in the ‘normal’ range (my reading was 130/80) for the first time in ten years. My previous average had been 160/90.

When I checked the others, nearly all of the group had also significan­tly improved their blood pressure and several patients were even able to come off their blood pressure medication, in some cases after many years.

MEANWHILE, Jen also experience­d dizziness and some weakness if she got up too quickly — she found it necessary to add extra salt to her food to help rectify this. She had always had low blood pressure and on low-carb, it became too good!

A second surprise was how the patients’ levels of ‘bad’ blood fats such as LDL cholestero­l (linked to heart disease) also improved. This was particular­ly interestin­g given that they were eating more full-fat dairy such as yoghurt, butter and cream.

Six years later I’ve seen similar results with hundreds of patients. At the time of writing I have a research group of 257 patients who have been low-carb for an average of nearly two years. One patient has lost 5½ stone (36kg), while the average weight loss is 21lb (9.4kg).

Their blood pressure reading and ‘bad’ fats levels have also improved, as a study I’ve published in the Internatio­nal Journal of Environmen­tal Research and Public Health shows. The research paper, which was written with the help of two senior cardiologi­sts, looked at 154 of the patients (the ones who had raised blood sugar levels).

These patients had been on 168 regular prescripti­ons for their high blood pressure — but thanks to going low-carb, their blood pressure improved significan­tly. Indeed, around a fifth (21 per cent) of the prescripti­ons were stopped. This is very unusual. People are normally on these medication­s for life.

To be frank, these blood pressure results particular­ly astonished me.

But then, when I looked back through the medical research, I found that evidence has been building for 20 years now that sometimes a diet heavy on carbs can cause the body to retain salt. That’s because of the effect that the hormone insulin has on the kidneys (carbs, as we now know, can raise insulin levels).

Insulin causes salt retention by the action of the kidneys in people with diabetes. This salt in its turn causes fluid retention and higher blood pressure. So when some people give up carbs, their insulin levels reduce.

They start urinating more than usual. That’s because their bodies are getting rid of the salt that their previously sugary diets had caused them to retain, which helps explain why their blood pressure improved and in some cases also their swollen ankles.

A few months ago a 66-year-old patient of mine lost 11lb (5kg) in just seven days.

This must have been mainly water. His blood pressure improved significan­tly so I needed to reduce his medication (which illustrate­s why it’s so important that people

on prescribed medication should d iscuss s ignificant d ietary c hanges w ith their doctor).

Then l ast w eek I s aw h im a gain a nd h e was wearing shorts. His previously severely s wollen a nkles h ad g one a nd h e is so proud of his now slim ankles he was happy to show them off. The same study of 154 patients also showed significan­t improvemen­ts in cholestero­l and triglyceri­de levels.

This was another surprise but again research backs this up. Last year, a major s cientific r eview l ed b y r esearchers at John Moores University in Liverpool found that low-carb was better for lowering cholestero­l and triglyceri­des than low-fat diets.

In fact, this is no surprise really, as excessdiet­arysugartu­rnsintoafa­t(triglyceri­de) in the liver.

While most people know that cholestero­landtrigly­ceridesare­badnews,perhaps we also should be wary of the hormone i nsulin, a nd b y ‘ we’ I d on’t j ust mean people with type 2 diabetes.

Increasing­lyit’semergingt­hatthishor­mone is central to many of our m odern problems – and not only type 2 diabetes, o besity a nd f atty l iver d isease. On top of this there is mounting e vidence that links insulin and obesity with cancer, high blood pressure and heart disease. Quite a list.

Insulin is a hormone produced by the pancreas: its job is to keep blood sugar low b y p ushing g lucose o ut o f t he b loodstream­andintocel­ls.Inthecaseo­fmuscle cells, the glucose is a source of energy b ut i f d ay a fter d ay y ou c onsume more glucose than needed, the excess sugarcanbe­pushedinto­othercells­where it becomes fat.

In the liver the excess sugar is c onverted i nto t riglycerid­e, w hich b uilds up o ver t ime, c ausing f atty l iver d isease, which in turn can lead to type 2 diabetes, liver scarring and even liver failure.

The good news is that much of this can be reversed. This can be done in three ways: weight-loss surgery, a very low-calorie diet — or a low-carb diet.

But how can you make this diet work best for you and your lifestyle?

In tomorrow’s Daily Mail I’ll show you how t o m aintain a nd ‘ personalis­e’ a l owcarb diet to make it even easier.

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