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 super-quick, taking just 30 minutes or under to prepare from fridge to fork, using everyday ingredients!
Free eat to beat diabetes recipe pull outs all next week in the Mail
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 sig- nificant 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.
Free eat to beat diabetes recipe pull outs all next week in the Mail
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 low-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 eight-fold increase.
Until 2012, I prescribed ever-increasing 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 poor-quality 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).
SEVEN STEPS TO GET YOU ON THE ROAD TO GOOD HEALTH…
1. Reduce or eliminate sugar and starchy carbohydrate foods. These include breakfast cereals, bread, pasta, white potatoes, rice, crackers, oats, oat cakes, rice cakes, cakes, biscuits, sweets, milk chocolate, fizzy drinks and cordials.
2. Load up with vegetables at every meal. Use non-starchy and salad vegetables to help you to feel full. Adjust your consumption of root vegetables according to how strictly low carb you are planning to go.
3. Eat good fats. Include oily fish, olive oil, coconut oil, avocado and animal fats; they’re good for your metabolism and for helping you to feel full. Add nuts and cheese in moderation only — although they’re nutritious and tasty, they’re also highly calorific.
4. Opt for fruit naturally low in sugar. This includes pears, apples and berries. Choose these over high-sugar tropical fruits such as bananas, mangoes or pineapples.
5. Eat protein at every meal. It’s essential for all your body’s repair mechanisms and makes you feel fuller for longer.
6. STOP snacking. Fasting between meals and overnight helps to improve insulin resistance (where your cells can’t easily take up sugar from your blood). Aim for three good meals a day and stop.
7. DRINK two litres of water a day.
But, also, rather like hybrid cars, we have a dual-fuel engine and can burn either glucose or fat for
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 best option 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.
Laura Scruton has been on a low carb diet for over a decade
I’m free of medication and fitter than ever
Laura Scruton, 59, is a civil servant. She lives in Berwick-upon-Tweed, Northumberland, with her husband, and has a daughter, Bethany, 26. Laura says:
People say a low-carb diet isn’t sustainable, but ten years on, I’m proof it is.
When I think of the food I used to put in my body, I feel angry because it was making me overweight and ill — even though I considered it to be healthy.
I’d been vegetarian since the 1970s and a typical day would be start with porridge and banana; wholemeal bread sandwich for lunch, and tofu or beans with brown rice for dinner. I didn’t eat biscuits or sweets and barely drank alcohol.
Yet by my mid-40s I weighed 12st, far too much for my 5ft 2in frame.
I’d developed gestational diabetes while pregnant and eight months after Bethany’s birth I was diagnosed with type 2; I was 33. I tried medication such as metformin and gliclazide to control it, but to no avail.
I also took tablets for arthritis in my hands, plus statins (for a family history of heart disease).
My ill-health and side-effects from the pills took their toll. On Bethany’s 19th birthday, we went for a day at the races but I spent most of it in the car as I was so exhausted; due to my size or my medication, I’m not sure — but something had to change.
I’d tried dieting but would get hungry and irritable. Also, the weight would creep on again when I started eating normally.
In 2008, a friend at work mentioned low-carb. I tried it half-heartedly but in 2013, decided to do it properly. It was a revelation.
Ms Scruton no longer has to take medication for her diabetes or rheum arthritis and is fitter and healthier
The weight fell off quickly and I didn’t struggle with hunger as I was filling up with protein — I started eating meat again. Having been a size 16, I was a size 10 within months.
Now, I don’t eat breakfast because I’m usually not hungry. For lunch, I’ll have tuna mayo and raspberries with mascarpone and dark chocolate for dessert, for example. Dinner might be shepherd’s pie.
I’ve been a healthy 9st 4lb for more than seven years and I’ve so much more energy to the point it’s quite annoying! I regularly do 12-mile bike rides and have taken up online Zumba classes and resistance-band work. What’s more, I’ve not been on my old medication since 2015.
I thought I was heading for a life of being unwell and would be approaching my 60s hardly able to move. But I’m feeling stronger, fitter, healthier and happier than ever.
I’ve reversed type 2 and have bags of energy
Jacqui Conway Ross, 50, an NHS occupational therapist, lives in Southport, Merseyside, with husband Mike, 55, who has two children. She says:
When I started on low-carb I didn’t just shed pounds, my mood improved dramatically. For 20 years I had depression on and off but as I changed my eating habits it was like a cloud slowly lifting.
Back in 2018 I was so low that I had to go on sick leave and struggled daily. I was so tired that I cried if I had to move and couldn’t think straight.
Jacqui Conway Ross, 50, an NHS occupational therapist, lives in Southport, Merseyside, with husband Mike, 55, who has two children (pictured after losing one stone)
Ms Conway Ross pictured before weight loss
My psychiatrist thought I had treatment-resistant depression and suggested lithium, a much stronger drug than the antidepressant I’d been on for ten years. But I felt I wasn’t just depressed, so in November 2018 I went to my GP, Dr David Unwin. Blood tests showed I had type 2 diabetes, which surprised me as I was less than half a stone overweight.
Dr Unwin suggested a low-carb approach, which was very different from how I’d been eating, not least as I had a terrible weakness for biscuits. Within two weeks of going low carb my body and my mind felt very calm. I’m still on antidepressants but they manage my symptoms better.
At work, I can concentrate again and have bags of energy. I ride my two horses and walk about 20,000 steps daily.
I’ve gone from 11st 4lb with a BMI of 26.3, ‘overweight’, to 9st 12lb and a BMI of 22.9. ‘healthy’. I’ve also reversed my type 2, improved my mental health and got my life back on track.
I lost so much weight people didn’t even recognise me
Lisa Dwyer, 55, a teacher, lives on Merseyside with husband Sam, 49, and 18-year-old son. She says:
I am a sugar addict — once I eat it, I can’t stop and I pay the price in poor health and piling on the pounds.
In late 2019, I was horrified to find I was 19st — my heaviest ever. I was a size 22 and had weight-related problems like joint pain, irritable bowel syndrome (IBS), migraine, acne and type 2 diabetes.
Lisa Dwyer, 55, a teacher, lives on Merseyside
I’ve struggled with my weight since my 30s. I became pregnant with twins, but at 24 weeks, went into premature labour and my babies died in intensive care. They were just three days old. I ate and drank loads, trying to numb the grief.
Nine months later, I was pregnant again and my son arrived safely — but I struggled to lose the weight afterwards.
Ms Dwyer said: ‘In late 2019, I was horrified to find I was 19st’ (pictured)
In March 2019 I was diagnosed with type 2. By December I’d reached my heaviest, so quit eating sweets, chocolate and desserts and stuck to three meals a day and no snacks. Then I began to cut down on bread, pasta and potatoes. I felt good but looked the same.
In lockdown last March I contacted Dr Unwin for support. He asked me to join a Zoom low-carb group he runs with his wife Jen who is a psychologist, another GP, plus patients on a low-carb diet.
I started a low-carb diet with intermittent fasting — where you eat only within set times. Soon, I’d lost so much weight some colleagues didn’t even recognise me. Within eight months I’d reversed my diabetes and by November 2020, I’d lost nearly 6st — I’m 5ft 10in tall and my BMI has gone from 38, ‘obese’, to 25.3, just outside the ‘healthy’ range.
My IBS and joint problems have vanished, I sleep better, and have more energy. And, as obesity and diabetes are believed to put you at higher risk of dying from Covid, my low-carb regime may just have saved my life.
My wife’s so happy that I don’t snore anymore
Mike Worthy, 54, lives in Southport, Merseyside
Mike Worthy, 54, managing director of a textile import agency, lives in Southport, Merseyside, with wife Sally, 46, and their daughters, aged 14 and 12. Mike says:
For years, I kept my head in the sand about my size. I knew deep down I needed to lose weight — 18 months ago, I weighed 20st 7lb; I’m 5ft 10in. So my BMI was 41, ‘obese’ — but I still kidded myself I was OK.
I ate out a lot on business trips and enjoyed cooking big meals, but didn’t consider myself unhealthy. I swam three times a week, didn’t smoke and drank just eight units of alcohol a week. I called myself ‘portly’ rather than overweight and believed I ate well — lots of fruit and vegetables, Mediterranean-style meals with wholegrains, and all meals cooked from scratch. But I was also having a lot of carbs and loved chocolate, puddings, and crisps.
When I went to see my GP Dr David Unwin in September 2019 for a regular blood-pressure check he said it was getting higher, despite my medication. I was also within the pre-diabetic range. He suggested I try to go low carb and lose weight because if I didn’t, I was heading for more medical problems. It wasn’t easy to hear. But I swapped my usual breakfast — a couple of slices of toast with butter and marmalade or porridge, for berries, full-fat Greek yoghurt and coffee.
At lunch, instead of a sandwich I’d make an omelette or miso soup plus an apple and cheese.
For dinner, it was homemade curry packed with veg, or chicken stir-fry. I made fruit salad or dark chocolate mousse to follow.
I also exercised a lot, walking and taking up golf.
The weight fell off fairly quickly and I was able to ditch my hypertension medication as my blood pressure fell to a healthy level.
Mr Worthy has lost four stone following Dr Unwin’s low carb diet to reverse diabetes (pictured before weight loss)
Eighteen months on, I’ve lost 4st — I’m now 16st 7lb. My waist has gone from 40in to 36in, so I fit into trousers I haven’t been able to wear for years. My blood sugar is in the normal range again so I’m not pre-diabetic.
My family are delighted at the slimmer me and my wife is happy as I don’t snore anymore. I’m glad Dr Unwin had the guts to tell me I needed to lose weight — doctors sometimes skirt around it.
ARE YOU ADDICTED TO CARBS? TAKE THIS QUIZ TO FIND OUT…
THE following, adapted from the Yale Food Addiction Scale, is a tool developed by Yale University’s Rudd Centre for Food Policy and Obesity in 2009 to identify those who exhibit addictive symptoms with the consumption of foods.
Consider the following seven statements to see how many correctly describe your relationship with, in this instance, sugary or high-starch carbohydrate foods.
1. I HAVE cravings or a strong desire for the food.
2. I SUFFER more cravings and other physical symptoms of withdrawal if the food is not available. These symptoms are relieved by consuming that food.
3. I EAT the food in larger quantities, or for longer than I intended.
4. I WANT to cut down on my consumption or quit entirely but I find I am not able to.
5. I SPEND a lot of time obtaining or planning how to get the food.
6. I EAT the food consistently despite acknowledging that it brings me persistent physical or psychological problems or other harm aris- ing from it.
7. I NEED to eat increased amounts of the food to get the same desired satisfaction from it.