The Eatwell Guide, a policy tool in the UK used to define government recommendations on eating healthily and achieving a balanced diet, currently advises the public to “base meals on potatoes, bread, rice, pasta or other starchy carbohydrates”. It’s clear that—in an overweight population such as the UK—eating foods that promote insulin secretion is likely to increase the risk of worsening insulin resistance and hasten the onset of type 2 diabetes. Yet, recommending lots of carbohydrates with every meal does just that!

Disturbingly, both Diabetes UK and NHS websites prioritise the consumption of starchy carbohydrates for type 2 diabetics. This seems to be completely illogical and the opposite of what should be recommended in order to halt the ever-increasing rates of obesity and type 2 diabetes. Such diets likely lead to progressive worsening of the disease with all its associated complications, such as blindness, kidney failure, nerve damage, peripheral vascular disease, heart disease and stroke.

On the other hand, a diet that doesn’t rapidly increase blood glucose and doesn’t provide too much carbohydrate to the body will help reduce the risk of worsening insulin resistance, and could actually improve it…

All carbohydrates metabolise into glucose in the blood, so as Dr David Unwin asks in the book, Diabetes Unpacked:

“If type 2 diabetes is largely about sugar, why should people with diabetes take in ‘concentrated sugar’ that is in starchy foods such as bread, pasta or rice?”

The low-carb, high-fat (LCHF) diet seriously reduces the amount of carbohydrate in the diet, typically by avoiding the consumption of high glycemic index foods—mainly bread and baked products, sugar, rice, grains and cereals, potatoes and starchy root vegetables. Adherents are also advised to avoid all processed foods and to concentrate their inputs on healthy fats and protein.

The vanguard of the LCHF movement in the UK is the Public Health Collaboration (PHC), a charity supported by clinicians, nurses, dieticians and LCHF enthusiasts. The organisation’s Healthy Eating Guidelines is a full exposition of the benefits of a LCHF diet, and it recommends that carbohydrates should be from real foods with a carbohydrate density of less than 25% (i.e. less than 25g carbs per 100g of food).

A recent comprehensive review concludes that dietary carbohydrate restriction is the “single most effective intervention for reducing all of the features of the metabolic syndrome” and should be the first approach in diabetes management. In terms of efficacy and cost, the low-carb lifestyle is a game changer that enables the majority of sufferers to take charge of their own condition, control their blood sugar levels by diet restriction and dramatically reduce the cost of medication and medical complications that would otherwise be inevitable.

As an example, a GP practice run by Dr David Unwin (RCGP clinical expert in diabetes, and NHS Innovator of the Year 2016) has pioneered offering patients the lower carb diet as an option to starting lifelong medication for type 2 diabetes. This resulted in improved HbA1c levels, other health benefits and significant savings in drug spend.

The very promising results obtained by LCHF lifestyle changes in combating the complications of the disease are becoming much better known, spearheaded by websites such as Diabetes.co.uk, with over 400,000 users registered for their online Low Carb Program, and DietDoctor.com, a Swedish site with over 500,000 subscribers worldwide.

Recently, restricted carbohydrate diets have been accepted by the NHS as a valid approach to controlling diabetes and The Low Carb Program app, produced by Diabetes.co.uk is available from the NHS app library.

In the last few years, LCHF has become much more established and has gained significant credibility worldwide. For instance:

• Recent BBC documentaries such as The Truth about Carbs‍
• Prominent restaurateur Giancarlo Caldesi just launched a cookbook, The Diabetes Weight-loss Cookbook.
• American Diabetes Association are recognising the importance of lifestyle (diet and exercise) in preventing and delaying type 2 diabetes.
• In South Africa, recent high-profile legal cases against Professor Noakes (which he won) have boosted publicity for the low-carb approach (known more commonly in the region as “The Banting Way”). The Lose It! magazine is on widespread circulation in the country. Food stuffs to support it are available in mainstream shops.

The low-carb lifestyle has been proven to be very effective at bringing diabetes and other chronic conditions into remission, aiding significant and sustainable weight loss and restoring good health and vitality. However, the lifestyle needs to be maintained to ensure continuing benefits.

In an era where there has been a huge increase in dependence on high-carb, pre-prepared food and takeaway food, maintaining the LCHF diet in practice means preparing everything from scratch in order to be certain of the contents. The absence of bread and baked goods in LCHF is particularly challenging, as the dependence on the convenience of sandwiches is ingrained into our food culture in the UK, as well as bread being a basic staple food.