Bonkers GP appointment

LtEve

pmc.ncbi.nlm.nih.gov/articles/PMC3882489/

An interesting research paper on this subject.
I would imagine it would be common sense to think that eating a salad before a meal would reduce subsequent intake of food. It was one of the things discussed when I did the Zoe trial.

But that's how I eat anyway!

This evening I've had grilled chicken with sun-dried tomatoes, sauted mushrooms with cauliflower, tendersweet brocolli and steamed baby spinach (no starchy carbs and the only carbs were in the tomatoes and veggies). I then had blueberries, strawberries and a dollop of creme fraiche. The biggest carb load was from the berries.

Surely most people eat their "sweet stuff" at the end of their meal. Just avoid fruit juice as a starter.

I don't understand what they mean about veggies before carbs. Veggies are made up of carbs! What they really mean is starchy carbs - quite honestly, diabetics or pre-diabetics would be wise to cut them down anyway.

I was just about to post that eating a salad before your meal is part of the Zoe programme. I found all the suggestions on the programme very helpful.
There is a freely available Zoe podcast and a book, Food for Life by Tim Spector. He's a professor at King's College, University of London, his talks are fascinating and full of useful information.

Was it actually a doctor you saw? Could it have been someone not medically qualified?
Either way I can't see the harm in eating more salad. I suppose T2 diabetes is a result of being overweight and if you fill up with salad there's less room for other more fattening stuff.
As to the qrisk, mine is very high, not to do with cholesterol but my other health conditions. Statins seem to be emerging as beneficial in all sorts of ways so I take them.

Notagranyet24

I was just about to post that eating a salad before your meal is part of the Zoe programme. I found all the suggestions on the programme very helpful.
There is a freely available Zoe podcast and a book, Food for Life by Tim Spector. He's a professor at King's College, University of London, his talks are fascinating and full of useful information.

She did mention Zoe. I used to watch Tim Spector during Covid- he talked a lot of sense.

I might have joined the Zoe programme but found it too expensive.

Yes, RedRidingHood she was a proper GP.

She admitted the QRisk thing was a government algorhythm, she seemed very tech and media savvy.

I just said I needed more info before starting statins- which is why I'm having my bloods done again.

Although they recommended my starting them she admitted they hadn't checked my cholesterol for over a year.

I think it's wise to ask questions and to question what you're told. I take my health very seriously.

I often do a salad starter and have done for years. Especially if the meal doesn't contain much veg in itself such as spaghetti bolognese, curry, etc. Our breakfasts start with some sort of fruit - grapefruit, blueberries, or even prunes. It helps keep you over your '5 a day' !

RedRidingHood

Was it actually a doctor you saw? Could it have been someone not medically qualified?
Either way I can't see the harm in eating more salad. I suppose T2 diabetes is a result of being overweight and if you fill up with salad there's less room for other more fattening stuff.
As to the qrisk, mine is very high, not to do with cholesterol but my other health conditions. Statins seem to be emerging as beneficial in all sorts of ways so I take them.

RedRidingHood No, no, no! T2 diabetes is not necessarily the result of being overweight! I was diagnosed in my mid 30s and I have never been overweight. I get fed up with people assuming that all T2 diabetics are fat and lazy.

Of course eating more salad isn't going to do anybody any harm. What I object to is that OP wasn't given some real advice about preventing her pre-diabetes progressing to T2. Does she need to lose weight? Does she need to do more exercise? Does she need more sleep? Does she need to eat fewer starchy carbs? Does she need to drink less alcohol? How will she know whether any lifestyle changes are working?

Jessie Inchauspé isn't a nutritionist, but she has books and supplements to sell and I guess she probably earns a fair amount from her media work. It's based on dodgy science and lots of claims which just aren't new.

Eating a few salad leaves before every meal is a fad. How many people are seriously going to keep that up for life? It'll go the way all other fads do eventually - but not before some snake oil saleswoman has made a lot of money out of it.

Trixi

I often do a salad starter and have done for years. Especially if the meal doesn't contain much veg in itself such as spaghetti bolognese, curry, etc. Our breakfasts start with some sort of fruit - grapefruit, blueberries, or even prunes. It helps keep you over your '5 a day' !

But fruit doesn't count in the JI recommendations. Grapefruit and prunes are full of sugar.

growstuff

RedRidingHood

Was it actually a doctor you saw? Could it have been someone not medically qualified?
Either way I can't see the harm in eating more salad. I suppose T2 diabetes is a result of being overweight and if you fill up with salad there's less room for other more fattening stuff.
As to the qrisk, mine is very high, not to do with cholesterol but my other health conditions. Statins seem to be emerging as beneficial in all sorts of ways so I take them.

RedRidingHood No, no, no! T2 diabetes is not necessarily the result of being overweight! I was diagnosed in my mid 30s and I have never been overweight. I get fed up with people assuming that all T2 diabetics are fat and lazy.

Of course eating more salad isn't going to do anybody any harm. What I object to is that OP wasn't given some real advice about preventing her pre-diabetes progressing to T2. Does she need to lose weight? Does she need to do more exercise? Does she need more sleep? Does she need to eat fewer starchy carbs? Does she need to drink less alcohol? How will she know whether any lifestyle changes are working?

Jessie Inchauspé isn't a nutritionist, but she has books and supplements to sell and I guess she probably earns a fair amount from her media work. It's based on dodgy science and lots of claims which just aren't new.

Eating a few salad leaves before every meal is a fad. How many people are seriously going to keep that up for life? It'll go the way all other fads do eventually - but not before some snake oil saleswoman has made a lot of money out of it.

I agree with all of this.
There is a tendency for diabetes in my family history- so one professional told me there may be nothing I can do, I may get diabetes anyway. Same with the statins- we will all get higher cholesterol as we age.

I have been pre-diabetic for over ten years. The first thing was to send me on a course, government funded that was supposed to last a few months (time to monitor change) but ended after only two sessions and I was not told why. I suspect they pulled the funding.

Then I was offered a health 'coach' at my GP. I saw her several times but became frustrated as she couldn't offer advice, only say she would support the choices I made.

The GP I saw had also referred me back to the 'coaching' but I told her it was useless and she just said well don't go then. I do wonder how much these 'coaches' get paid. They have no medical qualifications and are not nutritionists or counsellors. They have certificates in 'coaching' whatever that means.

Yes, I am mildly overweight and have become lazy and don't eat properly. This is mainly due to the enormous stress I have in my family life, but I am making excuses. I am relatively fit, but getting old and that's the reality we all have to face.

I agree the salad thing is a fad- but maybe I am feeling vulnerable and anxious and so we cling to these suggestions, for me it seems easy so I just had a little salad left over from last night!

Thank you for all your contributions- I am learning a lot!

If you haven't got worse in ten years, all you probably have to do is tweak things a bit - nothing drastic.

I have no idea what you eat, but cut down on starchy carbs. Summer is the ideal time to eat salads. Try to move after eating - even if it's just running on the spot or getting some weights and doing a few curls while you're waiting for the kettle to boil.

I wouldn't be so fatalistic about diabetes. Good luck!

Trixi

I often do a salad starter and have done for years. Especially if the meal doesn't contain much veg in itself such as spaghetti bolognese, curry, etc. Our breakfasts start with some sort of fruit - grapefruit, blueberries, or even prunes. It helps keep you over your '5 a day' !

I do the same sort of thing Trixi, when I’m feeling in a healthy frame of mind.

Just a side note: no grapefruit if you’re taking statins, they don’t mix!

Keepingquiet
Was your government course Second Nature?
I love their stuff. Chocolate coated things for dessert or snacks, adding cream to fresh fruit, or cream and butter to cauliflower.
Great.

normally eat without cream because it’s healthier

Mollygo

Keepingquiet
Was your government course Second Nature?
I love their stuff. Chocolate coated things for dessert or snacks, adding cream to fresh fruit, or cream and butter to cauliflower.
Great.

normally eat without cream because it’s healthier

I like the "Second Nature" plan too. I came across it online and it's more or less what I've been doing for years. I don't need to lose weight, although it helps keep my blood sugar stable.

Mollygo

Keepingquiet
Was your government course Second Nature?
I love their stuff. Chocolate coated things for dessert or snacks, adding cream to fresh fruit, or cream and butter to cauliflower.
Great.

normally eat without cream because it’s healthier

No- it wasn't promoting anything. They gave you info on the causes of diabetes, info on food and diet- it was very interactive and some people there were very shocked about what they had considered healthy food.

The Second Nature stuff doesn't sound at all healthy to me.

keepingquiet

Mollygo

Keepingquiet
Was your government course Second Nature?
I love their stuff. Chocolate coated things for dessert or snacks, adding cream to fresh fruit, or cream and butter to cauliflower.
Great.

normally eat without cream because it’s healthier

No- it wasn't promoting anything. They gave you info on the causes of diabetes, info on food and diet- it was very interactive and some people there were very shocked about what they had considered healthy food.

The Second Nature stuff doesn't sound at all healthy to me.

Have you looked at the Second Nature site? I really liked it and picked up a couple of recipe ideas. For so long, the public has been sold the idea that dietary fat is bad, but it isn't. From a diabetic point of view, fat has no carbs and doesn't raise blood sugar. Obviously, it depends on the kind of fat and the quantities involved. Non-saturated fat and even a small amount of saturated fat is beneficial because it slows down digestion and makes you feel full for longer, thus avoiding snacking. It also has the advantage of helping the absorption of fat soluble vitamins A, D, E and K. One of the first tricks I learnt about eating with diabetes was to have a small amount of fat with a carby food - think baked potato with cheese, toast with butter, pasta in oil. All cause few sugar spikes than potato, toast and pasta on their own.

keepingquiet if I was in your position I'd want a base line blood test before changes.

Could you call the surgery and ask for a full blood count? I told reception that idseen Dr X and wanted to implement changes so could I have this done.

He called me back to say he had left a form at reception.
Suggested I come back in two or three months for another.

PS it definitely included at least some vitamin levels Iron, D etc

I had a FBC- that's why I went to see the GP. The only thing not done was my cholesterol so I'm having that done next week.

My cholesterol and blood sugar were high. I started fasting and within 18mths be blood sugar and cholesterol dropped to a healthy range.
I eat rolled oats every morning and have a 14 to 15 hour fasting window starting around 8pm (after my choc treats) the eat at 11am.
I also walk 40 minutes at least 5 days a week.

I heard so many negative things about statins I decided to try the pro-active ideas such as fasting and walking to avoid them.
Not sure about the salad although the five a day veg rule is a good one.

Good luck

Thanks Dorrain. I have done the fasting thing in the past but coudn't sustain it long term.

I also start my morning with porridge- I think the timings of your fasts are something I could do as I usually have my last meal around 7-8 pm.

I try to eat the 80% dark chocolate but it can be pricey.

I really need to get back to walking too, especially now the evenings are lighter. I am pretty active most of the time anyway.

I'm finding the salad helps me feel less hungry- I ate a small one about 45 minutes ago and forgot I haven't had any lunch yet. I even ordered a side salad as a started when I was out for lunch yesterday and didn't get any cravings.

My favourite hotel in Italy always serves a salad before the rest of the 3 courses- none of which are huge.

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There was a documentary on TV recently and I am sure the presenter/healthy diet guru advocated something very similar to what you were told by the GP. I will see if I can find the programme name.

I guess a salad does much the same but My daughter and I eat a helping of green veg on its own before our main meal, that is to help regulate blood sugar. I am diabetic, she is not . I take oral medication but I’ve been diabetic for 13 years and my levels are very well controlled

Well how do I manage this as at least three or four times a week a salad is part of my main meal. This evening I had poached salmon, baby potatoes and a massive salad of lettuce, spinach, tomatoes, cucumber, spring onion, radishes, mushrooms and more green leaves followed by stewed apple, no sugar just a spoonful of honey. Honestly I don’t fancy having a salad before my morning weetabix and berries. I’ve been a T2 diabetic for
25 years, unfortunately it runs in the family, my mother, brothers and sisters all the same. I managed very well for quite a few years with diet but as I’ve got older 88 I now have two tablets to keep my count level, my doctor is excellent and keeps a close check on me.

TwiceAsNice

I guess a salad does much the same but My daughter and I eat a helping of green veg on its own before our main meal, that is to help regulate blood sugar. I am diabetic, she is not . I take oral medication but I’ve been diabetic for 13 years and my levels are very well controlled

The advice from the (dodgy) Glucose Goddess is to have a leafy salad before every meal (including breakfast). It is not science-based. It has long been known that if you are diabetic, it's a good idea to eat anything loaded with carbs at the end of the meal because the digestive process is already in motion. That's very different from eating a green salad before every meal. The research was only based on 11 participants anyway.

The danger of glucose spikes in non-diabetics has been debunked by respected scientists. If your insulin is working properly, the spike won't last long. The problem is if you're diabetic and your BG remains high for much longer.

It's a fad from a non-scientist, who has books to sell and seems to have got herself on to TV. In any case, if you're diabetic and keeping blood glucose down really matters, it's not something to be done for a few months - it's for life.

keepingquiet If you're serious about keeping your blood glucose down, swap the porridge breakfast for an egg-based one. Some people can eat porridge without too much effect, but I can't. My blood glucose shoots up and stays up all day. I've experimented a few times with testing every two hours and the results are always the same. My breakfasts include scrambled egg on a big, grilled mushroom/poached egg on spinach and rye bread/boiled eggs/omelette/Greek yoghurt with nuts.

I have no intention of not enjoying my food, so I sometimes have something sweet at the end of a meal. One of my favourites is a mini chocolate brownie or home-made chocolate mousse.

I have no more than three small (20g) portions of starchy carbs a day, so rarely eat potatoes, rice, pasta, bread, pastry etc. I have healthy fats with most meals. I make dishes such as cauliflower cheese with cream rather than a flour-based sauce because it has fewer carbs. Half my plate is usually green veg anyway, so eating a salad beforehand would be silly.

Lifestyle changes are for life, so I make sure that I eat food I enjoy and don't feel deprived.

I get quite cross with faddy solutions because they're not sustainable and somebody is usually making money out of them.