Public Health Collaboration – Frequently Asked Questions
Why are your services free?
We are funded by individual members of the public who want to help the UK become healthier and save the NHS money. This enables us to provide our services, such as patient meetings, to the NHS for free.
Where can I confirm your findings about the UK public health statistics?
You can confirm our findings on the NHS Digital and Diabetes UK websites.
Where can I confirm your findings about the UK population’s eating habits?
You can confirm our findings on the government website.
Where can I confirm your findings about the authors of the Eatwell Guide?
You can confirm our findings in the peer-reviewed journal British Journal of Sports Medicine in the editorial titled “Designed by the food industry for wealth, not health: the Eatwell Guide” by Dr Zoe Harcombe PhD.
The Real Food Lifestyle includes butter, doesn’t this cause cardiovascular disease?
Many meta-analyses and studies over the past several years have repeatedly shown that saturated fat is not associated with cardiovascular disease:
– “Intake of saturated fat was not associated with an increased risk of coronary heart disease, stroke, or cardiovascular disease.” https://doi.org/10.3945/ajcn.2009.27725
-“Saturated fats are not associated with all cause mortality, cardiovascular disease, coronary heart disease, ischemic stroke, or type 2 diabetes.” https://doi.org/10.1136/bmj.h3978
-“Dietary fat guidelines have prevailed for almost 40 years. The evidence base at the time of their introduction has been examined for the first time and found lacking. Evidence currently available provides no additional support.” http://dx.doi.org/10.1136/bjsports-2016-096734
-“Total fat and types of fat were not associated with cardiovascular disease, myocardial infarction, or cardiovascular disease mortality, whereas saturated fat had an inverse association with stroke.” http://dx.doi.org/10.1016/S0140-6736(17)32252-3
-“Large randomized controlled trials of at least 6 months duration with carbohydrate restriction appear superior in improving lipid markers when compared with low-fat diets.” https://doi.org/10.1093/nutrit/nuy049
If butter doesn’t cause heart disease, what does?
Increasing evidence shows that sugar and refined carbohydrates are responsible:
“When saturated fats are replaced with refined carbohydrates, and specifically with added sugars (like sucrose or high fructose corn syrup), the end result is not favorable for heart health.” https://dx.doi.org/10.1016%2Fj.pcad.2015.11.006
The Real Food Lifestyle looks expensive?
No. Healthy eating can be just as cheap or as expensive as unhealthy eating. For instance a portion of carrots is 6p, a portion of broccoli is 12p and a portion of pork chops is 64p. This totals 82p for a real food meal, and if you’re still hungry a portion of mixed nuts is 58p.
In addition, feel free to refer to our Real Food Real Budget flyer for a full list of real foods and their prices. If you lost the copy you were given you can always download it in PDF format from our website. www.PHCuk.org/booklets
Why is The Real Food Lifestyle For Weight Loss a low-carbohydrate diet?
The most recent meta-analysis shows that not only do low-carbohydrate diets of real food result in better weight loss but also result in better health outcomes:
• “Compared with subjects on low-fat diets, subjects on low-carbohydrate diets experienced significantly greater weight loss, greater triglycerides reduction and greater increase in HDL-cholesterol after 6 months to 2 years of intervention.” https://doi.org/10.1017/S0007114515004699
Also, our own research shows that low-fat diets have never significantly outperformed low-carbohydrate diets in 67 randomised controlled trials. Whereas low-carbohydrate diets have significantly outperformed low-fat diets in 36 out of 67 randomised controlled trials. https://www.PHCuk.org/RCTs
Can a low-carbohydrate diet of real foods help with type 2 diabetes?
Yes. The most recent meta-analysis found that low-carbohydrate diets were more effective than low-fat diets in improving weight, HbA1c, HDL cholesterol and triglycerides. https://doi.org/10.3390/nu12072005
Also, our own search of the scientific literature shows that low-fat diets have never significantly outperformed low-carbohydrate diets for HbA1c reduction from of 17 randomised controlled trials. Whereas low-carbohydrate diets have significantly outperformed low-fat diets 10 out of 17 randomised controlled trials. www.PHCuk.org/T2D
Can healthcare professionals working within the NHS advise low-carbohydrate diets?
Yes. The NICE guidelines for type 2 diabetes state under guideline 1.3.6:
“Individualise recommendations for carbohydrate and alcohol intake, and meal patterns.” https://www.nice.org.uk/guidance/ng28/chapter/1-Recommendations#dietary-advice-2
Diabetes UK also published a position statement in 2017 that supported low-carbohydrate diets for individuals living with type 2 diabetes:
“The current evidence suggest that low-carb diets can be safe and effective for people with Type 2 diabetes. They can help with weight loss and glucose management, and reduce the risk of cardiovascular disease. So, we can recommend a low-carb diet for some people with Type 2 diabetes.” https://www.diabetes.org.uk/Professionals/Position-statements-reports/Food-nutrition-lifestyle/Low-carb-diets-for-people-with-diabetes
The Royal College of General Practitioners has a 30 minute e-learning module called “Type 2 Diabetes – a Low GI Approach” developed by Dr David Unwin. http://elearning.rcgp.org.uk/t2diabetes
Dr Unwin has also published his practice’s results in the BMJ Nutrition, Prevention & Health titled ”Insights from a general practice service evaluation supporting a lower carbohydrate diet in patients with type 2 diabetes mellitus and prediabetes: a secondary analysis of routine clinic data including HbA1c, weight and prescribing over 6 years”. http://dx.doi.org/10.1136/bmjnph-2020-000072
The British Journal of General Practitioners published an article titled “Adapting diabetes medication for low carbohydrate management of type 2 diabetes: a practical guide”. https://doi.org/10.3399/bjgp19X704525
In July 2021 a group of specialist dietitians and medical practitioners supported by the British Dietetic Association and Diabetes UK published a narrative review in the Journal of Human Nutrition and Dietetics “low carbohydrate diets, if appropriately supported, are considered safe and should not be avoided in suitable individuals who find these approaches acceptable.” https://doi.org/10.1111/jhn.12938
Diabetes.co.uk’s Low Carb Program is on NHS Apps (https://apps.beta.nhs.uk/low-carb-program/) which can also be commissioned at either practice or CCG level. https://www.lowcarbprogram.com/nhs/
Finally, if you would like formal training in how to advise low-carbohydrate diets for patients living with type 2 diabetes we can recommend the NHS educator charity X-PERT Health. https://www.xperthealth.org.uk/