Table 2

Promoting and supporting incremental low-carb experimentation

Reference NoInterview excerpt
2.01 I give more of a real-food stance to it. It’s having whole-foods and not processed-foods—they tend to be the lower carb foods really. (PN15)
2.02 I find out where they’re starting from. And most people, if you’re diabetic, if you’re type 2, if you’re obese, got fatty liver, high triglycerides etcetera, you’re gonna have a high-carb diet. And so when I ask them about what they eat, and it’s cereal and toast for breakfast, sandwiches for lunch, pizza for tea, pasta for tea, cakes and biscuits in between, beer. It’s quite easy to cut 50% of those carbs out and lose a lot of weight. (GP04)
2.03 I’m not asking people to do calorie-restriction, I’m not asking them to starve, I don’t want them to be hungry. ‘If you feel hungry, eat. Just don’t eat bread and potatoes!’ (GP22)
2.04 On the Weight Watchers programme I’d lost a bit of weight, and then when I switched to [low-carb] I rapidly lost 15 kilograms without trying, and for the first time in my life hunger left me. (GP24)
2.05 I ask patients ‘what foods do you think spike your blood glucose?’ (HC08)
2.06 [For weight-loss] ‘We need to get you into fat-burning mode, so to do that we have to get insulin down.’ (GP06)
2.07 So a simple chat about physiology, basic science, that makes sense. And then wow, the effect it has is tremendous. (GP24)
2.08 You sow the seeds, hopefully get them on board, agree to give it a try, maybe four weeks later we check an HbA1c—which is far, far quicker than any diabetic clinic would do it, but we’re noticing big changes after four weeks. And if you can say to somebody ‘look, your blood pressure’s better, your HbA1c’s dropped from 120 to 80 and it’s only four weeks in, that’s an astonishing improvement’. (GP14)
2.09 It’s about [patients] figuring out: how low can they go? what does that do for their blood sugar? I say ‘just go away and play detective for a week, here’s a blood sugar machine, write down everything […]. Do you want to push it further? If not, OK… (GP17)