Another local meeting

Durnstein, October 2012

I continue to attend meetings of the grumpiest Diabetes UK local group, purely because of the occasional useful speaker. This time they had advertised a talk about 'The D-Diet', so I arrived nice and cynical, with my Diabetes Dietitian hat on, ready to do battle with some nutter with a passion for some crazy diet or other.

In fact I couldn't argue with the lecture in terms of nutrition. The speaker was from an animal welfare charity, which had clearly done their research and realised that their target audience could include people with diabetes as well as animal lovers - the diet for diabetics being advocated was vegan. And not just vegan food, but low-fat vegan food. And not just low-fat vegan food, but low-fat, low-glycaemic index (GI) vegan food.

It's usually possible to sustain a healthy vegan diet, forsaking all animal products including meat, dairy, eggs and even honey. A vegan diet is by definition low in saturated fat, and generally high in fibre, so low-fat and low-GI aren't too hard to achieve unless you go crazy with veggie burgers and banana fritters. The main nutritional risks are likely to be deficiency in vitamin B12, iodine, vitamin D and omega-3 essential fatty acids.

• B12 is only found naturally in animal products, although there are some fortified foods like marmite, so supplements are often needed. 
• Iodine is mainly in seafood - salt used to be fortified, but nowadays in the UK it isn't, so many people are deficient in iodine, and not just vegans. Green leafy vegetables and seaweeds like kelp are recommended vegan sources.
• Vitamin D is a hot topic for all of us, because the cancer campaigners have been so successful in persuading us to cover up, stay out of the sun and use high factor sun blocking products. This has helped no end in reducing the incidence of skin cancer, but the main source of vitamin D is from sunlight, so deficiency isn't just a vegan problem. A bit of safe exposure to sun, plus fortified foods and supplements are the answer.
• The omega 3 essential fatty acids are mainly found in fish, but also seeds and nuts and some marine algae - I'm not sure whether vegans consider algae to be animals or not.

I'm sure that a low-fat, low-GI vegan diet would be beneficial in terms of blood glucose control and cardiovascular health for most people, whether Type 1, Type 2, or not diabetic at all. With my cynical hat on, however, I think the main benefits would arise from weight loss due to the difficulty of working out what on earth to have for dinner, and then packing enough calories into a diet of wholewheat grains and high-fibre pulses, vegetables and fruit (but only low-GI vegetables and fruit). It would challenge a committed animal lover who had an active interest in food. The idea of anyone in this audience, mostly aged 60 and upwards, changing their diet to beans, tofu and kelp - with a sprinkling of hemp and linseeds on their natural oat cereal, then tucking into their Quorn and bean dinner and soya dessert - well, let's just say it seems very unlikely.

I think the audience probably agreed with me, because the questions at the end weren't really questions. One lady said she'd been a vegetarian nearly all her life, and she had still developed Type 1 diabetes, although she acknowledged that maybe it had arrived later in her life than it might have. Another man advised the speaker to read New Scientist magazine, because there were much more helpful developments towards curing diabetes in that publication. A third claimed that Type 2 diabetes had much more to do with genetics than lifestyle, and told someone else in the audience to 'shut up' when they tried to interrupt. They really are an unattractive bunch. And still nobody has voluntarily talked to me, or asked me my name or what I do for a living.

The group committee are going to ask the members for feedback about how we find the meetings, and what kind of activities or speakers are wanted. I haven't yet decided what I might say.