Eat to beat diabetes! Delicious ways to reverse type 2 and transform your health 

For anyone struggling with excess weight and type 2 diabetes, this low-carb plan — part of the Mail’s Good Health for Life series — could be life-transforming. Here, Dr David Unwin — the NHS GP behind it — explains how the plan works, while chef and food writer Katie Caldesi gives low-carb recipes, written exclusively for you, that take less than 30 minutes to prepare.

When I started as a GP in 1986, my practice had just 57 people with type 2 diabetes; 34 years later, with roughly the same number of people at the surgery, there are now 472 — that’s an eight-fold increase.

Alongside this, I have seen an epidemic of obesity. Of course, my practice in Southport, Merseyside, is hardly unique, with the global explosion in obesity and type 2 puzzling health experts worldwide. In the UK, nearly one in three people today is overweight or obese.

So what is going on? This cannot be genetic — people’s genes cannot change in just 35 years. It’s something about our environment that has changed. It’s our diet.

We’re told the fundamental cause of obesity is an imbalance between calories consumed and calories expended.

However, while the health benefits of exercise are generally agreed on, doctors increasingly suspect that losing weight is not one of them.

A major review published by The American Dietetic Association in 2007 concluded that exercise alone leads to minimal weight loss. Why is this?

The first problem is the length of time it takes to ‘exercise off’ the food you probably should not have eaten. For example, burning off a 300-calorie hamburger would take about 75 minutes of walking. It’s also possible that exercise makes some people hungrier, so calorie burning could be cancelled out, or worse, by what they then eat.

So if exercise is not the answer, is it calorie restriction?

When it comes to type 2 diabetes there is no doubt that a very low-calorie diet can help, as the groundbreaking work of Professor Roy Taylor at Newcastle University has shown.

In this case, rapid weight-loss and the reversal of type 2 diabetes is brought about by drinking specially devised shakes for eight weeks.

A low-carb approach offers another way to tackle type 2 that has the advantage of being a lifestyle change that many people find they can keep up.

It’s not about calorie counting, but choosing delicious foods — like those featured in Katie Caldesi’s recipes in the Mail this week — that help you maintain your energy levels and lose weight without feeling hungry.

And this is why so many of my patients who have tried cutting sugar and starchy carbs have stuck to it. To date, 279 of them (142 have type 2) have stuck to a low-carb approach for an average of two years.

Many of the early adopters of the diet, such as Chris Hannaway (whose story was told in Saturday’s Mail) are still on it after six or seven years.

In fact, Chris would describe it as a permanent lifestyle choice rather than just a diet. Katie and her husband and chef Giancarlo would agree — the Caldesis have been low carb for a total of six years now.

One of the reasons people are able to stick to the diet is because low carb can be satisfying and fend off hunger.

When we first started doing low carb, we were amazed how many of our patients reported reduced appetite.

There is research to support this — a 2011 study in the journal Obesity that looked at appetite in 270 obese patients allocated to either low-carb or low-fat diets for two years concluded that appetite was most reduced on a low-carb diet.

And this brings us to what might be behind the rise in obesity and type 2 diabetes — ultra-processed food, and its effect on health.

Ultra-processed food is the label given to food that essentially is wholly made up of ingredients that aren’t found in that form or combination in nature. There are four categories:

• Unprocessed foods, which includes fruit, vegetables, milk, meat, legumes, seeds, grains and eggs.
• Processed ingredients — these are derived from natural foods or by processes such as pressing and grinding. It includes lard, vegetable oil and honey.
• Processed foods — these are simple products made by adding sugar, oil, or salt, for example. Typically these have two or three ingredients and include canned fruit, salted nuts, smoked meats, and freshly baked bread.
• Ultra-processed foods — these often have long ingredient lists, including added preservatives, sweeteners and colour enhancers. They include fizzy drinks, ice-cream, chicken nuggets, instant soups, pizza, sugary cereals and many flavoured yoghurts. Foods in this group are what I call ‘junk foods’.

Ultra-processed foods are increasingly coming under scrutiny as a cause of obesity. This may be partly because of their effect on the ‘feel-good’ chemical messenger in the brain, serotonin, which might explain why people find such foods so hard to resist.

This was seen in a study in the journal Cell Metabolism in 2019, where volunteers were randomly allocated to eat calorifically matched, minimally processed meals or ultra-processed meals and told to eat until they felt full. Those on the ultra-processed food ate 500 calories more a day and gained weight.

More worrying is the possible link with these foods and premature death. A study in the British Medical Journal last year concluded a higher consumption of ultra-processed foods (more than four servings daily) was associated with a 62 per cent increased risk of ‘all-cause mortality’ — deaths from all causes. For each additional serving of ultra-processed food, all-cause mortality increased by 18 per cent.

Among my own patients over the years I have seen a steady reduction in the consumption of ‘natural’, unprocessed foods, more than matched by them eating more of the ultra-processed foods. A process we try to reverse in our dietary advice, encouraging them to eat more ‘real’ food by preparing simple meals for themselves from basic ingredients, just as our grandparents did years ago.

My rule of thumb with shopping is to be suspicious about anything with more than five ingredients.

NOTE: It is important that anyone on prescribed medication for diabetes discusses significant dietary changes with their GP 

Tuna, cheese & chilli omelette

This omelette can be whisked together in less than 15 minutes and is bursting with flavour. Make sure you have a warm plate and everything you need to hand because you will need to work quickly.

Serves 1 

Per serving: Carbs, 3.7g | Protein, 35g | Fat, 56g | Fibre, 2.8g | Calories, 664

For The Filling 

• 2 tbsp crème fraîche or cream cheese 
• 1 spring onion, finely chopped 
• 50g tuna 
• Salt and black pepper, to taste 
• Fresh chilli, finely chopped, to taste 
• 20g mature cheddar, grated 
• 3 cherry tomatoes, quartered

For The omelette

• 2 large eggs 
• 1 tsp extra-virgin olive oil 
• 10g butter 
• ¼ tsp fine salt and a few twists of freshly ground black pepper

Mix the filling ingredients together in a bowl. Taste and adjust the seasoning and chilli as required. set aside. Use a fork to beat the eggs in a small bowl with the seasoning until well combined. heat a non-stick frying pan over a medium heat. 

Add the oil and butter to the pan and swirl them around to coat the base of the pan. Turn the heat up to high and when the butter starts to foam, add the eggs. swirl the pan around to spread the eggs. When the outer edge becomes opaque run the spatula around the rim of the pan to loosen it. 

Shake the pan to make sure the omelette can slide. When the bottom is almost set, add your filling to half of the omelette. Use your spatula to flip the uncovered half over to seal in the filling. Turn the heat to medium and leave the omelette to cook for two minutes on each side. slide it onto the warmed plate and serve immediately.

 Mediterranean sea bass & roast vegetable traybake

A quick and easy dish that you allows you to do something else while it’s in the oven — put your feet up, perhaps, and pour yourself a glass of wine.

Serves 2 

Per serving: Carbs, 7.8g | Protein, 31g | Fat, 52g | Fibre, 4.5g | Calories, 661

• 7 tbsp extra-virgin olive oil 
• 1 fennel bulb, finely sliced 
• 1 onion, finely sliced into half moons 
• 1 courgette, sliced into 1cm rounds 
• 100g cherry tomatoes, halved 
• Sprigs of thyme or 1 tsp dried thyme 
• 75ml dry white wine 
• Sea salt and ground black pepper 
• 4 small fillets (or 380g) sea bass 
• Few leaves of parsley, optional

Preheat the oven to 220c/200 fan/ gas 7. Brush a tablespoon of the oil over a large roasting dish. Arrange the fennel, onion, courgette and tomatoes over the tray in a single layer. Tuck the thyme sprigs underneath or scatter over the dried thyme. Drizzle three tablespoons of the olive oil and the wine over the top and scatter over salt and pepper. 

Put the tray into the oven and cook for eight minutes. season the fish on both sides with salt and pepper. remove the tray from the oven, move the vegetables around to ensure even cooking. lay the fish on top skin side up, this helps to keep the flesh juicy. 

Drizzle with two more tablespoons of the oil. Put the tray back into the oven to cook for a further ten minutes, or until the fish fillets are firm to the touch. serve the fish on top of the vegetables on warm plates with the juices from the tray poured over the top and the last remaining tablespoon of olive oil. scatter over the parsley, if using.

Vietnamese chicken broth with prawns, pork & noodles

A really satisfying bowl of hot and spicy food. By using noodles made of the konjac root, you reduce the carbs massively from wheat pasta.

Serves 2

Per serving: Carbs, 6.9g | Protein, 73g | Fat, 12g | Fibre, 0.5g | Calories, 428

For the broth

• 4 dried shiitake mushrooms
• 1 L chicken stock
• 200g prawns with heads and shells left on
• ½ lemongrass stick, chopped
• 1 Thai green or red chilli, split in half
• 10g ginger, peeled and finely sliced
• 1 clove garlic, finely chopped or crushed
• Small handful coriander stems, finely chopped
• Pinch of salt

For the meatballs

• 500g pork mince
• ½ lemongrass stickc , very finely chopped
• 3 spring onions, very finely chopped 
• 1 tsp salt
• 250g konjac noodles, rinsed and drained
• Small handful coriander leaves

Put the mushrooms and chicken stock in a medium saucepan and bring to the boil. Add the remaining broth ingredients to the pan. Reduce the heat and keep the broth simmering. Mix the ingredients for the meatballs together by hand or in a food processor and form into walnut-sized balls. Flatten between your hands to form patties and drop into the broth.

Allow to cook for eight minutes, or until cooked through. Add the drained noodles to the pan and heat thoroughly.

Taste, and adjust the seasoning accordingly. Serve straight away, scattered with the coriander leaves, in warm bowls.

Spicy chilli beef

You can make this quick and spicy stir-fry with steak or mince, both work brilliantly. serve with a dressed salad or baby spinach.

Serves 2 

Per serving: Carbs, 15g | Protein, 48g | Fat, 32g | Fibre, 5.4g | Calories, 556

• 2 tbsp extra-virgin olive oil 
• 1 red pepper, thinly sliced 
• 1 brown onion, sliced into half moons 
• 2 garlic cloves, crushed 
• 300g minced beef with 20% fat 
• Salt and black pepper, to taste 
• ½ tsp chilli powder 
• 1 tsp unsmoked sweet paprika 
• ½ tsp ground cumin 
• ½ tsp oregano
• ¼ tsp cinnamon 
• 1 tbsp tomato puree 
• 100g cherry tomatoes, halved 
• 125g mozzarella, grated 
• Small handful coriander leaves

Turn the grill to hot. heat the oil in a wok and fry the pepper and onion over a high heat for five minutes, or until they start to brown and soften. Add the garlic, minced beef, seasoning and spices and stir through. cook for five minutes until the beef is browned.

Mix the tomato puree with 75ml water in a mug and add to the pan with the cherry tomatoes. cook for five minutes, or until everything is piping hot. Taste and adjust the seasoning to your liking.

 Transfer to an ovenproof dish and top with the mozzarella. Put on a high rack under the grill for eight minutes, or until golden brown and bubbling and some of the meat has crispened. remove from the grill and serve, scattered with coriander leaves.

Stuffed cabbage leaves

This vegan recipe is quick to whip up. if you have any leftover low-carb risotto it will also make a delicious filling for these cabbage rolls. 

Serves 2 

Per serving: Carbs, 23g | Protein, 11g | Fat, 29g | Fibre, 8.6g | Calories, 415

• Oil for greasing 
• 1 sweetheart cabbage 
• 240g cooked chickpeas 
• 4 tbsp extra-virgin olive oil 
• Salt and pepper, to taste 
• Chilli flakes, to taste 
• Pinch oregano, thyme or rosemary, finely chopped 
• 2 garlic cloves, grated 
• 125g cherry tomatoes 

Heat the oven to 220c/200c fan/gas 7. Grease a large baking tray. cut the woody end from the cabbage and remove any tough or broken leaves from the outside of the cabbage. These can be shredded and cooked another day. carefully peel away four of the best and largest leaves and lay them on a work surface. 

Mash the chickpeas, half of the oil, seasoning, chilli, herbs and garlic together in a bowl with a fork. Taste and adjust the flavours to your liking. spoon the mixture into the centre of the cabbage leaves, dividing it equally between them and spread it along the length. roll up each leaf into a sausage shape. Use a sharp knife to slash across the stem of the cabbage leaves. 

This will break up the stem and allow the heat to penetrate inside. scatter over the tomatoes and remaining oil. season the rolls with a twist of pepper and a little salt and bake in the oven for 20 minutes, or until the leaves are tender and lightly browned. remove from the oven and eat straight away on their own or with salad.

 ‘Beanguine’ with lemon, basil & cream sauce

Buy any green beans ready shredded or cut them finely yourself. if you are feeling lazy, just leave them as they are. Whichever way you prepare them, they will be delicious with the sauce. 

Serves 4 

Per serving: Carbs, 6g | Protein, 16g | Fat, 44g | Fibre, 5.1g | Calories, 493

• 480g green beans 
• 250ml double cream
• 75g Parmesan, finely grated 
• Zest of 1 lemon 
• 40ml lemon juice 
• 20 basil leaves, roughly torn 
• Good pinch salt and pepper 
• 125g mozzarella, roughly torn

Bring a saucepan of salted water to the boil. cook the beans until al dente. Meanwhile, put the cream, 50g Parmesan, lemon zest and juice, half the basil, salt and pepper into a large frying pan over a medium-to-high heat. 

Let the mixture bubble for a couple of minutes. When the beans are cooked, drain and pour into the frying pan. return the pan to a medium heat and toss the beans with the sauce. serve immediately topped with the Mozzarella, remaining Parmesan and basil.

Salad bowl with harissa chicken & tahini dressing 

It takes just minutes to assemble the salad and stir the sauce together while the chicken cooks. iceberg lettuce adds a lovely crunch to the salad and keeps well in the fridge — as does versatile harissa paste, which instantly adds spice and flavour to meat, fish and all kinds of vegetables. 

Serves 1 

Per serving: Carbs, 6.6g | Protein, 46g | Fat, 51g | Fibre, 5.1g | Calories, 689

• 150g chicken breast, diced 
• 1 tsp harissa paste 
• 2 tbsp extra-virgin olive oil 
• Salt and ground black pepper, to taste 
• 2 tsp tahini 
• Juice of ½ lemon 
• 2 tbsp Greek yoghurt 
• Large handful iceberg lettuce 
• 3 cherry tomatoes, halved l 1 avocado, sliced

Mix the chicken, harissa paste, one tablespoon of the oil, salt and pepper in a bowl. heat a small frying pan over a medium heat and tip the chicken into the pan and cook, turning frequently for about 10 minutes, or until cooked through. 

Meanwhile, mix the tahini with two teaspoons of the lemon juice, the yoghurt and a little salt and pepper in a small bowl. Taste and adjust the flavours. spoon the tahini dressing into the bowl in a pile. 

Put the shredded lettuce next to it and spread out a little. Add the tomatoes and avocado. Finally transfer the chicken to the bowl over the lettuce. Drizzle the remaining lemon juice over the avocado, and pour the remaining oil over the whole salad. Give it a twist of black pepper and serve.

Quick ways to build your low-carb meal

Keeping things simple makes it much easier to stick to a low-carb diet as a way of life.

Most of us haven’t got the time to make dishes from scratch all the time so it’s helpful to have some simple recipes up your sleeve. I love the idea of ‘mix and match’: this is how I put together nearly all meals at home — in a few simple steps — it’s easy.

STEP 1: PROTEIN

Pick from these protein-rich foods (about 120g meat or fish, 100g cheese, half a tin of pulses or one or two eggs per person).

• Eggs
• Fish
• Lamb chops
• Steak
• Low-carb sausages (these contain pure meat with no starchy filler)
• Cheese
• Chicken legs
• Sliced, cooked ham or beef
• Tinned salmon or tuna
• Beans/lentils/nuts/seeds for a vegetarian option

STEP 2: FRESH VEG

Choose at least one low-carb veg; you want to fill most of your plate with this.

• Green salad
• Spinach
• Cabbage
• Cauliflower
• Mushrooms
• Peppers 
• Aubergine
• Asparagus
• Avocado 
• Eat starchy carbohydrates sparingly, depending on how low carb you want to go; these include beetroot, parsnips, butternut squash, carrots, swede, sweetcorn and turnip.

STEP 3: SAUCE

Finally choose one of these low-carb sauces:

• Shop-bought full-fat mayonnaise, pesto, hollandaise (but check the label for added sugar)
• Melted herb butter
• Cheese — you could simply grate some over hot green veg or add a dash of olive oil or a knob of butter.
• It’s also easy to make a vinaigrette dressing with a little salt and pepper, a teaspoon of Dijon mustard, a teaspoon of white wine vinegar and topped up with olive oil — then shaken together in an empty jam jar.
• Why not try one of the low-carb sauce recipes that Katie Caldesi has created and shared this week?

If you make a batch of the tomato-based Quick Italian Sauce or Creamy Mushroom Sauce (both featured in Saturday’s Weekend magazine, Mail Plus and Mail Online) you could either keep a portion in the fridge for up to three days or freeze it until needed.

STEP 4: PUDDING

Cheese and walnuts or celery, or berries and cream are two delicious ways to finish off an evening meal — and you do not have to cook a thing!

My grandchildren love five or six strawberries or raspberries whisked into double cream with a few drops of vanilla essence. If you spoon it into a wine glass, put a couple of extra chopped berries on top with a shaving of dark chocolate it’s good enough to serve at a dinner party.

REMEMBER: THE SEVEN RULES OF THE PLAN 

Use these simple rules to help you stick to your low-carb target.

1. Reduce or eliminate sugar and starchy, high-carbohydrate foods. These include: breakfast cereals, bread, pasta, white potatoes, rice, couscous, crackers, oats, oat cakes, rice cakes, cakes, biscuits, sweets, milk chocolate, fruit juice, fizzy drinks and cordials.

2. Load up with vegetables at each meal. Use non-starchy and salad vegetables, such as broccoli, courgettes, green beans, aubergine and cabbage, to help you feel full without raising your blood sugar levels.

3. Eat good fats. Include oily fish, olive oil, coconut oil, avocado and animal fats — they’re good for adding flavour, as well as for helping you feel full. Add nuts and cheese in moderation only — although nutritious and tasty, they are also highly calorific.

4. Opt for fruit that is naturally low in sugar. This includes berries, apples and pears. Choose these over high-sugar tropical fruits, such as bananas, mango and pineapple.

5. Eat some form of protein in every meal. It’s essential for all your body’s repair mechanisms and helps you feel fuller for longer.

6. Stop snacking. Fasting between meals and overnight helps to improve insulin control. Aim for three meals a day — and then stop.

7. Drink two litres of water each and every day.

The Reverse Your Diabetes Cookbook by Katie and Giancarlo Caldesi with Jenny Phillips is published by Kyle Books on March 19 at £20. © Katie and Giancarlo Caldesi 2020. To order a copy for £16 (offer valid until March 21, 2020; P&P free), visit mailshop.co.uk or call 01603 648155.