2.    Intermittent Fasting and the 5:2 Diet

That’s when a certain Dr Michael Mosley came to the rescue.  By chance I came across the seminal BBC Horizon programme he made in September 2012 called “Eat, fast, and live longer”.  I found spooky parallels to my own situation.  Like me he was a bit overweight, but certainly not obese, and had been stunned to learn that his blood sugar and cholesterol levels were unacceptably high.  In fact he was firmly into the “pre-diabetes” zone.  In the programme Mosley investigated a number of approaches to improving health and increasing longevity through calorie restriction and intermittent fasting.    Studies in lab mice have shown that it was possible to extend lifetimes by restricting calories and a number of humans now practice calorie restriction combined with optimum nutrition in an attempt to live longer.   


The effects of fasting on blood sugar, cholesterol, and the growth factor hormone IGF1 reported in that documentary were really quite remarkable and in the years since it was made many clinical studies have shown that there do appear to be real health benefits from restricting calorie intake on an intermittent basis.


In the 1970s, along with the low fat approach to diet, I remember that the universal childhood advice of “not eating between meals” was being overturned in favour of a grazing approach – smaller meals or snacks eaten more frequently throughout the day.  The theory behind intermittent fasting runs completely counter to the grazing approach.  Intermittent Fasting is claimed to be more in tune with the way humans evolved where food was not available 24/7 and where “feast and famine” was more likely the norm.  Mosley’s programme suggested that one of the factors behind the current rise in Type 2 Diabetes is that we are now much more likely to be consuming constantly throughout the day which means that our pancreas is constantly pumping out insulin to control the blood sugar.  Over time this can then lead to “insulin resistance” or “metabolic syndrome” where the muscle cells no longer respond fully to the insulin, average blood sugar levels start to rise, and this becomes the precursor for Type 2 Diabetes.   Moreover it was claimed the constant availability of food and raised IGF1 levels meant that body cells remained in “Growth” mode which increases the risk of cancer, whereas by restricting calories or fasting the cells could be switched to “Maintenance” mode where they self repair rather than re-generating - a process called autophagy.  In the programme Dr Mosley showed that he was able to radically reduce his blood sugar, cholesterol, and IGF1 readings with just a single four day fast.


Extended fasts are not sustainable however and his blood sugar and cholesterol resumed their previous high levels after about a month of return to normal eating.  His now famous 5:2 Fast Diet was his approach to getting most of the benefits of fasting in a sustainable way that can fit in with every day life.   The principles are very simple.  For two days a week the calorie intake is restricted to 25% of the normal level, which means 600 kcals for men and 500 kcals for women.  While no foods are completely off limits, if you want to feel full and satisfied on 600 kcals then foods with high calorie density such as chocolate bars, refined carbohydrates, or alcohol should be avoided.  The days you fast are entirely up to you.  Mosley suggested Mondays and Thursdays, and that’s what I did, but you could equally well fast for two days back to back, and if you need to temporarily swap days to fit in with unexpected commitments  then that’s fine too.  Just make sure that you restrict your calorie intake for two days in every seven.


In his book “The Fast Diet” Dr Mosley says that you can eat your 600 kcals in one go or spread throughout the day as breakfast, lunch, and dinner.  I much preferred to have a single evening meal as it filled me up and I never went to bed feeling hungry.  Also, as a longer fasting period is inherently better for allowing the gut bacteria to recover, a single evening meal means that your microbiome has a period of 24 hours without any food twice a week and that’s definitely a good thing for some of our key gut bacteria.



2.1    The 5:2 Fast Diet in practice

600 kcals enables quite complex and very tasty meals to be created if you focus largely on vegetables, whereas 3x200 kcals meals become quite challenging.  In addition, I find that a small 200 kcals breakfast is not satisfying – it just leaves me wanting more.  However if I simply skip breakfast then I can last all day, particularly when I know my reward will be a substantial dinner, followed by normal eating the following day.  Initially I used some of the recipes in the Fast Diet book to get me started but soon started to create my own.  I found that 600 kcals, with careful choice of ingredients, would allow a main course and a fruit dessert in sufficient quantity that I sometimes could not finish the meal.  The key words there are “careful choice of ingredients”!  Choose unwisely, for example a couple of chocolate bars, and your calories will be consumed in seconds and you will go to bed hungry! 


If you follow the book’s many recipes then you do not have to bother counting calories.  The recipes are actually pretty good and you can just modify the quantities if you want one large meal, but I wanted to be able to design meals to my own taste. So I created  a database of the foodstuffs I regularly used (which currently contains about 500 items – that surprised me!) to make it easy to produce recipes that satisfied my culinary desires while simultaneously meeting the calorie restrictions and the right macronutrient balance.  That also made it easier to ensure that I was not exceeding my calorie needs on the five “Feast” day.  You can download apps such as “MyFitnessPal”  that will do something similar or you may find the visual approach by the “Carb and Calorie Counter”  is all you need to get going.


Whatever approach you take long term to tracking calories, maintaining a food diary for a week or two before starting the diet in earnest is very educational and I think essential.  You need to be meticulous as it is very easy to miss out a few hundred calories on minor “nibbles”.  I discovered that, although I ate pretty healthily overall, I was a grazer and just tended to eat too much throughout the day.  Write it all down then add up at the end of the day!


While fasting it is important to drink more water to compensate for the fact that the volume of food you are consuming is substantially less than normal which means that the water we normally obtain from our food is equally reduced.  Dr Mosley recommends drinking 2 to 2.5 litres of non calorie liquid on Fast days.  Tea or coffee, without milk, both count as does fizzy spring water or good old tap water.   I initially ignored the "drink much more" advice because I did not feel thirsty on Fast days but I experienced some headaches and muscle cramps at night.  However these completely disappeared as soon as I followed his advice and drank at least 2 litres of liquid on Fast days.  Interestingly the need for this level of hydration seemed to tail off after the first few weeks, essentially after the initial period where a lot of the weight loss comes from loss of water as the body depletes its glycogen reserves in a process that releases three grams of water for every gram of glycogen.  So do not stint on the water on Fast days, even if you do not feel thirsty.


I found it remarkably easy to implement the 5:2 Fast Diet and quickly discovered that one meal a day suited me best.  I expected to feel tired but actually found the opposite to be the case as my energy levels soared, although that may well have been due to the reduction in my consumption of starchy carbohydrates, of which much more later.


Dr Mosley says that the average weight loss is 1-2 pounds per week but that depends on whether you exercise and on what you eat on the non-Fast days.  My initial weight loss was more than that but the loss settled down to about 1kg per week after a couple of weeks.  Later, as I introduced weight training to my regime,  my weight loss slowed to about 0.7 kg per week although my body fat percentage continued to decline, which meant I was still losing fat but gaining lean muscle which is fine as it is fat loss we are concerned with, not weight loss per se.


Note that as of May 2018 Dr Mosley has slightly modified the requirements for Fast days which now allow up to 800 kcals to be eaten, which makes Fast days even easier.   If you choose to have breakfast however, you should allow at least 13 hours to elapse from when you finished eating the previous evening.



2.2    The Mediterranean diet for “Feast” days

Whatever approach you take, either calorie counting your own meals or adopting standard Fast Diet recipes, it is essential to keep an accurate food diary so that you can understand how much you are actually eating and also to become educated in where the calories are coming from which helps weight maintenance in the long term.  I started such a diary a couple of weeks before I began my Fast Diet in earnest and this diary confirmed that throughout the previous four decades I had been following the recommended dietary advice almost exactly.  My diet was definitely low fat as it contained only about one third of the maximum recommended total daily calories from fat and saturated fat, and it was high carb with about 60% of my carbohydrates coming from starchy carbohydrates like bread, rice, pasta, and potatoes.  And yet, despite my exemplary conformance to the dietary advice and the fact that I exercised regularly, my weight had risen every decade and I was now overweight with high cholesterol and blood sugar.  Something did not add up.   Something needed to change in my diet on a longer term basis, even if I used intermittent fasting to help reverse the blood sugar problems accumulated so far.  But what needed to change?


Enter Dr Mosley again along with Professor Roy Taylor of Newcastle.   Professor Taylor was the first to show that diabetes and pre-diabetes could be reversed through the application of rapid weight loss achieved through calorie restriction :


“Type 2 diabetes is a reversible condition”  : https://www.ncl.ac.uk/press/articles/archive/2017/09/type2diabetesisreversible/


“Reversing type 2 diabetes “  : https://www.ncl.ac.uk/magres/research/diabetes/reversal/ - publicinformation

Professor Taylor’s work has shown that excess fat in the liver can cause the liver to respond poorly to insulin and also to produce too much glucose.  Worse still the excess fat in the liver is passed to the pancreas which eventually causes the insulin producing cells to fail, which is the start of insulin resistance and Type 2 Diabetes.  Since the 1970s there has been a significnat increase in obesity in the UK and a large increase in the numbers of people diagnosed with Type 2 Diabetes.   However Professor Taylor showed in this paper https://www.ncl.ac.uk/media/wwwnclacuk/newcastlemagneticresonancecentre/files/PersonalFatThreshold_Paper.pdf that the increase in Type 2 Diabetes was not restricted to  those whose Body Mass Index (BMI) classified them as obese because people with normal BMIs were also showing an increase in Type 2 Diabetes.  In fact he states in thjis paper that an individual's susceptibility to Type 2 Diabetes is unrelated to his or her BMI.  Professor Taylor postulates that this is because we each have a Personal Fat Threshold (PFT) above which excess fat starts to be stored in the liver so it is individual weight gain in relation to this PFT that is the trigger for glucose intolerance, rather than an individual's absolute weight or BMI.  So thin people can develope Type 2 Diabetes too if they have a low PFT, and there are examples mentioned in Michael Mosley's "8-Week Blood Sugar Diet" book of people who were outwardly thin, or even very thin,  suffering blood sugar problems which were fixed by them losing even more weight.   Michael Mosley himself  was surprised to discover he was pre-diabetic and he certainly did not look overweight, yet body scans showed that he had a lot of internal or visceral fat around his liver and pancreas.  He was the classic "TOFI" - thin outside, fat inside.


The PFT could well explain how my previously good blood sugar and cholesterol readings had become bad, despite no significant change of lifestyle or eating habits.  I had put on a bit more weight and had obviously crossed my PFT threshold which triggered the start of glucose intolerance.   Once the PFT threshold has been crossed then the effects are non-linear.   You cannot cross back over the threhold of pre-diabetes by losing a small amount of weight.


To begin the reversal of Type 2 Diabetes only requires the loss of 1g of fat from the pancreas but to restore glucose tolerance to normal typically requires the loss of about 15kg of body fat, Professor Taylor's Blood Sugar Diet which describes a vigorous crash diet with only 800 calories per day to ensure rapid weight loss over 8 weeks.  The weight can be lost over a longer time but for someone who is diabetic the crash diet restores normal blood sugar in the shortest possible time.  Since I was borderline pre-diabetic I opted to lose weight over a much longer period, partly so that the return to “normal” eating would be easy since it would only be a relatively minor adjustment to the calorie intake.   I did however set a weight loss target of 18kg (based on the figure of 15kg from Professor Taylor’s studies, plus a margin) which would take me back to my weight when I left university in 1976.  The target seemed somewhat ambitious at the outset but it did not seem so ambitious once my diet was underway and the weight was falling off at about 1kg per week.   In the end I lost about 19.6kg of fat and added 2.1kg of lean muscle to give a net weight loss of about 17.5kg (although, to be clear it is the fat loss that is important, not the absolute weight loss, and fat lost around the belly region is the most important).


Professor Taylor’s approach to diabetes and blood sugar control is encapsulated in Michael Mosley’s book “The 8-Week Blood Sugar Diet” which is aimed at people who are pre-diabetic or diabetic.  It describes a very restrictive 800 calorie per day regime for 8 weeks and the case studies show impressive turnaround results.


I found this diet intriguing because, apart from the potential benefit of reducing my blood sugar, it eschewed the “low fat” approach that had been promoted for years in favour of a Mediterranean style of diet that is low carb and relatively high in fat and saturated fat.  Not "fast food" style bad fat but fats that are considered nutritious and as unadulterated as possible from their natural state.  So walnuts, almonds, seeds and avocados, which are all high in fat and saturated fat, are fine; highly refined vegetable oils are out but extra virgin cold pressed olive oil is definitely in.  In fact one of the underlying principles of the Mediterranean diet is that processed food of all kinds should be avoided in favour of foods as close as possible to their natural state.  As my years on a low fat, high carb diet had seemingly not done much for my weight, which increased every decade for the past 40 years, switching to a low carb, higher fat diet was certainly a completely different direction.


I had decided that the potential health benefits of intermittent fasting, in addition to simple weight loss, definitely made fasting an attractive proposition but restricting non-Fast days to 800 calories as well sounded a bit punitive so I decided to combine two Fast days with five Feast days of Mediterranean style food each week.  While the Fast days would follow Michael Mosleys 600 kcals/day limit, the Feast days would be also be calorie constricted to speed up the fat loss, but only by a few hundred calories as I certainly did not want to fell deprived, or on a diet, every day.


The key point about this approach that it is not prescriptive on the Feast days which means that for five days a week I ate what I wanted within the general ethos of the Mediterranean diet, with only starchy carbohydrates and free sugars being completely off limits.  If I dined in a restaurant I chose food in line with the low carb/high fat principle where possible and I avoided desserts, but would often have cheese instead.  I drank red wine and malt whisky, and had the odd square of dark chocolate too (85% and 100%).  This regime is pretty easy to follow and probably explains why the 5:2 fast diet has a relatively low drop out rate compared to “normal” continuous diets.


Combining the 5:2 fast Diet with the Mediterranean pattern of food consumption also means that when the weight loss phase comes to an end there is no change in the type of food consumed – you just continue with the same style of food but increase the amount you eat.  That seems to me to be a key factor in the success of any weight loss diet.  I am sure I could lose just as much weight on the Atkins diet, which is ultra low carb.  It would be absolutely fine in the short term to lose weight but it sounds too unbalanced a diet to consume for the long term so a return to the previous “normal” diet at some point will be necessary, and returning to the previous diet means that it is likely that the weight will go back on eventually.  If you want to keep weight off on a permanent basis then you need to make a permanent change in the way you eat.



2.3    The Mediterranean diet guidelines 

Michael Mosley’s book “The 8-Week Blood Sugar Diet” (see books section below) provides lots of specific menu options and recipes for 800 kcals per day.  I chose not to restrict myself to 800 kcals per day and in fact I made up my own menus and recipes within the Mediterranean ethos that is very clearly described in the book.   Alternatively you can easily use the book’s menus and scale them up to whatever calorie intake you want.


If you like cooking then it is very easy to devise your own meals to meet the requirements of Mediterranean pattern.  Starchy carbohydrates like white rice, pasta, potatoes, and flour should be avoided along with free sugars and sweet treats or junk food of any type.  These carbohydrates are also referred to as "fast carbs" as they can cause a rapid spike in blood sugar levels.   Carbohydrates should not however be considered inherently bad.   They contain valuable nutrients that our body needs, and they also provide energy.  The problem arises when we process carbohydrates to refine them from whole grains and thereby remove the fibre which would naturally slow down their absorption in our digestive system.  Whole grains provide "slow carbs" while vegetables and many fruits provide "green carbs" because they also contain loads of fibre to slow down the release of energy in to the blood stream. 


So limited carbohydrate from whole grains like red rice, quinoa, and barley is fine in the Mediterranean diet as are vegetables (which should be multi-coloured as possible), and fruit (but minimize or avoid altogether the sweet tropical fruits like melon, pineapple, mangos and grapes).  Legumes, oily fish, shellfish and other high quality protein like chicken, beef, and pork are encouraged but avoid all processed meats.


Garlic, onions and tomatoes are encouraged as well as full fat live yogurt and fermented foods like kefir and sauerkraut.  Unsalted nuts like walnuts and almonds are also encouraged, along with cold pressed extra virgin olive oil to raise the intake of mono and poly unsaturated fats.


Breakfast cereals, in general, are all off limits because they are usually full of sugars, even the mueslis that are promoted as healthy, but traditional rolled oats (not instant) are fine for porridge.


Avoid anything labeled “low fat” and replace margarine with butter.  Traditional (i.e. non processed) cheese is fine in moderation (about 30g per day seems to be recommended, but I eat more than that, on occasion).


Regular consumption of red wine in small quantities (1x125ml glass per day) several times a week is fine as is the occasional piece of very dark chocolate (i.e. 85% and above).  Milk chocolate is definitely out because of the high sugar content - 50% chocolate bar means that 50% is cocoa solids while the rest is sugar.


The underlying principle of this diet is that food should be prepared freshly from raw ingredients, while the consumption of processed food of all kinds should be minimized or avoided.  Processing or refining of whole foods generally results in food that is more readily absorbed by the body and that usually has a bad effect on our blood sugar levels.


I found several books that greatly helped me to create wonderful tasty food that ticked all the boxes and these are listed later in Section 10 : Recommended Books.  If you were to only buy one book then I would recommend “The Doctor’s kitchen” by Dr Rupi Aujla.  It is the only cookbook in my collection that refers to about 250 medical papers to back up what the good doctor suggests we eat.  However you do not need to refer to any of the scientific backup as this stunning book provides healthy recipes in the Mediterranean style which are all outstanding in terms of the tastes and textures. It is also the only cookbook I possess where I have to date cooked over 50% of the recipes it contains.  It is the first cookbook whose recipes convinced me that an almost vegetarian diet could satisfy all my culinary needs, yet it is not a vegetarian book per se.  It includes recipes with protein from meat and fish but overall meets the goal of “Eat food. Mostly plants. Not Much.”  What this book highlighted for me was how great a vegetarian dish can be when you stop using the vegetables as a side dish to a piece of meat or fish.   When I started cooking from Dr Rupi’s book I would add occasionally a piece of meat or fish and I’m glad I did because it made me realize that in most cases the meat or fish added nothing to the overall dish as the vegetables were the star.  I’m sure all vegetarians have known this for years but I guess I’ve been slow to catch on!



2.4    The Mediterranean Diet in Practice

I’ve been eating this diet now for about 6 months.   Setting aside the undoubted health benefits and improvement in my blood sugar and cholesterol, this diet has transformed my eating habits and I can honestly say that I have never eaten better.   I have never felt hungry during the 6 months, even though I cut back on calories to around 2000 kcal on Feast days, and I think that is down to two factors :


Firstly it is a myth that starchy carbohydrates like bread, rice, and pasta fill you up.  They do for a very short while but after the blood sugar has spiked the crash which results afterwards leaves you feeling hungrier and likely to eat more.   Swapping to wholegrain carbohydrates minimizes the rise in blood sugar and the energy in the food is released over a longer period which makes you feel full for longer and provides a more gradual release of energy.


The second factor which helps you feel full is that you eat a lot more fruit and vegetables.  These foods are very low in energy density compared to refined starchy carbohydrates or sugary treats so, for any given number of calories, vegetables and fruit will provide a much greater volume of food on the plate.  This alone helps you feel full while the low glycaemic load of these foods means that the blood sugar remains controlled while the food’s energy is released much more slowly so you remain satisfied for longer.  I was amazed to find that I could easily create a substantial main course followed by a dessert of fruit and kefir or yogurt that was only 600 kcals yet almost had too much food to consume in one sitting.


The Mediterranean diet helps you to feel full while cutting calories and eating superbly tasty food.  That’s why it does not feel like a diet and why it is so easy to lose weight following its principles.  It also has many health benefits too, of which the prevention of Type 2 Diabetes is a major factor.



2.5    Are there any downsides to the Mediterranean diet?  

Another factor that surprised me is just how much space is required in the fridge for a few days supply of vegetables when you are eating a largely vegetarian diet for maybe four days out of seven.  The increased volume of raw ingredients is just a natural consequence of the lower energy density of vegetables and fruit but it is a real problem unless you have an allotment to hand or live next door to a convenient shop.   So I am now looking at buying a much bigger refrigerator.


2.6  Replacing free sugars in your diet                    

 Free sugar is pure refined sugar which can take the form of table sugar, honey, glucose, syrup, treacle .....    It is unquestionably bad for us and many clinical trials have now shown that it seems to have been the major contributor to the rapid rise in obesity and heart disease over the past few decades.  Unfortunately, switching to sugar substitutes does not appear to be a healthier option or one that will avoid weight increase.  Michael Mosley in “The Clever Guts Diet” and Phil Spector in “The Diet Myth” make the point that zero calorie alternative sweeteners seem to be bad news for some of the key bacteria in the microbiome and can actually interfere adversely with key metabolic processes.  In addition there is some evidence that artificial sweeteners can have the same effect on raising blood sugar as real sugar, even although they contain no calories, because the body seems to have a memory that links sweetness with the need to pump out insulin.  The mechanism is not understood but studies have shown that the use of artificial sweeteners does not help with weight loss.   So if you have a sweet tooth then artificial sweeteners are not the preferred option, you need to retrain your palate.

I have never had a particularly sweet tooth but I have certainly enjoyed my fair share of sticky treats and milk chocolate over the years.  But it is quite amazing how quickly the body responds to dietary changes.  I cut out all free sugar and replaced milk chocolate with an occasional square of dark chocolate which I had always enjoyed anyway.  The difference was that instead of 72% or 85% dark chocolate (which contain about 28% and 15% sugar respectively) I switched to 100% dark chocolate which contains zero sugar.   100% pure cocoa contains a lot of polyphenols and flavonoids which are actually good for our gut bacteria so cocoa can be considered quite healthy if eaten in its darkest, sugar free, form.  Initially I found that 100% dark chocolate to be significantly more bitter to my taste than even 85% chocolate but within a matter of a few weeks my taste buds adapted remarkably well.  Having essentially eliminated free sugar from my diet I now find that 100% dark chocolate actually tastes pleasantly sweet and that milk chocolate, which is approximately 50% sugar, is now way to sweet for me.  The human body adapts pretty quickly to a life without sugar so, given the enormous benefit to blood sugar levels of cutting out the white stuff, I would say that completely eliminating sugar and artificial sweeteners from the diet is not as hard as it might seem.


Table sugar is sucrose which is actually a combination of two other sugars, namely glucose, which we have in our bloodstream, and fructose which is found in fruit.  Surely sugars that occur naturally in fruit must be good for us?  Unfortunately, all the different kinds of sugar we eat can cause our blood glucose to rise and cause the pancreas to secrete the fat storage hormone, insulin.  Whether the sugar is in the form of refined table sugar, or naturally produced by bees as honey, or by fruits, it still has the power to raise our blood glucose levels and that is something to be avoided if you are diabetic or pre-diabetic.  Fructose is actually sweeter than table sugar which is why it is commonly used in processed foods since its high sweetness means that less volume has to be added.  In commercial foodstuffs it usually appears in the form of high fructose corn syrup (HCFS) which is manufactured from corn starch.  If you are concerned about your blood sugar levels then you should definitely avoid processed foods containing fructose or corn syrup.


If fructose is a high intensity sugar that can raise blood sugar levels, does that mean that all fruit should be avoided?  Fortunately the answer to that question is a qualified "no",  The reason being that while an apple contains fructose, the effect of that fructose on our blood glucose is minimal because the sugar is eaten with a load of fibre that the apple also contains.   The fibre slows down the digestive process and hence the release of energy in to the blood stream which means that an apple is considered a low GI food.  A glass of apple juice however is a completely different matter since the juicing process removes all the mitigating fibre and gives you a concentrated hit of sugar equivalent to eating the equivalent of perhaps ten or twenty apples, and that is definitely not good for your blood sugar levels.   After years of thinking that fruit juice must be healthy I have now eliminated it entirely from my diet.


The reason for the qualified "no" above is that not all fruits are considered to be low GI.   Berries such as strawberries, raspberries, blackberries and blueberries are fine.  Apples, pears, plums, and oranges are also relatively low GI, but the sweet tropical fruits like mangoes and pineapples should be avoided if you are trying to lower your blood sugar because they contain a higher proportion of fructose.   Michael Mosley's book "The 8-week blood sugar diet" has more advice on this as does the Diabetes UK website.


You should also be wary of food labels that proclaim "no added sugar" or "sweetened with fruit sugars" and check the nutritional panel to see how much sugar the product actually contains.  Whether a product is sweetened with fruit sugar or sucrose makes little difference to our  blood sugar levels - it is the quantity of sugars that count. 


2.7    Replacing "fast" carbs with "slow" carbs

Replacing refined carbohydrates with something healthier is fortunately much easier than trying to find a healthier alternative to sugar, since there is none.  I now use red rice almost exclusively in place of white basmati rice even though I had never heard of the stuff six months ago.  It is still a carbohydrate but being wholegrain it releases its energy slowly into the bloodstream.  Even better, it tastes wonderfully nutty and cooks much faster than brown rice or wild rice.  Just make sure you limit the portion size to 50g per person of uncooked rice as it is still a carbohydrate and full of energy, so treat it as a side dish not a main.  Alternatively you can use quinoa or barley instead of white rice.  The former is a seed but has a nutty taste and is full of nutrients.  Barley is useful for more than Scotch broth too.  Partially cook it, drain and toss with some olive oil and spices such as garam masala or harissa, then finish in a hot oven for 10 minutes.  It will become nutty and full of flavour and you’ll wonder what you ever saw in white basmati rice! Or you could try oat groats which are the whole kernels of the oat grains and taste superbly nutty when par boiled then given a light roast.


Pasta and rice may not have to be entirely off the menu.  Although I have not tried this myself, Michael Mosley reports that cooking white rice or pasta, followed by cooling them in the fridge then subsequently re-heating them modifies the starch they contain into a form called resistant starch, which apparently does not cause blood sugar levels to rise by anything like as much as normal.  I’ve not found it hard to eliminate white rice and pasta from my diet but this might be worth a try if you find the thought of giving up white rice and pasta to be a step too far.   However if you find it impossible to give up white rice, James Wong says in his book "How to eat better" that if you eat beans, and preferably black beans, with rice then the beans will have the remarkable effect of suppressing the rise in blood sugar that would normally arise from the rice alone.


I’ve always been a fan of potatoes and used to eat quite a lot.  Now I do not eat potatoes at all because of their very pronounced effect on blood sugar, although James Wong notes that Charlotte and Nicola potatoes have the least effect on raising blood sugar to the extent that Nicola potatoes are almost able to be classified as low GI.  That's one to plant next year then!


However there are alternatives that do not have such a pronounced effect as the average spud.  Sweet potatoes, despite their name, have a relatively low glycaemic load and taste wonderful as a topping for fish pie, and Dr Rupi’s “Masala Celeriac Mash” recipe [see Section 10 : Recommended Books below], with or without the spice, makes a low calorie replacement for mashed potatoes that tastes superb.


What about breakfast?  Michael Mosley recommends avoiding muesli and most breakfast cereals because of their high sugar content, but he does recommend porridge made with traditional oats because of its low glycaemic index.  While a bowl of porridge is reputed to keep you going all day I find it does not work like that for me.   On the contrary I find that I am hungrier a couple of hours after eating porridge than if I had not eaten it at all.  Which highlights something about glycaemic index : this is calculated as an average of the responses of a number of real people and is not therefore an absolute property of the foodstuff.   Michael Mosley does note in his book “The 8-Week Blood Sugar Diet” that we all have a personal sugar level, so for me porridge seems to raise my blood sugar level disproportionately and this leads to a subsequent sugar crash and hunger pangs.   Which is possibly why for most of my life breakfast has never been a big part of my day.  My wife, on the other hand, finds a bowl of porridge keeps her going for a long time.


However I have found an alternative that I enjoy and which does fill me up for a long time.  Most days I now start off with a bowl of fruit, usually a chopped green pear, topped with 125g of kefir and 75g of yogurt cheese/labneh, and sprinkled with 25g of chopped walnuts or almonds and a teaspoon of mixed seeds like chia, flax, sesame, and pumpkin.  Endless variations are possible on this theme : substitute any frozen fruit or other whole fruit for the pear; add about 15g of a soft blue cheese like Strathdon whose creamy texture and tart taste blends perfectly with the Kefir and yogurt; sprinkle one quarter teaspoon of green tea powder (Matcha powder) on the top; add a tablespoon of toasted porridge oats or unsweetened cranberries; or for a more oriental touch combine a tablespoon of sushi ginger with a tablespoon of pickled red jalapenos.


If you want something hot and low carb for breakfast then Michael Mosley recommends scrambled eggs paired with smoked salmon.  Bacon would also qualify for the low carb label but be aware that the latest advice is that processed meats like bacon should definitely not be consumed on a regular basis.


And if porridge keeps you going all day then go for it!


Note that if you have breakfast on Fast days Michael Mosley now recommends leaving it at least 13 hours from when you finished dinner the previous evening.