Chef Giancarlo Caldesi and Dr David Unwin show you how to eat to keep diabetes at bay 

Today, in the final part of our groundbreaking series, NHS GP Dr David Unwin reveals how exercise can improve the results of the low-carb plan, while chef Giancarlo Caldesi and his food writer wife Katie offer more of their delicious recipes.

Adding exercise to your low-carb eating plan can be one of the most powerful ways you can transform your health.

Getting into the habit of doing regular exercise can not only help you to see better results more quickly — but also to feel happier about yourself, too, due to the ‘feel good’ chemicals that being active produces in the brain.

This, in turn, can help you feel positive about your new eating programme, less in need of the brain boost that sugary treats give — and therefore more motivated to stick to your new diet plan.

NHS GP Dr David Unwin (right) reveals the tricks to keep you motivated to stick to the low-carb plan, while chef Giancarlo Caldesi (left) and his food writer wife Katie offer more of their delicious recipes

NHS GP Dr David Unwin (right) reveals the tricks to keep you motivated to stick to the low-carb plan, while chef Giancarlo Caldesi (left) and his food writer wife Katie offer more of their delicious recipes

NHS GP Dr David Unwin (right) reveals the tricks to keep you motivated to stick to the low-carb plan, while chef Giancarlo Caldesi (left) and his food writer wife Katie offer more of their delicious recipes

Experts agree it is hard to lose weight by exercise alone; but it is clear that regular aerobic activity may speed up weight loss. This can be anything that leaves you out of breath but still able to hold a conversation, such as jogging, dancing, brisk walking or swimming.

When you begin to exercise, your body needs extra energy, which means it soon needs to turn to your fat supplies and starts converting them into fuel. Over time, this may help to reduce your waistline.

Improving the flow of blood around your body and really using your muscles can also bring numerous benefits to heart and blood health, as many scientific studies have shown.

When type 2 diabetes develops, our bodies become resistant to the effects of insulin and so struggle to cope with that excess sugar. Exercise can help reverse this. Weight training can also help you by increasing your muscle mass [File photo]

When type 2 diabetes develops, our bodies become resistant to the effects of insulin and so struggle to cope with that excess sugar. Exercise can help reverse this. Weight training can also help you by increasing your muscle mass [File photo]

When type 2 diabetes develops, our bodies become resistant to the effects of insulin and so struggle to cope with that excess sugar. Exercise can help reverse this. Weight training can also help you by increasing your muscle mass [File photo]

Many of these are particularly relevant to those with type 2 diabetes. They include lowering blood pressure, reducing ‘bad’ LDL cholesterol and blood fats known as triglycerides, raising ‘good’ HDL cholesterol levels, strengthening bones and muscles, and even reducing anxiety.

In my own practice, the average type 2 diabetes patient is 63 years old and weighs about 15st 7lb, so it may not be realistic or even safe to expect them to start running up hills.

What I see quite often is that once people have lost some weight, they feel more energetic and start wondering about which form of exercise may suit them best. I have one female patient who has lost a third of her body weight on the low-carb diet in a year. She’s so proud now to be able to join her husband every week for a 5km run.

For me, running outdoors (albeit, rather slowly) with my wife Jen is a source of joy. So often we wonder about setting off because it looks cold and windy — but afterwards there is a sense of achievement and calm.

I did regret it once, though. To celebrate turning 50, I ran a marathon on a cold day in Blackpool, collapsed with hypothermia and ended up in the resuscitation tent.

The thing to remember is that any form of exercise that suits you is good: it doesn’t have to mean putting on Lycra shorts and sweating in a gym, or running a marathon. 

Climbing stairs or brisk walking is exercise, too. Importantly for type 2 diabetes, exercise — in all forms — can help to regulate blood sugar levels and increase the body’s sensitivity to insulin, the hormone our bodies produce to help control excess sugar.

When type 2 diabetes develops, our bodies become resistant to the effects of insulin and so struggle to cope with that excess sugar. Exercise can help reverse this. 

Weight training can also help you by increasing your muscle mass: muscle helps your body burn more energy.

When you begin to exercise, your body needs extra energy, which means it soon needs to turn to your fat supplies and starts converting them into fuel. Over time, this may help to reduce your waistline [File photo]

When you begin to exercise, your body needs extra energy, which means it soon needs to turn to your fat supplies and starts converting them into fuel. Over time, this may help to reduce your waistline [File photo]

When you begin to exercise, your body needs extra energy, which means it soon needs to turn to your fat supplies and starts converting them into fuel. Over time, this may help to reduce your waistline [File photo]

The ability of your muscles to use up glucose also increases with your strength, making your body more efficient at regulating its blood sugar levels.

So, as your body builds up more muscle and loses fat, the amount of insulin it needs to produce is reduced.

Researchers have also found that people with type 2 diabetes who walked at least two hours a week were less likely to die of heart disease than their sedentary counterparts. Those who exercised three to four hours a week cut their risk even further.

So you’ve now every incentive to find an activity or sport you like. Every little helps.

Many people enjoy the camaraderie of exercising in groups. Might a yoga class suit you? In general, start gently and build it up as you become stronger.

You’ll find it easier than you think to increase your activity levels once you get started. Try to spend at least 30 minutes a day doing some form of exercise, at least four times a week. You could start to see a noticeable difference in the coming weeks and months.

How to become more active 

If you haven’t exercised for a while, are taking medication or are concerned about your health, you should always consult your GP before embarking on a new programme of exercise. 

In general, start gently and build it up as you become stronger. (This is particularly important if you are overweight.) Here are some tips to help get you started:

  • Change your attitude. It’s easier than it sounds. Decide not to be a couch potato and start being more active. Find ways to move more — whether it’s taking the stairs or getting off the bus a stop earlier than usual.
  • Set realistic goals. For instance, try going for two 15-minute walks a day or cycling to work. Start small and build up.
  • Choose something you like as you’re more likely to stick with it. Now could be the time to take up yoga, dancing, badminton or gardening.
  • Get stuck into the housework. This will help you be generally more active. Cleaning, scrubbing and gardening can all add to calories burned off.
  • Buy a good pair of shoes. It’s really important to own good trainers that are right for your chosen activity.

Your footwear should support your feet properly and correct any gait issues you may have that could end up causing injuries when exercising. If you’re planning your first jog, it’s a good idea to get assessed at a sports shop with a running machine to help you find the right shoes.

  • Have a clear goal and some medium-term goals. If you’re a runner, this could be to take part in a park run. These are local events where you turn up and walk, jog or run 5km. Some GP surgeries have teamed up with parkrun.org.uk; check out the website to find a run near you.
  •  Make a conscious effort to notice improvements in your health as you become fitter. This can be very motivating.

Perhaps you are sleeping better, have more energy or breathe more easily?

This was certainly Katie Caldesi’s experience. She says that with the low-carb diet, she feels so much more energetic — and this gave her the impetus she needed to start exercising again.

‘I got a personal trainer who made me start running — which I have always hated,’ she explains. ‘However, I persisted and, after a couple of weeks, actually found myself enjoying it.

‘I think this was because I started to feel so energised when I came back from a run. Another big bonus of exercising was that it took me away from thinking about food, writing about food and eating food.’

Note: If you are taking medication or are worried about your health, consult your GP before embarking on a new programme of exercise or change in diet.

Steak with green peppercorn sauce

Giancarlo likes to cook steaks in their own fat for flavour, so try to buy them with an edge of creamy fat still attached. We like to eat this dish with a heap of sautéed spinach.

Serves 2

Per serving: Calories, 642; carbohydrates, 1.3g; protein, 57g; fat, 40g; fibre, 0g

  • 2 sirloin steaks
  • A knob of butter
  • 1 shallot or half an onion, finely chopped
  • 3 tbsp brandy
  • 75ml single or whipping cream
  • 1 tbsp green peppercorns
  • 1 tsp Dijon mustard

Season the steaks generously with salt. Warm up a non-stick frying pan over a medium to high heat.

Using tongs, stand the steaks up together, fat-side down, in a hot frying pan. Let the fat brown and melt; you will soon have a pool large enough to cook the steaks.

Now lay the steaks down flat separately in the pan and cook to your liking.

Remove the steaks from the pan and set aside in a warm place to rest while you make the sauce. Leave a little melted fat and any brown bits in the pan for flavour.

Add the butter to the pan and fry the onions for 8-10 minutes over a medium heat, until soft.

Pour in the brandy and let it reduce for 3 minutes before adding the cream, peppercorns, salt and mustard.

Crush the peppercorns with the flat of a wooden spoon to release the flavour. Season with salt to taste.

Let the sauce bubble for few minutes to thicken it. To serve, put the steaks on individual warm plates and pour the sauce over the top.

Giancarlo likes to cook steaks in their own fat for flavour, so try to buy them with an edge of creamy fat still attached to make this steak with green peppercorn sauce

Giancarlo likes to cook steaks in their own fat for flavour, so try to buy them with an edge of creamy fat still attached to make this steak with green peppercorn sauce

Giancarlo likes to cook steaks in their own fat for flavour, so try to buy them with an edge of creamy fat still attached to make this steak with green peppercorn sauce

Mushroom rarebit

This is an easy lunch recipe or a light supper. Serve on its own, with sautéed spinach or a crisp, green salad on the side.

Serves 2

Per serving: Calories, 189; carbohydrates, 3.5g; protein, 9.4g; fat, 15g; fibre, 2.7g

  • 2 large portabello mushrooms, stalks removed
  • 2 tsp extra virgin olive oil
  • 25g grated cheddar
  •  ½tsp Dijon mustard
  • A few drops of Worcestershire sauce
  •  1 tbsp full-fat Greek yoghurt
  • Salt and freshly ground black pepper

Place the mushrooms stalk side up on a wire rack over a baking tray, brush with the oil and season. Grill for 7 minutes, or until tender and darker around the edges.

Using tongs, turn the mushrooms over so the domed sides are upwards and grill for 3-5 minutes. When cooked through, set aside.

Mix remaining ingredients in a bowl and pour into the cavity of the mushrooms. Grill for 5 minutes, or until golden brown. Cook any extra filling in a ramekin at the same time.

Mushroom rarebit is an easy lunch recipe or a light supper

Mushroom rarebit is an easy lunch recipe or a light supper

Mushroom rarebit is an easy lunch recipe or a light supper

Courgette and cheese patties with red pepper sauce

This versatile recipe can be made bite sized, as in this recipe, or burger sized for a main meal. The dip also makes a delicious sauce for white fish, eggs or chicken.

The patties keep in the fridge for three days.

Serves 4

Per serving: Calories, 271; carbohydrates, 7.1g; protein, 12g; fat, 20g; fibre, 6.3g

  • 1 red pepper
  • 400g courgettes
  • 100g ground almonds
  • 50g smoked cheddar, coarsely grated
  • 3 spring onions, finely chopped
  • 1 medium egg
  • 2 tsp fresh or dried thyme leaves
  • Salt and freshly ground black pepper
  • 1 tbsp extra virgin olive oil

Heat the oven to 220c/gas mark 7. Bake the red pepper for 25-30 minutes, or until blackened and blistered. Put it into a bowl and cover with cling film. Turn the oven down to 180c/gas mark 4.

Meanwhile, grate the courgettes into a sieve over a bowl. Add a teaspoon of salt and mix, then leave for 10 minutes. Squeeze out any water from the grated courgette and put into a bowl with the remaining ingredients. 

Mix well. Make one round patty approximately 2cm deep by 5cm wide to test the mixture. Fry in a little oil until cooked.

Taste tester patty and alter seasoning in the rest of the mixture as necessary. Make the rest of the patties and cook in the oven on an oiled tray for 20 minutes or until firm and browned.

Remove the skin, seeds and core from the pepper. Blend with salt to taste and pour into a serving bowl. Serve with the patties.

This versatile recipe for courgette and cheese patties with red pepper sauce can be made bite sized, as in this recipe, or burger sized for a main meal

This versatile recipe for courgette and cheese patties with red pepper sauce can be made bite sized, as in this recipe, or burger sized for a main meal

This versatile recipe for courgette and cheese patties with red pepper sauce can be made bite sized, as in this recipe, or burger sized for a main meal

Crunchy broccoli with a lemon dip

This is a flavoursome, healthy dish to serve as a starter or as a side dish for a big family meal.

Serves 8

Per serving: Calories, 266; carbohydrates, 3.8g; protein, 5.8g; fat, 25g; fibre, 3g

For the broccoli: 

  • 1 garlic clove, grated
  • 100ml extra virgin olive oil
  • 2 tbsp red or white wine vinegar
  • ½ tsp chilli flakes
  • Salt and freshly ground black pepper
  • 2 heads of broccoli, cut into bite-size florets
  • 2 tbsp pink peppercorns, lightly crushed

For the lemon dip:

  • 200g full-fat Greek yoghurt
  • 100g mayonnaise
  • Finely grated zest of a lemon
  • Salt and freshly ground black pepper

Mix the garlic, olive oil, vinegar, chilli and seasoning in a bowl. Add the broccoli florets and make sure they are well coated in the dressing. 

Put the dish into the fridge for 30 minutes.

To make the dip, stir the ingredients together and season to taste.

Put the broccoli on a serving dish and scatter over the pink peppercorns.

Allow the broccoli to come to room temperature and serve with the dip.

This crunchy broccoli with a lemon dip is a flavoursome, healthy dish to serve as a starter or as a side dish for a big family meal

This crunchy broccoli with a lemon dip is a flavoursome, healthy dish to serve as a starter or as a side dish for a big family meal

This crunchy broccoli with a lemon dip is a flavoursome, healthy dish to serve as a starter or as a side dish for a big family meal

Roast chicken with mustard and caramelised onions

This unusual but incredibly simple recipe is from Tuscany, when Giancarlo worked there in a restaurant. It has become a family favourite.

Serves 6

Per serving: Calories, 490; carbohydrates, 17g; protein, 40g; fat, 26g; fibre, 3.8g

  • 1.5kg free range chicken
  • 170g jar mustard
  • 1kg onions, finely sliced
  • 4 garlic cloves, halved and lightly crushed
  • 6 tbsp extra virgin olive oil
  • 1 sprig rosemary
  • 150ml white wine
  • Sea salt and freshly ground black pepper

Preheat the oven to 180c/gas mark 4.

Put the chicken onto a chopping board and use a spatula to spread mustard over the skin of the chicken to coat it all over. Don’t be worried about using too much mustard – it’s absorbed by the chicken during the cooking and the sweet taste of the onions balances the flavours well.

Put the chicken into large roasting tray, season and drizzle half the olive oil on top. Cook it in the oven for 35 minutes.

Put the sliced onions and garlic into a mixing bowl, season and add the remaining oil. Toss to make sure they are evenly coated.

Remove the chicken and transfer to a plate. Place the sliced onions and garlic onto the hot tray, add the rosemary to the centre.

Take the chicken and turn it over so that the crown is on the rosemary and onions. Cook for 25 minutes.

Turn the chicken again, pour over the wine and put it back into the oven for another 20 minutes or until cooked through.

To check if the meat is cooked, pierce a chicken leg with a skewer – when the juices run clear it is ready. Remove from the oven. 

Spoon some of the caramelised onions onto a warm plate, top with a portion of chicken and the juices from the tray and serve with green vegetables.

This unusual for roast chicken with mustard and caramelised onions but incredibly simple recipe is from Tuscany, when Giancarlo worked there in a restaurant

This unusual for roast chicken with mustard and caramelised onions but incredibly simple recipe is from Tuscany, when Giancarlo worked there in a restaurant

This unusual for roast chicken with mustard and caramelised onions but incredibly simple recipe is from Tuscany, when Giancarlo worked there in a restaurant

Lorenzo’s beef stew with gremolata

Lorenzo Biagi was 15 years old when he taught us this Tuscan recipe. The beef can be swapped for lamb or venison. We like to serve the stew with celeriac mash and top it with zesty gremolata for colour and zing.

Serves 6

Per serving: Calories, 459; carbohydrates, 19g; protein, 28g; fat, 24g; fibre, 5g

  • 1 medium red onion, chopped
  • 1.2kg stewing beef
  • 5 tbsp extra virgin olive oil
  • 7 medium sage leaves
  • 10g rosemary needles, chopped
  • 2 tsp salt
  • 300ml red wine
  • 2 tbsp tomato puree
  • 2 x 400g tin of plum tomatoes
  • Freshly ground black pepper
  • 25g butter

For the gremolata:

  • Fresh flat-leaf parsley, chopped
  • 1 tsp lemon rind, finely grated
  • 1 small clove garlic, grated

Fry the onions over a medium heat in a dish until soft. Add the meat and cook over a high heat until the water has evaporated.

Now make a little pile of the sage leaves, rosemary and salt and chop them together. This is called a battuto and it should make for a finely chopped mixture. 

Add this mixture to the pan, stir and pour in the wine. Let it bubble for a few minutes, then add the tomato puree and stir through.

Next add the tomatoes and bring to the boil. Bash the tomatoes with a wooden spoon. Turn the heat down to simmer, put a lid on ajar and let it cook for 2 hours, or until the sauce has reduced and the meat is very tender.

To make the gremolata, mix the parsley, lemon rind and garlic together in a bowl.

Serve the stew topped with gremolata in a large serving dish or individual shallow bowls.

The beef can be swapped for lamb or venison in Lorenzo's beef stew with gremolata

The beef can be swapped for lamb or venison in Lorenzo's beef stew with gremolata

The beef can be swapped for lamb or venison in Lorenzo’s beef stew with gremolata

Sauteed mushrooms in cognac

This is a Greek recipe picked up on our travels. It is ideal as a side with any roast meat or cheese dish.

Serves 4

Per serving: Calories, 108; carbohydrates, 4.3g; protein, 1.7g; fat, 8.9g; fibre, 5g

  • 500g chestnut mushrooms
  • 5 tbsp extra virgin olive oil
  • 3 cloves garlic, lightly crushed
  • A good pinch of dried thyme leaves
  • 1 sprig rosemary
  • Salt and freshly ground black pepper
  • 3 tbsp cognac
  • 2 tbsp balsamic vinegar
  • A knob of salted butter
  • A small handful of parsley, roughly chopped

Cut the mushrooms in half and sauté over a high heat in the oil with the garlic, thyme, rosemary and seasoning. Allow the mushrooms to brown well — about 20 minutes. 

You want them to be quite dry to concentrate the flavour. When caramelised, add the cognac and vinegar and allow them to sizzle for a few minutes, then add the butter. Season to taste and serve scattered with the parsley.

Sauteed mushrooms in cognac is a Greek recipe picked up on our travels

Sauteed mushrooms in cognac is a Greek recipe picked up on our travels

Sauteed mushrooms in cognac is a Greek recipe picked up on our travels

Southern baked chicken

For years, Giancarlo’s guilty pleasure was to eat crispy chicken late at night. After being told he had type 2 diabetes, this was no longer an option. 

After much experimentation, we have re-introduced one of his favourite foods. We love the spicy coating and often have this with coleslaw and a crisp green salad.

Serves 6

Per serving: Calories, 746; carbohydrates, 12g; protein, 76g; fat, 43g; fibre, 4.4g

  • 2 eggs, beaten
  • 50g buckwheat or gluten-free flour
  • 12 skinless boneless chicken thighs
  • Salt and freshly ground black pepper
  • Extra virgin olive oil spray

For the coating:

  • 150g ground almonds
  • 3 tsp ground ginger
  • 2 tsp salt
  • 3 tsp unsmoked paprika
  • 1 tsp freshly ground black pepper
  • 3 tsp oregano
  • 3 tsp mustard powder
  • 3 tsp thyme, finely chopped

Heat the oven to 180c/gas mark 4. Put the ingredients for the coating into a food processor and whizz to make a powder. Tip onto a plate.

Put the eggs into a soup bowl and beat with a fork. Put the flour into a soup bowl.

Season the chicken and coat in flour. Tap off the excess and dip each thigh into the egg to coat all over.

Finally, lightly press the chicken into the spice mixture and ensure it is coated evenly. Do this with all the thighs and place on an oven tray.

Spray the oil onto both sides of the chicken and lay them out flat.

Bake for 10 minutes, then turn the chicken over. Cook for another 10-15 minutes, or until they are cooked through and juices are no longer pink when pierced with a skewer.

For years, Giancarlo¿s guilty pleasure was to eat crispy chicken late at night. After being told he had type 2 diabetes, this was no longer an option, so made a new recipe instead, above

For years, Giancarlo¿s guilty pleasure was to eat crispy chicken late at night. After being told he had type 2 diabetes, this was no longer an option, so made a new recipe instead, above

For years, Giancarlo’s guilty pleasure was to eat crispy chicken late at night. After being told he had type 2 diabetes, this was no longer an option, so made a new recipe instead, above

We transformed our lives with the diet- and you can too  

Reversed diabetes and lost 6 stone

Michele Gladden, 63, is a carer and lives in Worcestershire, with her husband George, a retired librarian. They have two sons.

I wish I’d known about the low-carb approach for type 2 diabetes sooner. I was diagnosed in 2015 after I’d gone to the GP for a urinary tract infection and they did a blood test as I’d also been very tired. 

I was told I had type 2 diabetes and started on metformin. I’m 5ft 6in and was 14st 7lb, so my BMI was 30.5, touching ‘obese’. I cut back on obvious sugar such as cake and fruit juice and was restrictive with fats.

Michele Gladden, 63, once weighed 14st, above

Michele Gladden, 63, once weighed 14st, above

Michele has now settled at around 8st 10lb

Michele has now settled at around 8st 10lb

Michele Gladden, 63, is a carer and lives in Worcestershire, with her husband George, a retired librarian. She once weighed 14st, left, but managed to slim down and settled at around 8st 10lb

But while I lost a bit of weight and my blood sugar levels came down, they slowly increased again. I was exercising, too, but still got bigger.

I found the low-carb plan, developed by Dr David Unwin, online at diabetes.co.uk in summer 2017. 

It was incredibly easy and the results rapid. After ten weeks I’d lost two stone and I no longer need metformin. I also stopped needing anti-depressants, which I’d been taking for ten years.

The better you feel, the less inclined you are to go back to your old ways of eating. I still have check-ups, but in May my diabetes will have been in remission for 18 months. My last blood sugar reading was 29 — normal — and I’ve settled at around 8st 10lb.

I hide pictures of the old me 

Mark Hancock, 48, is a financial adviser and lives near Portsmouth with his wife Heather, 48, a finance administrator, and their two sons.

There’s a photo of me at a football match with my son 15 years ago that I keep hidden in a cupboard — I can’t believe I was that size.

Now, three years after switching to a low-carb diet, I might get a six-pack.

Mark Hancock, 48, is a financial adviser and lives near Portsmouth with his wife Heather, 48, a finance administrator, and their two sons. Three years after switching to a low-carb diet, he might get a six-pack

Mark Hancock, 48, is a financial adviser and lives near Portsmouth with his wife Heather, 48, a finance administrator, and their two sons. Three years after switching to a low-carb diet, he might get a six-pack

Mark Hancock, 48, is a financial adviser and lives near Portsmouth with his wife Heather, 48, a finance administrator, and their two sons. Three years after switching to a low-carb diet, he might get a six-pack

I met Dr Unwin through a charity and I think everyone with type 2 diabetes should be told about his approach. Using it, I’ve lost nearly four stone.

Mark once weighed 16st with a BMI of 27.8, but took on a low-carb diet and lost four stone. Mark is pictured before his weight loss, above

Mark once weighed 16st with a BMI of 27.8, but took on a low-carb diet and lost four stone. Mark is pictured before his weight loss, above

Mark once weighed 16st with a BMI of 27.8, but took on a low-carb diet and lost four stone. Mark is pictured before his weight loss, above

I was diagnosed with type 2 diabetes in 2010. I was sorting out some life cover and having some tests done by a nurse. A urine test picked up excess sugar. 

I was 39 and I’d be at my desk all day, grabbing the wrong things to eat and getting takeaways. I was 16st and my BMI was 27.8 — overweight. 

I was prescribed metformin and told to have more wholegrain versions of things like bread and pasta, plus fruit and veg. 

My blood sugar levels initially improved but by 2016 were going back up.

Then I happened to hear on the radio that a low-carb diet could help. 

Out went pasta and bread: instead, I had full-fat yoghurt, eggs, cheese, butter. It was great to eat all these things again.

In the first week I felt tired and had headaches, but I lost 9lb and it felt amazing. 

I now weigh a healthy 12st 7lb. I also have so much more energy: I ran a marathon before Christmas. 

Now we do a lot of running events as a family.

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