13 ms·

Type 2 diabetes: NHS to offer 800-calorie diet treatment

164 points by prostoalex 8y ago

a3n 8y ago
When I was first diagnosed with T2 I did some reading around. Interesting history, especially pre- manufactured insulin. For example, war is "good" for reducing incidence of diabetes, because famine.
- pmiller2 8y ago
  Two minor points: T2 isn’t controlled with insulin; it’s a syndrome of insulin resistance and other metabolic dysfunctions. And “manufactured insulin” came on the scene in 1922. Before that, T1 diabetes was universally fatal.
  - a3n 8y ago
    My T2 is not treated with insulin today, but it could be later if it gets worse. And I am indeed talking about history pre-20th century. For example, diabetes used to be diagnosed by peeing on the ground and seeing if ants we attracted to it. According to whatever diabetes history book I checked out of a medical library on inter library loan.
known 8y ago
Could be feasible due to https://www.medicalnewstoday.com/articles/267241.php https://www.medicalnewstoday.com/articles/267241.php
arcticbull 8y ago
Makes sense, it is a diet related illness, so it should have a diet related treatment. Instead of treating the symptoms, treat the cause.
- chosenbreed 8y ago
  > Makes sense, it is a diet related illness, so it should have a diet related treatment. Instead of treating the symptoms, treat the cause. If everyone starts that doing we're going to put the pharmaceuticals out of business. There'd be riots!
- chimeracoder 8y ago
  > Makes sense, it is a diet related illness, so it should have a diet related treatment. Instead of treating the symptoms, treat the cause. Type 2 diabetes isn't caused by diet. Certain diets can increase the risk of Type 2 diabetes, but it's not a foregone conclusion, and it's not uncommon to develop Type 2 diabetes despite an otherwise healthy diet.
  - magnamerc 8y ago
    T2D is caused by a combination of genetic and environmental factors such as diet, and you're correct that someone can get T2D based mostly on genetic factors alone. It is however very uncommon, and diet plays a role in the majority of cases. There are several studies that show this.
    - chimeracoder 8y ago
      > It is however very uncommon It is not very uncommon, and in fact the most recent (last ~decade of) research has actually caused us to question the extent to which people genetically predisposed to diabetes can mitigate their risk through diet and lifestyle choices.
      - ConceptJunkie 8y ago
        My Dad and his brother both have T2D. My Dad is 75 and my uncle is going on 60. They are both very active, in shape, and not overweight at all. e.g., My Dad was playing tennis 4 times a week when he was diagnosed. He's probably cut down some since, um, he's 75, and has had two hip replacements, but he's in way better shape than I am. Neither were significantly overweight when they were diagnosed. In fact, my Dad has been trim for decades, and while I don't see my uncle often, he was always thin and very fit-looking when I have seen him. There _has_ got to be a genetic component independent of lifestyle and diet choices. Me? I have no excuse. I'm overweight and not active and I know I need to change that. edit: Didn't proofread.
belltaco 8y ago
Losing a lot of weight with very low calorie diets is hard, but not regaining it over the next couple of years is next to impossible. Your body will try all the tricks in the book, it will reduce your metabolism to way below that of the person of the same weight, it will amp up your hunger hormones so much that you will think and dream about food 24/7. Only 5 to 7% of people that lose a large amount weight are able to keep it off successfully in the medium and long term. Hope there is more research into this mechanism.
- klmr 8y ago
  This new diet is specifically tailored to avoid this yoyo effect. It’s currently not yet clear whether this is indeed the case (hence this expanded epidemiological study) but preliminary results indicate that this is indeed the case. In other words, this specific diet (severely limited calories as well as restriction of food to almost completely liquids) reportedly helps sustaining the weight loss long-term (and is allegedly effective for around 50% of patients).
  - jobigoud 8y ago
    Are you saying they stay on 800kcal/day for long-term? I'm skeptical. Usually the problem is when you switch to the maintenance diet.
    - klmr 8y ago
      No. The 800 kcal/day liquid diet is kept up for three months. However, the resulting weight loss is sustained long term.
- philip1209 8y ago
  Type II diabetes is a diet-related illness. If you cure the illness with diet, then switch back to what you were eating before - of course, diabetes will come back. These dietary changes need to be seen as new habits, not temporary changes.
  - 8y ago
philip1209 8y ago
Calories are not the core problem - carbohydrates are. The research from VirtaHealth.com makes this clear. They are getting T2 diabetics off of insulin within a week, while still giving patients the satiety they want from meals.
- Nokinside 8y ago
  Heh. Whole company launched based on single study with short duration, no control group and big drop-out rate. But when you add long list of citations for medical literature it looks valid. Even when those studies don't directly validate your approach. People don't look at what the studies actually say.
- rpvreviews 8y ago
  Dr. Michael Greger, Dr. McDoughall are my heros. Carbs and starch are not the problem, animal fats and proteins are. Whole food plant based diet are the best
  - hourislate 8y ago
    It's interesting that once I cut out grains, potatoes, pasta, fruit/sweets, starches and continued to eat beef, chicken, fish, Organ meat, low carb vegetables and foods filled with fat (nuts, cheese, olives, etc) caused a 100lb weight loss that I have kept off over 3 years. This was without any exercise or extra activity. Perhaps I am an outlier.
    - ng12 8y ago
      I think that's pretty normal. Carbohydrate-heavy foods are good for over-loading your body with enegy. It's fine if you're working on a farm 10 hours a day, less so if you're sitting in an office. The reality is 2k calories of lean meat, fruits, and veggies is A LOT more food than 2k calories worth of cereals. It's physically difficult to overeat when your diet looks like that.
    - pnw_hazor 8y ago
      Worked for me too. Still mad about eating breakfasts of skim milk and unsweetened shredded wheat for years. Now it is whole milk with bacon and eggs every morning.
hirundo 8y ago
I think that this is effective because it reduces the carbohydrate load. Protein and fat consumption also increase insulin response but not nearly as much. Type 2 diabetics could get most of the blood sugar reducing benefit of this by just removing/replacing the carbs. That has been my N=1 experience with both fasting and carb restriction.
- will_brown 8y ago
  Well reversing is different but most cases can be reveresed with dietary/lifestyle changes. On the other hand prevention of type2 is N=100% with these changes. I know people, especially in the US consider it thier right/freedom to eat what they want and live how they want, but in my mind it’s deeply disturbing especially because children don’t have any choice (it’s parental). I think as soon as a child is diagnosed with fatty liver disease...there should be some mandate on parents to “treat” their child with diet (which I know is probably equally disturbing to people, government dictated diet).
  - hirundo 8y ago
    In the US the official nutrition advice has been both wrong and corrupt since the 1970s. Gotten wrong by sincere hard working scientists with the best intentions. Corrupted by corporate capture of regulatory bodies and funding of exculpatory studies. These same forces would choose what is mandated. That is horrifying. Not only could they give bad advice, they could compel ever larger fractions of the population to follow it. Far better to let parents decide, so when they get it wrong we can learn from it, and don't all get it wrong at once.
    - will_brown 8y ago
      >Far better to let parents decide, so when they get it wrong we can learn from it, and don't all get it wrong at once. The problem is the disease is growing in epidemic proportions, no one is learning from mistakes. The government got it wrong sure, but let the doctors prescribe the diet and government won’t dictate the diet only mandate following doctor prescribed treatment/diet (and this too I know has flaws). But here is the thing, say a child does get diabeties and the doctor prescribed insulin, but the parents think they know better and refuse the treat their child. Should government be able to step in or allow the parent to withhold insulin treatment based on their freedom? Legally parents can refuse (life saving) treatment on religious grounds, and that arguement comes into play in diet, but I’ve also been involved in a case where a 13 year old was pregnant with HIV and was refusing court ordered treatments so the baby would be born without HIV, legally and morally they are complex issues.
jonteru 8y ago
This sounds pretty similar to some of the things Dr. Valter Longo has been mentioning in his book the longevity diet where a part of it are also occasional 5 day fasts with 800 calories, that (supposedly) have great benefits. Great to see this being tested with the general public.
gregf 8y ago
Ouch, this is going to be hard on me.
emersonrsantos 8y ago
When people will realize that carbs are the only non-essential macronutrient? The sports community (especially bodybuilding) knows that for decades. If an athlete says to me that a thing he does to his body work 95% of the time, I would consider to try it, and already did, some things against over-the-counter conventional medicine like this no-carb diet.
- ryanwaggoner 8y ago
  Bodybuilders eat plenty of carbs.
  - sfotm 8y ago
    Not sure why this is being downvoted, bodybuilders do eat carbs - they just time them appropriately. If you're about to work out, carbohydrates will help you get through it. On the other hand, if you're going to be sedentary for a while, or you're really trying to prioritize fat loss, you probably wouldn't eat as many carbs. Of course, Keto is a thing, but I haven't heard many stories of bodybuilders that actually target the keto-state. It's about getting the right amount of carbohydrates (hint: not as much as most people eat).
    - brandonmenc 8y ago
      If by "time them appropriately" you mean "constantly all day long", then yeah. Unless they're prepping for a contest, which is not what they spend the majority of their time doing.
  - razakel 8y ago
    No they don't. A bodybuilding diet is mostly protein, then certain fats, then starchy carbs at the right time (breakfast and post-workout).
    - have_faith 8y ago
      > A bodybuilding diet is mostly protein Bodybuilders typically consume about ~30% protein. Where did you get the idea that it is mostly protein? Not to say that there aren't outliers obviously.
zavi 8y ago
How will they make sure people don't cheat and eat more anyways? 800 calories a day for an overweight person requires some serious will power.
- rufus_2 8y ago
  I found it easier to do via intermittent fasting and then eating all of my calories in one meal per day. Something about completely abstaining from food is easier for me psychologically than having multiple tiny meals and making myself stop eating when I'm not full.
  - sfotm 8y ago
    Thing is, 800 calories is a meal for a lot of people. Ever go to Chipotlé? Already over.
  - jobigoud 8y ago
    I was assuming these 800kcal were done through OMAD, are they not? I don't see how you could spread that over the day and keep your sanity.
  - tchaffee 8y ago
    It's also easier for me. I have no problem skipping breakfast and then skipping lunch takes a little willpower but I'm often distracted by work. I have friends who find it easier to eat a big lunch as their only meal. Worth experimenting for each person to find what works best for them.
lilcorey10 8y ago
This sounds to be marketed as some scientific potion to cure diabetes or at least rid the need of medication. All it comes down to is cleaning up your diet (e.g. eating the right amount of calories for your body and eating nutrient rich foods). There's no one diet fits all but getting a good balance of proteins, carbs, and fats is all this is doing for these people. NHS is simply doing the leg work. I control my weight by counting calories and macro-nutrients. If people could figure out how to do that own their own we'd see a huge decrease in Type 2. It's true, a cleaner diet tends to be more expensive and requires more work than the convenience of a fast food diet - but at the the end of the day we're trading diabetes so we can be lazy with our diet and health.
- ryanwaggoner 8y ago
  800 calories per day for three months is hardly just "cleaning up your diet".
  - SilasX 8y ago
    Exactly. This seems like an Onion headline: "We have your cure for diabetes! Just eat a ridiculously low amount of food, fatso." I don't mean to sound like a whiner, but ... if it were that easy to cut down my food consumption, I wouldn't be going to a doctor in the first place! It's like telling people with extreme loneliness or social anxiety to "just strike up a conversation with someone!" Or PTSD suffers: "Geez, just don't freak out so much, take a deep breath or something." Or narcissists/sociopaths: "Just, you know, think more about how your actions hurt other people." Given Herculean willpower, most diseases of civilization can be conquered. Don't pat yourself on the back for calling it "prescription".
    - akvadrako 8y ago
      It's not like that because it's all about how you approach the problem. It's easy to do all those things if you have the right mindset. Creating that mindset isn't easy, but wording everything in the worst possible manner is a sure way to make it more difficult. In the case of diabetes, it's saying: here's an alternative prescription that will cure you, we have good evidence it will work, you can afford it, here are the steps to follow, each of which looks easy by itself...
ronreiter 8y ago
Or in other words: Type 2 Diabetes is a normal metabolic state of humanity (or at least some significant parts of it), it's just that we're too goddamn fat
- make3 8y ago
  ? you mean, it's a consequence of being fat
megaman8 8y ago
It's great that they teach the idea that Diabetes (type 2) is preventable and even treatable with responsible eating habits. Too many people believe it's just something your doctor is supposed to treat with a pill. Food companies often push the idea that all you need to do is exercise more. Whilst exercise might be a great thing: it alone can't fix the problem. You still need to learn how to eat.
acangiano 8y ago
You absolutely don’t need such caloric restriction to revert diabetes. All it takes is a very low carb or keto diet. Even without exercise.
- toddh 8y ago
  At that calorie level it's basically a fast mimicking diet, so part of the benefit would be autophagy and the respawning of stem cells. It's hard to tell how much that helps however.
  - acangiano 8y ago
    That’s definitely a factor. That and the automatic reduction in carb intake with such a caloric restriction. I mean, if they fed them pure sugar, they’d still be getting “only” 200g of carbs per day which is still less than what a lot of people who developed diabetes used to eat. More realistically they are likely getting significantly less carbs per day with elements of fasting thrown in.
- PerfectElement 8y ago
  Or certain types of plant-based diets[1][2][3]. 1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5466941/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5466941/ 2. https://www.omicsonline.org/open-access/diabetes-reversal-by-plantbased-diet-2167-0943-1000232-94442.html https://www.omicsonline.org/open-access/diabetes-reversal-by... 3. https://www.ncbi.nlm.nih.gov/pubmed/20425575 https://www.ncbi.nlm.nih.gov/pubmed/20425575
  - jumanchiss 8y ago
    1. Vegan doctors Bernstein AM, Esselstyn, Barnard ND et al. (and of course the WHO) cherry-pick studies that support their theory. 2. 3-days study with only 55 patients 3. Questionable observational (selection bias) studies and more Neal D. Barnard.
- onetimemanytime 8y ago
  Problem is keeping it, as almost everyone can keep the diet for a few months. We all know what we should do but don't, sometimes until is too late. The person that invents a pill to trick our genes not to seek what was once rare (fat, sweets, carbs etc) will be a trillionaire. When our current genes were stamped "we" maybe had to hunt for days to eat once. Now we drive to McDonalds, order our or open the fridge door. Maybe something that puts our metabolism on steroids?
virtuallynathan 8y ago
The 800 calories they are eating doesn't seem terribly healthy: "patients were asked to follow either a ‘home-made’ milk- and fruit-juice-based diet (811 kcal/day, 64 g protein, 132 g carbohydrate, 6 g fat) with a multivitamin/mineral supplement (Forceval® [Alliance]), or a micronutrient-replete commercial LELD (832 kcal/day, 87 g protein, 120 g carbohydrate, 12 g fat). I imagine these people are probably staving... I'd rather go low-carb myself. This is the study, DiRECT: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4754868/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4754868/
- throwaway5752 8y ago
  Cool. What about renal load?
- vertline3 8y ago
  So I guess back in the day, milk and bananas were considered an ideal food combination,
  - debacle 8y ago
    A bowl of milk with bananas and about 1/4 cup of sugar. My grandpa ate that right up until he died. Man never gained a pound.
    - vertline3 8y ago
      Yeah I think I had it backwards it was nutrients that mixed perfectly, I was editing my post as you wrote that about weight gain. I thought Norman Rockwell used it to try and join the war.
    - magic_beans 8y ago
      Nothing wrong with that kind of diet for people without a genetic predisposition for diabetes (or lactose intolerance) and who are otherwise eating moderately.
- xd 8y ago
  It's targeted at people with type 2 and are obese .. which is an ever increasing issue in the UK. The BBC don't like to rock the boat.
ak39 8y ago
I am not a doctor. This is what I have learned so far (there are no references here - sorry, I will need to dig up the material to substantiate this if you ask): The upshot: Managing diet is not sufficient (for type 2) remission. The damage is at cellular level. That damage needs to be reversed. Therefore muscles need to be rebuilt. Even for the over 60 years! The thinking: Diabetes Type 2 is the end point of years of abuse the body endures with elevated insulin and the _extent_ of insulin resistance the body progresses to. Diabetes therefore is a spectrum - the end point is when the pancreas bonks out and refuses to produce any more insulin. It's a tiny tiny organ and I think it's fragile. And it's threshold is also genetically determined. The interesting thing is that we all (including healthy folks) have levels and sometimes acute bouts of insulin resistance! The thing that made sense to me, reading about this, was that insulin resistance is a function of your muscle cells denying entry to glucose. And the insulin concentration in the bloodstream is a direct function of the concentration of free flowing glucose. Poor Pancreas is only doing its job but the muscles are not taking in any new glucose. They are refusing (resistant). Pancreas tries its best by pumping more insulin and for longer but the adamant muscles are the contract breakers in this arrangement - they don't open the gates for glucose. The only way to change direction permanently in type 2 is to rebuild muscles which will have better insulin receptors to allow glucose to be shunted into the cells. For this to happen you have to do strength training. Lift sufficiently heavy. (No, not Arnie levels by any measure.) (I recently read a study that administering testosterone to type 2 diabetics improved their insulin resistance. What happens with testosterone and anabolic steroids? New muscles, that's what.)
- matt4077 8y ago
  Yeah... Also get a lawyer, quit Facebook, and start dressing for the job you want!
  - ak39 8y ago
    I don't quite understand.
    - matt4077 8y ago
garenp 8y ago
About 3 years ago (late 2015 now) I was quite overweight, had a knee injury that limited my mobility (stairs mostly) and had a fasting glucose and post-meal readings that indicated I was nearly pre-diabetic (T2). So, I cut out out all sugary drinks, refined carbs, late night eating (!!) and tried various intermittent fasting / time restricted feeding techniques (5:2, alternate day, one-meal-a-day) and after about 3.5 months my glucose readings returned to the "normal" range. (Which is WAY more tolerable than sticking to a low-calorie diet every single day IME. I still had pizza and cheeseburgers on occasion, just no soda, fries, "junk" etc.) After around 6-7 months I'd lost 40+lbs, my knee stopped bothering me and no longer had to entertain the idea of fixing it with surgery. I'm now down well over 60+lbs without having put in hardly any effort to exercise (occasional walking) - pretty stunning to me.
- illiac_1962 8y ago
  Same thing here. Except I also refuse any refined flour, Co sidering it sugar. I only eat whole foods, no milk, very little cheese, barely any meat. Lots of vegetarian meals. Dropped 50+ lbs without much drama. I cycle extensively in the warm summer months.
- costcopizza 8y ago
  Congrats! What fasting method do you currently use, or do you switch between the ones listed?
  - garenp 8y ago
    Nowadays I mostly just do OMAD (one-meal-a-day) or close to it (eating window is about 1-3 hours) as it's simpler. Initially some will power was needed to stop myself from snacking in the evenings, but as long as I make sure I have a fair amount of protein in that one meal, it never seems to happen now. Occasionally I'll do alternate-day if I feel 'stuffed' or had a big day of lots of calories (holidays, social events) - whatever is more convenient at the time.
    - lj3 8y ago
msiyer 8y ago
My mother suffered Type-2 diabetes for almost 20 years. I put her on an extremely strict raw food diet three months ago and stopped injecting insulin. Her fasting blood sugar level is now in the 90-110 mg/dL range. I now give her some steamed potatoes also. I too follow the same diet to give her company. Elimination of oil, sugar and dairy has helped, I believe. She is a vegetarian, so flesh was never in the picture. I do not have to restrict calories with raw food. Eat as much as you can. No juicing, however. That is a totally not allowed.
- nradov 8y ago
  I'm glad your mother is improving, but there's no real evidence that raw vegetables are better for blood sugar levels than cooked vegetables.
  - msiyer 8y ago
    Raw fruits are what I feed her. No vegetables at all. I started giving her some steamed potatoes recently. Bananas have become her staple food.
ryanwaggoner 8y ago
Loving the broscience takedowns of this NHS pilot program about how "this won't work!", or "low carb / keto is the best way!" If only doctors knew how to read internet forums, then they'd be as knowledgable as all the armchair docs here, few (none?) of whom seem to have any actual training or T2 diabetes themselves.
deleted 8y ago
[deleted]
rkiyer 8y ago
The 800 calories number indicates that this might be related to the Fasting Mimicking Diet of Valter Longo. Since actual fasting has a "scary" reputation among some patients and doctors, Valter Longo developed a 5 day fasting like protocol with severely restricted calories that appears to have similar benefits to fully fasting for 5 days. It looks like this modified version of complete fasting is gaining popularity among the medical establishment. https://en.wikipedia.org/wiki/Valter_Longo#Fasting_mimicking_diet https://en.wikipedia.org/wiki/Valter_Longo#Fasting_mimicking... https://www.marksdailyapple.com/does-the-fasting-mimicking-diet-live-up-to-the-hype/ https://www.marksdailyapple.com/does-the-fasting-mimicking-d...
tacon 8y ago
Type 2 diabetes is currently on track to bankrupt the world's healthcare system. Easily 60% of the US residents reading this comment are already insulin resistant, they just don't know it yet. Many of those will progress to full blown T2DM in ten to fifteen years. It used to take a very expensive sequence of blood tests involving injecting glucose and tracking the concentrations of glucose and insulin over a few hours. Lately the tech has improved and there is a single blood test that can give an "insulin-resistance score", LP-IR[0][1]. While Peter Attia showed this test in a blog post from 2012[2], it seems to be getting more attention lately[3]. Just because your blood glucose after fasting is "normal" does not mean you will not get T2DM. Just ask Tim Noakes, world class exercise scientist and medical doctor, who finished more than 70 marathons and still woke up one day with diabetes, just like his father.[4][5] [0] https://www.labcorp.com/test-menu/31976/nmr-lipoprofile%C2%AE-with-graph https://www.labcorp.com/test-menu/31976/nmr-lipoprofile%C2%A... [1] https://www.walkinlab.com/media/attachment/file/1/2/123810.pdf https://www.walkinlab.com/media/attachment/file/1/2/123810.p... [2] https://peterattiamd.com/the-straight-dope-on-cholesterol-part-iii/ https://peterattiamd.com/the-straight-dope-on-cholesterol-pa... [3] https://www.managedcaremag.com/archives/2018/4/new-test-diagnosing-insulin-resistance-could-turn-tide-against-diabetes https://www.managedcaremag.com/archives/2018/4/new-test-diag... [4] https://www.diabetes.co.uk/in-depth/tim-noakes-challenging-dietary-guidelines/ https://www.diabetes.co.uk/in-depth/tim-noakes-challenging-d... [5] https://www.amazon.com/Lore-Nutrition-Challenging-conventional-dietary/dp/1776092619/ https://www.amazon.com/Lore-Nutrition-Challenging-convention...
voidbip 8y ago
In July I was 203 pounds which for a 5'6" frame, put me in the "obese" category. It was the highest weight I had ever been, and I felt I occupied more space than I should in the world ( not in a good way ). I follow a youtuber on Indian cooking and for whatever reason this woman mentioned how she recently started eating in a more "Keto" way. This woman is thin as a rake. She mentioned she was doing this for mental clarity. On a whim, I decided to try it. I literally threw the little debbie box I had my hand in, in the garbage that day. Today, I am 166 pounds, still "overweight" but this is the most amount of weight I have ever lost. I feel so much better and healthier, and its true about the mental clarity. My unsubstantiated hypothesis is that it takes away the emotional swings insulin give you. I eat till I am full. Honestly. There is not a day that I "think" about what I am eating other than keeping sugar and carbs out my month. I could not be happier. I am a 38 yo technology professional, and I imagine many others here are similar. I have nothing to sell. I just want to make people aware of a lifestyle that may help many of us who sit all day for a living.
GreaterFool 8y ago
From what I've read about starving yourself vs fasting and my own experience 800-calories sounds like HELL. I can fast for 2 weeks no problem (although that's kinda long and I wouldn't do it if I didn't have enough body fat to sustain it. If you're skinny and don't have fat to spare better not stretch it unnecessarily). I'm eating keto and I usually only eat once a day. Fasting feels good. Starving yourself feel horrible.

164 points by prostoalex 8y ago

a3n 8y ago

When I was first diagnosed with T2 I did some reading around. Interesting history, especially pre- manufactured insulin. For example, war is "good" for reducing incidence of diabetes, because famine.

pmiller2 8y ago
Two minor points: T2 isn’t controlled with insulin; it’s a syndrome of insulin resistance and other metabolic dysfunctions. And “manufactured insulin” came on the scene in 1922. Before that, T1 diabetes was universally fatal.
- a3n 8y ago
  My T2 is not treated with insulin today, but it could be later if it gets worse. And I am indeed talking about history pre-20th century. For example, diabetes used to be diagnosed by peeing on the ground and seeing if ants we attracted to it. According to whatever diabetes history book I checked out of a medical library on inter library loan.

known 8y ago

Could be feasible due to https://www.medicalnewstoday.com/articles/267241.php https://www.medicalnewstoday.com/articles/267241.php

arcticbull 8y ago

Makes sense, it is a diet related illness, so it should have a diet related treatment. Instead of treating the symptoms, treat the cause.

chosenbreed 8y ago
> Makes sense, it is a diet related illness, so it should have a diet related treatment. Instead of treating the symptoms, treat the cause. If everyone starts that doing we're going to put the pharmaceuticals out of business. There'd be riots!
chimeracoder 8y ago
> Makes sense, it is a diet related illness, so it should have a diet related treatment. Instead of treating the symptoms, treat the cause. Type 2 diabetes isn't caused by diet. Certain diets can increase the risk of Type 2 diabetes, but it's not a foregone conclusion, and it's not uncommon to develop Type 2 diabetes despite an otherwise healthy diet.
- magnamerc 8y ago
  T2D is caused by a combination of genetic and environmental factors such as diet, and you're correct that someone can get T2D based mostly on genetic factors alone. It is however very uncommon, and diet plays a role in the majority of cases. There are several studies that show this.
  - chimeracoder 8y ago
    > It is however very uncommon It is not very uncommon, and in fact the most recent (last ~decade of) research has actually caused us to question the extent to which people genetically predisposed to diabetes can mitigate their risk through diet and lifestyle choices.
    - ConceptJunkie 8y ago
      My Dad and his brother both have T2D. My Dad is 75 and my uncle is going on 60. They are both very active, in shape, and not overweight at all. e.g., My Dad was playing tennis 4 times a week when he was diagnosed. He's probably cut down some since, um, he's 75, and has had two hip replacements, but he's in way better shape than I am. Neither were significantly overweight when they were diagnosed. In fact, my Dad has been trim for decades, and while I don't see my uncle often, he was always thin and very fit-looking when I have seen him. There _has_ got to be a genetic component independent of lifestyle and diet choices. Me? I have no excuse. I'm overweight and not active and I know I need to change that. edit: Didn't proofread.

belltaco 8y ago

Losing a lot of weight with very low calorie diets is hard, but not regaining it over the next couple of years is next to impossible. Your body will try all the tricks in the book, it will reduce your metabolism to way below that of the person of the same weight, it will amp up your hunger hormones so much that you will think and dream about food 24/7. Only 5 to 7% of people that lose a large amount weight are able to keep it off successfully in the medium and long term. Hope there is more research into this mechanism.

klmr 8y ago
This new diet is specifically tailored to avoid this yoyo effect. It’s currently not yet clear whether this is indeed the case (hence this expanded epidemiological study) but preliminary results indicate that this is indeed the case. In other words, this specific diet (severely limited calories as well as restriction of food to almost completely liquids) reportedly helps sustaining the weight loss long-term (and is allegedly effective for around 50% of patients).
- jobigoud 8y ago
  Are you saying they stay on 800kcal/day for long-term? I'm skeptical. Usually the problem is when you switch to the maintenance diet.
  - klmr 8y ago
    No. The 800 kcal/day liquid diet is kept up for three months. However, the resulting weight loss is sustained long term.
philip1209 8y ago
Type II diabetes is a diet-related illness. If you cure the illness with diet, then switch back to what you were eating before - of course, diabetes will come back. These dietary changes need to be seen as new habits, not temporary changes.
- 8y ago

philip1209 8y ago

Calories are not the core problem - carbohydrates are. The research from VirtaHealth.com makes this clear. They are getting T2 diabetics off of insulin within a week, while still giving patients the satiety they want from meals.

Nokinside 8y ago
Heh. Whole company launched based on single study with short duration, no control group and big drop-out rate. But when you add long list of citations for medical literature it looks valid. Even when those studies don't directly validate your approach. People don't look at what the studies actually say.
rpvreviews 8y ago
Dr. Michael Greger, Dr. McDoughall are my heros. Carbs and starch are not the problem, animal fats and proteins are. Whole food plant based diet are the best
- hourislate 8y ago
  It's interesting that once I cut out grains, potatoes, pasta, fruit/sweets, starches and continued to eat beef, chicken, fish, Organ meat, low carb vegetables and foods filled with fat (nuts, cheese, olives, etc) caused a 100lb weight loss that I have kept off over 3 years. This was without any exercise or extra activity. Perhaps I am an outlier.
  - ng12 8y ago
    I think that's pretty normal. Carbohydrate-heavy foods are good for over-loading your body with enegy. It's fine if you're working on a farm 10 hours a day, less so if you're sitting in an office. The reality is 2k calories of lean meat, fruits, and veggies is A LOT more food than 2k calories worth of cereals. It's physically difficult to overeat when your diet looks like that.
  - pnw_hazor 8y ago
    Worked for me too. Still mad about eating breakfasts of skim milk and unsweetened shredded wheat for years. Now it is whole milk with bacon and eggs every morning.

hirundo 8y ago

I think that this is effective because it reduces the carbohydrate load. Protein and fat consumption also increase insulin response but not nearly as much. Type 2 diabetics could get most of the blood sugar reducing benefit of this by just removing/replacing the carbs. That has been my N=1 experience with both fasting and carb restriction.

will_brown 8y ago
Well reversing is different but most cases can be reveresed with dietary/lifestyle changes. On the other hand prevention of type2 is N=100% with these changes. I know people, especially in the US consider it thier right/freedom to eat what they want and live how they want, but in my mind it’s deeply disturbing especially because children don’t have any choice (it’s parental). I think as soon as a child is diagnosed with fatty liver disease...there should be some mandate on parents to “treat” their child with diet (which I know is probably equally disturbing to people, government dictated diet).
- hirundo 8y ago
  In the US the official nutrition advice has been both wrong and corrupt since the 1970s. Gotten wrong by sincere hard working scientists with the best intentions. Corrupted by corporate capture of regulatory bodies and funding of exculpatory studies. These same forces would choose what is mandated. That is horrifying. Not only could they give bad advice, they could compel ever larger fractions of the population to follow it. Far better to let parents decide, so when they get it wrong we can learn from it, and don't all get it wrong at once.
  - will_brown 8y ago
    >Far better to let parents decide, so when they get it wrong we can learn from it, and don't all get it wrong at once. The problem is the disease is growing in epidemic proportions, no one is learning from mistakes. The government got it wrong sure, but let the doctors prescribe the diet and government won’t dictate the diet only mandate following doctor prescribed treatment/diet (and this too I know has flaws). But here is the thing, say a child does get diabeties and the doctor prescribed insulin, but the parents think they know better and refuse the treat their child. Should government be able to step in or allow the parent to withhold insulin treatment based on their freedom? Legally parents can refuse (life saving) treatment on religious grounds, and that arguement comes into play in diet, but I’ve also been involved in a case where a 13 year old was pregnant with HIV and was refusing court ordered treatments so the baby would be born without HIV, legally and morally they are complex issues.

jonteru 8y ago

This sounds pretty similar to some of the things Dr. Valter Longo has been mentioning in his book the longevity diet where a part of it are also occasional 5 day fasts with 800 calories, that (supposedly) have great benefits. Great to see this being tested with the general public.

gregf 8y ago

Ouch, this is going to be hard on me.

emersonrsantos 8y ago

When people will realize that carbs are the only non-essential macronutrient? The sports community (especially bodybuilding) knows that for decades. If an athlete says to me that a thing he does to his body work 95% of the time, I would consider to try it, and already did, some things against over-the-counter conventional medicine like this no-carb diet.

ryanwaggoner 8y ago
Bodybuilders eat plenty of carbs.
- sfotm 8y ago
  Not sure why this is being downvoted, bodybuilders do eat carbs - they just time them appropriately. If you're about to work out, carbohydrates will help you get through it. On the other hand, if you're going to be sedentary for a while, or you're really trying to prioritize fat loss, you probably wouldn't eat as many carbs. Of course, Keto is a thing, but I haven't heard many stories of bodybuilders that actually target the keto-state. It's about getting the right amount of carbohydrates (hint: not as much as most people eat).
  - brandonmenc 8y ago
    If by "time them appropriately" you mean "constantly all day long", then yeah. Unless they're prepping for a contest, which is not what they spend the majority of their time doing.
- razakel 8y ago
  No they don't. A bodybuilding diet is mostly protein, then certain fats, then starchy carbs at the right time (breakfast and post-workout).
  - have_faith 8y ago
    > A bodybuilding diet is mostly protein Bodybuilders typically consume about ~30% protein. Where did you get the idea that it is mostly protein? Not to say that there aren't outliers obviously.

zavi 8y ago

How will they make sure people don't cheat and eat more anyways? 800 calories a day for an overweight person requires some serious will power.

rufus_2 8y ago
I found it easier to do via intermittent fasting and then eating all of my calories in one meal per day. Something about completely abstaining from food is easier for me psychologically than having multiple tiny meals and making myself stop eating when I'm not full.
- sfotm 8y ago
  Thing is, 800 calories is a meal for a lot of people. Ever go to Chipotlé? Already over.
- jobigoud 8y ago
  I was assuming these 800kcal were done through OMAD, are they not? I don't see how you could spread that over the day and keep your sanity.
- tchaffee 8y ago
  It's also easier for me. I have no problem skipping breakfast and then skipping lunch takes a little willpower but I'm often distracted by work. I have friends who find it easier to eat a big lunch as their only meal. Worth experimenting for each person to find what works best for them.

lilcorey10 8y ago

This sounds to be marketed as some scientific potion to cure diabetes or at least rid the need of medication. All it comes down to is cleaning up your diet (e.g. eating the right amount of calories for your body and eating nutrient rich foods). There's no one diet fits all but getting a good balance of proteins, carbs, and fats is all this is doing for these people. NHS is simply doing the leg work. I control my weight by counting calories and macro-nutrients. If people could figure out how to do that own their own we'd see a huge decrease in Type 2. It's true, a cleaner diet tends to be more expensive and requires more work than the convenience of a fast food diet - but at the the end of the day we're trading diabetes so we can be lazy with our diet and health.

ryanwaggoner 8y ago
800 calories per day for three months is hardly just "cleaning up your diet".
- SilasX 8y ago
  Exactly. This seems like an Onion headline: "We have your cure for diabetes! Just eat a ridiculously low amount of food, fatso." I don't mean to sound like a whiner, but ... if it were that easy to cut down my food consumption, I wouldn't be going to a doctor in the first place! It's like telling people with extreme loneliness or social anxiety to "just strike up a conversation with someone!" Or PTSD suffers: "Geez, just don't freak out so much, take a deep breath or something." Or narcissists/sociopaths: "Just, you know, think more about how your actions hurt other people." Given Herculean willpower, most diseases of civilization can be conquered. Don't pat yourself on the back for calling it "prescription".
  - akvadrako 8y ago
    It's not like that because it's all about how you approach the problem. It's easy to do all those things if you have the right mindset. Creating that mindset isn't easy, but wording everything in the worst possible manner is a sure way to make it more difficult. In the case of diabetes, it's saying: here's an alternative prescription that will cure you, we have good evidence it will work, you can afford it, here are the steps to follow, each of which looks easy by itself...

ronreiter 8y ago

Or in other words: Type 2 Diabetes is a normal metabolic state of humanity (or at least some significant parts of it), it's just that we're too goddamn fat

make3 8y ago
? you mean, it's a consequence of being fat

megaman8 8y ago

It's great that they teach the idea that Diabetes (type 2) is preventable and even treatable with responsible eating habits. Too many people believe it's just something your doctor is supposed to treat with a pill. Food companies often push the idea that all you need to do is exercise more. Whilst exercise might be a great thing: it alone can't fix the problem. You still need to learn how to eat.

acangiano 8y ago

You absolutely don’t need such caloric restriction to revert diabetes. All it takes is a very low carb or keto diet. Even without exercise.

toddh 8y ago
At that calorie level it's basically a fast mimicking diet, so part of the benefit would be autophagy and the respawning of stem cells. It's hard to tell how much that helps however.
- acangiano 8y ago
  That’s definitely a factor. That and the automatic reduction in carb intake with such a caloric restriction. I mean, if they fed them pure sugar, they’d still be getting “only” 200g of carbs per day which is still less than what a lot of people who developed diabetes used to eat. More realistically they are likely getting significantly less carbs per day with elements of fasting thrown in.
PerfectElement 8y ago
Or certain types of plant-based diets[1][2][3]. 1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5466941/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5466941/ 2. https://www.omicsonline.org/open-access/diabetes-reversal-by-plantbased-diet-2167-0943-1000232-94442.html https://www.omicsonline.org/open-access/diabetes-reversal-by... 3. https://www.ncbi.nlm.nih.gov/pubmed/20425575 https://www.ncbi.nlm.nih.gov/pubmed/20425575
- jumanchiss 8y ago
  1. Vegan doctors Bernstein AM, Esselstyn, Barnard ND et al. (and of course the WHO) cherry-pick studies that support their theory. 2. 3-days study with only 55 patients 3. Questionable observational (selection bias) studies and more Neal D. Barnard.
onetimemanytime 8y ago
Problem is keeping it, as almost everyone can keep the diet for a few months. We all know what we should do but don't, sometimes until is too late. The person that invents a pill to trick our genes not to seek what was once rare (fat, sweets, carbs etc) will be a trillionaire. When our current genes were stamped "we" maybe had to hunt for days to eat once. Now we drive to McDonalds, order our or open the fridge door. Maybe something that puts our metabolism on steroids?

virtuallynathan 8y ago

The 800 calories they are eating doesn't seem terribly healthy: "patients were asked to follow either a ‘home-made’ milk- and fruit-juice-based diet (811 kcal/day, 64 g protein, 132 g carbohydrate, 6 g fat) with a multivitamin/mineral supplement (Forceval® [Alliance]), or a micronutrient-replete commercial LELD (832 kcal/day, 87 g protein, 120 g carbohydrate, 12 g fat). I imagine these people are probably staving... I'd rather go low-carb myself. This is the study, DiRECT: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4754868/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4754868/

throwaway5752 8y ago
Cool. What about renal load?
vertline3 8y ago
So I guess back in the day, milk and bananas were considered an ideal food combination,
- debacle 8y ago
  A bowl of milk with bananas and about 1/4 cup of sugar. My grandpa ate that right up until he died. Man never gained a pound.
  - vertline3 8y ago
    Yeah I think I had it backwards it was nutrients that mixed perfectly, I was editing my post as you wrote that about weight gain. I thought Norman Rockwell used it to try and join the war.
  - magic_beans 8y ago
    Nothing wrong with that kind of diet for people without a genetic predisposition for diabetes (or lactose intolerance) and who are otherwise eating moderately.
xd 8y ago
It's targeted at people with type 2 and are obese .. which is an ever increasing issue in the UK. The BBC don't like to rock the boat.

ak39 8y ago

I am not a doctor. This is what I have learned so far (there are no references here - sorry, I will need to dig up the material to substantiate this if you ask): The upshot: Managing diet is not sufficient (for type 2) remission. The damage is at cellular level. That damage needs to be reversed. Therefore muscles need to be rebuilt. Even for the over 60 years! The thinking: Diabetes Type 2 is the end point of years of abuse the body endures with elevated insulin and the _extent_ of insulin resistance the body progresses to. Diabetes therefore is a spectrum - the end point is when the pancreas bonks out and refuses to produce any more insulin. It's a tiny tiny organ and I think it's fragile. And it's threshold is also genetically determined. The interesting thing is that we all (including healthy folks) have levels and sometimes acute bouts of insulin resistance! The thing that made sense to me, reading about this, was that insulin resistance is a function of your muscle cells denying entry to glucose. And the insulin concentration in the bloodstream is a direct function of the concentration of free flowing glucose. Poor Pancreas is only doing its job but the muscles are not taking in any new glucose. They are refusing (resistant). Pancreas tries its best by pumping more insulin and for longer but the adamant muscles are the contract breakers in this arrangement - they don't open the gates for glucose. The only way to change direction permanently in type 2 is to rebuild muscles which will have better insulin receptors to allow glucose to be shunted into the cells. For this to happen you have to do strength training. Lift sufficiently heavy. (No, not Arnie levels by any measure.) (I recently read a study that administering testosterone to type 2 diabetics improved their insulin resistance. What happens with testosterone and anabolic steroids? New muscles, that's what.)

matt4077 8y ago
Yeah... Also get a lawyer, quit Facebook, and start dressing for the job you want!
- ak39 8y ago
  I don't quite understand.
  - matt4077 8y ago

garenp 8y ago

About 3 years ago (late 2015 now) I was quite overweight, had a knee injury that limited my mobility (stairs mostly) and had a fasting glucose and post-meal readings that indicated I was nearly pre-diabetic (T2). So, I cut out out all sugary drinks, refined carbs, late night eating (!!) and tried various intermittent fasting / time restricted feeding techniques (5:2, alternate day, one-meal-a-day) and after about 3.5 months my glucose readings returned to the "normal" range. (Which is WAY more tolerable than sticking to a low-calorie diet every single day IME. I still had pizza and cheeseburgers on occasion, just no soda, fries, "junk" etc.) After around 6-7 months I'd lost 40+lbs, my knee stopped bothering me and no longer had to entertain the idea of fixing it with surgery. I'm now down well over 60+lbs without having put in hardly any effort to exercise (occasional walking) - pretty stunning to me.

illiac_1962 8y ago
Same thing here. Except I also refuse any refined flour, Co sidering it sugar. I only eat whole foods, no milk, very little cheese, barely any meat. Lots of vegetarian meals. Dropped 50+ lbs without much drama. I cycle extensively in the warm summer months.
costcopizza 8y ago
Congrats! What fasting method do you currently use, or do you switch between the ones listed?
- garenp 8y ago
  Nowadays I mostly just do OMAD (one-meal-a-day) or close to it (eating window is about 1-3 hours) as it's simpler. Initially some will power was needed to stop myself from snacking in the evenings, but as long as I make sure I have a fair amount of protein in that one meal, it never seems to happen now. Occasionally I'll do alternate-day if I feel 'stuffed' or had a big day of lots of calories (holidays, social events) - whatever is more convenient at the time.
  - lj3 8y ago

msiyer 8y ago

My mother suffered Type-2 diabetes for almost 20 years. I put her on an extremely strict raw food diet three months ago and stopped injecting insulin. Her fasting blood sugar level is now in the 90-110 mg/dL range. I now give her some steamed potatoes also. I too follow the same diet to give her company. Elimination of oil, sugar and dairy has helped, I believe. She is a vegetarian, so flesh was never in the picture. I do not have to restrict calories with raw food. Eat as much as you can. No juicing, however. That is a totally not allowed.

nradov 8y ago
I'm glad your mother is improving, but there's no real evidence that raw vegetables are better for blood sugar levels than cooked vegetables.
- msiyer 8y ago
  Raw fruits are what I feed her. No vegetables at all. I started giving her some steamed potatoes recently. Bananas have become her staple food.

ryanwaggoner 8y ago

Loving the broscience takedowns of this NHS pilot program about how "this won't work!", or "low carb / keto is the best way!" If only doctors knew how to read internet forums, then they'd be as knowledgable as all the armchair docs here, few (none?) of whom seem to have any actual training or T2 diabetes themselves.

deleted 8y ago

[deleted]

rkiyer 8y ago

The 800 calories number indicates that this might be related to the Fasting Mimicking Diet of Valter Longo. Since actual fasting has a "scary" reputation among some patients and doctors, Valter Longo developed a 5 day fasting like protocol with severely restricted calories that appears to have similar benefits to fully fasting for 5 days. It looks like this modified version of complete fasting is gaining popularity among the medical establishment. https://en.wikipedia.org/wiki/Valter_Longo#Fasting_mimicking_diet https://en.wikipedia.org/wiki/Valter_Longo#Fasting_mimicking... https://www.marksdailyapple.com/does-the-fasting-mimicking-diet-live-up-to-the-hype/ https://www.marksdailyapple.com/does-the-fasting-mimicking-d...

tacon 8y ago

Type 2 diabetes is currently on track to bankrupt the world's healthcare system. Easily 60% of the US residents reading this comment are already insulin resistant, they just don't know it yet. Many of those will progress to full blown T2DM in ten to fifteen years. It used to take a very expensive sequence of blood tests involving injecting glucose and tracking the concentrations of glucose and insulin over a few hours. Lately the tech has improved and there is a single blood test that can give an "insulin-resistance score", LP-IR[0][1]. While Peter Attia showed this test in a blog post from 2012[2], it seems to be getting more attention lately[3]. Just because your blood glucose after fasting is "normal" does not mean you will not get T2DM. Just ask Tim Noakes, world class exercise scientist and medical doctor, who finished more than 70 marathons and still woke up one day with diabetes, just like his father.[4][5] [0] https://www.labcorp.com/test-menu/31976/nmr-lipoprofile%C2%AE-with-graph https://www.labcorp.com/test-menu/31976/nmr-lipoprofile%C2%A... [1] https://www.walkinlab.com/media/attachment/file/1/2/123810.pdf https://www.walkinlab.com/media/attachment/file/1/2/123810.p... [2] https://peterattiamd.com/the-straight-dope-on-cholesterol-part-iii/ https://peterattiamd.com/the-straight-dope-on-cholesterol-pa... [3] https://www.managedcaremag.com/archives/2018/4/new-test-diagnosing-insulin-resistance-could-turn-tide-against-diabetes https://www.managedcaremag.com/archives/2018/4/new-test-diag... [4] https://www.diabetes.co.uk/in-depth/tim-noakes-challenging-dietary-guidelines/ https://www.diabetes.co.uk/in-depth/tim-noakes-challenging-d... [5] https://www.amazon.com/Lore-Nutrition-Challenging-conventional-dietary/dp/1776092619/ https://www.amazon.com/Lore-Nutrition-Challenging-convention...

voidbip 8y ago

In July I was 203 pounds which for a 5'6" frame, put me in the "obese" category. It was the highest weight I had ever been, and I felt I occupied more space than I should in the world ( not in a good way ). I follow a youtuber on Indian cooking and for whatever reason this woman mentioned how she recently started eating in a more "Keto" way. This woman is thin as a rake. She mentioned she was doing this for mental clarity. On a whim, I decided to try it. I literally threw the little debbie box I had my hand in, in the garbage that day. Today, I am 166 pounds, still "overweight" but this is the most amount of weight I have ever lost. I feel so much better and healthier, and its true about the mental clarity. My unsubstantiated hypothesis is that it takes away the emotional swings insulin give you. I eat till I am full. Honestly. There is not a day that I "think" about what I am eating other than keeping sugar and carbs out my month. I could not be happier. I am a 38 yo technology professional, and I imagine many others here are similar. I have nothing to sell. I just want to make people aware of a lifestyle that may help many of us who sit all day for a living.

GreaterFool 8y ago

From what I've read about starving yourself vs fasting and my own experience 800-calories sounds like HELL. I can fast for 2 weeks no problem (although that's kinda long and I wouldn't do it if I didn't have enough body fat to sustain it. If you're skinny and don't have fat to spare better not stretch it unnecessarily). I'm eating keto and I usually only eat once a day. Fasting feels good. Starving yourself feel horrible.