Has anyone failed to reverse their T2 on Newcastle Diet?

[Tannith]

Unfortunately many of us can testify that getting the right off, and keeping it off are not always possible. Our bodies are not machines, and do odd things sometimes.

"enthusiasm of some people with Type 2 diabetes to take major steps to escape from diabetes became clear in the very large-scale email feedback [5]. The email feedback from those who lost weight and returned to normal glucose tolerance, showed that duration of normal glucose control in some now approaches 3 years [18]. Provided that weight loss is maintained, diabetes does not return, at least over several years."
http://www.ncl.ac.uk/media/wwwnclac...s/long-versus-short-term-reversal-article.pdf The key of course is the "provided the weight loss is maintained" bit, ie they must not regain the liver and pancreas fat they lost.
Also the new study whose formal results are to be published in Dec shows that 100% participants have now passed the 1 year line (on aug 17th 2017) However these people had support with their maintenance diet from the survey organisers.

 

[bulkbiker]

100% participants have now passed the 1 year line

I think you will find that refers to them following the diet plan for the required period rather than being "reversed" or at least that's how I read it.

 

[Mbaker]

Surely the Eatwell Plate is only a '****** diet' in the sense that for diabetics it's full of carbs? I would imagine a person with normal blood sugar response would be fine on that diet so long as they kept portions reasonable. Most people eat that way, after all, with relatively few ill effects. Obviously if you're a diabetic it's terrible, but the point of the ND is to make the participants non-diabetic. For a diet that seeks to restore pancreatic function to non-diabetic normal then it makes sense that they'd want to see what happens when you start eating carbs again. You wouldn't lose weight, but as long as you weren't throwing in tons of excess carbs I don't see that it would cause an issue - provided that your insulin response was back to normal.

Though again we're circling round to what constitutes remission, reversal and non-diabetic within the parameters of the study

I have a different view of the effects of the Eatwell plate and similar. I think the number of people who have blood sugar issues since the guidelines have been implemented have a significant correlation. For me the graphs since 1977 are too coincidental to not conclusively show the high carb low fat diet is a root cause of the current health crisis across all continents. When a non diabetic eats a typical processed meal, they can spike past guidelines - this causes minute damage without discrimination. I am not sure that portion size is adhered to, with the really tasty stuff such as pizza, chips, crisps, milk chocolate etc. The other day I looked at the nutritional detail on the back of the trendy just add hot water latte packets, from memory the carbs were around 67 of which were sugars 50 (in my view garbage).

If low carb is considered circa < 130 g then the Eatwell guide is obviously higher, so surely this is a recipe in an average person to have challenges with fat retention.

 

[Oldvatr]

I have a different view of the effects of the Eatwell plate and similar. I think the number of people who have blood sugar issues since the guidelines have been implemented have a significant correlation. For me the graphs since 1977 are too coincidental to not conclusively show the high carb low fat diet is a root cause of the current health crisis across all continents. When a non diabetic eats a typical processed meal, they can spike past guidelines - this causes minute damage without discrimination. I am not sure that portion size is adhered to, with the really tasty stuff such as pizza, chips, crisps, milk chocolate etc. The other day I looked at the nutritional detail on the back of the trendy just add hot water latte packets, from memory the carbs were around 67 of which were sugars 50 (in my view garbage).

If low carb is considered circa < 130 g then the Eatwell guide is obviously higher, so surely this is a recipe in an average person to have challenges with fat retention.

Just as an aside, my local supermarket has just started stocking Paleo snack bars for the health conscious, I looked at the nutrition label and one bar was 54% carbs, of which sugars were 37% The other bars were worse. Highest one was a fruit bar at 72% carb and the sugar was still around 35% so it seems to be added sugar.

 

[lindisfel]

Isn't the Newcastle diet a little like a smoker going on to vaping? One wonders if a large number yoyo like many other non long term eating regimes? D.

 

[badcat]

Isn't the Newcastle diet a little like a smoker going on to vaping? One wonders if a large number yoyo like many other non long term eating regimes? D.

No

 

[Art Of Flowers]

Most type 2 diabetics are overweight or obese. The goal of ND and intermittent fasting is to burn off visceral fat around the liver and pancreas. Fatty liver causes insulin resistance and fatty pancreas causes reduced beta cell function. Intermittent fasting also triggers a repair mechanism in the body called autophagy. The difference between very low calorie diets and intermittent fasting is that with fasting you have alternate fast and feast phases and the autophagy regeneration phase happens when you start eating after the fast.

Experiments with mice suggest that they live considerably longer with intermittent fasting (IF) and that their brain cells regenerate as a result of fasting. Both ND and intermittent fasting have benefits for sufferers of type 2 diabetes. The difference is ND is quite intense and IF is more a long term lifestyle change to maintain good health. Of course, you can combine both by using IF after the 8 week ND session.

 

[Brunneria]

Isn't the Newcastle diet a little like a smoker going on to vaping? One wonders if a large number yoyo like many other non long term eating regimes? D.

Weight regain and yoyoing is a huge risk after any weight loss regime. Huge numbers of people rebound and end up weighing more than their original greatest weight. Serial dieting is serial exactly because of this (and i have the t shirt)

However, if the food re-entry phase is well managed, and people actually stick to the reduced portions advised in the protocol for the rest of their lives, then they should be in a better situation than people who don't have that kind of guidance.

It is very hard to tell from posts on the forum how prevalent regain is - it is going to be highly personal - and it will depend on a lot of factors including exercise, co-morbidities and other health issues, way of eating, social life, etc.etc. But it is certainly possible to avoid re-gain. I have that T shirt too. But i confess i didn't use ND protocols to achieve it.

I would like to think that the loomimg spectre of un-reversal on the horizon would help to discourage weight regain for type 2s who have committed so much time and effort to their ND.

Edited for sense.

 

[Oldvatr]

One question I have in my my mind is this: For many, many years now people have been using meal replacement shakes and ultra low calorie diets to attack weight issues. Many will be T2, since obesity and adipose fat seems strongly linked to the condition. Now many of these T2 will be taking large doses of medication. I am surprised that there has not been an outbreak of T2's having hypos that are directly related to going on the diet and have either had to reduce medication or come off the diet. Slimfast / Optifast are not new formulations, so how come it needs an MRI scan to detect so called remission? And if this is actually a new phenomenon due to the Protocol, what is different about ND that does not occur in a regular VLC diet?

 

[badcat]

Weight regain and yoyoing is a huge risk after any weight loss regime.

I would like to think that the loomimg spectre of un-reversal on the horizon would help to discourage weight regain for type 2s who have committed so much time and effort to their ND.

I agree
I think it is really dangerous to confuse remission and reversal and the striving for the holy graile of a diet that gives a "cure" for T2 is fraught with problems in terms of the mindset that can be created. I think mindset is crucial in terms of breaking any habit and know for myself that one major problem in the many years it took me to give up smoking was whenever I thought Id cracked it, a little voice began to say " one wont matter, Im ok now" and 1 soon became 20. Thankfully Ive now been a non smoker for nearly 21 years - it was only the diabetes consultant telling me smoking is between 2 and 10 times as dangerous for a diabetic as a non diabetic that finally shut that little voice up
For me the search for a dietary "cure" which is defined as an ability to manage a significantly higher level of carbs without any meds, runs the risk of creating the "1 wont matter, I'm ok now" mindset and start the slippery slope of weight regain and a worsening of BS control, no matter which dietary approach you favour

 

[Begonia]

I am also unclear about what exactly causes the 'remission/reversal'.

From what I've read, Prof Taylor says that theres nothing special about using the shakes to lose weight. So long as you lose enough weight to clear first the liver fat and then the pancreatic fat that should do the trick. Then you must stay below your own 'Personal Fat Threshold' so that you don't build up fat in liver and pancreas again.

So what exactly is the key to it:

Is it effective if you lose the same weight (15% of weight at diagnosis) over a much longer period of time (eg 6 months) ?
What if you don't have so much weight to lose. Will 10% be effective ?
Is the secret that the calorie restriction is so severe that it 'shocks' your body and is like fasting ?

 

[Tannith]

i think it would be a good idea for people to try Newcastle first , soon after they are diagnosed. Because we don't usually know how long we have had T2 and there is a risk if we don't act fast to get it into reversal (or at least try to) that we might miss our personal window of opportunity and leave it till we have had T2 too long for the ND to work. ie when damage has already been done and pancreatic cells are dead rther than just "sleeping". If it doesn't work nothing is lost.

 

[Tannith]

One question I have in my my mind is this: For many, many years now people have been using meal replacement shakes and ultra low calorie diets to attack weight issues. Many will be T2, since obesity and adipose fat seems strongly linked to the condition. Now many of these T2 will be taking large doses of medication. I am surprised that there has not been an outbreak of T2's having hypos that are directly related to going on the diet and have either had to reduce medication or come off the diet. Slimfast / Optifast are not new formulations, so how come it needs an MRI scan to detect so called remission? And if this is actually a new phenomenon due to the Protocol, what is different about ND that does not occur in a regular VLC diet?

 

[Tannith]

"what is different about ND that does not occur in a regular VLC diet?" Nothing. You can use whatever diet suits you. Its the quantity not the composition of the diet that matters. However you have to continue vlc until you have lost all the fat off your liver and pancreas. 8 to 20 weeks usually, and usually this will be 15% of your weight at diagnosis. Without an MRI scan you can't tell exactly in advance and have to go by when your BGs normalise without the help of drugs and without being controlled by low carb.

 

[AlexMagd]

I am also unclear about what exactly causes the 'remission/reversal'.

From what I've read, Prof Taylor says that theres nothing special about using the shakes to lose weight. So long as you lose enough weight to clear first the liver fat and then the pancreatic fat that should do the trick. Then you must stay below your own 'Personal Fat Threshold' so that you don't build up fat in liver and pancreas again.

So what exactly is the key to it:

Is it effective if you lose the same weight (15% of weight at diagnosis) over a much longer period of time (eg 6 months) ?
What if you don't have so much weight to lose. Will 10% be effective ?
Is the secret that the calorie restriction is so severe that it 'shocks' your body and is like fasting ?

Prof Taylor says weight loss over any period of around 15% weight at diagnosis should do it. It's not been everyone's experience though and there could be a lot of reasons for that (including not knowing how long you've had diabetes before diagnosis, how much beta cell function you have remaining etc). I would expect the threshold would be different for everyone but I guess the idea is that if you're recently diagnosed you probably only recently went over the personal fat threshold so it should be fairly straightforward to hop back over.

Unfortunately without getting an MRI you can't tell what your fat levels are and if you've lost them. It's quite frustrating! In the past I've had fatty liver and (I believe) reversed it by losing weight - but clearly I didn't manage to shift the pancreatic fat as I still developed T2D. It's that last bit that's the pain in the ****!

Will be interesting to see if the new DIRECT study is tracking factors like insulin production and other things that may have an effect on the diet's efficacy.

Personally I think that the severe calorie restriction may have something to do with it, but until we have more data it's all rather subjective. Visceral pancreatic fat seems hard to shift and if that's the key - getting rid of it before there is irreversible damage to the beta cells - then it makes sense to me that tricking the body into thinking it's starving would force it to start to burn that fat.

 

[Fleegle]

Doing the math: 800cal - 200cal (vegetables) = 600cals
600cals / 3 = 200cals per meal
200cals split evenly btwn Carb Prot Fat = 12 gm C, 12gm P, 12gm F = 48cal + 48cal + 108cal = 204cal / meal

It would be hard to find a nutritious food (dextrose maybe) that would be 50gms of straight carbs (200cals)

Anyway, I think an 800 cal a day diet would be hard pressed to spike at anytime. It might be adequate to replenish used glycogen, but body fat would be supplying a lot of the energy during the eight weeks.

Err - I must be an exception then...
I am doing the ND. In my first few days - and even a couple of weeks, my BG was spiking on the shakes.
The shakes with the milk equate to 25g of carbs and that was enough to send me to 9.3.

Better now.

 

[Fleegle]

Exception noted. On second thought, we're all different and I didn't look at the shake ingredients to get an idea of the GI of the carbs. So, as you've noted there are more variables involved than my math takes into consideration. Thanks.
One more thing: Congrats on the great job you're doing and appreciate all the questions you're bringing up.

Thank you - it is all an education for me. Appreciate everyone's advice.

 

[Oldvatr]

Doing the math: 800cal - 200cal (vegetables) = 600cals
600cals / 3 = 200cals per meal
200cals split evenly btwn Carb Prot Fat = 12 gm C, 12gm P, 12gm F = 48cal + 48cal + 108cal = 204cal / meal

It would be hard to find a nutritious food (dextrose maybe) that would be 50gms of straight carbs (200cals)

Anyway, I think an 800 cal a day diet would be hard pressed to spike at anytime. It might be adequate to replenish used glycogen, but body fat would be supplying a lot of the energy during the eight weeks.

I don't think you have answered the question, Take your worked example, but halve the carb and protein but up the fat, then you can still get the 200 cals. Likewise if you treble the carbs but halve the protein and keep the fat you still get 200 cals. I bet the latter example I give will have greater effect on bgl than the low carb variant I gave. So Composition is important to a person with metabolic disorder.

The question boils down to whether any 200 cal meal will force a keto response so that burning adipose (i.e. lipid based fat) occurs, since replenishing glucogen stores in the liver will prevent ketosis from happening and thus the liver and pancreas would retain their fat due to the carb and protein content of the meal. Looking at the Optifast nutrition details it seems the use of 3 shakes a day will actually keep most participants out of ketosis, so it appears that the ND is using a different mechanism to remove the liver and pancreas fat.

 

[Fleegle]

I don't think you have answered the question, Take your worked example, but halve the carb and protein but up the fat, then you can still get the 200 cals. Likewise if you treble the carbs but halve the protein and keep the fat you still get 200 cals. I bet the latter example I give will have greater effect on bgl than the low carb variant I gave. So Composition is important to a person with metabolic disorder.

The question boils down to whether any 200 cal meal will force a keto response so that burning adipose (i.e. lipid based fat) occurs, since replenishing glucogen stores in the liver will prevent ketosis from happening and thus the liver and pancreas would retain their fat due to the carb and protein content of the meal. Looking at the Optifast nutrition details it seems the use of 3 shakes a day will actually keep most participants out of ketosis, so it appears that the ND is using a different mechanism to remove the liver and pancreas fat.

I complete agree with you on the shakes and their make up.
However, it now seems to be not so important because there are loads of examples now of Prof T telling people the make up of the diet doesn't matter. It is VLCD, circa 600-800 a day eating normal food and the shakes were indeed just a way of controlling portion size and standardizing the experiment where it could be.

Being a bit of a stickler in my first attempt - I am, quite painfully, sticking to shakes and veg as prescribed. Not fun though at all and if I hadn't made the full investment in all the shakes needed to do the 8 weeks I would have, long ago, moved to proper food whilst trying to maintain the macros to some degree.

Ketosis or not, weight is falling off me so far - having already lost over 3 stone another stone came off in less than 4weeks.

 

[Chook]

I complete agree with you on the shakes and their make up.
However, it now seems to be not so important because there are loads of examples now of Prof T telling people the make up of the diet doesn't matter. It is VLCD, circa 600-800 a day eating normal food and the shakes were indeed just a way of controlling portion size and standardizing the experiment where it could be.

Being a bit of a stickler in my first attempt - I am, quite painfully, sticking to shakes and veg as prescribed. Not fun though at all and if I hadn't made the full investment in all the shakes needed to do the 8 weeks I would have, long ago, moved to proper food whilst trying to maintain the macros to some degree.

Ketosis or not, weight is falling off me so far - having already lost over 3 stone another stone came off in less than 4weeks.

Well done you for sticking to it! x