Low-energy formula diet yields short-term results for type 2 diabetes, study finds

[DCUK NewsBot]

A low-energy formula diet followed for 12 weeks leads to greater weight loss, insulin reduction and HbA1c improvement in insulin-dependent type 2 diabetes compared to gold-standard NHS care, according to new research. The study, conducted at Imperial College, London, used data from 20 people with type 2 diabetes to draw its conclusions. The participants were divided into one of two groups: one group followed a low-energy formula diet (808-836kcal/day) diet, the other followed NHS gold-standard care (600kcal deficit diet - 1,400kcal/day for women, 1,900kcal/day for men). The low-energy formula group lost substantially more weight than the NHS group. They also lowered their insulin dosage. In the low-calorie group, HbA1c levels went down by an average of 11.3mmol/mol, compared to 7mmol/mol in the NHS group. "This is a very interesting study that builds on existing research, looking at the role a low-calorie diet can play in the management of type 2 diabetes," said Anna Morris, Interim Director or Research at Diabetes UK. "Importantly, the researchers are focusing specifically on the effects of a low-calorie diet in those with type 2 diabetes who are already taking insulin. "This study is being presented at our Diabetes Professional Conference this week, and we look forward to learning more about the results once they have been published in a scientific journal. As always, for those with type 2 diabetes who are taking insulin and considering making any major dietary changes, please speak to a healthcare professional, as you will need support to adjust your insulin doses." Very Low-calorie diets have been proven to have significant short-term benefits for people with type 2 diabetes, such as those described in this study; however, the study did not review long-term outcomes. Participants on the low-energy diet were taking in much fewer calories than the gold-standard group so it is not surprising that they experience lower insulin doses and a significantly reduced HbA1c. How the participants in each group fared once they stopped after 12 weeks is a key question but further research will be needed to answer this. The study was part-funded by Cambridge Weight Plan, which also provided the low-energy formula diet products.

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[zand]

Worth buying shares in Cambridge Weight Plan I reckon......

 

[zand]

I'm I the only one here who sees a long term problem with these 800 calorie diets? And yes, before anyone asks, I have done quite a few of them. That's why I'm replying.

Low calorie dieting negatively affects our thyroid gland. Low thyroid issues have been linked to both depression and weight issues. In one study, a 1,200-calorie diet led to a 40% reduction in the thyroid hormone T3. The study also showed that thyroid levels remained 22% below baseline after a re-feeding period.

They can also increase the stress hormone cortisol which can lead to insulin resistance, weight gain, and cardiovascular disease. High levels of cortisol have also been linked to mood disorders such as depression and can also cause weight gain around the middle.

Are any of these things ringing a bell yet? Insulin resistance, weight increase around the middle? Yep That's T2 in a nutshell.

Following these diets in the past are what has got me here...seriously obese and T2 . I never had a big waistline before I dieted. Now these diets are being touted as a short term solution to T2? Really? How can slowing down your metabolism and increasing insulin resistance help?

I fear this is just another ruse to get us all buying the newspapers to tell us about the diets, then we'll buy the shakes and soups, then we'll join Weight Watchers and buy their low fat food.

I'm not denying these diets are popular right now, especially for big business, but if you really want to tackle your T2 then low carbing is the answer for life, not just for 8 or 12 weeks.

To my mind the only good reason to follow one of these diets is as an alternative to bariatric surgery, if you really are that heavy and you need to see an improvement right now. Otherwise there's the low carb program here www.diabetes.co.uk/lowcarb or LCIF (low carb increased fat)

I know I will be upsetting a lot of people by saying this, but please do not do what I did. Don't wreck your body by following these diets. Yes, I'm wasting my time. 'Science says......yadayadayada....' I have already been told that the 800 calorie diet I did 30 or even 5 years ago isn't like the modern ones! But if just one person listens to me and saves themselves the heartache (both literally and metaphorically) that I went through because of these diets then this post will have been worth it.

Signing off now
zand

 

[poshtotty]

Bravo @zand. No you are not alone, but you have articulated it better than I could have done

I think we only have to look at the number of excuses for "breaking" (I prefer the term sabotage!) these diets to see how very difficult and unrealistic these regimes are to follow. I applaud those few who have persevered and succeeded but only time will tell whether whether the long term effects remain positive or damaging.

I would not give up my LCHF lifestyle for any other regime having seen such positive effects on BS, health conditions and energy levels

 

[Jamrox]

Hi my friend @zand , Thankyou for sharing your concerns .
I have major concerns about the shakes , I have seen to many people balloon after stopping them.

I want to reassure you that my diet is nutritious , as you know Im not daft , I have looked at the nutrition in my diet, it is basically clean eating low carb diet.

Having an under active thyroid I am interested in what you are saying about the T3 result , I'd like to read the article do you have the reference please.

Thanks again for sharing .
Dr Mosely's diet is basically a low fat low carb diet .

 

[Brunneria]

Total agreement @zand.

I suspect that many who do these diets will find that enthusiasm and short term weight goals only get you so far, with knock on metabolic consequences that could last a lifetime.

I did the 330 Calorie Cambridge Diet in my teens. Before that, i had 'puppy fat'. Since then, i have battled with a number of metabolic and hormone issues. No idea if one helped trigger the other, but i can say with certainty that having a very 'switched on' thrifty gene has made things worse than they should have been for the last 30 years.

Shudder to think what the effect of the VLC diets will be on menopausal women - who are probably a large portion of the target audience!

 

[Jamrox]

@Brunneria the Mosley plan is 800 calories which is healthy food . 300 calories is starvation level , ok I allowed to have my opinion .

I have an under active thyroid , my mother had an under active thyroid , my daughter was born with congenital hypothyroid disease . I know about Thyroid issues .

Are you talking about osteoporosis when you worry about menopausal women ? Or have you other concerns regarding oestrogen levels ?

 

[poshtotty]

Signing off now
zand

Very wise. Wish I had!

 

[Brunneria]

I am talking about general hormonal upset through starvation levels, slowed metabolism, insulin resistance, reduced nutrition at a time of life when nutrition is particularly important, kidney stones... I could go on.

And i am sorry, but i do not think that 800 calories, shakes or food, is enough.

@Jamrox you are speaking as a temporarily sedentary woman already used to eating fewer calories than the recommended daily average (suggesting that your metabolism was already working thriftily!) This diet is intended for anyone who wants to do it. For someone with a usual of 2500+ calories, dropping to 800 a day is a big shock to the system. It is shocks like that that cause long term hormonal changes, as @zand mentioned above.

Additionally, this thread is not about the Mosely diet. Mosely is just one of several trendy starvation diets (a starvation diet is where you eat so little that, in time, you would starve on the food intake). Doesn't matter if it is shakes, protein only or nutritious balance, if there is too little food to sustain health in the long term. The 8 weeks is a guide, not an absolute. And there will be many who carry on much longer than that.

There will also be many who use cheap shakes which provide inadequate nutrition, do not get themselves checked out by a doc before, during and after, and who have no clue of the damage they could be doing to themselves.

It is something that i feel very strongly about. Severe calorific restriction in my teens (when i was younger and much more resilient than the average middle aged T2!) has affected my eating, weight and metabolism for the past 30 years. It breaks my heart to see a whole new generation of sheep bumbling ignorantly into the same boat. Of course this damage will only happen to a minority, but if it only happens to (I'm guessing) a few percent of dieters, that could be 1,000s of people, with the amount of publicity these diets are getting at the moment.

This is my last post in this thread because i actually find it distressing.
The thought of the harm these diets will do - lets just say I don't wish it on anyone!

 

[Indy51]

My guess, intuition, call it what you like, is that while men who have never before dieted can undertake the diet without too many repercussions, for women who've already spent a lifetime of yo-yo dieting the results could be very different due to the very different hormonal cycles involved. There was a recent study showing the different effects of fasted exercise between the sexes - great results for men; bad results for women in terms of fat burning. Women are also way more likely to get thyroid issues compared to men even without dieting. The sooner we get personalised, tailor-made diets based on our individual metabolisms the better.

My other guess is that the diet is more likely to be appropriate for post-menopausal than for pre-menopausal women due to the complexities of oestrogen balancing. I also think anyone who is stressed (or who already knows they react badly to stress) could find this diet has unintended consequences. JMHO.

 

[NoCrbs4Me]

@zand - can you provide some references re thyroid and cortisol issues on a v. low calorie diet? That sounds quite interesting.

 

[zand]

@zand - can you provide some references re thyroid and cortisol issues on a v. low calorie diet? That sounds quite interesting.

Mostly it's from my own experience and has been confirmed by a naturopath and a nutritionist. I think the effects are usually worse for women who tend to do anything to look good in a bikini (lol yep that was me once, now I struggle to find a tent to fit). I found a few articles (but two are just articles) yesterday when I was writing this. There is another thread on this forum which talks about what happens when your own personal experience differs from the science. Well that's what happened to me.

When I follow a diet I do it to the letter. When I did 800 calories if I ever went up to 810, then next day it was 790. This 'perfectionism' has made any ill effects worse for me personally than for someone who cheats occasionally (which is why the 5:2 diet is better). Drinking diet coke before meals to fill myself up also had an impact on me. Now I do what my slim husband does and I drink (water nowadays) between meals, not at mealtimes.

So the links I found (probably not good ones) :-

http://breakingmuscle.com/nutrition/is-low-calorie-dieting-dangerous
http://cathe.com/how-low-calorie-diets-affect-thyroid-function
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2895000/

Edit: Since I am the only diabetic in my family (both sides) I was either unlucky or did something to cause it. What I did wrong was dieting to extremes which led to insulin resistance and obesity. I was never lazy until I got fat.

 

[Jamrox]

@zand - can you provide some references re thyroid and cortisol issues on a v. low calorie diet? That sounds quite interesting.

I am really interested in the research too.

 

[Jamrox]

Thanks @zand I'll have a read.
If I thought for one minute that the 800 Cals was going to become an obsession with me then I would stop .

 

[zand]

Thanks @zand I'll have a read.
If I thought for one minute that the 800 Cals was going to become an obsession with me then I would stop .

Just know that I'm not having a dig at you Jamrox. It's just with all this hype about low cal diets I felt I had a duty to share what happened to me. It's so easy to keep getting on the scales and see more weight go every week, it's really tough when the weight goes back on every week and there's seemingly nothing you can do to stop it.

 

[Jamrox]

@zand having spoken to you a lot I know you aren't lazy at all . I think you underestimate yourself Mrs .

 

[Brunneria]

Here is an interesting article on thyroid - lots of links to follow up, if people are interested.

http://paleoleap.com/thyroid-a-paleo-introduction/

and here is a study

http://www.ncbi.nlm.nih.gov/pubmed/12055988

 

[Jamrox]

Sorry Brunneria but the first one is more about advertising the Paleo diet and its worrying.

The second one is more about anorexia than reduced calories , even people who take the nutritious shakes approach are not anorexic . Believe me there is a world of difference.

I'm not being deliberately argumentative here by the way. To my mind you are right , short sharp shock to the body , be it food or exercise related is no the answer . Everyone is different and should listen more to what their body is saying . At 50 years old I don't want to be a stick thin body , I would however like to say that I'm at least in the yellow zone on the diabetes tape measure instead of the red . That is my goal .
I am 5'7" and weigh 155 , apparently my BMI is 24.3, but I have 2 inches to loose off my waist to be in the yellow warming zone.

 

[Brunneria]

Yet they both highlight real issues.

I was actually quite pleased with the Paleo one. Did you reach the sensible discussion bit where it considers various diet options, including the negatives of Paleo?

I also found it interesting because it mentioned the LC diet as a possible contributor to thyroid problems, which I had not considered before - but the key thing, or course is the extent of low carb and personal physical reactions to it.
Well worth a thorough read, and I intend to follow up the links when I have more time.

As for Anorexia - this is a direct lift from that study's summary - which speaks directly to what @Indy51 was saying about stress levels

I have added the bold.

Treatment of obesity with hypocaloric diets causes changes in thyroid function that resemble sick euthyroid syndrome. Changes consist of a decrease in total T4 and total and free T3 with a corresponding increase in rT3. untreated obesity is also associated with low GH levels; however, levels of IGF-1 are normal. GH-binding protein levels are increased and the GH response to GHRH is decreased. These changes are reversed by drastic weight reduction. Cortisol levels are abnormal in people with abdominal obesity who exhibit an increase in urinary free cortisol but exhibit normal or decreased serum cortisol and normal ACTH levels. These changes are explained by an increase in cortisol clearance. There is also an increased response to CRH. Treatment of obesity with very low calorie diets causes a decrease in serum cortisol explained by a decrease in cortisol-binding proteins. The increase in cortisol secretion seen in patients with abdominal obesity may contribute to the metabolic syndrome (insulin resistance, glucose intolerance, dyslipidemia, and hypertension). States of chronic starvation such as seen in anorexia nervosa are also associated with changes in thyroid hormone, GH, and cortisol secretion. There is a decrease in total and free T4 and T3, and an increase in rT3 similar to findings in sick euthyroid syndrome. The TSH response to TRH is diminished and, in severe cases, thyroid-binding protein levels are decreased. In regards to GH, there is an increase in GH secretion with a decrease in IGF-1 levels. GH responses to GHRH are increased. The [table: see text] changes in cortisol secretion in patients with anorexia nervosa resemble depression. They present with increased urinary free cortisol and serum cortisol levels but without changes in ACTH levels. In contrast to the findings observed in obesity, the ACTH response to CRH is suppressed, suggesting an increased secretion of CRH. The endocrine changes observed in obesity and starvation may complicate the diagnosis of primary endocrine diseases.

Anyway, I did say I was out othis thread. Only came back to post the links. Am gone again now.

Edited cos I messed up the cut and paste!

 

[Avocado Sevenfold]

For "low energy" I am reading "low carb". If I decided to use all my 800 calories on Mars Bars, that would be about 100g carbs. Compared to the Eat Well plate, that is positively low carb