More Media Attention For T2

Bluetit1802

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Though I'm not sure I'm understanding you entirely - if he's contradicting himself within his own belief system then I'm missing something.

What I mean is, on one hand he says it can ONLY be achieved by calorie restriction. On the other hand he says it can be achieved no matter how you lose the weight. So, is he saying if someone loses weight without calorie restriction it can still be achieved??
 

AdamJames

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What I mean is, on one hand he says it can ONLY be achieved by calorie restriction. On the other hand he says it can be achieved no matter how you lose the weight. So, is he saying if someone loses weight without calorie restriction it can still be achieved??

I think his view is that if you can lose overall body fat by any means then you will hopefully lose pancreatic fat. I also think that his view is that the only way to lose overall body fat is to burn more calories than you expend (the bit that irritates a lot of people).

So I think he'd say you always need to restrict calories, i.e. burn more than you expend. That could be to eat less of the same food, or to exercise more, but he's quite anti-exercise from what I've read. So I think what he's saying is that you do need to restrict calories, and when he talks of weight loss by 'any means' he's probably saying that any type of diet, and any level of calorie restriction, should result in loss of pancreatic fat in the long run.
 

bulkbiker

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So I think he'd say you always need to restrict calories, i.e. burn more than you expend. That could be to eat less of the same food, or to exercise more, but he's quite anti-exercise from what I've read. So I think what he's saying is that you do need to restrict calories, and when he talks of weight loss by 'any means' he's probably saying that any type of diet, and any level of calorie restriction, should result in loss of pancreatic fat in the long run.

And that is where lots of people will say that because of the way he has run his experiments (using meal replacements) he is wedded to the low cal paradigm which may work for some but not for all. There are many members of this forum who severely calorie restrict but are no longer losing any weight.
If by changing what you eat and when you eat you can have a similar weight loss then there's no reason why some of it won't be visceral fat (which I think he means rather than specific pancreas fat) as so far as I know there is no guaranteed way to loose that gram off your pancreas.
 

AdamJames

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And that is where lots of people will say that because of the way he has run his experiments (using meal replacements) he is wedded to the low cal paradigm which may work for some but not for all. There are many members of this forum who severely calorie restrict but are no longer losing any weight.
If by changing what you eat and when you eat you can have a similar weight loss then there's no reason why some of it won't be visceral fat (which I think he means rather than specific pancreas fat) as so far as I know there is no guaranteed way to loose that gram off your pancreas.

He does seem to be 100% wedded to calories based on all my reading / viewing. That's a pity. It's pretty astounding that he specialises in diabetes, but I don't recall him ever talking / writing about carbohydrates and insulin in the context of the most sensible diets for diabetic people. It's equally astounding that, while he promotes weight loss by any means, he hasn't addressed the issue of lowering RMR and the difficulties that creates.

If weight loss is the important thing, then it would be nice if it was acknowledged just how poor the statistics for that are, and if sensible ideas were given for how to overcome the odds. The one thing that the DiRECT study does at least acknowledge is that weight maintenance is so hard that patients should be offered regular counselling after weight loss.

But that's a psychological approach, not a biological one. The biological assessment of the best diet for diabetics, how best to lose weight and keep it off seems to be completely absent from Newcastle.

Not only is it absent, but the main approach that most people are likely to take if they read up on the Newcastle studies is possibly going to be one of the worst approaches. It will result in people with T2 eating more carbohydrates than they need, and taking the advice to do no exercise while losing weight, and even be cautious of exercise after losing weight.

My own view, especially after the amazing study that @Indy51 highlighted recently (https://www.ncbi.nlm.nih.gov/pubmed/29467800), is that the 'rapid' part of the approach is probably okay, but it's much more sensible to keep carbs as low as possible, and to try to do some resistance exercise if you can.

I find a lot of what Roy Taylor says is overly simplistic, and can actually make the science seem less credible than it actually is.

The various studies however I've got a lot of time for. The correlation of lowered liver fat with increased insulin sensitivity, the correlation of lowered pancreatic fat with restored first-phase insulin response, the observations under the microscope of what happens when you remove fat from a beta cell, and the observation that only in bariatric patients with T2 does pancreatic fat decrease after the operation, is all great scientific insight.
 

ringi

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Remember that they are ONLY aiming at people with high BMI who have not had type2 for long. It is also not a long term moderate low fat diet that we know hardly every works.

(We all know that low carb benifits everyone with type2, but not always to the same extent.)
 
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ringi

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A lot of resaechers consider low carb to be a very good way for poeple to reduce calories without having to count calories, and without their body reducing how many calories are burned.

Personly on the one hand I believe in "calories in calories out", but I don't consider it is a useful way to think in reallife, as the type of calories in, changes how much people want to eat, and how many calories goes out.

In some of his recent talks, he has said that low carb can be a great way to stop wight grain after the 8 weeks. And it is totally logical to believe this at the same time as thinking it is all about calories.
 

Guzzler

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At the risk of repeating myself, why was I never overweight? Calories are measured in a laboratory using a closed system, the human body is not a closed system, we take in solids, liquids and gasses and we excrete solids, liquids and gasses. The body uses energy even when sleeping, as we know the mere fact that at the moment that the fight or flight response is is provoked and before we have taken a step or raised a fist that energy is already being used.
No one is arguing about the benefit of excercise for overall health but I do tire of hearing that it is vital for weight loss or Diabetes management.
 

Bluetit1802

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I am 100% in agreement with @Guzzler except I was overweight when diagnosed and have since lost it all (33%) and maintained for nearly 4 years entirely on LCHF, without meds, and without any additional exercise over and above what I did before, which wasn't a lot.
 

AdamJames

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I'm also entirely in agreement that exercise isn't needed for diabetes management, but I don't see that that's been suggested in this particular thread.

My own take on the subjects of exercise and calories are:

Exercise: If you are trying to lose weight then it's a good idea to try to preserve lean mass. Things like a ketogenic diet can help with this, as can resistance exercise.

Calories: I don't think that having a diet with a carb:fat ratio of 9:1 is going to have the same results as a diet consisting of the same calories but with a carb:fat ratio of 1:9. All calories are not equal. I don't expect those two different ratios, even at the same calories, to have the same effect on body fat. And particularly in the case of someone with T2, they are not going to have the same effect on overall health. However I do think that, for the same diet, i.e. keeping the macro ratios the same, then if you have 5,000 calories a day of that diet, or 500 calories a day of that diet, you are not going to get the same result. For most people, I'd expect weight gain on the first, and weight loss on the second. So calories are a real variable with real effect, but to overlook what foods are making up those calories is crazy.
 

Mr_Pot

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I am 100% in agreement with @Guzzler except I was overweight when diagnosed and have since lost it all (33%) and maintained for nearly 4 years entirely on LCHF, without meds, and without any additional exercise over and above what I did before, which wasn't a lot.
Do you have any before and after figures for calorie intake? I adopted a low carb diet to reduce my BG but it also reduced my weight by nearly 20% . I suspect the weight loss was because I eat a lot less calories (a Naan bread is 400 kcal) but I have only ever counted carbs so I don't have any figures.
 

Guzzler

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At the one year stage of LCHF and with no change in energy levels and no change in activity levels and certainly no discernible change in muscle mass but a definite change in body weight convinces me that it is all about fuel source for me. In fact the only things that affected muscle performance during this past year was the statin I took for one week which caused muscle pain and weakness. And the transitory weakness I felt during carb flu. Make of that what you will.
 

Bluetit1802

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Do you have any before and after figures for calorie intake? I adopted a low carb diet to reduce my BG but it also reduced my weight by nearly 20% . I suspect the weight loss was because I eat a lot less calories (a Naan bread is 400 kcal) but I have only ever counted carbs so I don't have any figures.

Of course I did. It is bound to happen. I was eating very high carb beforehand and also sweet stuff, fat and protein. I never really went low fat in the period before diagnosis. I did count my calories during the first year in addition to carbs, fats and protein and as it happened I was on about 1200, more some days, less other days. But this was coincidental and not deliberate. In order to stop losing and also to improve my BS I lowered my carbs and increased my fats and protein until I found the right balance. I haven't counted a thing since then.
 
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AdamJames

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I think that so long as nobody tells anyone else what they should do, and instead says "this is my experience," all is good.

I never assume my own personal experience will be true for others, and I see the findings of scientific studies as being an effort to tell us what is common, nothing more.

In some way's that's a great failing of scientific studies. They focus on trying to produce an 'average' so that they can spot patterns and make sense of the world. But they ignore individuals. There are a few studies I've seen in which one or two individuals get such atypical results that I'm thinking "forget the average results, I'd like to see a further investigation to work out what was so special about the atypical individuals - that could lead to a major breakthrough in our understanding". It's easy to see why that isn't possible after a study, but it's frustrating.

But in matters where I don't have personal data / experience, the best I can do is turn to studies and use them as a guide in the hope I may have a similar experience to the average person. I also think it's helpful on a forum like this that if we spot an interesting study, we post about it. Not to say to other people "this is what you should be doing", but to say "you may be interested in this".

In my position, I find the vlck diet study to be very exciting, I find the thought of having a horribly low RMR after weight loss to be troubling, and so I'll certainly be making every effort to keep carbs very low, and to keep muscle mass up while losing weight. Since I can do resistance training to increase my chances, I might as well.
 
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AdamJames

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This is on at 9pm tonight on ITV if anyone is interested. "The Fast Fix: Diabetes" it's called.

Given that I'll have this diabetes thing fixed shortly by the sounds of it, so long as I watch this program, I think I can afford to get complacent.

It starts in just over an hour, so that gives me time to nip to Tesco and get a big bag of Doritos, some doughnuts and a six-pack of Carlsberg Special Brew to have while watching it.
 

KK123

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The reason I like to exercise is not actually for my diabetes. Outside of this diabetes thing, I run because I like to keep my joints strong, my heart and lungs healthy, my blood pressure down, my bone density good to avoid all sorts of other things and because I like it! Sometimes I think we get too immersed in doing things or not JUST for diabetes sake. Everybody is different and have different reasons for the things they do or don't do but I think it is pretty much recognised that NO exercise or movement now and again is bad for you, especially at my age! (Yes, I know, any individual can be healthy without exercise but I like to think of it, along with watching my diet, not smoking etc, as trying to minimise all of those other nasty health conditions). Does it help lower my glucose levels?, dunno for sure.
 

AdamJames

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Just another bump as it's about to start, if anyone is interested.
 

Guzzler

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I'm all set up, it is about to start.
 

Scimama

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recording it so i can shout at the tv tomorrow without waking kids up
 

Guzzler

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First up, guilt.
 

slip

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Half an hour in and no mention of the c word!