This 600kcal thing

[LittleGreyCat]

There is quite rightly a lot of interest in the study of the effects of a 600kcal per day diet for 8 weeks.

However it has also been posted that this is the first part of the Optifast diet plan.

The web site says

Optifast® succeeds because it treats the whole you - not just your weight. It combines support and counselling, comprehensive lifestyle education and medical monitoring with a great-tasting very low calorie diet range to help people lose weight and significantly reduce weight-related health risks.

So is the secret of success just having a VLCD (very low calorie diet) of any design, specifically using the Optifast products, or is it only safe and effective when used withing the counselling and monitoring structure of the full Optifast plan?

I (probably along with many others) am always suspicious of diet plans which involve lots of additional (no doubt expensive) input from a commercial organisation. You have to wonder how much is directly beneficial and how much is for commercial gain.

Also, in this case the aim is not a lifestyle reorganisation as such but a short term harsh regime to flush fats out of your liver and pancreas.
The study suggests that this flushing of the liver and pancreas can have a significant effect even if other lifestyle and changes are still needed to maintain a healthy(er) weight.
I am referring to the ability to "pass" a Glucose Tolerance Test which I believe is usually beyond those who are maintaining good numbers by low carbing or other effective approaches.

So - should we be pushing for the NHS to offer a service to T2 diabetics which consists of an assesment of the fat levels in liver and pancreas, followed by a regulated 600kcal diet plan with medical supervision for 8 weeks (or less if your starting weight is in the "normal" range)?
This should not be beyond the NHS to design and fund and should also have positive cost benefits due to the reduction of the load subsequently on the NHS due to improved BG control.
Given that medical support for the diabetic community is an immense cost this should be a very attractive proposition for the NHS.

This may not be as attractive to drug companies and vendors of "whole life" diet plans.

A properly controlled study and regime would also have much higher benefits in confirming or denying the research results.
One off 600kcal diets which are not Optifast or designed specifically for the liver/pancreas flush (unless they all turn out to be 100% effective) may cloud the issue if the results are not positive.

The idea of an 8 week period of struggle followed by partial remission of T2 is an amazingly attractive one and I can't blame anyone for just going for it if they don't get the support of their HCPs.

Just please take care - extreme diets can be risky.

Cheers

LGC

Hmmm....possible business idea here?
600k camps which provide an environment for the extreme diet and also have a dedicated medical team for the monitoring instead of having to work around the demands of a GP's surgery?
Or perhaps a new 'pancreas flusher' plan which could be franchised like Weight Watchers?

 

[pianoman]

Here is a PDF of the Full Article... http://www.diabetologia-journal.org/Lim.pdf

To be honest I am shocked at the amount of attention this very small and very short trial has garnered.... it seems to be out of all proportion. I would not be in favour of 8 week fat camps to reverse Type 2 -- I had hoped the "short sharp shock" idea was shelved long ago.

 

[catherinecherub]

I think there are a lot of desperate people who are clutching at straws and as I don't fall into that category I too find it difficult to understand why they are pinning their hopes on this.

 

[LittleGreyCat]

I think it is because this seems to be a genuine accidental discovery.

If I understand correctly the regime in question was used for people preparing for stomach stapling and the reults of the stomach stapling were unexpectedly good in the improvement of T2 BG control.

This study was a follow up to see if the stomach stapling itself was causing the results, or the regime immediately before.

If this is correct then this is an example of good science where unexpected results are cross checked.

It wasn't a one off study - it was a follow up to investigate already noted results.

So it is a beguiling prospect especially as the general prognosis for T2s is a constant struggle reaching into the far future and ending in a possibly painful death and shorter than average life span if control slips.

If I could flush my pancreas and revitalise it I would be over the moon.

So at the moment it looks like a small investment in time and effort with a potentially very large long term benefit.

Even if the results are not as startling as hoped it is possible that the overall results are still beneficial as this gives a very strong incentive to drop some weight.

As with all crash diets there is the risk of depression when the weight all goes back on again.

Cheers

LGC

 

[borofergie]

One thing that worries me slightly about the Optifast thing is that each shake contains 20g of carbohydrate.

I'd expect one of those to spike my blood, although I suppose that sacrificing some control for 8 weeks in return for the suggested benefits would be worth it in the long term.

 

[pianoman]

Jenny Ruhl (of Blood Sugar 101) posted her opinion of this study here... http://diabetesupdate.blogspot.com/2011/06/idiotically-dangerous-diet-reverses.html

My reading of the study was that it was set out to mimic the effect of bariatric surgery itself (where it seems some percentage with Type 2 go into remission within days of the operation) rather than the diet leading up to such surgery. In this case I believe the study is flawed as persons who undergo this surgery do not restrict calories to 600 a day for the first 8 weeks -- of course there are a few days post-op when eating is tricky but as soon as possible the calories (and protein) are encouraged (in liquid form at first) to aid in recovery.

In terms of this starvation diet I'd ask how many have considered that: at least at the cellular level, the participants are effectively getting a very large of percentage of their energy from fat -- saturated animal fat at that. In which case why not try a high fat diet instead without the starvation?

Is there possibly an element of guilt here where we feel responsible for "letting ourselves go" and must suffer as a penance?

 

[jopar]

What everybody seems to be forgetting though is that the participants had the diet for 8 weeks, Then onto a supervised heatlhy eating plan!

The problem is what eating plan are they following and what will happen in the future... This 600kcal may seem sucessfull to start off with, but will it long term! Is it just holding things at bay or actually curing?

 

[CMichael]

I suspect that Optifast is a bit of a red herring in this debate as the point of the study was to deliver a 'metabolic shock to the system' of severe calorie reduction. They could probably have done this by feeding the participants with 600 calories' worth of eggs (to pick something at random) but they would have been trying not to reduce people's nutrients too much, and to stop people dropping out (which three of the original 14 did).

 

[bowell]

I suspect that Optifast is a bit of a red herring in this debate

I don't know so much ?
Its often used when no Solid food can be taken in hospital
or recovering at home Well my PCT does
its the same people (Nestle) That make some of the peg food given
I have also been given both via peg and oral ,when i could not eat solid food

The patents from stomach surgery were they not feed a liquid diet post op ?
so if you are trying to copy the results would you not keep to a similar diet ?

So I believe Optifast was already a know start point and willing to offer supplies free to the
study

600kal of eggs would bung me up let alone the smell :lol:

 

[southerly]

Why doesn't Diabetes.co.uk publish a 600 k diet so we can try it. I certainly not going to a commercial organisation when I can weigh and cook food myself. If not can someone not weigh and publish as to what this company is supplying after all its food unless there are special chemicals in it that they dont want anyone to know about.

 

[Patch]

I'm a little concerned about all of the vits/mineral, etc, in the shakes. They seem to have a LOT of good stuff in them. Could that be a contribution?

I'm also interested in the portion size. No doubt th estomach shrinks when on this "shake" diet, maybe that is a contibuting factor. If one is to eat a 600cal diet made up of more substantial food, maybe that stomach shrinkage won't happen?

 

[pianoman]

I'm a little concerned about all of the vits/mineral, etc, in the shakes. They seem to have a LOT of good stuff in them. Could that be a contribution?

I'm also interested in the portion size. No doubt th estomach shrinks when on this "shake" diet, maybe that is a contibuting factor. If one is to eat a 600cal diet made up of more substantial food, maybe that stomach shrinkage won't happen?

I had similar thoughts Patch: the researchers suggest that the study was to replicate bariatric surgery and yet they only seem to focus on the calorie side of things... what about the exploring ideas such as a smaller volume of food being consumed (regardless of calories -- post-surgery patients are encouraged to take in much more than 600 cal per day), or that in both cases the first few weeks are virtually all liquid diet.

I'm wonder if the researchers went in with too many preconceptions and are not being open-minded about their findings?

 

[Patch]

Without being to provocative - I'm sure I could eat a 600cal per day diet made up of high fat/high energy food. Although the volume of food would be very small, I'm certain that 600cal from fat would be more satisfying than 600cal from lettuce (or eggs...).

 

[Sid Bonkers]

All smoke and mirrors I suspect, many years ago, back in the 1980's to be specific I wanted to loose a bit of weight prior to a holiday I had planned. I bought a bunch of 'shakes' from a diet plan company whose name I have long since forgotten, the diet plan was to eat three of their shakes a day and eat nothing else, but also to drink a lot of water, I did the diet for two weeks and lost about a stone and a bit if my memory serves me right, I felt very weak whilst on this diet and had planned to go jogging every night after work but just didnt have the energy.

I bought a bunch of new cloths and had a great two weeks in the sun but within another two or three weeks I had put back on all the weight I had lost plus a bit more and the new clothes I had bought never got worn again :cry:

I cant remember the name of the diet plan/the company who supplied the shakes but like any quick fix diet it didnt work long term, at least not for me at that time.

The lifestyle I have adopted since being diabetic, which is not a starvation diet has worked brilliantly though, go figure, as our American cousins might say.

 

[noblehead]

Was it Shake n Vac Sid?

Nigel

 

[bowell]

If there was a 2nd larger group study to run with the 600kcal 8 week program
with follow up diet and diabetic care for next 24 months

T2s up to 10 years now using diabetic medication

Who would be up for that? :roll:

 

[Patch]

Me. 100%

 

[Sid Bonkers]

Talking of starvation diets I stumbled upon this today whilst searching for information on ketones and I have to say I found it quite interesting, the final chapter talks very briefly about the Atkins diet being described by some as a ketogenic diet but says it should be more accurately referred to as a ketouric diet as the amount of ketones are so small due to the amount of protein eaten. I would think this is true of most extreme low carb diets as those who follow such diets talk of going in and out of ketosis, which acording to this report is not a ketogenic diet.

I'm sure someone here will discredit this report but I found it most interesting and informative.

Edit: oops forgot to post the link :lol:

http://www.i-sis.org.uk/HTSFDS.php

 

[Gratope]

Me too Patch. We will go together.

 

[Patch]

I was in Lloyds Chemist last night - they had Optislim sachets for 99p ea. (banana, strawberry and chocolate shakes, and tomato soup).

I ordered 2 weeks worth of the sachets (about £42) - then got home and realised that we've been talking about OPTIFAST and not OPTISLIM