Newcastle Diet 3 years on

[youngmanfrank]

I haven't worked out my BMI (T am 5' 3" so I guessing I am a bit under weight for my height. My liver scan will tell me if all is well and if they don't find anything then I will start the diet; I don't think they can tell if you have a fatty liver from a normal scan but I will ask them when I go for the scan.

I only found I was diabetic when I went for a free NHS health check and was gobsmacked to find I was diabetic as was the DN when I went for my first visit. She was expecting someone larger! She couldn't believe that I had no symptoms as my glucose was 18.6mmol/L and my HbA1c was 10.4%

I think you should be very careful at your weight when considering the Newcastle Diet.There is a lot of research going on at the moment which has not filtered through to the practice level.I myself volunteered for a research project in which blood was taken and then DNA coded.The research was to try and establish whether there was a genetic basis for type 2 diabetes,so a family history was taken to be used in conjuction with the DNA coding.I found out that they were already finding families with a regular history of developing type 2 in middle age.My first thought was that this was poor nutrition and exercise patterns being passed on down the generations,but apparently not.They had also identified subsets with type 2 eg 25% of patients on a particular steroid treatment went on to develop type 2.

I knew someone who had gastric band surgery and went from 22 stone to 12 stone,losing her diabetic symptoms along the way.Through her I found out about a long running survey of gastric band patients.Apparently approx 75% lost their diabetic symptoms post surgery,however 25% had not,which sort of brings you back to the genetic research.

The Newcastle Diet quite often normalises fasting bloods by the end of the first week,so if you do try it I doubt you would need the full 8 weeks.

 

[trotskyite]

Although the newcastle diet was supposed to mimic the effects of gastric bypass surgery it appears that is not the case, except for the calorie restriction/weight loss part.

From http://www.healthline.com/health-news/aging-how-gastric-bypass-eliminates-type-2-diabetes-072913:

"Here's how it works: After gastric bypass, which is a common weight loss solution for the severely obese, the small intestine spontaneously begins to produce a molecule called GLUT-1 that helps the body use glucose.

“The quite amazing thing is that this is not present normally in the small intestine of adults, but only in the fetus,” said Dr. Erini Nestoridi, a research fellow in Stylopoulos' lab, in an interview with Healthline. “This happens most likely because the intestine has to work harder to do its job, for example to absorb the nutrients or move the food further down. Also, it may be that the mechanical stress of 'dumping' the food directly to the intestine, since the stomach is bypassed, contributes to these changes.”

Although weight loss and improved diabetes symptoms go hand in hand, previous research has shown that gastric bypass surgery helps resolve the disease even before weight loss occurs."

Have to comment on this even though it is from a while ago.
The quote "before weight loss occurs" is incorrectly reported. They do lose weight, just not much. The fasting bloods which are used to assess diabetes reversal are controlled by how much fat is in the liver. There is very little weight of this fat in the liver and it is used quickly when fasting, it will be used within a few days also the weight loss seen by loss of muscle glycogen (in water) will be controlled as they will be rehydrated. This coupled with the fact they will be mainly on a milk only diet for a week before the operation (for the very reason to reduce the size (fat) of the liver to access the stomach) Tells you exactly why bariatric surgery works to reverse diabetes.

 

[Arab Horse]

If you are female and 5'3" and 7 stone you are already seriously underweight on the BMI scale - have a look yourself at:

http://www.nhs.uk/Tools/Pages/Healthyweightcalculator.aspx

Yes, I realise I am now under weight but I was about 8 stone 10lbs before I cut the carbs which put me bang in the middle of my range (so my ideal weight although I preferred to be a few pounds lighter but wasn't bothered enough to do anything about it)! I have since posting put on about 4lbs but the idea of doing the ND is to try and reverse my diabetes, not to lose weight. I struggle to get my glucose normal but don't want to go on the downward spiral of more drugs increasing amounts if I can help it.

I realise I am a very untypical T2 and there is a chance the diet will not work for me but I feel it is worth a try as I have nothing to lose: Well, a few more pounds but I can put those back on gradually.

 

[vit90]

Have to comment on this even though it is from a while ago.
The quote "before weight loss occurs" is incorrectly reported. They do lose weight, just not much. The fasting bloods which are used to assess diabetes reversal are controlled by how much fat is in the liver. There is very little weight of this fat in the liver and it is used quickly when fasting, it will be used within a few days also the weight loss seen by loss of muscle glycogen (in water) will be controlled as they will be rehydrated. This coupled with the fact they will be mainly on a milk only diet for a week before the operation (for the very reason to reduce the size (fat) of the liver to access the stomach) Tells you exactly why bariatric surgery works to reverse diabetes.

Does this infer that the basis of the Newcastle Diet is flawed because the stomach is no bypassed and therefore the small intestine, I guess, is not forced tp function a modified manner?

 

[trotskyite]

Does this infer that the basis of the Newcastle Diet is flawed because the stomach is no bypassed and therefore the small intestine, I guess, is not forced tp function a modified manner?

I was saying the hypothesis that bariatric surgery,above the calorie restriction/fat loss, alters the body in some way to reverse type2 is unsupported. The main point that was pushed (by bariatric surgeons(i wonder why ££££?)) was that no weight loss had occurred before fasting bloods came down to normal. However we now know that fasting bloods are controlled, (in t2) by the insulin resistance of the liver and this is caused by the levels of intra-hepatic fat. This fat is burned for energy and disappears within days on a fasting diet which corresponds to normalising fasting blood glucose. This normalisation of fasting blood glucose which is the test they were using to establish reversal of diabetes.(even though it is not it is reversal of hepatic insulin resistance further weight loss is needed to truly reverse t2)

The Newcastle diet replicated this fasting and looked at what happened in the liver and pancreas and showed exactly what was seen in people who had undergone bariatric surgery but without the actual surgery.

Another point overlooked was the fact that before surgery ,for up to two weeks, you are put on a milk diet that is to "shrink the liver" ie de-fat it which would have gone most if not all the way to "reversal" before surgery.
See below:

http://www.dbh.nhs.uk/Library/Patient_Information_Leaflets/WPR32820 Milk Yoghurt Diet.pdf

MILK AND YOGHURT PRE-OPERATIVE DIET
"Before your weight loss surgery, it is essential that you follow a special diet for two weeks. This diet is to help shrink the liver so the surgeon can operate more easily."

Liver fat can go down substantially even in 2 days before you would notice any weight loss:

http://www.sciencedaily.com/releases/2009/08/090824151304.htm
"If you lose a small amount of weight, you can markedly reduce the fat content in your liver. In fact, even two days of calorie restriction can cause a large reduction in liver fat and improvement in liver insulin sensitivity."

 

[trotskyite]

Yes, I realise I am now under weight but I was about 8 stone 10lbs before I cut the carbs which put me bang in the middle of my range (so my ideal weight although I preferred to be a few pounds lighter but wasn't bothered enough to do anything about it)! I have since posting put on about 4lbs but the idea of doing the ND is to try and reverse my diabetes, not to lose weight. I struggle to get my glucose normal but don't want to go on the downward spiral of more drugs increasing amounts if I can help it.

I realise I am a very untypical T2 and there is a chance the diet will not work for me but I feel it is worth a try as I have nothing to lose: Well, a few more pounds but I can put those back on gradually.

You would do well to try and put on an amount of muscle to increase bmi (depending on age/disabilities etc).Unless you have increased your activity/exercise levels that 4lb weight increase may well be mostly fat. The ND is purely about losing fat to reverse type2 using calorie restriction.
It really doesn't matter what your BMI is as long as you are type2. BMI is not accurate for assessing levels of fat in an individual. eg an average 60kg 20 year old will have double the muscle and less than half the fat of a 60kg 65year old. Much more accurate is waist measurement . Increased risk of health problems start from 80cm and over in a woman of European extraction. However are lower for Asians.
See here:
http://www.myhealthywaist.org/evalu...s/waist-circumference-measurement-guidelines/

 

[vit90]

I was saying the hypothesis that bariatric surgery,above the calorie restriction/fat loss, alters the body in some way to reverse type2 is unsupported. The main point that was pushed (by bariatric surgeons(i wonder why ££££?)) was that no weight loss had occurred before fasting bloods came down to normal. However we now know that fasting bloods are controlled, (in t2) by the insulin resistance of the liver and this is caused by the levels of intra-hepatic fat. This fat is burned for energy and disappears within days on a fasting diet which corresponds to normalising fasting blood glucose. This normalisation of fasting blood glucose which is the test they were using to establish reversal of diabetes.(even though it is not it is reversal of hepatic insulin resistance further weight loss is needed to truly reverse t2)

The Newcastle diet replicated this fasting and looked at what happened in the liver and pancreas and showed exactly what was seen in people who had undergone bariatric surgery but without the actual surgery.

Another point overlooked was the fact that before surgery ,for up to two weeks, you are put on a milk diet that is to "shrink the liver" ie de-fat it which would have gone most if not all the way to "reversal" before surgery.
See below:

http://www.dbh.nhs.uk/Library/Patient_Information_Leaflets/WPR32820 Milk Yoghurt Diet.pdf

MILK AND YOGHURT PRE-OPERATIVE DIET
"Before your weight loss surgery, it is essential that you follow a special diet for two weeks. This diet is to help shrink the liver so the surgeon can operate more easily."

Liver fat can go down substantially even in 2 days before you would notice any weight loss:

http://www.sciencedaily.com/releases/2009/08/090824151304.htm
"If you lose a small amount of weight, you can markedly reduce the fat content in your liver. In fact, even two days of calorie restriction can cause a large reduction in liver fat and improvement in liver insulin sensitivity."

OK thanks for the explanation, though it sort of depresses me a little as I have lost a fair bit of weight (11kg) since diagnosis and I wasn't obese to start with and my fasting BGs are still not consistently low 5s or even 4s. Or am I just being impatient?

 

[trotskyite]

You will get there don't stress it.
To make you feel better/worse your bmi is still over the normal range for health for a south east asian according to WHO

"In this latter case, the intermediate cut-off point (23 kg/m2 ) was chosen as the public health action point on the basis of the results of the meta-analysis involving results from nine countries in Asia and other published work"
http://www.who.int/nutrition/publications/bmi_asia_strategies.pdf

"Research shows that fat around the belly of a south Asian person is more risky than the same amount of fat in a white person, putting them at increased risk of heart disease and diabetes," says Dr Justin Zaman of the South Asian Health Foundation and consultant cardiologist at James Paget University Hospital in Norfolk.

"This means that south Asian people are more likely to develop diabetes than white people."
http://www.nhs.uk/Livewell/SouthAsianhealth/Pages/Waistmatters.aspx

"A healthy waist size for south Asian men is 90cm (35in) or less"

Measure just above the hip bones parallel to the ground when you get to 90cm I would then start checking your glucose tolerance. hba1c, fasting etc

 

[trotskyite]

OK thanks for the explanation, though it sort of depresses me a little as I have lost a fair bit of weight (11kg) since diagnosis and I wasn't obese to start with and my fasting BGs are still not consistently low 5s or even 4s. Or am I just being impatient?

Actually using a S E Asian bmi calculator you were obese at diagnosis as the cut-off is 25
http://www.pamf.org/southasian/healthy/screening/bodysize.html

sorry

 

[vit90]

This is interesting but I am a little confused in places. Hopefully my Chinese/Malay genes (and 50% Anglo Saxon) mean I have not yet run out of fat adjustment room although I do look at myself and think I am skinny and I certainly did not look obese 6 months ago. Compared to my Asian relatives I do have a taller build and larger bone structure and my build is more akin to my UK relatives.

Referring to the comment about fat reduction in the liver taking a fairly short time on a fasting diet - this is what I have been doing on and off for the last 6 months but am I looking for the wrong consequential effect? My best fasting BG was 5 and best several day average about 5.2 . It did bounce back to 6s when I had to stop the diet despite continuing on a low-ish carb diet and continuing added activity (walking 10-15 miles per week more than I would have done before diagnosis).

Anyway, I have been back on a more strict low energy/carb diet regime for the last 10 days while maintaining daily activity and I am seeing my FBGs steadily reducing again in the last few days (6.1, 5.7, 5.5 in the last three days) and I have lost 4-5 lbs in this period (the digital scales are a bit temperamental!).