Avoiding diabetes

[Lataxe]

Just recently I acquired an umbilical hernia. The doc tells me that there's no chance of an NHS fixing operation but that losing weight would help keep the little rascal benign.

In truth, I've been thinking for a while about losing weight as, although I'm not diabetic just now, it's probably a risk that I could develop type 2 as I get older. So - I'm seeking advice on how to go about such a diet. (The doc says, "I'm not a dietician").

Professor Roy Taylor's research and book on reducing the risk of (or getting rid of) type 2 diabetes impressed me. I'm planning to do his 1-2-3 diet (8 weeks at 800 calories a day followed by a gradual return to normal eating). I'd like advice from anyone who's tried this diet.

I'm now 75 years old, 5ft 10ins in height and 13 stone 3 pounds. (I weigh myself each morning before breakfast, as a long-term habit). My body type is mesomorph (thick-boned and large-muscled). I'm quite fit (cycling 70 - 100k, swimming 2 miles and doing basic strength routines in the gym, every week). I read in Prof Taylor's book that my "ideal" weight would be around 11 stone 0 pounds, give or take a bit.

My first question is: what meal replacement drinks will suit this diet in providing, say, 600 calories per day inclusive of all the necessary vits, mineral and proteins? Fortisip seems the pharmacist's recommendation but this is expensive and also has quite a lot of sugars in it.

Any advice will be gratefully received.

 

[Pipp]

Hello and welcome @Lataxe.
Having had surgery for umbilical and incisional hernias, I am confused by your doctor’s attitude to your condition . Hernias need careful monitoring.. Your doc could refer you to a dietician, if you need advice on how to go about losing weight.
Members here, even if they are health care professionals / dieticians etc. could not offer medical advice, but may be able to offer support and information based on their own experiences.

I did use the method devised by Prof Taylor. It was in the early stages of development of what is known as the Newcastle diet, way back in 2011. I did lose a lot of weight. 49kg. I am still overweight, as I regained some 20kg over a period of 3 years, and this has been hard to shift. During the calorie restricted phase, I did not feel hungry at all, and was able to continue with intense daily exercise in the swimming pool.

The main flaw in the method, as I see it, is that the media often portrays it as a quick fix. In reality, you cannot return to your previous way of eating if you want to maintain the weight loss. Had I been aware, I would have had a follow on plan. Which , now I have more knowledge, would be to follow a low carb diet.

As for the meal replacement products, there are lots more available these days. If you decide to follow the Prof Taylor method, I would recommend checking carb content of the products. For example, if you are having 3 meal replacements a day, keep the carbohydrate content to a total of 50 - 60 grams.
There are some keto products .
This is an example

SlimFast Keto Fuel Shake Creamy Vanilla - 320g - Boots

Buy SlimFast Keto Fuel Shake Creamy Vanilla - 320g collect Advantage Card Points for every £1 you spend.

www.boots.com

Alternatively, you could use real food, as you have indicated in your mention
of 1 2 3 diet. The main thing to remember is to consider a permanent way of eating following the reduced calorie diet. I would recommend low carb, and there is a lot of information throughout the forum about that.

Have a look at the info for new members below my signature in this post.
Come back with any questions you may have.
Best wishes.

 

[Lataxe]

Hi Pipp,

Thanks for your comprehensive reply and the history of your Newcastle diet experience - a very helpful bit of info.

The umbilical hernia - doc's advice was that the NHS is queue-bound just now so that minor things like umbilical hernias are likely to see a wait of years. Unless of course I get a strangulated protrusion! She also suggested that weight loss from the site of the hernia might see it reduce to near-nothing or even fix itself. It's likely that its a weakening of a keyhole surgery op scar of around eight years ago, through the navel. (Gall bladder removal). It doesn't hurt or bother me, although I wear a truss if doing anything strenuous. It does feel like the fat that surrounds the gut/colon rather than the gut/colon itself.

So .... it seems a good idea to lose weight. I did lose 20llbs some 15 years ago, after going up to 14st 6llbs - although this was partly muscle gain from a lot of power lifting at the time. But since losing that weight (in 8 weeks via what would now be called a keto diet + a lot of fell walking) I haven't put any of it back on. I've been around 13st 1-4llbs for the last 15 years.

The lady wife & me do have a good diet in terms of nutrition and lack of processed fud; no excess of refined sugar or salt. Everything is made from basic fresh ingredients .... although we do eat a fair amount of carbohydrate in the form of (real) bread, pasta, rice (all whole grain) and potatoes. I doubt if I'd have any issue keeping a lower weight if I can attain it. We'd have the same diet as now less a percentage to account for a smaller body weight burning less daily calories.

I might also do more cycling, as losing a stone or two would see me flying up them Welsh hills.

The appeal of the Newcastle diet is, fundamentally, that its quick; and that after the first week of very low carbs the dieting gets easier as the appetite diminishes. (I know this from doing that previous diet 15 years ago). But how to avoid eating or drinking liquid "meals" that contain an appetite-stimulating amount of carbs? I suppose I have to gather a list of "meal replacement" products then read the content info very carefully. Being a bit lazy sometimes, I was hoping someone might give me a shortcut to a good product.

There is an alternative mentioned in Prof Taylor's book, which is to drink 2 litres of semi-skimmed milk each day to get the 600 calories of "meal replacement" but to also take multi-vit & mineral supplements. Not sure about that one, really. But then, what are commercial "meal replacement" products such as Fortisip made of if not those very things, all in one bottle?

The real food option is tempting. But I suspect that I'd fool myself into the belief that the 1200 calories of real food meals I actually ate were only 800 calories.

Anyroadup, I intend to start in the middle of next week, after one last New Year invitation to tea by some friends.

Regards,
David (Lataxe)

 

[Pipp]

@Lataxe

Many members here lose weight, and maintain the loss by great reduction in the carbs in their diet. Though most do that to control their T2 diabetes, which you don’t have. It is less restrictive, but you make your choices.

I am not sure I would have managed with just milk. One advantage I found using meal replacement products was that despite not liking highly processed foods, generally, they were nutritionally complete. It was only for a short time, and I regarded it as ‘medication to aid recovery’. Much like the meal replacements a friend had to use to stabilise crohns disorder. I used the products with support from GP as a Total food replacement, because, as you mention , using real food could be too tempting to overindulge. The most difficult part was the social occasions where there is always food, and people trying to encourage you to eat or drink with them.

Whatever you decide, best of luck, and do keep us informed Of progress.

 

[Lataxe]

'Morning Pipp,

After some interwebbery "research" (poking about various websites offering reviews on a range of meal repalcement products) I decided to try the meal replacement shakes in powder form from SciMx. It seems to be oriented at weight loss, with a wide range of 24 "micro-nutriments" and twice as much protein calories as carb calories. 205 calories per serving of 54gms The reviews say "great taste and not lumpy" so likely to be tolerable over several weeks. It's also on sale direct from the maker's at the moment at a mere £9.99 per kilo - allegedly 1/3rd the usual price.

Not that I'm a miser .... but ....

It seems best to use this stuff with some form of real-food, on a daily basis. The ladywife reckons she can make not just low-calorie soups with plenty of nutrition (and roughage) in them but also many "ordinary" meals with a bit of fish, meat, cheese, legumes etc. but (for me) no portion of carbs such as pasta, tatty, rice or bread. This makes it easier for her culinary procedures as she can still make the same thing for both of us but without adding the carbs portion for me. I get the real fud only once per day, of course - and a reduced portion.

So - one 50gms shake serving made with 100ml semi-skimmed milk = 205 + 156 calories (361) with a real-food meal making up another 400-500 calories per day. Probably another 100 calories in the form of non-starchy veg, for roughage and tooth-exercise.

I'll start next Friday

 

[Lataxe]

'Afternoon Pipp,

I've now been dieting (low-to-zero carb one-meal-a-day + one glass of meal replacement stuff) for just over one week. Happily I don't seem to be developing food cravings or otherwise feeling hungry all the time. An estimation of the calorie count tells me I'm having 800 - 1000 calories each day. I've gone from 13st 3llbs to 12st 13llbs in 9 days, although I imagine a couple of those pounds is just the water loss that occurs when a diet is begun.

The real food contains a portion of protein (fish, meat, eggs and the like) with a lot of low-starch vegetables, of as many different kinds as can be found locally. For example, today was a chunk of braised local Welsh black beef with spring green cabbage, mange tout, carrots, onions and mashed celeriac. This evening I'll have a glass of SciMX meal replacement stuff made with half water and half skimmed milk (350 calories). For breakfast I have a coffee with just a teeny amount of skimmed milk and one square of 85% dark chocolate.

The usual exercise regime has been kept up, with: a mile swum twice a week; a weekly bike ride or two of 30 - 40 hilly kilometres (weather permitting); a weekly weight training session and daily dog walks in Fforest Brechfa of around 2 - 4 hilly miles.

To discover if I do have any signs of Type 2 diabetes, I had a blood test last Monday. Happily the results show no indicators of pre-diabetes or any other of the not-unusual health issues of 75 year-olds.

I hope I can keep this regime up for however long it takes to get down to 12st 0llbs. I'll then have a week-off the strict diet (but no blow-outs) with perhaps a beer or two and even a slice of a friend's delicious home-made sourdough bread! Then another bout of dieting to get to 11st ??llbs. I hope I can maintain that final weight by eating normally but at around 80 - 85% of the amounts I've eaten historically, to avoid any post-diet weight gain, the bane of all dieters, eh?

I'm hoping the Spring will see more miles on the bicycle, as being 2st lighter will certainly make the hills less onerous.

 

[OrsonKartt]

Just recently I acquired an umbilical hernia. The doc tells me that there's no chance of an NHS fixing operation but that losing weight would help keep the little rascal benign.

In truth, I've been thinking for a while about losing weight as, although I'm not diabetic just now, it's probably a risk that I could develop type 2 as I get older. So - I'm seeking advice on how to go about such a diet. (The doc says, "I'm not a dietician").

Professor Roy Taylor's research and book on reducing the risk of (or getting rid of) type 2 diabetes impressed me. I'm planning to do his 1-2-3 diet (8 weeks at 800 calories a day followed by a gradual return to normal eating). I'd like advice from anyone who's tried this diet.

I'm now 75 years old, 5ft 10ins in height and 13 stone 3 pounds. (I weigh myself each morning before breakfast, as a long-term habit). My body type is mesomorph (thick-boned and large-muscled). I'm quite fit (cycling 70 - 100k, swimming 2 miles and doing basic strength routines in the gym, every week). I read in Prof Taylor's book that my "ideal" weight would be around 11 stone 0 pounds, give or take a bit.

My first question is: what meal replacement drinks will suit this diet in providing, say, 600 calories per day inclusive of all the necessary vits, mineral and proteins? Fortisip seems the pharmacist's recommendation but this is expensive and also has quite a lot of sugars in it.

Any advice will be gratefully received.

Hi

I did the Newcastle diet against the diabetic nurses advise , maybe 8 years ago, so early days of this research

I found it pretty brutal, I’ve never officially been overweight, so losing 10% of my body mass in a couple of months meant that friends thought I had cancer.

About a month in I developed an inguinal hernia while playing tennis

On reflection I suspect I was losing muscle as well as fat on the diet

The nhs did the surgery around a year later , they added a plastic mesh and frankly it still on occasion hurts when I excercise

My advise for what it’s worth is to avoid the surgery if possible.

I now maintain my blood glucose by eating meat, fish, eggs, cheese, cream and butter with the very occasional gherkin or side of saucraut


Initially I ate low carb , then keto , then my current regime as my glucose levels crept up over the years

I’d lay a small wager that a low carb diet for a couple of months would help ?

 

[Lataxe]

'Morning Orson,

The umbilical hernia - as you suggest, I'm going to avoid surgery for what seems to be the eventual failure of a keyhole surgery stitch-up eight years after having my gall bladder removed through the teeny belly-button hole. Most advice seems to suggest that the repair of such a re-opened surgery hole in the belly button area will likely fail again; and that any reinforcing mesh will probably be painful and perhaps subject to local infection from time to time. I'm wearing a basic truss just now (a broad elastic waistband with a small pressure pad to stop the hernia expanding its protrusion, which is very slight anyway).

Swimming, gyming and cycling don't seem to bother this hernia, so I'll just hope that the status quo remains.

I did have an inguinal hernia long ago, in my 30s. I lived with it and its occasional gurgle & pout for a number of years but eventually got it fixed at the same time as I had "the snip", in my early 40s. It's never re-appeared; and I have no idea why it appeared in the first place. Perhaps it was the power-lifting I foolishly did in my youth, for which I now suffer a rather delicate sacroiliac joint.

******
I have dieted (about 15 years ago) to lose 20 llbs in around 8 weeks using what these days is called a keto-diet I think. After the first few days of feeling ravenous, it became very easy as my appetite stopped raging. I made sure to keep up the exercise whilst dieting despite various advice that exercise would stimulate my appetite. I suffered little muscle loss, I presume as a result of this.

In my powerlifting days I was familiar with body building folk who used the same gym. They had an adherence to a then current theory that starvation dieting without exercise was a usual feature of primitive European hunter-gatherer life, with the hunters & gatherers semi-hibernating through winter when game and fruits were too scarce to be hunted and gathered. Resting not needing muscle, the starvation diet tended to lead to muscle burn-up rather than fat burn-up because fat contains a lot of minerals, vitamins and other trace elements which are essential for life, so the body hung on to fat the longest, eking it out over winter.

Well, its an interesting theory but I have no idea if there's now any scientific truth been discovered about it. It sounds plausible but then so does all sorts of mad theory found on the web these days - until its plausibility is shot down in flames with hard fact missiles.

************
Doing lots of vigorous exercise inevitably does need the consumption of carbs. The trick is to avoid those forms of food-carbs that seem to have various deleterious effects on our health. The "bad" carbs seem to include those that are highly refined and concentrated into stuff like sweeties and, these days, every kind of supermarket "food" sold.

When not dieting, I try to eat only those carbs that have a low glycaemic index.

I also try to apply the rule: nothing to eat after 5pm.

Having maintained a body weight of 13 st 1-3llbs for 15 years after that keto diet I mentioned, I feel that this is probably a successful strategy re carb ingestion. I also avoid processed fud in favour of meals created from base ingredients, especially the avoidance of stuff laden with UPF (although the definition of UPF is not exact).

 

[Chris24Main]

About a month in I developed an inguinal hernia while playing tennis

On reflection I suspect I was losing muscle as well as fat on the diet

Ha !!!

Fantastic insight Orson.
That could be another piece of the puzzle for me as well.. about 2 years in to my initial "standard" diet plan, I developed an inguinal hernia as well.
That was about a year prior to being diagnosed, so I never thought about any kind of connection, but losing muscle as part of the low-calorie diet - yes; that really makes sense..
No such problems these days, but man, do I ever not miss stuffing my intestines back into my groin... sheesh. That was not fun.

 

[Chris24Main]

Doing lots of vigorous exercise inevitably does need the consumption of carbs.

@Lataxe - I'm no expert really in vigorous exercise, but was watching an interview this morning that was going over some really current research that may overturn that generally held conviction - very short version is that all previous studies had simply not allowed sufficient adaptation, but when athletes were allowed ~4 weeks to adapt to fat burning - the levels of performance with low carb and "normal carb" were identical - including hitting the wall the same way. Really interesting and needs more research, but could indicate that this widely held view needs re-visiting.

 

[Lataxe]

@Lataxe - I'm no expert really in vigorous exercise, but was watching an interview this morning that was going over some really current research that may overturn that generally held conviction - very short version is that all previous studies had simply not allowed sufficient adaptation, but when athletes were allowed ~4 weeks to adapt to fat burning - the levels of performance with low carb and "normal carb" were identical - including hitting the wall the same way. Really interesting and needs more research, but could indicate that this widely held view needs re-visiting.

It's been a subject of contention for many years, really. It seemed to begin with the notions of "the stone age diet" which there's no evidence for of any definitive kind but which can be the subject of very educated guesses. The guesses tend to go: hunter gatherers didn't/couldn't gather stuff like wheat, rice and the other staples of our modern high-starch diet so they must have lived on a diet with a much greater proportion of fats and proteins than we moderns live on.

It does seem unlikely that enough grain-foods could be gathered and stored before the advent of farming to match modern diets. But then what about the rest of the hunter/gatherer lifestyle? For example, high levels of physical activity may have been relatively brief (the hunt) with long periods of very low level physical activity (the gathering). Such a lifestyle has a relatively low demand for glycogen in the liver and blood. On the other hand, many styles of hunting may have been wolf-like, requiring day-long following and chasing at levels rather like that of a marathon.

There do seem to be different evolved body types (often classified as mesomorph, endomorph and ectomorph - big boned/muscled, large proportion of body-fat, very slim and low weight). Perhaps these are associated with the evolution of different hunter-gatherer lifestyles burning different amounts of energy at different rates?

All speculation.

As a racing cyclist (road racing and time trialling) I found it impossible to avoid a need for carbs. We all certainly trained to use bodyfat as a readily available fuel for exercise but it's metabolisation from fat to glycogen (muscle-fuel) is unavoidbaly slow compared to the transformation of carbs into glycogen. Cycling at high energy levels can only go on for a relatively short time without carbs, the usual time quoted being two hours-ish. And this is the time taken for the body to burn up all the blood and liver-stored glycogen when we try hard and continuously. When its gone, its possible to continue riding on bodyfat fuel if one has trained to more easily transform fat-to-glycogen ..... but not at race-pace. Race pace means "the bonk" (identical to the runners' "hitting the wall").

I do know touring cyclists who can go hours and a lot of miles (60+) without eating. I've done it myself on long Sunday club runs when the pace is 15mph average rather than the 25mph pace of road racing or time trialling. I was always ready for a large serving of mashed tatty and a bowl of rice pud when I got home though. Yes.

 

[Chris24Main]

So this study was really focused on a low-glycogen state..

I'm 100% NOT saying that this "is a game changer!!" - I did a long hard paddle after a 36 hour fast. Ketones through the roof, but could I accelerate? not at all... so I get the "the need for carbs is unavoidable" feeling ... but this study really points to, there may be something else that we're missing...

https://journals.physiology.org/doi/abs/10.1152/ajpcell.00583.2024

See what you think (cards on table, haven't read the report myself, only watched the interview with Thomas DeLaurier.

 

[Lataxe]

'Morning all,

Another week of dieting at 800 - 1000 calories a day sees me now at 12st 11.0 llbs - another 2llbs of weight shed in a week. So far, so good then. I'm not finding it difficult to keep to this regime although I do miss the pleasures of eating a more normal diet (for the pleasures of the tastes & textures rather than because of appetite cravings).

One side effect of this diet has been a slowing of my digestion - not uncommon, I read. The diet I'm following does include one carb-free normal meal a day that's basically a large heap of low-starch vegetables .... but the digestion had slowed to once every other day, which is alarming to a chap that normally goes twice a day and can set the clocks by the times-gone.

I've been gulping down a sachet of something called Fybogel twice a day, which has increased my frequency to once per day. That'll do until the end of the diet, I suppose. This stuff contains ispaghula husk as the roughage to stimulate the gut into peristalsis, with an orange flavour that tastes like those 1960s Jubbly frozen "orange" juice things that didn't do my teeth any good when I was a bairn. One also has to mix and drink it reet-quick or it turns into a glass of orange snot that can only be got down in one gulp. Ughhh!

Still - it works.

Exercise continues although I notice that I run out of blood sugar a lot faster when cycling. Normally I can go flat out-ish (for me) for a couple of hours but now I feel a certain lack of ooomph after an hour and a bit. Swimming is unaffected, although I'm only swimming a mile at a time, which takes 35 minutes and never, anyway, requires the amount of ooomph that cycling does.

I also took up indoor flat-green bowling this week, to distract me from thinking about delicious lunches. Although I'm 75 I think I might be the youngest member of the local bowling club! Most seem to be in their mid-80s. A lot of very interesting characters ..... but nearly all of them have diabetes, not to mention various other "conditions". I offered to take one or three for a bike ride but got no takers. ;-/ Every one of them can bowl the woods with an unerring accuracy, whilst mine seem to go for the gutters.

 

[Lizzie2]

Just recently I acquired an umbilical hernia. The doc tells me that there's no chance of an NHS fixing operation but that losing weight would help keep the little rascal benign.

In truth, I've been thinking for a while about losing weight as, although I'm not diabetic just now, it's probably a risk that I could develop type 2 as I get older. So - I'm seeking advice on how to go about such a diet. (The doc says, "I'm not a dietician").

Professor Roy Taylor's research and book on reducing the risk of (or getting rid of) type 2 diabetes impressed me. I'm planning to do his 1-2-3 diet (8 weeks at 800 calories a day followed by a gradual return to normal eating). I'd like advice from anyone who's tried this diet.

I'm now 75 years old, 5ft 10ins in height and 13 stone 3 pounds. (I weigh myself each morning before breakfast, as a long-term habit). My body type is mesomorph (thick-boned and large-muscled). I'm quite fit (cycling 70 - 100k, swimming 2 miles and doing basic strength routines in the gym, every week). I read in Prof Taylor's book that my "ideal" weight would be around 11 stone 0 pounds, give or take a bit.

My first question is: what meal replacement drinks will suit this diet in providing, say, 600 calories per day inclusive of all the necessary vits, mineral and proteins? Fortisip seems the pharmacist's recommendation but this is expensive and also has quite a lot of sugars in it.

Any advice will be gratefully received.

several years ago I developed steroid induced T2 diabetes after I was put on a course of steroids for inflammatory arthriti. I was lucky enough to discover this w9nderful doctor and his book. https://www.diabetes.co.uk/in-depth/david-cavan-reversing-type-2-diabetes/

I bought his book and a glucose monitor and by doing exactly what he said. I was able to identify all the foods that spiked my blood glucose, I reduced my HbA1c to normal levels and I also lost weight.
i have gradually allowed my weight to creep up - I got bored and had been hitting the milk chocolate for months, I had started to have puddings and coffee and cake when we went out so the weight gain and subsequently the increase in HbA1c was no surprise - had crept up to 42. It could be worse but I want to be well out of the prediabetic range so it has to come down.
I have gone back to recording what I eat and cutting out the things I know I ought not to be eating (because they spike my blood sugar) if I want to be healthy and I have dropped 9kg since mid December. I still want to lose another six or so.

We are like you - we get lots of exercise - in my case daily walks - an hour at least and Pilates twice a week for an hour each session - our food is all cooked from scratch, good quality healthy ingredients, no fast food, junk food, etc - welL apart from my chocolate habit that is, our main problem is that our portions have got larger and larger. My husband appears to have taken over cooking and his portions were huge. Not any more they’re not.

So good luck with it, it can be done.