Diet To Help Type 2s Who Are Not Obese...

[NicoleC1971]

https://blogs.diabetes.org.uk/?p=10727

Professor Taylor is looking into this issue on hehalf of Diabetes UK. I beleive his contention is that we all have a personal fat threshold thus someone who has a bmi of 24 may need to reduce it to 22 or lower to get into remission.
Interesting but I am frustrated by the article regarding remission of type 2 which totally fails to mention low carb/high fat.
The options are Newcastle Diet or weight loss via the low fat diet or bariatric surgery with various dietary studies compared then disclaimed because they aren't studying the same things anyway.
No mention of the various studies where low carb/high fat has gone head to head with low fat and even the Mediterranean and either beaten it or done equally well. Low carb appears to be Voldemart as far as DuK are concerned.
I am seriously wondering if they have been getting any funding from those shakes companies to show the ND in a favourable light (starvation does sound slightly more appealing than irreversible surgery or the v.low remission rate quoted for cal contolled low fat!).

 

[Guzzler]

Very frustrating.

 

[Dark Horse]

The link given includes the following under the heading, 'Option 1 diet or lifestyle' :-

2. An Italian study used a low-carb Mediterranean diet. 5% of people were in remission after six years (or 1 in 20)​

 

[NicoleC1971]

The link given includes the following under the heading, 'Option 1 diet or lifestyle' :-

2. An Italian study used a low-carb Mediterranean diet. 5% of people were in remission after six years (or 1 in 20)​

I think that is referring to the PrediMed? Spanish study which may not have actually been low carb since the mainstream regards under 130g as low carb (the average Western intake is 240g.). The study allowed for daily fruit and ad liberum consumption of wholegrains. It was not designed to prove that diabetes could be put into remission though lots of participants were diabetics but to see if it could prevent cardiovascular events which seeminly it did when compared to the low fat group.
If the purpose of the blog was to present a balanced discussion of the various options for getting into remission, it failed IMO!

 

[Dark Horse]

I think that is referring to the PrediMed? Spanish study which may not have actually been low carb since the mainstream regards under 130g as low carb (the average Western intake is 240g.). The study allowed for daily fruit and ad liberum consumption of wholegrains. It was not designed to prove that diabetes could be put into remission though lots of participants were diabetics but to see if it could prevent cardiovascular events which seeminly it did when compared to the low fat group.
If the purpose of the blog was to present a balanced discussion of the various options for getting into remission, it failed IMO!

As they say 'Italian' rather than 'Spanish', I'm guessing that it might refer to this:- http://care.diabetesjournals.org/content/37/7/1824

I didn't see the blog as being a guide to 'how to go into remission' but just an explanation of why they think it is worth doing further research.

 

[DavidGrahamJones]

I am seriously wondering if they have been getting any funding from those shakes companies to show the ND in a favourable light (starvation does sound slightly more appealing than irreversible surgery or the v.low remission rate quoted for cal contolled low fat!).

Diabetes UK were a major force in funding the very early research done in 2011 as well as a more research done in 2017 with larger numbers and more follow up. Diabetes UK are also putting more money into further research to do more follow up.

Optifast shakes (£2-£3 each sachet) are used and as each shake has 20gm of carb I would suggest that's a major reason for reduced BG. However, the research does show large reductions of liver and pancreas fat and attribute that to reversing the condition longer term.

My personal experience of my own version (800 to 1,000 cals per day), vegetable based is that it has straightened out my BG which even on a low carb diet (, 50gms per day) had been a bit like a roller coaster. Weight loss seems to be illusive though.

 

[NicoleC1971]

Diabetes UK were a major force in funding the very early research done in 2011 as well as a more research done in 2017 with larger numbers and more follow up. Diabetes UK are also putting more money into further research to do more follow up.

Optifast shakes (£2-£3 each sachet) are used and as each shake has 20gm of carb I would suggest that's a major reason for reduced BG. However, the research does show large reductions of liver and pancreas fat and attribute that to reversing the condition longer term.

My personal experience of my own version (800 to 1,000 cals per day), vegetable based is that it has straightened out my BG which even on a low carb diet (, 50gms per day) had been a bit like a roller coaster. Weight loss seems to be illusive though.

Its not that i disagree with the ND as an option for reversing diabetes and I am glad that the reversal concept has been accepted in the mainstream because of this research. Its just that the other option (LCHF) gets conspicuously little consideration and the mainstream discussion then tends to focus on the caloric restriction aspect which as you rightly point out leads to the diet being low carb. As your experience shows perhaps getting good bgs isn't all about losing weight.
Happy that DuK continue to fund the research but feel there is some politics involved in its interpretation by DuK and the mainstream media.

 

[brassyblonde900]

Its not that i disagree with the ND as an option for reversing diabetes and I am glad that the reversal concept has been accepted in the mainstream because of this research. Its just that the other option (LCHF) gets conspicuously little consideration and the mainstream discussion then tends to focus on the caloric restriction aspect which as you rightly point out leads to the diet being low carb. As your experience shows perhaps getting good bgs isn't all about losing weight.
Happy that DuK continue to fund the research but feel there is some politics involved in its interpretation by DuK and the mainstream media.

Being that its the high insulin levels that drive most of the pathology in T2DM, even long before the BG levels are high enough for a definitive T2DM diagnosis, any way of eating which involves any foods, whether on its own, or in combination with other foods, which results in less insulin secretion, is helpful in the quest for normal BG levels. Which means, the emphasis should be on eating in a way which results in food choices, as low carb as is needed, to get zero spikes and to also achieve and maintain normal BG levels, plus eat enough protein based on the individuals's needs, and eat enough good fats, to maintain weight, when no weight loss is desired.

 

[lindisfel]

This thread started addressing the concerns of T2's who are normal weight and by extension, underweight.

I don't think this group could assume anything about visceral fat. It may be their hba1c is not a reliable measurement in their case, or worse still, there is insufficient insulin being produced.

They may not even have insulin resistance and their markers may be excellent.

One would have to have a fat scan and an insulin profile done in the case of some of us T2D's.

I would not embark on the risks of a starvation diet and eat rubbish shakes rather than my well formulated keto diet!

I am sorry they do not have sufficient funds to treat the small percentage of oddities like me, who, try as I might cannot get out of the prediabetic range, with a lowish weight and we'll within limits waist to height ratio.
Then again, I do have other complications messing up my endocrine system. And anyway the diabetes reference levels show the authorities are too easily satisfied, the heart damage starts at around an hba1c of 38.

What we need are well written protocols for dealing with the various complexities in what is called T2D.
D.

 

[Guzzler]

This thread started addressing the concerns of T2's who are normal weight and by extension, underweight.

I don't think this group could assume anything about visceral fat. It may be their hba1c is not a reliable measurement in their case, or worse still, there is insufficient insulin being produced.

They may not even have insulin resistance and their markers may be excellent.

One would have to have a fat scan and an insulin profile done in the case of some of us T2D's.

I would not embark on the risks of a starvation diet and eat rubbish shakes rather than my well formulated keto diet!

I am sorry they do not have sufficient funds to treat the small percentage of oddities like me, who, try as I might cannot get out of the prediabetic range, with a lowish weight and we'll within limits waist to height ratio.
Then again, I do have other complications messing up my endocrine system. And anyway the diabetes reference levels show the authorities are too easily satisfied, the heart damage starts at around an hba1c of 38.

What we need are well written protocols for dealing with the various complexities in what is called T2D.
D.

Prof. Taylor has stated that ectopic fat is the first to be lost and using his zooped up scanner in Newcastle he would be in the best position to say that.
I sometimes tire of people saying that slim/thin T2s must be suffering a lack of insulin when this is not routinely measured so if your premise on ectopic fat is correct so is your premise on insulin production.

 

[NicoleC1971]

Professor Taylor has hypothesised that the non overweight type 2s have a low personal fat threshold above which they store fat in the pancreas and liver leading to type 2 diabetes e.g. those who have to get to a lower bmi to reverse their diabetes.
Conversely there are some super fat people who can tolerate their fat celss expanding almost infinitely without becoming metabolically ill.

 

[Guzzler]

Professor Taylor has hypothesised that the non overweight type 2s have a low personal fat threshold above which they store fat in the pancreas and liver leading to type 2 diabetes e.g. those who have to get to a lower bmi to reverse their diabetes.
Conversely there are some super fat people who can tolerate their fat celss expanding almost infinitely without becoming metabolically ill.

As an n=1 this makes sense to me. I was a painfully thin child, a super skinny adolescent, I was thin in my twenties and after having children and reaching my forties I was slim. Perhaps I am genetically predisposed to being a scrawny elder which is what I am now.

 

[The_Keto_Cockeny]

LCHF/Keto is the only effective treatment for T2D But most people forget to up their SALT SALT SALT! this is one of the most important parts of LCHF/Keto. FYI: Any study testing LCHF never do. Keto 20g or less of carbs per day. 130g of Carbs per day is not LCHF or Keto. and if you have ever spent more than 2 weeks in the Med then you will know that the Med diet is a miff it's the Mediterranean way of life not just the diet.

 

[lucylocket61]

1) 130g of carbs a day IS low carb, its the uppermost limit, but is still considered low carb

2) having spent years living in the Med as a child, I can assure you that the increase in size of Italian/Spanish/Greek women in their later middle years happen a LOT. Its not the way of life. Its the diet.

 

[AloeSvea]

I take it 'Diabetes.org.uk' is your national conservative diabetes organisation? A charity?, funding including Big Food? (As well as Big Pharma of course.) Very well meaning but compromised? Every country seems to have one of these.

But for a conservative organisation, this admission and discussion of remission is a good thing, no? A big step in the right direction? I would absolutely direct interested but conservative parties to that article. (Like, my doctor!)

I absolutely agree that the non-mention of Lower Carbing by different regimes is very (very very) glaring, and very frustrating. (I am deliberately being careful - in my normal speech I would just say - "criminal"!!) Especially when they mentioned children! As in only a maybe on children being able to get out of the type two mire. (Which I am thinking, re lower carbs - of course they can!!!) I can forgive a lot, but find this mealy mouthedness when it comes to getting kids healthy - unforgiveable.

The unforgiveable nature of this particular line, re promoting bariatric surgery and not lower carbing, is really brought out when you think of 18 year olds going under the knife to have a significant part of their digestive system cut out in order to do what low-carbing could do without irreversible major surgery - that literally cuts out the joy of eating and dining for the rest of their lives. Those new-to-adulthood folks with T2D cannot opt for what they didn't know about, what was not offered as an option. (This happens in Aotearoa/New Zealand at least.)

I think there will be a future where folks no longer having type two (as in resolution or reversal) is part of the normal discourse about type two, and folks will be laughing that there was a time when the reality of 'remission' was dealt with so mildly and carefully! Everyone walking on eggshells discussing it. I hope I live to see that day when we can have a laugh about it.

In the meantime - baby steps but good steps for your national conservative diabetes organisation? My equivalent, diabetes.org.nz has zero results, still, on remission (on a just now re-search). Ditto on a real suggestion of lowering carbs ("Don't forget some wholemeal bread to provide some carbohydrate" - good grief! Well, we all know the score.)

It's a road, but a long one, sadly, it seems.

 

[lindisfel]

Prof. Taylor has stated that ectopic fat is the first to be lost and using his zooped up scanner in Newcastle he would be in the best position to say that.
I sometimes tire of people saying that slim/thin T2s must be suffering a lack of insulin when this is not routinely measured so if your premise on ectopic fat is correct so is your premise on insulin production.

Well it could be proved one way or another if his theories were a fact by doing the measurements as a matte of protocol. If measurements are not done how would we know? We may as well put a wet finger in the air?

Recent findings indicate T2D is not one disease.

 

[Guzzler]

Well it could be proved one way or another if his theories were a fact by doing the measurements as a matte of protocol. If measurements are not done how would we know? We may as well put a wet finger in the air?

Recent findings indicate T2D is not one disease.

Which was my point but there are a couple of clues. Improved liver function tests and/or lessening of IR over time. The one 'clue' we should avoid is assuming that because a person with T2 has not experienced weight gain that automatically suggests impaired insulin production or beta cell death.

 

[lindisfel]

In the long run, whatever T2D 'type' we have the Newcastle and other long term fasting diets are not sustainable.
They cannot ever be a way of life. For me they are not proper diets but temporary fixes.

Some swear by low fat diets and they appear to work to certain degree with some individuals

For me I shall continue on a well formulated keto diet. It works for me, it has stopped migraines, it stops Reactive Hypoglyceamia and does keep me in the prediabetic range. I cannot cure the other health issues I have, but there are seldom any panaceas to cure all ills.
D.

 

[NicoleC1971]

As an n=1 this makes sense to me. I was a painfully thin child, a super skinny adolescent, I was thin in my twenties and after having children and reaching my forties I was slim. Perhaps I am genetically predisposed to being a scrawny elder which is what I am now.

Think wiry elder! (Sounds better than scrawny)

 

[lindisfel]

I doubt if the Newcastle diet as administrated is a random example of diabetics. I suspect the 'low hanging fruits' are picked as subjects, from what I read those older than their late 60's are not chosen.
I suspect the same may apply to waist versus height ratio.
Does anyone have any evidence on candidate selection.
And
How in fact do they choose the later diet.
I hope it's not by BDA recommendations.
D.