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Dr Mosley and the diet that reverses type 2 diabetes.

I've just brought the kindle version of Dr Mosley's book. You can get the kindle version for under £4.
 
I'm reading that book at the moment, very interesting and informative read.
 
It is most probably a very good.book and following his advice for 8 weeks might very well result in weight loss and level out your BS but just be aware that even if you get your BS down to non diabetic levels it isnt reversed as such more like put into remission and if you fall back into old eating habits your BS will start to rise again.
 

What you are eating is important, but far more important is the weight. I read the book two days ago, it is the best book I have ever read on diabetes, despite some bad parts, they think the glycemic index is important for instance, it explains diabetes very well, and have loads of real life examples of people having gone on the diet, lost weight, and normalized their bloodsugars. And here is the important part, their bloodsugars are still normalized after having done the diet. The only thing everyone that got their diabetes under control had in common was this, they lost weight. Some lost 4 kg, others lost 20, but it is all about that weightloss.

So say your bmi is 23, and type 2 diabetic before you begin the diet. You go on the diet, and get down to a bmi of 19, you check your bloodsugar and it is normalized. So lets say your personal fat threshold for diabetes is a bmi of 21. If this person manages to keep his bmi under 21, he can eat what he wants, and still have good bloodsugar control, we will never get diabetes again. His diet may well be a extreme strict lowcarb, or it may be vegan, as long as the weight is in check, the sugars will be in control.

Most of the examples in the book do not follow the lowcarb diet, most of them think saturated fat is dangerous forexample, one guy says he still indulges in cheeses and fatty meats after having undergone the diet, lol, we know that this is not dangerous, but many here belives wholegrains are, which many of those cured in the book, eat after having reversed themselves.

So this is important. If somebody weighed 140 kg at a height of 188 cm and was diagnosed with diabetes, they get down to a weight of 75 kg, and perhaps their personal fat threshold is 100 kg, and they have their bloodsugar normalized, what will happen now? My understandning is that as long as they keep under the 100 kg limit, they will not get diabetes. They could eat a diet of 90% carbs, with 5 % protein and 5 % fat, something many people on this site never would risk, or they could eat a diet of just 10 % carbs and the rest fat and protein, lowcarb high fat high protein, choose the ratio you like the most, or even a standard diet of 50 carb 20 fat 30 protein. All these diets could be eaten and as long as under 100 kg, they would not cause the big D.

Weight is the most important thing, and which weight you need to be at, is called your personal fat threshold. Do buy the book, it can save your life.
 
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But try being really lean (and with a bmi of 19, 21 - that is really lean!) on 90% carbs - wo ho! Impossible, I would say.

After I did the Newcastle Diet with real food for two months I had to carry a cushion around so I could sit on hard chairs comfortably - and I had a bmi at that point of 22. And I cannot imagine getting even leaner and then sustaining that indefinitely! I couldn't, and I didn't. And I did not become non-diabetic, but in the prediabetic range. The same range I am in now low-carbing - but with a bmi of 24 (ish). And look - no cushion! Yay!

Telling folk to lose a lot of weight and get really lean, and then STAY really lean for the rest of their lives is easier said than done! If I was like Samantha in 'Bewitched' I would wiggle my nose and be skinny and non-diabetic - now that I would like! But going hungry to stay lean for.... ever! That is no nose wiggle....
 
My experience is very similar to yours @AloeSvea

Then there's trying to get below the whole "set point" thing. Unless I was willing to starve myself for weeks on end (ie. true starvation which I'm definitely NOT going to do), I've been unable to get below 58kgs in all my years of yo-yo dieting. And once I up calories again, there's always a slow creep upwards so I don't manage to stay there for long. My hormones seem to want me to hover in the 60-62kg range. Even if I fast, I'll lose a bit, as soon as I eat again, I pop back up.

I think there's many studies that prove that long term starvation dieting is harmful - I'm not doing that to my body when I know I can't possibly sustain it.
 
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I am a "thin" T2 and my BMI is 17.4. I lost one and three quarter stones when I cut out carbs after diagnosis, going from 8 and 3/4 stones to 7 stone. I have never been fat in my adult life, tubby in my pre and early teens but never since then. I can keep my glucose normalish by not eating any carbs (or virtually none) but if I eat any carbs it goes up. I had a liver and pancreas scan (just routine hospital one) and was told I don't have a fatty liver or pancreas and (virtually) no fat at all on my abdomen so not sure if I will be able to reverse my diabetes but I am sick of not being able to eat so many things. I am reading Dr Masleys book in the Daily Mail, might buy the book, to see if there is anything that might help me. I really don't have any weight to lose; well, maybe a very little, or I will be losing muscle and not fat!
 
On a low carb diet I reduced my BMI from 31 to 21. I have maintained a BMI of 21 for over 12 months and am very low carb (under 30g) but I cannot get out of the pre-diabetic range for love nor money. My HbA1c results have been in the pre-diabetic range since June 2014 and seem set to remain there. I am diet only, no meds and no other health issues. I just tell myself this is where my body and my hormones and enzymes want me to be.
 

You make some definitive statements in your post, which I am pretty certain cannot be made until some of these people have lived their lifetimes, post diet. Yes, I "get" and I believe in the Personal Fat Threshold (PFT), but who actually knows where that is? I know I've gone skinny and can eat far more carbs than I could at diagnosis. I now eat as many as I want, but that would still be termed a reduced carb diet, such is the modification in my tastes and preferences.

I corresponded with Professor Taylor, a year or so ago, to ask a couple of me-specific questions, and he was gracious enough to respond in a fairly fullsome way. His statements were more focused on not re-crossing the PFT - ergo keeping my trimmed up weight off. However, as I understand it, with maturity (OK, aging) one's insulin resistance gets worse, and hormonally many folks are more likely to gain weight, even without changing anything in their diet (menopausal/post-menopausal women), and there have been suggestions that the PFT may also come down, simply with age.

For me, only when we have truly long term data from this approach would I be bold enough to make any suggestion of definite permanence of the cure/remission/reversed/gone away status* (use your term of choice). Of course, we all have to decide what we believe for ourselves.

For me, I have gone once around the revolving diabetes roundabout and been able todismount on the non-diabetic side for now. So, my mission is not to re-join that diabetic roundabout, because who knows how well I might be able to jump in a few years time. For now, I have some clues that may help me, but I wouldn't be so bold as to make definite statements.
 
This sounds as if it is based on Roy Taylor's research at Newcastle. There are some caveats though and it does not cover all types of type 2 diabetes, a diseased pancreas for example.

The principle is that everyone has a personal threshold:

"A crucial point is that individuals have different levels of tolerance of fat within liver and pancreas. Only when a person has more fat than they can cope with does type 2 diabetes develop. In other words, once a person crosses their personal fat threshold, type 2 diabetes develops. Once they successfully lose weight and go below their personal fat threshold, diabetes will disappear.

Some people can tolerate a BMI of 40 or more without getting diabetes. Others cannot tolerate a BMI of 22 without diabetes appearing, as their bodies are set to function normally at a BMI of, say 19. This is especially so in people of South Asian ethnicity."

BUT, once you have had diabetes, whilst some of your insulin producing beta cells can recover, some remain dead. This has the result that your personal threshold is now lower than what it used to be, so, don't push things! It is true that sufficient weight loss, for most people, will do more than just give good control. It will normalise the pancreatic function but, you will be at risk if you abuse your new found and hard won health,
 
AndBreathe said:
Yes, I "get" and I believe in the Personal Fat Threshold (PFT), but who actually knows where that is?
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Or how much damage has been done to your beta cell mass? People who have had undiagnosed diabetes for a long time are likely to have a reduced potential than someone who reacts quickly after. I think one of the research aims of Taylor's team is to image the beta cell mass in order to assess the level of damage which will then help them to assess risk at diagnosis. The rate of beta cell death appears to be completely unknown.
 

I always refer to diabetes as a portfolio disease, in that there are many factors and just as many variations of how each individual presents. My post was really responding to the absolute focus on weight loss and the definite statement that provided the weight stayed off there would be no regression.

But, yes, Yorksman, you are correct.
 

We had a couple of blokes who didn't appear overweight at all but who had been diagnosed on my Desmond course. They were both in their 70s. I've just been chatting to one guy, aged 73, cycles regularly 4 to 5 hours per session and has a BMI of 23.
 
AndBreathe said:
Reply to Andbreath
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That is a truly excellent post and I basically agree with everything you said, but I will try to tackle some of the points,WARNING WALL OF TEXT COMING!

I am lucky to not be in Roy Taylors postion, in the book for instance he claimed that he always felt that the "bariatric surgery fixes your gut hormones and therefor your diabetes"-theory was quite bonkers theoretically, but as a respected professor of medicine you cannot say that publicly, so he did that shrewd experiment where they had a control groups of diabetics versus non-diabetics undergoing bariatric surgery, and everyone lost weight, the same amount, but the diabetics lost more from their pancreas and liver and got cured.

So he has to prove things, and not be so definite, where as I can just shout out things, but I agree with you people have to be skeptical and in the end decide for themselves, so now people can read my very brazen definitve post, and your more nuanced, some what less definitive post and decide for themselves.

And the reason why I like this forum and write here so much, is that I will not get banned for saying things like this, the other 4 major diabetes forums I have been to, I have been banned for even mentioning the possibility of a cure or Roy Taylor, and to me that is not good.

So yes, where is exactly the personal fat threshold is can be difficult. I know my one fairly well now, and people must find it for themselves. Mine is where I have a completly flat stomach, like a professional soccer player, and I do not go around obessed by hunger, but eat normally until satisfied, and I manage to keep my weight around this level, without to much stress and hazzle. Muscle mass is also a confounder, I come from the nordic region, and the most famous strength bloggerhere, a guy who preaches intermittent fasting, says that somebody who is at their maxicum muscular potential with a good bodyfat, can just take their height in centimetres, and minus it with a 100cm, and that would be in kg, your optimal drugfree muscle state, as a rule, for somebody of normal genetics. Well I have never done any serious strength training my life, so I am 18 kg away from my ideal muscle weight, but I am very certain I am around my setpoint. I look like a 60 or 70-s male movie star in my upperbody( not face lol) but just a flat stomach, and normal arms and feet not subjected to years in the gym or steroids. Best representative picture( warning shirtless moviestar from sixties picture coming up here. https://onemoreoption.files.wordpress.com/2007/08/3-michelangelo-antonioni-blow-up-6.jpg?w=480
If I started training vigoursly my weight would go up, but muscle is better than fat, and my bmi would change massively if I went up 18 kg of pure muscle( this is not realistic just a thoughtexperiment, if I dedicated my life to strengthraning I could perhaps add 7 kg extra of muscle.
 
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Roytaylorjasonfunglover said:
That is a truly excellent post and I basically agree with everything you said, but I will try to tackle some of the points,WARNING WALL OF TEXT COMING!
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I agree with you one of the most important questions about the newcastle diet is the following, is it a fix forever or can diabetes come back? If the latter is the case, are you powerless to stop it, or does it depend on what you do, are all the factors outside of your control, or is it possible to affect them?

I strongly belive that you can change this factors into your favour and that we do have, some data to prove it, but not as good as we should have. Genes are the most imporant, the Mosley books states that 30% percent of diabetics have a healthy bmi, but a healthy bmi is anything from 18.5 to 24.9 . And the book states that if your bmi is under 21, you should not embark on a diet,something which I disagree with, because bmi does not tell anything about age, bodycomposition and so forth. But even so, if the world got a bmi of 40 when waking up tomorrow, many more would get diabetes, and more so in china and india because of genetic and epigenetic factors, and less in northern europe, but not everybody in the world would have diabetes. So you need genetics in order to get diabetes, withouth the right genetics it is impossible to get diabetes.

And then comes in my opinion, bodyweight, or bodyfat to to be more specific, and age, then, exercise, and then sleep. + stress.
Insulin resistance increases with age, but as long as you have a very low bodyfat and bodyweight, this increase is managble. Even if you lose muscle mass, and have more unfavourable fat disposition, the reason old people get more diabetes is because you need less weight to push them over the threshold, not the old age itself, and most people today have some extra kilos as they get older.

Michael Mosley managed to increase his insulin sensitivity by 24% by doing hiit on the truth about exercise documentary, but then he stopped it and went back to normal, and it was not until he did the fast documentary and lost 10 kg that his sugars got normalized without exercise, so exercise is important, but again weight trumps it.

Sleep is kind of the same, it is important, people who go sleepless nights increase their IR, but is more reparable, than 50 kg of excess weight, lack of sleep just boost the diabetes, it is not the sole cause

Stress is also important for bloodsugar control, but I still belive nobody can be stressed so much at a low bodyweight that diabetes comes, it more excerbates it when weight is to big.

Diet is a topic of its own, do not think being an alcoholic would help somebody predispotioned to diabetes, but I have seen to many people get their sugars normalized on bad standard american diet, crazy vegan, or delicious lowcarb diet, so if it helps weightloss is the most imporant.
 

So if somebody had a height of 188 cm, and weighs 70 kg with little muscle, but still have genetic dispostion for diabetes, aged, slept terribly and never exercised and ate a terrible diet, with lots of stress but as long as this weight is maintained with not to much percentage of the weight slipping into visceral fat,
as I understand the science he would not get diabetes in the future, and I cannot think of others factors that might contribute, except for of course some rare diseases medications and so forth, and the type 1.5 diabetes people are a whole other ballgame, but to me it is a reason why we have hundres of millions of diabetics today compared to 30 millions in 1980, and that is excess bodyweight.



As for data if the newcastle diet is a definitive cure, I agree with your sentiment, but the Michael Mosley book was packed with telling statistics and good anecdotes, I read it on kindle so I do not have all the references but I did 94 small noting points in my obesity notebook. and some were about durability of diabetes remission .Many people in the book have had a remission going into several years now, Mosley himself, just rounded 3 years, and Richard Doughty was still cured after his diagnosis in 2011 in the interview in the book, but the most telling this is the scientific paper that made Roy Taylor think about the link about weightloss and diabetes. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1234815/

it is a follow up of 600 patients 15 years later, since their bariatric surgery, and by the roughly 150 people with diabetes, 120 were still cured,such a long time later. 98 percent of those prediabetic at start of operation were normal still 15 years later. If they had done a bmi and bodyfat scan case by case for those who still were in remission and those that got diabetes again, my guess woould be that weightloss and bodyfat would have been the single most important factor in determining who got it back and so forth.

You also have several others bariatric surgeries telling the same, especially swedish ones. Since bariatric surgery is more effective for weightloss than the standard scientific advise given about weightloss by the normal medical commnunity, You will find more batriac surgery papers having positive longterm results for diabetics, than either lowcarb studies or lowfat studies for the most part, so Roy Taylor is kind of unique in showing the great effect of weightloss, since he actualy made people lose weight, over a very short period of time.

Also I belive if you lose lot of weight you can live a very healthy life on either a very lowcarb, or a lowvegan diet, for life, but I have not really seen the scientific papers that it will never cause diabetes again, I just belive it according to the all the medical diabetes evidence I have seen, as long as weight is kept below.

And on a personal level, I have seen to many people having gone the lowcarb route, lost some weight, but not as much as they should, and as the years have gone by, 10 for instance, they need metformin and others drugs to control the bloodsugar who slowly creeps up. So I am not against lowcarbing, but I do belive the weightloss part is the more important part of it, so when somebody says you do have to eat lowcarb if diabetes is given, I disagree ,point out what I think is the evidence, and then let people decide for themselves. People should eat lowcarb if they want, but people should know it is not the only way( not saying you have portrayed it as such)

Also lastly twin studies with an nice anecdotal evidence to round it up.

http://www.diapedia.org/type-2-diabetes-mellitus/3104085122/genetics-of-type-2-diabetes an excerpt from this article.

However, the twin studies performed for type 2 diabetes provide very different estimates of concordance in twin pairs. For monozygotic twin pairs these estimates range from 36% in a study of Finnish twins[2] to 83% in a Japanese study[3]. Equivalent figures for dizygotic twins were 16% and 40% respectively. One of the most robust studies used 44 pairs of identical twins where one twin had developed type 2 diabetes. After following up for 15 years 76% of the initially non-diabetic twins had developed the condition[4]. It is this contributor’s opinion that studies of heritability in type 2 diabetes are just too variable to provide a meangingful figure – it could be as low as 20% or as high as 70%.

In the last study 25 percent of the twins still had not developed it, and they were in old age then, if i Remember correctly. Had they performed bodyweight and bodyfat analysis again, this would have been the link between those who gained it and not.

Anecdotal evidence, meet the Daley twins from Boston, first article is from 2010, the second from 2015. In 1996 one of the twins, Paul, got diagnosed with diabetes at a weight of 220 pounds. The same year the other one, Tim, weighed 200 pounds, that is just 20 pounds difference between a diabetes diagnosis and not between monozygotic twins! He was pre-diabetic however, and he then lost 14 pounds more, which normalized his bloodsugar. In 2010 the first article they were 60 years old, so they got diagnosed at 46, 14 years later, one still has it, the other not.

The other articles is about the twins 5 years later, the diabetic twin now uses insulin, the non-diabetic is still non-diabetic having lost 25 pounds when he learned about his brothers diagnosis, and they are 65. To me this shows it is possible to keep diabetes away, despite age, but I think his fat threshold would be lower when he got to 75 than 65 as he is now.

So in my mind all the science points towards diabetes being curable, getting under the personal fat threshold is by far the most important, I do not belive a Lowcarb is a necesarry for diabetics, even though it is a totally healthy choice for people to have it as a lifediet if they are at a good weight, and I belive diabetes can ke kept away for life as long as you keep your weight under the personal fat threshold. This is against what many preach here, but I am going to say it regardless, because that is how I view the science, and also despite the fact that it may hurt the feelings of many. Diabetes and obesity are two of the conditions people probably feel most shameful about, and even if people technically brought it on themselves, most people do not know enough about the science of either, to be blamed,shamed or riduculed for having it, as well as living in a society that is primed for making people get both conditions, pushing you into it from all kinds of directions. My hope is just that I will be allowed to say these things, despite all of this, and then people can make up their own minds, forexample, is this post helpful for them or is just the ramblings of a mad man, and then they can decide for themselves, but I am going to say what I mean is right about diabetes in the most civil, respectful, unhafetul way I can, so people have the option to decide for themselves.
 
Roytaylorjasonfunglover said:
So yes, where is exactly the personal fat threshold is can be difficult. I know my one fairly well now, and people must find it for themselves.
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I'm somewhat bemused by your statement that you know your PFT fairly well now. My interpretation of PFT, in the context of Professor Taylor's work is it has absolutely zero to do with aesthetics, and almost 100% to do with the point at which the pancreas and other organs have been de-fatted to an extent their function improves enough to better self-regulate both insulin production and blood glucose levels. Similarly on the upward swing, the PFT is the point beyond which if further visceral fat is deposited the pancreas and other organs become overwhelmed and unable to maintain blood glucose levels in a safe, non-diabetic range. I think for one to know where one's PFT is, in any given period of their life, they would have to be having very regular testing, including OGTTs. As a non-diabetic, I do feel that, with respect, you haven't a clue where your PFT is, but you do know where you feel good, and consider you look good.

Of course, there are other markers for noting metabolic syndrome and subsequent diabetes, but I am addressing the point in the most simplistic manner I can.

Whilst I am content to discuss cure/remission/reversal and all of those other descriptive words, I think it is vital that those embarking on their diabetic adventure realise that reversal is not guaranteed. Even on Professor Taylor's controlled programme, only 70% achieved the Holy Grail. By it's nature I am assuming the balance 30% is made up of those whose condition did not improve sufficiently, within the programme time-frame, either by physical frailty (e.g. too much beta cell damage) or dietary non-compliance.

Can you imagine being promised a cure, only to find, having gone through many weeks of a brutal dietary regime that nobody bothered to mention that 30%? That is the sort of experience that drives folks to a "S*d it!" response, and send them heading off to eat their way through their local Sainsbury's, starting off in the ready meal department and finishing in the Patissiere.
 
Yorksman said:
We had a couple of blokes who didn't appear overweight at all but who had been diagnosed on my Desmond course. They were both in their 70s. I've just been chatting to one guy, aged 73, cycles regularly 4 to 5 hours per session and has a BMI of 23.
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Your two fellow Desmonders might find this link interesting
http://www.salk.edu/news-release/blocking-immune-cell-treats-new-type-age-related-diabetes/

It certainly resonates with the multiple diabetics that have run in my family for the last 3 generations.
 

On the other hand, imagine you're a type 2 that followed the standard NHS advice, your type 2 gets progressively worse, you get diabetes complications, then are on insulin. THEN you find out there was a 70% chance you could have avoided all that just by changing your diet.
 
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