Has anyone failed to reverse their T2 on Newcastle Diet?

[AlexMagd]

The link between fatty liver and T2D is interesting to say the least. I had an ultrasound in 2011 and they identified fatty liver with me - though nobody at the time discussed diabetes. That year I lost about 3 stone in order to reverse it, though with no follow-ups ( was living abroad ) I have no idea if I succeeded. Lately I have been wondering if this wasn't pretty much what Prof Taylor was talking about and whether I crashed the visceral fat out of my body and (accidentally) avoided developing T2D much sooner. When I gained the weight back (and then some) is probably when I developed T2D. It won't help any of us now, but it really makes me wish we had routine screenings for overweight/obese people. Like people have said though, ultrasounds aren't cheap for the NHS.

Diabetes is such a mystery at the moment - everyone seems to react differently to it. With the ND for instance we don't know how many of the participants had strong beta cell function to begin with, how long they'd actually had diabetes (I had symptoms for a year before diagnosis - who knows how long I actually have had it). It stands to reason that the earlier you are in the diabetic process the more likely your chance to 'cure' it - though to even be diagnosed at all your beta cell function has to have been significantly reduced so your chance of developing symptoms again must be quite high. I'm hoping to see some detail on this when DIRECT reports back - along with some clearer indication of what Prof Taylor means by remission and by reversal (i.e. managed control or a restoration of function as with Carlos Cervantes and his blueberry muffin). Either would be fantastic of course, but the latter would be quite revolutionary, even if not everyone could achieve those results.

 

[Oldvatr]

Why is the ND diet always pitted against LCHF? Why not do both? I have heard many say "LCHF isn't a diet, it is a way of life". So an 8 week break to try a VLCD style, low sugar diet - would that really do harm? Why not adapt the ND diet to being a LCHF diet with reduced calories? Then everyone is happy.

I just do not understand why there is so much resistance to something - I really don't. I would like to see the evidence that it is a load of rubbish. It would be terribly sad if the DCUK team decided to invest all of that money so they could finally stick two fingers up to LCHF? For me, it just doesn't make any sense.

I am giving it a go - what harm, my ability to tolerate even 10g of carbs is absolutely insane so even if the ND means I can tolerate a few more for a short period that would be great. I am certainly not knocking the LCHF diet - brilliant; did me a load of good it really did and I intend, after my ND, to chose this as a way of life. And if it has nothing to do with the ND way but is something else - I don't care as long as I see an improvement.

It was DUK not DCUK that sponsored the ND research. I think we are expecting too much of the ND#1 and ND#2. We seem to forget that these were just proof of concept trials to demonstrate what effects a VLC diet has on a group of diabetic volunteers. To minimize extraneous noise and variation they used The Protocol to make sure all participants had the same food intake by using standardised replacement meal shakes with a fixed and known caloric content and micronutrients, That is to make the study repeatable as all scientific studies need to be,

It may form the template to base a common diet plan on later on, but I suspect there will be tweaking going on before it becomes a serious offering to the general public. It could be adapted to a LC type diet, but this would not allow undefined fat intake like LCHF. I see no problem with using a quick burst of ND to reset the old system every once in a while, and following it up with LCHF lifestyle, the two are very simpatico.

So as an experiment it worked. As a diet plan for weight loss it mainly worked. As a Fatty Liver Reducer it worked. As a T2 reversal program it had limited, but statistically significant, success. So yes, the team deserves its moment of glory IMHO. We await their next trial results. Then we may get something they can put in a bottle to sell to us.

 

[bulkbiker]

https://www.diabetes.org.uk/Researc...t/Research-spotlight-low-calorie-liquid-diet/
This describes the success of the 11 out of 40 who completed the first diet and the success of 100% 0f the people in the second study done in 2016. (30 people)
"After the eight-week diet, volunteers had reduced the amount of fat in their liver and pancreas. This helped to restore their insulin production and put their Type 2 diabetes into remission. Three months later, some had put weight back on, but most still had normal blood glucose control.

An MRI scan of the liver shows high levels of fat in green (left) and a sharp decrease in liver fat achieved using a low-calorie diet (right)
Another study, published in 2016, confirmed these findings and showed (in 30 people) that Type 2 diabetes could be kept in remission six months after the low-calorie diet was completed. It also suggested that the diet was effective in people that had had Type 2 diabetes for up to 10 years."

Hi @Tannith
I don't think you have read the report correctly
" In 2011, a Diabetes UK research trial at Newcastle University tested a low-calorie diet in 11 people with Type 2 diabetes,"
That's the first study with 11 people as I said the "Counterpoint" study
" Another study, published in 2016, confirmed these findings and showed (in 30 people) that Type 2 diabetes could be kept in remission six months after the low-calorie diet was completed." The is the second study the "Counterbalance" study.
Diabetes.org.uk are wildly misrepresenting the results of this study with the state that 30 people showed remission. It was as I said 12 or 13 depending on your criteria (by the end of the study 12 and after 6 months one more had got there so 13) . The percentages will vary if you include the 30 original members or the 29 as @Oldvatr has mentioned.
None of these studies ever showed 100% remission and I think that DUK are simply misrepresenting the results (putting it mildy) in their wording.

 

[bulkbiker]

I just do not understand why there is so much resistance to something - I really don't. I would like to see the evidence that it is a load of rubbish. It would be terribly sad if the DCUK team decided to invest all of that money so they could finally stick two fingers up to LCHF? For me, it just doesn't make any sense.

Hi again
I'm not resistant to it but I think so many people think it is a cure all and it simply hasn't so far been shown to be so.
As I said the actual trials were on 41 (or maybe 40) people. It also smacks a bit of the "you gave yourself Type 2 because you are fat" mentality which many of us think is incorrect and that our obesity is a symptom not the cause of Type 2.
As I said before give it a go and see how you get on. I for one will be very interested in your results if you decide to post them here.
I also find it interesting that the 800 calorie a day number also sounds very similar to Dr Valter Longo's fasting mimicking diet but still can't really get my head around why people just wouldn't just intermittent fast and then eat one 800 calorie meal per day.

 

[Tannith]

In my case, I had been doing LCHF since 2013 with reasonable weight loss - 3 stone, 1 pound (43 pounds) over an 18 month period. My HBA1c's were in the 30's/5's on 2gms Metformin/day.

Fast forward to early 2015 when I was hospitalized for one week with flu/pneumonia/sepsis. Over the course of a week, I lost 1stone 4lbs (19 lbs) due to the hypercatabolic state of acute illness. That rapid weight loss seemed to trigger a much more sensitive metabolic response which I attribute (rightly or wrongly) to a rapid decrease in pancreatic and liver fat while rapidly losing weight. Over the course of the next six months I lost an average of 2 pounds per week continuing the same LCHF diet I had been on previously.

My weight eventually stabilized at 9 stone 0 lbs in September 2016 and has remained stable since then, all the while continuing the exact same LCHF diet that I had been on previously. I am in remission, off all meds since March 2016, and continue on LCHF (approx. 30 grams CHO/day). I think of my one week of rapid weight loss as my ND equivalent. However, I also know that I have not reversed my condition; I only have it well controlled.

How awful to get sepsis. Hospitals are filthy places, they scare me. I'm glad its all over now.

 

[bulkbiker]

I think this DUK take on the success of the diet does not tie up with the actual report findings, as published in another thread. I mean DUK was funding it, so no doubt want to bang their drum louder than anyone else, but it is a reported fact that the second study was only 29 not the 30 claimed by DUK since one participant was excluded due to problems with doing the diet properly in the first week. The second study only had 11 out of the 29 that were still in remission after 6 months which by my reckoning works out at 38% success rate. @bulkbiker was it you that shared that report? I do not have a copy since it is not something I intend to do at present and my current interest is academic only. However, the MRI scans were what I found to be exciting, Even 38% is a good improvement for sustained remission

Just re-read the e-mail I received from Prof Taylor and you are absolutely correct..

"Counterbalance 2016. Powered to answer two questions – durability of changes during 6 months of normal eating, and effect of prior duration of type 2 diabetes upon reversibility. 29 people. Funded by National Institute of Health Research, Newcastle Biomedical Research Centre. The salary of the clinical research fellow was funded by the NovoNordisk Research Foundation, an independent grant awarding body."

 

[Tannith]

Just re-read the e-mail I received from Prof Taylor and you are absolutely correct..

"Counterbalance 2016. Powered to answer two questions – durability of changes during 6 months of normal eating, and effect of prior duration of type 2 diabetes upon reversibility. 29 people. Funded by National Institute of Health Research, Newcastle Biomedical Research Centre. The salary of the clinical research fellow was funded by the NovoNordisk Research Foundation, an independent grant awarding body."

I think a diet should only be judged by the initial success (or otherwise). If the diet shrinks the liver and pancreas and removes their fat, and this results in normal BG levels then I think the diet should be called successful. Obviously it is important for people to keep the fat off , but whether or not they do has nothing whatsoever to do with the original diet by which they lost the weight. It only has to do with the quality of the maintenance diet and adherence to it.

 

[AlexMagd]

Hi again
I'm not resistant to it but I think so many people think it is a cure all and it simply hasn't so far been shown to be so.

I think this is a very good point. Of course we'd all like it to be a real shot at 'curing' the condition but at the moment I would say the statistical validity of the results is questionable due to both the sample size and the mixed results of the follow-up studies. It does seem clear that for *some* T2D sufferers this in effect gives them a 'second chance' by resetting their pancreatic function to non-diabetic operation but the long-term feasibility is not at all confirmed. Though on that point, it's not really the scope of the study to assess that - keeping the weight off after the ND is really the patient's responsibility. Hopefully we'll find out the preliminary results in December at the ADA event (does anyone know exactly when that is by the way?)

 

[DCUKMod]

But then shouldn't Counterbalance have had more success? I completely agree about the likelihood of NAFLD being significant in Type 2 but if most on the diet experienced benefits then surely most should have "reversed". I'm just a bit surprised that 2 studies with such small samples have been puffed up to be the great "cure" for Type 2.
Now back to the "Mail on Sunday" for some more health news updates..

From memory Dr Unwin calls the progress to fatty liver as being like the body's silent scream.

(Pretty certain it was Dr Unwin, as opposed to Professor Taylor.)

 

[bulkbiker]

From memory Dr Unwin calls the progress to fatty liver as being like the body's silent scream.

(Pretty certain it was Dr Unwin, as opposed to Professor Taylor.)

Definitely Dr Unwin..

 

[bulkbiker]

I think a diet should only be judged by the initial success (or otherwise). If the diet shrinks the liver and pancreas and removes their fat, and this results in normal BG levels then I think the diet should be called successful. Obviously it is important for people to keep the fat off , but whether or not they do has nothing whatsoever to do with the original diet by which they lost the weight. It only has to do with the quality of the maintenance diet and adherence to it.

But I'm afraid you can't really claim to have reversed Type 2 if it only lasts for 2 days surely? And advocating the "Eatwell Plate for maintenance.. well we all know where that is likely to end up..

 

[Oldvatr]

Just re-read the e-mail I received from Prof Taylor and you are absolutely correct..

"Counterbalance 2016. Powered to answer two questions – durability of changes during 6 months of normal eating, and effect of prior duration of type 2 diabetes upon reversibility. 29 people. Funded by National Institute of Health Research, Newcastle Biomedical Research Centre. The salary of the clinical research fellow was funded by the NovoNordisk Research Foundation, an independent grant awarding body."

No mention of funding support from DUK, I notice

 

[bulkbiker]

No mention of funding support from DUK, I notice

I think that DUK funded the first one

"Counterpoint 2011. Powered to test the hypothesis. The effect size was so large that definitive results could be obtained with relatively small numbers (cf effect of tablets – dozens to thousands needed to detect a modest effect). Yes, funded by Diabetes UK"

and the current one...

" DiRECT, the largest study ever funded by Diabetes UK commenced in 2014. Everyone will have crossed the 1 year line by August 2017, and we intend to publish these data. It was rapidly over-subscribed, and we recruited 306, not the planned 280 people. It is testing whether NHS Primary Care staff can achieve the ~15% weight loss needed to reverse type 2 diabetes, then apply the weight maintaining strategy. It is a randomised comparison with best treatment according to current guidelines."

Interesting that he is far more bullish in the mail than the protocol for the trial...Also the 15% weightloss figure..

 

[Tannith]

But I'm afraid you can't really claim to have reversed Type 2 if it only lasts for 2 days surely? And advocating the "Eatwell Plate for maintenance.. well we all know where that is likely to end up..

It lasts for as long as the patient chooses for it to last. It is difficult to imagine why anyone who had just spent weeks on an 800 cal diet and cured their diabetes would want to take their diabetes back again by overeating. To get the 15% of weight back they would have to overeat ie eat more calories than their body needed, for some time. As to the Eatwell plate Prof Taylor has never advocated it - he always stresses that it is the QUANTITY not the composition of the diet that matters. He actually suggests eating approx three quarters of what the patient previously ate as a maintenance diet.

 

[bulkbiker]

It lasts for as long as the patient chooses for it to last. It is difficult to imagine why anyone who had just spent weeks on an 800 cal diet and cured their diabetes would want to take their diabetes back again by overeating. To get the 15% of weight back they would have to overeat ie eat more calories than their body needed, for some time. As to the Eatwell plate Prof Taylor has never advocated it - he always stresses that it is the QUANTITY not the composition of the diet that matters. He actually suggests eating approx three quarters of what the patient previously ate as a maintenance diet.

From the DiRECT study protocol
"Food reintroduction phase (weeks 12–18)
The FR phase includes a stepped transition to a food- based diet based on the “Eatwell” guidelines "

 

[Oldvatr]

From the DiRECT study protocol
"Food reintroduction phase (weeks 12–18)
The FR phase includes a stepped transition to a food- based diet based on the “Eatwell” guidelines "

This would make perfect sense since DIRECT is being funded by DUK, who would have to approve the Trial Protocol and how their money gets spent. After all Eatwell is the accepted (?) norm isn't it? So we get a return to Normal Diet after the trial has ended. otherwise an LC diet would skew the results if it works, which of course it doesn't - evrybody knows THAT! What we personally would do during recovery is probably ignore DUK advice, since as pointed out it will probably tend to negate all the good work in the longer term. However what better way to prove remission if going back to eating a cr**py diet is handled ok by the patients (sorry = participants)/

 

[walnut_face]

The ND is primarily aimed at reducing the size of the liver.
The size of the liver (and thus the amount of fat) can be found by an ultrasound scan or an MRI scan.
MRI is expensive but ultrasound isn't as far as I know.
At least, it is used routinely during pregnancy and also for screening for aortic aneurysms.
Which makes me wonder why ultrasound scans of the liver are not part of T2 care.

I paid for an ultrasound privately in early 2016. £149 for a comprehensive report and pics. I was hoping to see a fatty liver etc, but was disappointed to find there was none! I had hoped that if I was carry viseral fat, I had an 'easy' solution

 

[AlexMagd]

This would make perfect sense since DIRECT is being funded by DUK, who would have to approve the Trial Protocol and how their money gets spent. After all Eatwell is the accepted (?) norm isn't it? So we get a return to Normal Diet after the trial has ended. otherwise an LC diet would skew the results if it works, which of course it doesn't - evrybody knows THAT! What we personally would do during recovery is probably ignore DUK advice, since as pointed out it will probably tend to negate all the good work in the longer term. However what better way to prove remission if going back to eating a cr**py diet is handled ok by the patients (sorry = participants)/

Surely the Eatwell Plate is only a '****** diet' in the sense that for diabetics it's full of carbs? I would imagine a person with normal blood sugar response would be fine on that diet so long as they kept portions reasonable. Most people eat that way, after all, with relatively few ill effects. Obviously if you're a diabetic it's terrible, but the point of the ND is to make the participants non-diabetic. For a diet that seeks to restore pancreatic function to non-diabetic normal then it makes sense that they'd want to see what happens when you start eating carbs again. You wouldn't lose weight, but as long as you weren't throwing in tons of excess carbs I don't see that it would cause an issue - provided that your insulin response was back to normal.

Though again we're circling round to what constitutes remission, reversal and non-diabetic within the parameters of the study

 

[Anthony1738]

I paid for an ultrasound privately in early 2016. £149 for a comprehensive report and pics. I was hoping to see a fatty liver etc, but was disappointed to find there was none! I had hoped that if I was carry viseral fat, I had an 'easy' solution

Hi, looked at your results in your signature, well done great going, but you have answered your own question re fatty liver, its there to see in your results.

All the best and I hope you keep on the right track and maintain these low Hb1AC levels

 

[Fleegle]

Even if the ND turns out to be not as successful as originally thought - some of the work done is great.
Take being fat. In his presentations he often shows a slide which shows the peek in T2 and that at either end of the curve of BMI - and points out the number of people with really low BMI who have T2 - debunking the myth, scientifically, that T2 is about being fat. Then there is the liver scan, the pancreatic scan - imagine if in 5 years every newly diagnosed T2 got a scan and was told "you need to eat 800 cals a day for further notice, come back every three weeks for a scan" or "sorry - you are likely to have this for a long while". His research could change peoples perception and improve the life of so many. How many T2s in the UK? What percentage success - 20% - hundreds of thousands of cured T2s. Even if I am not one of them, brilliant research!