Modified ND for (at least) the last 19 lbs to my weight loss goal

[Neohdiver]

Since the second Taylor paper, I've been researching the theory behind the Newcastle diet. Way more than I have time to track down or understand completely now - and since I'm within 19 lbs of where I expected to stop losing weight, I need to make a quick decision.

My decision:

For the last 19 pounds (all I had intended to lose), I'm going to try a low carb, real-food variation of the Newcastle diet - based loosely on the Moseley's blood sugar diet (inspired by the ND - with an introduction from Dr. Taylor at the beginning of the book). I'll also be doing what some people call intermittent fasting most days - by skipping breakfast so my eating will all be in an 8 hour window starting somewhere between 1 and 2. What I'm doing is nutritionally consistent with the ND - so we'll see.

My primary criteria before embarking on life as a guinea pig are (1) there is some scientific reasoning that makes sense, (2) preferably some data supporting it, and most important (3) what I'm doing will not cause irreversible harm - or require me to stop medical care that is working. {It is sad that I have criteria at the ready - but we've been around the no effective treatment/no cure merry-go-round with three other conditions I can name without even thinking hard, and this criteria has been successful (at least in doing no harm) in all 3 cases - and in resolving a medical condition that I had been told was not capable of resolution in 2 of the three.} I've met all these criteria reasonably well, although my comfort level lower for the first criteria than I typically like. I'll add my reasoning in the next post - to avoid cluttering this one.

Once I lose the last 19 lbs (4-6 weeks?), I'll re-evaluate. If it looks like remission rather than control, I may push on a bit. If it looks like control rather than remission, I may maintain at my goal weight for a while - and try 36:12 fasting. Fasting can be used to maintain weight - an 800 calorie diet is better suited for losing, so that's the biggest reason for trying an 800 calorie diet first. As of this morning, I still have 19 lbs to lose - so now is when I have weight I can afford to/should lose.

Whatever happens, I know I can always go back to low carb and control my blood glucose that way. If I don't tolerate the severe calorie restriction - I can always stop. I'd just prefer remission, if I can get there.

I started yesterday. I'm tracking what I eat on myfitnesspal.com (same user name). My diary is open - if you're curious about what I'm eating (I sometimes preload and then adjust for actual weights, so today's will not be entirely accurate until after I weigh the ingredients for dinner/snack). I won't report a lot of food here (too time consuming - and anyone curious can find it elsewhere), but I'll update this thread at least weekly with how it's going.

FWIW - the pepper with jeweled feta (Monday lunch) is the best thing I've eaten in a long time! Mine - absent scallions - came in at 238 calories/21 net carbs.

Week 1 - Fasting blood glucose: M: 5.05 mmol/l, T: 5.28 mmol/l W: 5.06 Th: 5.39 (highest in months) F: 4.44 S: 4.39 Sun: 4.44
Week 1 - Starting weight: 150.2 lbs - Ending weight:
Week 1 - High for the week: 7.72, Low for the Week: 4.06, Average for the week: 5.5

 

[Neohdiver]

My thinking - just recording it, in case it helps someone else and so that I can touch it up later when I have time to do more thorough research (or find the notes I took).

The ND was created based on the premise that it was the rapid decrease in calories - followed by a sustained diet at that calorie level that created the remission. The composition of the diet was largely convenience and to create reliable data: 600 calories from a known, consistent, source. The remaining 200 came from real foods to create variety so it might actually be sustainable. The meal replacement was arbitrary (Nestle was willing to donate the shakes), and I have found no explanation for how the list of permitted/not permitted foods was created.)

The study author NOW says that the rapid decrease in calories is irrelevant. What you eat is irrelevant. How you lose weight is irrelevant. The rate at which you lose weight is irrelevant. The point is to get below your personal fat threshold. Since I've already lost far more (24%) than the longstanding recommendation to lose 10% of your body weight - as well as more than Taylor's more recent recommendations (15%) - I don't buy his reasoning. It also doesn't explain why he has deviated from his original theory of mimicking the bariatric surgery, without actually doing the surgery, the evidence on which he is basing his altered theory, or why he continues to study the 800 calorie diet (a third study is underway), if a different diet - or rate of loss works just as well.

A challenge for me is that I have been consuming 1200 calories (or fewer) a day since October, and have been in nutritional ketosis most/all of that time (I don't actually check, but most days I am below the carb threshold that generally suggests nutritional ketosis). Dropping 400 more calories for me is not going to create the kind of drop experienced by most people starting this diet. (That should make it easier for me to adjust to - but perhaps less effective?)

A theory (very generally) behind the ND is that the diet consists of so few calories that your body shifts into survival/muscle conservation mode and shifts to burning off body fat as an energy preference. At some tipping point (1 gram of fat lost from the pancreas - according to some studies), the pancreas starts behaving and its first phase insulin response returns (that 1st phase response normally signals the liver to temporarily shut down the glucose production, since there's food on the way, and is apparently absent in diabetics long before BG levels rise enough to trigger a diabetes diagnosis). Restoration of the first phase response seems to be key to remission v. management.

Short term (or long term - but I'm not going there) fasting appears to work similarly. The best results, in terms of insulin response, seem to be tied to 16-18 hours or more of fasting.

So the question then becomes - if I want to try to trigger the restoration of the first phase response, is some form of fasting or some form of ND a better option (or just keep on with the 1200 calorie restriction - which is projected to take off the remaining weight over a 6 month period).

Given my family history, I'm not inclined to believe that weight loss alone will put me into remission (or even help manage my diabetes). I explored meal replacement shakes/drinks - I haven't seen any that pass muster for something I want to put into my body (especially for 75% of my daily calories, especially starting with a large calorie (and possibly micro nutrient ) deficit for 5+ months already). And I haven't seen anything by anyone who suggests that the shakes are magic (aside from, "It's what was tested") I considered 36-12 fasting - but there are too many unexpected events I'd need to negotiate on fasting days.

So - here I go!

 

[SunnyExpat]

Sounds like you are writing a new chapter, it will be good no matter how it plays out.

 

[Neohdiver]

Sounds like you are writing a new chapter, it will be good no matter how it plays out.

I do that pretty often with medical maladies - tons of research, explore treatment options, pick the best (or cobble a couple together). Confound the doctors, since I have a better track record with my own body than they do. Not quite enough time for the thorough research on this one, since I'm nearing the point at which trying a VLCD would be insane. But mimicking the bariatric surgery makes some sense - and for the short period I'll be following it, I'm pretty sure it won't do any long term damage.

If nothing else, I'll confirm my suspicion that my diabetes isn't weight related. But I would be very happy to be proven wrong.

 

[Winnie53]

The Newcastle Diet is interesting, but after eating a paleo style, whole foods, plant based diet for a year, I can't imagine doing anything other than adding intermittent fasting. That said, I lost 26 pounds, gained 8 back, and am now losing weight again. I'm now at 143 pounds and have decided to get serious about losing weight again, easier done in the non-winter months for me - (I weighed 95 pounds in high school, and not through dieting; I had an incredible metabolism). I want to see if I can further reverse my diabetes.

Looking forward to your weekly reports.

 

[muzza3]

Hi @Neohdiver

Just wanted to wish you luck with this and I will be following your journey. The planning and logic of your diet is very considered as is your combination of ND's calories and intermittent fasting. Thanks for sharing this.

 

[Neohdiver]

I want to see if I can further reverse my diabetes.

Looking forward to your weekly reports.

I'm committed to keeping my BG within normal ranges - but the thought of adding several hundred calories of fat once I hit maintenance to an already high fat diet does not thrill me. So if I can find whatever it is that triggered remission (and return to moderate carbs/lower fat), it is worth whatever short-term changes I'm making in the process.

 

[Roytaylorjasonfunglover]

If nothing else, I'll confirm my suspicion that my diabetes isn't weight related. But I would be very happy to be proven wrong.

Oh but Roy Taylor very much means that diabetes is connected to weight. The problem is what the excess weight consists of. Type 2 diabetics, has lots of visceral fat, fat in the liver and fat in the pancreas compared to non-diabetics. I you want I can give you lots of examples.

And everyone has this personal weight limit, and if above that limit, your body will get diabetes, if it has the genes for it that is.

So when you say that Roy Taylor is wrong for saying that a 10% or 15% is enough, then you are quite right, because the amount of weight needed to be lost will be unique for every diabetic, Some will need to lose 30 percent others 50! Others maybe only 10.. Bmi is a good example, normal bmi is between 18.5 and 24.9. With my height that mean I can have a weight of either 65kg or 88 kg, span of 23 kg! That is insane, so weightloss is absolutely essential and the main cause of diabetes.

 

[SunnyExpat]

It will be interesting, as most of the studies seem to have been done on a high proportion of carbs.
Modified to low carb, it seems to be lacking the similar end result.
It would be interesting to scan the pancreas and liver of some of those, and see if the visceral fat has been removed, or it the pancreas has not restarted to produce insulin.
Professor Taylor does appear to have moved slightly from results produced his studies, and more into some speculative responses.

 

[AndBreathe]

Oh but Roy Taylor very much means that diabetes is connected to weight. The problem is what the excess weight consists of. Type 2 diabetics, has lots of visceral fat, fat in the liver and fat in the pancreas compared to non-diabetics. I you want I can give you lots of examples.

And everyone has this personal weight limit, and if above that limit, your body will get diabetes, if it has the genes for it that is.

So when you say that Roy Taylor is wrong for saying that a 10% or 15% is enough, then you are quite right, because the amount of weight needed to be lost will be unique for every diabetic, Some will need to lose 30 percent others 50! Others maybe only 10.. Bmi is a good example, normal bmi is between 18.5 and 24.9. With my height that mean I can have a weight of either 65kg or 88 kg, span of 23 kg! That is insane, so weightloss is absolutely essential and the main cause of diabetes.

I would argue that Professor Taylor's description of the weight link with diabetes is over simplifying what is actually the key. The key id the Personal Fat Threshold (PFT), not the number on the scales. My personal hypothesis is that I could actually gain weight on the scales, provided that was muscle. Provided I gained muscle weight, and my internal organs didn't accumulate any fat in the process, I'd be OK.

When I had begun trimming up, and discovered Professor Taylor's work (I never followed his diet), I upgraded my scales at home to a set which also measure my body composition. As well as the weight number, which I view like an Executive Summary, I ensure my composition of fat/muscle and visceral fat isn't changing adversely.

I have no idea where my PFT kicked in, because I didn't weigh myself for the first three months after diagnosis, and only did so when I encountered some weighing scales in a hardware store. I was overseas travelling for that period. My initial follow up HbA1c, four moths after diagnosis was already under diabetic levels, so I have no idea when I may have kicked over the line.

The 10-15% weight loss Professor speaks of, is I believe a common amount of weight loss, and I seem to recall he used a phrase something like "It seems like 15% is about what it takes", so I don't believe he would encourage thinking 15% is any kind of silver bullet figure.

@Neohdiver - Good luck with this phase, I hope you achieve your personal objective.

 

[Roytaylorjasonfunglover]

I would argue that Professor Taylor's description of the weight link with diabetes is over simplifying what is actually the key. The key id the Personal Fat Threshold (PFT), not the number on the scales. My personal hypothesis is that I could actually gain weight on the scales, provided that was muscle. Provided I gained muscle weight, and my internal organs didn't accumulate any fat in the process, I'd be OK.

The 10-15% weight loss Professor speaks of, is I believe a common amount of weight loss, and I seem to recall he used a phrase something like "It seems like 15% is about what it takes", so I don't believe he would encourage thinking 15% is any kind of silver bullet figure.

@Neohdiver - Good luck with this phase, I hope you achieve your personal objective.

Yeah totally agree, bodycomposition is the important thing here, I really agree. But most people do not have loads of extra muscle, and a very low bodyfat percentage, most have just excess fat, so when somebody says that have a bmi of 24, and cannot understand why their sugars are bad, it is most often not because of extra muscle. But yes, bodycompostion is the key, not weight per se.

 

[Neohdiver]

Oh but Roy Taylor very much means that diabetes is connected to weight. The problem is what the excess weight consists of. Type 2 diabetics, has lots of visceral fat, fat in the liver and fat in the pancreas compared to non-diabetics. I you want I can give you lots of examples.

And everyone has this personal weight limit, and if above that limit, your body will get diabetes, if it has the genes for it that is.

So when you say that Roy Taylor is wrong for saying that a 10% or 15% is enough, then you are quite right, because the amount of weight needed to be lost will be unique for every diabetic, Some will need to lose 30 percent others 50! Others maybe only 10.. Bmi is a good example, normal bmi is between 18.5 and 24.9. With my height that mean I can have a weight of either 65kg or 88 kg, span of 23 kg! That is insane, so weightloss is absolutely essential and the main cause of diabetes.

I know what Taylor means, and the theory about personal fat level. I just don't believe his assessment is necessarily accurate for all T2 diabetics. I also don't believe that his diet worked because of the weight loss it induced (as he now says), rather than the manner in which it was induced (his initial theory). I'm not rejecting the possibility that for some people with diabetes weight loss alone, by any means, may be sufficient to induce remission - only the notion that it is a universal solution for all recently diagnosed T2 diabetics.

As to your statements about T2 diabetics, I agree as a broad generalization, but not as an accurate assessment of everyone with T2 diabetes, based on not only my family history - but other families in which many people with low-normal to normal weight who are very active have diabetes. Diabetes, in those circumstances, also appears to be much more strongly genetically linked than in the general population - in my case it is 100% of the descendants of one individual who are 59 or older - regardless of weight or activity level. My spouse's family has a similar pattern (although it is closer to 50% and also impacts people much earlier). There is way too much we don't know yet about diabetes - and my strong suspicion is that we will learn that even T2 diabetes is a collection of metabolic disorders that present in a way that we give them all the same label. We've started to recognize that, to some extent, already - look at all of the categories of diabetes that were formerly all identified as T2. I expect that to continue - and that we will identify others who likely make up the 5% who did not respond to the bariatric surgery in the same way as the 95% in whom diabetes was reversed.

 

[Neohdiver]

I

The 10-15% weight loss Professor speaks of, is I believe a common amount of weight loss, and I seem to recall he used a phrase something like "It seems like 15% is about what it takes", so I don't believe he would encourage thinking 15% is any kind of silver bullet figure.

10% is the guideline. The context in which I've read/heard him say it is that far more weight loss may be necessary than the 10% that has been previously suggested, and he suggested 15%. But I'm now near the sum of both (24%). So even if he meant it as an "about" figure - I'm well beyond "about."

I strongly suspect the success he achieved was directly connected to the manner or speed of weight loss, rather than the personal fat threshold - although for some, reaching that threshold may be sufficient - and he is hearing from the some, but not the many for whom the manner/rate of loss may be critical.

 

[Neohdiver]

It will be interesting, as most of the studies seem to have been done on a high proportion of carbs.
Modified to low carb, it seems to be lacking the similar end result.
It would be interesting to scan the pancreas and liver of some of those, and see if the visceral fat has been removed, or it the pancreas has not restarted to produce insulin.
Professor Taylor does appear to have moved slightly from results produced his studies, and more into some speculative responses.

What do you mean by "most of the studies"?
Taylor has only done 2 studies, that I'm aware of. (A third is in progress.) All 3 studies use his meal replacement as the 600 calorie starting point.

Low carb studies (generally) are challenging to draw any conclusions from, since the definition of low carb ranges from 20 grams (gross)/day to 150 grams (net) a day - often without clarifying what their criteria was. That is compounded by factors (also often undefined) such as what the remainder of the diet consists of (fat? protein?) and whether it is calorie restricted, and whether it is being compared to calorie restricted diets. (To date, I'm not aware of any low carb diet study tied to weight loss with the goal of diabetic remission.)

 

[AndBreathe]

I know what Taylor means, and the theory about personal fat level. I just don't believe his assessment is necessarily accurate for all T2 diabetics. I also don't believe that his diet worked because of the weight loss it induced (as he now says), rather than the manner in which it was induced (his initial theory). I'm not rejecting the possibility that for some people with diabetes weight loss alone, by any means, may be sufficient to induce remission - only the notion that it is a universal solution for all recently diagnosed T2 diabetics.

As to your statements about T2 diabetics, I agree as a broad generalization, but not as an accurate assessment of everyone with T2 diabetes, based on not only my family history - but other families in which many people with low-normal to normal weight who are very active have diabetes. Diabetes, in those circumstances, also appears to be much more strongly genetically linked than in the general population - in my case it is 100% of the descendants of one individual who are 59 or older - regardless of weight or activity level. My spouse's family has a similar patter (although it is closer o 50% and also impacts people much earlier). There is way too much we don't know yet about diabetes - and my strong suspicion is that we will learn that even T2 diabetes is a collection of metabolic disorders that present in a way that we give them all the same label. We've started to recognize that, to some extent, already - look at all of the categories of diabetes that were formerly all identified as T2. I expect that to continue - and that we will identify others who likely make up the 5% who did not respond to the bariatric surgery in the same way as the 95% in whom diabetes was reversed.

I would completely agree with you that the cause of any one person's diabetes isn't necessarily the same as mine, yours or anyone else's. In fact, you may have read me post that I believe it is a portfolio condition, with many, many influencing factors.

One point I would throw into the melting pot is, with reference to the genetic elements. I don't believe there is, as yet, any gene (mutated, missing or otherwise) identified which is significantly and materially linked with diabetes. Who is to say that our individual element in the equation isn't quite simply that for at least a decent proportion of those people, in particular those who are slim all their lives, including at diagnosis, that their genes just "gift them" a low Personal Fat Threshold. I mean that in the same way that 70% of obese individuals will not be T2 diabetic.

 

[Neohdiver]

I would completely agree with you that the cause of any one person's diabetes isn't necessarily the same as mine, yours or anyone else's. In fact, you may have read me post that I believe it is a portfolio condition, with many, many influencing factors.

One point I would throw into the melting pot is, with reference to the genetic elements. I don't believe there is, as yet, any gene (mutated, missing or otherwise) identified which is significantly and materially linked with diabetes. Who is to say that our individual element in the equation isn't quite simply that for at least a decent proportion of those people, in particular those who are slim all their lives, including at diagnosis, that their genes just "gift them" a low Personal Fat Threshold. I mean that in the same way that 70% of obese individuals will not be T2 diabetic.

It's not hereditary, in the same way that eye color is hereditary - but it is genetically linked. Here's some of the research going on: https://www.ncbi.nlm.nih.gov/pubmed/?term=GWAS+and+type+2+diabetes The kind of genetic component it has typically requires genetic predisposition + environmental trigger for the disease to be expressed, and the environmental trigger may be very different for different individuals - which is why I just don't buy a personal fat threshold as applicable in all cases (or as in an un-triggering event in connection with remission)

I have quite a bit of experience with complex, not well understood, diseases. My daughter has a rare genetically linked disease. There is no cure and nothing FDA approved for even symptomatic treatment. What was working for her to halt progression was yanked out of the treatment box as a result of the first double-blind test that demonstrated really dramatically bad endpoints (death, transplant, cancer) for an unacceptably high number in the trial. We worked with her doctor to keep her on the treatment on the basis of a different study that demonstrated a better long term prognosis if a certain biomarker was kept in the normal range - by any means (and this drug did that). My theory was much like what I believe will be established for diabetes: There are many variations of a condition that we have given one label - and for some, the drug is a killer, but for those who respond with a lowered biomarker, it is creates a better long-term prognosis. The doctors involved in the study have now, 4 years later, gone back and refined their look at the double-blind study and it is a perfect correlation with what I argued to my daughter's doctor, so others are being cautiously (and quietly) put back on the drug to test to see if they are responders.

I expect with better genetic tools, and more individual medicine, we will find similar variations in what triggers remission in diabetes - and whether remission is even possible for everyone. A PFT is likely to be one of those variations - but I expect it will not hold true for everyone - and I expect that some in the actual studies reversed based on reaching their PFT and others based on some other factor (such as fasting or near-fasting - completely unrelated to the actual weight)

 

[Roytaylorjasonfunglover]

The Newcastle Diet is interesting, but after eating a paleo style, whole foods, plant based diet for a year, I can't imagine doing anything other than adding intermittent fasting. That said, I lost 26 pounds, gained 8 back, and am now losing weight again. I'm now at 143 pounds and have decided to get serious about losing weight again, easier done in the non-winter months for me - (I weighed 95 pounds in high school, and not through dieting; I had an incredible metabolism). I want to see if I can further reverse my diabetes.

Looking forward to your weekly reports.

Very interesting story, how did your body react to a plantbased diet? I am of the rare school that I belive that both a plantbased diet,veganstyle, and a lowcarb diet can work really well for diabetes, but most are in either camps, and the lowcarb camp outnumbers the plantbased dietcrowd for sure, so how did it go down?

 

[Winnie53]

@Roytaylorjasonfunglover we do have one Vegan member of my local education and support group who is doing the LCHF diet with plant based proteins and fats. He's doing fine. Weight loss starts then stalls, then starts again. He's as type 1, blood glucose swings have lessened and are easier to manage.
with the diet.

I'm eating animal protein and a mix of animal and plant based fats. Carbs are lots of vegetables and small amounts of berries. I've eliminated sugar and grains from my diet. The only "fruit" I eat are berries, lemons, and limes. I greatly limit below ground vegetables and legumes, though I continue to eat carrots.

Dr. Mark Hyman, MD promotes a LCHF diet that can be done Vegan or Paleo style. He refers to his diet as the "Pegan" diet.

He has two books out now on the LCHF diet: The Blood Sugar Solution and Eat Fat, Get Thin. The latter book was released in February and provides a lot of information on healthy and unhealthy fats, both animal and plant based. I've read the first book cover to cover. Reading the new book now. It's quite good. You are not alone in doing a Vegan LCHF diet. Others here on this forum are doing it too.

 

[Winnie53]

@Neohdiver what is "PFT"?

I agree strongly that losing excess weight is helpful, but not the entire answer for some of us. I just calculated my weight loss for last year. Started at 163 pounds, lost 26 pounds. 26 divided by 163 is 16%. Didn't work. My blood glucose levels dropped and stabilized within four weeks of starting the diet. The weight loss started and stalled off and on for months.

Because I weighed 95 pounds as a young adult, I know I can lose a lot more weight. I'm at 143 pounds today. 143 minus 95 is 48 pounds. Now I don't want to be that thin again, but I'd like to get a lot closer to that weight. The bummer of it is that every time I lose 15 to 20 pounds, I have to buy all new clothes. Couldn't afford this if it wasn't for thrift stores.

I don't want to get too heavily into this, but I recently learned that heavy metals and other toxins may be at play here too with type 2 diabetes. If that's the case, and the heavy metals and toxins are being stored in the fat, releasing the fat is the only way to release them. So I'm going to give weight loss another good go to see what happens.

I'm very saddened to hear about your daughter. My grandparents were first cousins, two of their three children suffered for it. My brother and I were affected too. I was luckier. I only inherited the ulcerative colitis.

I'm very interested in following your progress.

 

[Indy51]

@Winnie53 - PFT is shorthand for "personal fat threshold" - Prof Taylor's research is based on the level of visceral (particularly liver and pancreatic) fat that he considers causative in Type 2 for most people.