Newcastle Diet, Reversal, Professor Taylor's / Dr Fung's Views

[Living-by-the-beach]

I've been diabetic now for going on 2 years and not been able to put my diabetes into remission. I've exercised strenuously & that includes up to 2 hours of cycling every other day plus lifting weights on the non-cycling days.

I have a great deal of dedication to getting myself into remission, yet I've had a difficult time with Professor Taylor in some of his talks saying that it is simply overall weight loss that counts

http://www.ncl.ac.uk/magres/research/diabetes/reversal.htm

"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."

Here's some of Doctor Jason Fung's thoughts on surgery

https://intensivedietarymanagement.com/bariatrics-surgically-enforced-fasting-t2d-6/

where, he hypothesizes about bariatric surgery

"Interestingly, the T2D is often reversed within weeks and far, far before significant weight is lost. For example, a 500 pound man might lose 50 pounds in a few months. That’s great, but that still leaves him at 450 pounds. Despite this weight, T2D is often fully reversed. Why does it work? There are many theories. But it is pretty obvious how bariatric surgery really works its magic. Bariatrics is surgically enforced fasting."

How does this affect me? Well I 've a BMI now in the 24's range and yet I am still diabetic! I am relatively svelte at 200 lbs and I'm 6'4" my point is that why haven't I experienced full remission?

I am starting to draw my own conclusions that a combination of factors one of extreme ND + weight loss too. I don't now believe that its just weight loss on its its own, but for the best chances for diabetic remission come with weight loss, plus enforced fasting (Newcastle diet) for an optimal outcome.

I'd love for anyone with an opinion to chime in.. Please let me know your experiences?
Thanks

Living by the beach

current weight lost 52lbs
BMI 24.3
Still diabetic.

 

[AndBreathe]

I think it is absolutely noteworthy and critical to point out at this stage that Professor Taylor had 30 subjects on his trial, of whose 12 "reversed" their diabetes by the end of the 8 week programme term, with one further subject achieving the same within the following 6 months.

Whilst that is an extremely exciting and laudable 40-43% "reversal"rate, the facts are, it remains less than a half way chance of achieving the holy grail for those somehow mirroring Professor Taylor's subjects.

I don't make that statement to cast a downer for anyone, but to state that which is overlooked. That there is considered a less than 50% rate or reversal backs up my own gut feeling driven approach of managing the blood scores, with the hope of associated improvements. That way there is less chance of a devastating disappointment and more chance of a happy outcome, even if that isn't a complete reversal.

 

[SunnyExpat]

I've been diabetic now for going on 2 years and not been able to put my diabetes into remission. I've exercised strenuously & that includes up to 2 hours of cycling every other day plus lifting weights on the non-cycling days.

I have a great deal of dedication to getting myself into remission, yet I've had a difficult time with Professor Taylor in some of his talks saying that it is simply overall weight loss that counts

http://www.ncl.ac.uk/magres/research/diabetes/reversal.htm

"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."

Here's some of Doctor Jason Fung's thoughts on surgery

https://intensivedietarymanagement.com/bariatrics-surgically-enforced-fasting-t2d-6/

where, he hypothesizes about bariatric surgery

"Interestingly, the T2D is often reversed within weeks and far, far before significant weight is lost. For example, a 500 pound man might lose 50 pounds in a few months. That’s great, but that still leaves him at 450 pounds. Despite this weight, T2D is often fully reversed. Why does it work? There are many theories. But it is pretty obvious how bariatric surgery really works its magic. Bariatrics is surgically enforced fasting."

How does this affect me? Well I 've a BMI now in the 24's range and yet I am still diabetic! I am relatively svelte at 200 lbs and I'm 6'4" my point is that why haven't I experienced full remission?

I am starting to draw my own conclusions that a combination of factors one of extreme ND + weight loss too. I don't now believe that its just weight loss on its its own, but for the best chances for diabetic remission come with weight loss, plus enforced fasting (Newcastle diet) for an optimal outcome.

I'd love for anyone with an opinion to chime in.. Please let me know your experiences?
Thanks

Living by the beach

current weight lost 52lbs
BMI 24.3
Still diabetic.

Did you follow the Newcastle diet, doing the 8 weeks of 800 calorie shakes?

 

[Brunneria]

The idea of the Personal Fat Threshold is fundamental here.

It doesn't matter whether someone has a BMI of 40 or 17, if their body is above their personal fat threshold, then they will still see the symptoms of T2.

From the original post on this thread (which quotes Professor Taylor out of context), i am unsure whether the implication is that ALL T2s can see 'reversal' with weight loss. This is definitely NOT the case.

There are many, many different causes of the diabetes that is generally known as Type 2.

My personal opinion is that anyone wanting to diet for health, fitness and weightloss is to be encouraged.
But dieting with the hope of 'reversing' T2 is only worthwhile if you have been tested to see if you have a fatty liver first. Then, even if you slim your liver to non-fattiness, there may be scarring and cellular damage that means it will never return to full function.

Plus, if your T2 is not caused by a fatty liver, but by steroid damage, statin damage, other drugs, various genetic factors, organ degeneration, PCOS, or one of the many other causes, then weight loss will make you slimmer, but will never make you less diabetic.

 

[AndBreathe]

The idea of the Personal Fat Threshold is fundamental here.

It doesn't matter whether someone has a BMI of 40 or 17, if their body is above their personal fat threshold, then they will still see the symptoms of T2.

From the original post on this thread (which quotes Professor Taylor out of context), i am unsure whether the implication is that ALL T2s can see 'reversal' with weight loss. This is definitely NOT the case.

There are many, many different causes of the diabetes that is generally known as Type 2.

My personal opinion is that anyone wanting to diet for health, fitness and weightloss is to be encouraged.
But dieting to 'reverse' T2 is only worthwhile if you have been tested to see if you have a fatty liver first. Then, even if you slim your liver to non-fattiness, there may be scarring and cellular damage that means it will never return to full function.

Plus, if your T2 is not caused by a fatty liver, but by steroid damage, statin damage, other drugs, various genetic factors, organ degeneration, PCOS, or one of the other causes, then weight loss will make you slimmer, but will never make you less diabetic.

I'd agree with 99% of what you say Brunneria, especially for those whose T2 (like you, I think of it as a portfolio condition) was triggered by steroids or the like, it is probably worth trimming up as a matter of course -if nothing else to rule out visceral fat related insulin resistance, but not in what often seems like an expectation of reversal.

Whilst I no longer carry any diabetes markers on my physical or blood profiles, and I have been removed from the diabetes register, I don't talk about myself being cured. If pressed I'll take about tidying it away, in the hope I can forget where I put it, but for me claims of being cured could set me about challenging myself with serial real food, glucose tolerance tests - in other words, carb-tastic gluttony!

 

[Pipp]

I think it is absolutely noteworthy and critical to point out at this stage that Professor Taylor had 30 subjects on his trial, of whose 12 "reversed" their diabetes by the end of the 8 week programme term, with one further subject achieving the same within the following 6 months.

Whilst that is an extremely exciting and laudable 40-43% "reversal"rate, the facts are, it remains less than a half way chance of achieving the holy grail for those somehow mirroring Professor Taylor's subjects.

I don't make that statement to cast a downer for anyone, but to state that which is overlooked. That there is considered a less than 50% rate or reversal backs up my own gut feeling driven approach of managing the blood scores, with the hope of associated improvements. That way there is less chance of a devastating disappointment and more chance of a happy outcome, even if that isn't a complete reversal.

I think it is also important to consider how many of the people purporting to be following the Newcastle diet protocol actual do follow it. Not sure about the pilot study, by Taylor et al, but how often do we read posts here where people make comments such as 'When I did my version of ND'? There is no such thing. You can't 'cherry pick' the bits you want, or have days off or 'treats'. To do ND, one needs to consider all the points made in the research papers, and follow the instructions. Otherwise it is not a ND. Most overlooked is the need, after the initial very low calorie phase, to thereafter eat less than one did before starting out. Also, if the cause of T2 is NOT that you have visceral fat beyond personal fat threshold, then it is futile to follow the methodology.

 

[Living-by-the-beach]

@AndBreathe & @Brunneria I thank you both for your opinions.

However, Dr Fung https://intensivedietarymanagement.com/bariatrics-surgically-enforced-fasting-t2d-6/
goes on to say ;-
"Bariatric (stomach stapling) surgery quickly and successfully reverses type 2 diabetes (T2D). The most recent trial was published in the New England Journal of Medicine on 242 adolescents undergoing bariatric surgery. Most got Roux-en-Y bypass, with most of the rest getting sleeve gastrectomy. After 3 years, the results were good. 74% of high blood pressure resolved. 66% of abnormal lipids resolved. 86% of abnormal kidney function resolved. And Type 2 diabetes? Glad you asked. A stunning 95% of type 2 diabetes was reversed,"

Which thus goes back to Dr Fung's earlier point that "Bariatrics is surgically enforced fasting" . I'll also agree that 95% success ratio isn't 100% success but its close. I understand PFT but forcing a body by bariatric surgery to consume the liver and pancreas fats seem to me to be causing T2 Reversal? We cannot argue over a person who was 500 lbs pre-bariatric surgery and goes into T2 remission post surgery with only 20-30lbs weight loss, has lost their diabetes. They are still obese, though now non-diabetic.

I think what I am suggesting is that slow weight loss (I've lost 52lbs) isn't nearly as effective as enforced fasting weight loss. (either bariatric or ND) I know I've done the slow weight loss and not lost my T2DM.

I am not intentionally taking any information out of context or trying to be clever or obtuse, just trying to get a better understanding here.. I am just trying to figure out the best way forward for myself and other diabetics.

LBB

 

[Living-by-the-beach]

I think it is also important to consider how many of the people purporting to be following the Newcastle diet protocol actual do follow it. Not sure about the pilot study, by Taylor et al, but how often do we read posts here where people make comments such as 'When I did my version of ND'? There is no such thing. You can't 'cherry pick' the bits you want, or have days off or 'treats'. To do ND, one needs to consider all the points made in the research papers, and follow the instructions. Otherwise it is not a ND. Most overlooked is the need, after the initial very low calorie phase, to thereafter eat less than one did before starting out. Also, if the cause of T2 is NOT that you have visceral fat beyond personal fat threshold, then it is futile to follow the methodology.

@Pipp

I think you're right on target too. "I did my version of ND" I've lost 52lbs. I didn't do the 3 shakes a day routine. I did a great deal of exercise and I have totally cut back my weight to normal levels. So I have come to the conclusion, that I am still carrying that hard to remove liver and pancreas fats. That's what the 95% success ratio of bariatric surgery is saying (at least to me)

LBB

 

[Living-by-the-beach]

Did you follow the Newcastle diet, doing the 8 weeks of 800 calorie shakes?

@SunnyExpat

Nope I didn't & that may be why now I am still diabetic.

 

[andcol]

Here is a supposition. Did you actually fast for periods of time? This puts your body into repair mode where it fixes cells instead of replace with any defect copied. I think this is the difference. It does not take much insulin in your system to switch off the repair mode. It could be not fasting fully and too much exercise kept you out of repairing.

 

[SunnyExpat]

I have read up on this type of diet, and it does seem that rapid weight loss seems to target different fat to slow weight loss.
Personally, I tried low calorie, I cut fat to a minimum, counted the calories, and did it that way. Purely personal, but I had read a lot on here that sometimes LCHF reduces BG, but still can have higher fasting levels.
I also subscribed to the idea like Andrew that your body goes into 'repair' mode during fasting, and I wanted to make sure my pancreas and liver were getting exercised, and didn't get overlooked in the process. Hence keeping the carbs in my meals.
I had a meter, so watched the results of what I ate daily, and didn't seem to have an issue.

I must admit, it suited me, and it did seem to work for me.

Looking at the contents of the shakes, I would do it that way if I ever needed to address the issue again in the future. They may be 'high carb' to some people, but for the actual amount eaten in the day, BG would probably soon comes down.

 

[Hiitsme]

Very interested in this thread. Diagnosed Feb 2015 and the one hope I found when browsing was The Newcastle Study. My GP was not interested so I set about my weight loss in a lot slower fashion, 500 cals less than I was burning. Went from BMI of 25 down to BMI of about 19.6. GP now wants BMI up to 20, I think he feels I am undernourished as my trigs are very low. I've also got to see a dietician. My HbA1c is 33, both Aug 2015 and again this month. I don't feel I have reversed my diabetes but I do feel I now have some control.

 

[SunnyExpat]

I've been diabetic now for going on 2 years and not been able to put my diabetes into remission. I've exercised strenuously & that includes up to 2 hours of cycling every other day plus lifting weights on the non-cycling days.

I have a great deal of dedication to getting myself into remission, yet I've had a difficult time with Professor Taylor in some of his talks saying that it is simply overall weight loss that counts

http://www.ncl.ac.uk/magres/research/diabetes/reversal.htm

"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."

Here's some of Doctor Jason Fung's thoughts on surgery

https://intensivedietarymanagement.com/bariatrics-surgically-enforced-fasting-t2d-6/

where, he hypothesizes about bariatric surgery

"Interestingly, the T2D is often reversed within weeks and far, far before significant weight is lost. For example, a 500 pound man might lose 50 pounds in a few months. That’s great, but that still leaves him at 450 pounds. Despite this weight, T2D is often fully reversed. Why does it work? There are many theories. But it is pretty obvious how bariatric surgery really works its magic. Bariatrics is surgically enforced fasting."

How does this affect me? Well I 've a BMI now in the 24's range and yet I am still diabetic! I am relatively svelte at 200 lbs and I'm 6'4" my point is that why haven't I experienced full remission?

I am starting to draw my own conclusions that a combination of factors one of extreme ND + weight loss too. I don't now believe that its just weight loss on its its own, but for the best chances for diabetic remission come with weight loss, plus enforced fasting (Newcastle diet) for an optimal outcome.

I'd love for anyone with an opinion to chime in.. Please let me know your experiences?
Thanks

Living by the beach

current weight lost 52lbs
BMI 24.3
Still diabetic.

That's an excellent link. I hadn't realised just how firmly Fung had come out in support of the Newcastle Diet, and fasting overall.
He seems to be a very staunch advocate now.
No wonder really, those figures he quotes are amazing.

He's spot on here as well.

'Many myths are associated with fasting. These myths have been repeated so often that they are often perceived as infallible truths. Some of the these myths include:

Fasting puts you in ‘starvation’ mode
Fasting will overwhelm you with hunger
Fasting causes overeating when you resume feeding
Fasting will make you lose muscle
Fasting deprives the body of nutrients
Fasting causes hypoglycemia
The brain needs glucose to function
It’s just ‘crazy’

 

[Neohdiver]

Here is a supposition. Did you actually fast for periods of time? This puts your body into repair mode where it fixes cells instead of replace with any defect copied. I think this is the difference. It does not take much insulin in your system to switch off the repair mode. It could be not fasting fully and too much exercise kept you out of repairing.

Intriguing idea!

 

[Living-by-the-beach]

Here is a supposition. Did you actually fast for periods of time? This puts your body into repair mode where it fixes cells instead of replace with any defect copied. I think this is the difference. It does not take much insulin in your system to switch off the repair mode. It could be not fasting fully and too much exercise kept you out of repairing.

@Andrew Colvin

You may have a valid point, I've read the some of most recent study from Professor Taylor and found the average weight loss is 30lbs or so for the 43% who reversed T2DM.

http://www.ncl.ac.uk/press/news/2016/03/profroytaylordiabetesresearch/#hpbanner

"In this new study, 30 volunteers with Type 2 diabetes embarked on the same diet of 600 to 700 calories a day. Participants lost on average 14 kilograms - just over 2 stone"

I've lost nearly double that number and at one point I'd lost 65 lbs. so a full double of that number yet never lost the diabetes. I still do have good control on FBGs, I'm trying to figure out what extra I need to do to become like that 95%.

 

[andcol]

Intriguing idea!

This was discussed in another thread. It had a few references so will try and locate it

 

[Pipp]

@Andrew Colvin

You may have a valid point, I've read the some of most recent study from Professor Taylor and found the average weight loss is 30lbs or so for the 43% who reversed T2DM.

http://www.ncl.ac.uk/press/news/2016/03/profroytaylordiabetesresearch/#hpbanner

"In this new study, 30 volunteers with Type 2 diabetes embarked on the same diet of 600 to 700 calories a day. Participants lost on average 14 kilograms - just over 2 stone"

I've lost nearly double that number and at one point I'd lost 65 lbs. so a full double of that number yet never lost the diabetes. I still do have good control on FBGs, I'm trying to figure out what extra I need to do to become like that 95%.

@Living-by-the-beach , it grieves me to have to be the one to say this, but, it is highly likely that you are going to be one of the 5%, you mention. (Though, as others have mentioned, the figure not achieving the sort of results some have through following the Newcastle method, is higher than this)

There is no shame in having tried, and no shame either in being a 'diet and lifestyle controlled T2'. Which, some would argue, is exactly what some 'reversed ' T2s actually are.

 

[AndBreathe]

@AndBreathe & @Brunneria I thank you both for your opinions.

However, Dr Fung https://intensivedietarymanagement.com/bariatrics-surgically-enforced-fasting-t2d-6/
goes on to say ;-
"Bariatric (stomach stapling) surgery quickly and successfully reverses type 2 diabetes (T2D). The most recent trial was published in the New England Journal of Medicine on 242 adolescents undergoing bariatric surgery. Most got Roux-en-Y bypass, with most of the rest getting sleeve gastrectomy. After 3 years, the results were good. 74% of high blood pressure resolved. 66% of abnormal lipids resolved. 86% of abnormal kidney function resolved. And Type 2 diabetes? Glad you asked. A stunning 95% of type 2 diabetes was reversed,"

Which thus goes back to Dr Fung's earlier point that "Bariatrics is surgically enforced fasting" . I'll also agree that 95% success ratio isn't 100% success but its close. I understand PFT but forcing a body by bariatric surgery to consume the liver and pancreas fats seem to me to be causing T2 Reversal? We cannot argue over a person who was 500 lbs pre-bariatric surgery and goes into T2 remission post surgery with only 20-30lbs weight loss, has lost their diabetes. They are still obese, though now non-diabetic.

I think what I am suggesting is that slow weight loss (I've lost 52lbs) isn't nearly as effective as enforced fasting weight loss. (either bariatric or ND) I know I've done the slow weight loss and not lost my T2DM.

I am not intentionally taking any information out of context or trying to be clever or obtuse, just trying to get a better understanding here.. I am just trying to figure out the best way forward for myself and other diabetics.

LBB

With a BMI of 24, you still have poundage to juggle if you wanted to try a spell of ND. The full 8 weeks might be too much, but have you worked out how much leeway you have before you would be considered clinically underweight?

Personally, I doubt I would do it, but who knows if I were in your shoes?

 

[SunnyExpat]

With a BMI of 24, you still have poundage to juggle if you wanted to try a spell of ND. The full 8 weeks might be too much, but have you worked out how much leeway you have before you would be considered clinically underweight?

Personally, I doubt I would do it, but who knows if I were in your shoes?

24 is at the top of normal. Below 18.5 is underweight, (in the UK anyway I believe), so it seems well within the comfort zone. I'd give it a shot, but only by the book, what can you lose?
Even if it doesn't work, trimming up isn't a bad thing.
(I'm starting to convince myself now, summer is coming)

 

[Neohdiver]

This was discussed in another thread. It had a few references so will try and locate it

I just listened to Dr. Taylor, hoping to find some enlightenment - and found only more confusion!

As of 10/2014, his position was that (1) the diet wasn't magic (you can create your own), (2) the speed of weight loss wasn't magic (slow, over time, is just as effective as rapid), and (3) what appears to create the change (as a rough guideline) is weight loss of ~15% or 15 kg.

Since I've exceeded both with no change, it appears I would be in the unlucky portion that it would be no help for. (Which I mostly suspected, anyway, until the intriguing theory you posted - which made me hope that it might be worth it to see if I could trigger cellular repair by finishing my weight loss by following the Newcastle Diet.)

Was it Dr. Taylor who suggested that, or someone else reviewing his work? I'd definitely be interested in more information about the source of the theory you suggested!