Personal Fat Threshold.

[Guzzler]

I was wondering what your opinions are on Prof. Roy Taylor's theory of 'The Personal Fat Threshold' in regards to Type 2 Diabetes.
The theory explains why some people become obese but never develope Type 2 and why some people of a 'healthy' weight go on to develope the disease. It could explain 'weight loss stalling' but the Prof. does not mention this.
What are your thoughts?

 

[CherryAA]

In line with my theory about insulin, I think that some people have are very insulin sensitive. Quite why that would be I don't know, though maybe that is genetic? Genetics must play some part in all this, otherwise nearly 100% of the population would already be diabetic given the content of the Western diet and whilst we are moving in that direction quickly we are not there yet.

As such they are able to return quickly to fasting levels of insulin after meals . This means that despite the fact that they are eating way too much and therefore putting on weight and suffering from the wild swings in blood sugar just like the rest of us, causing them to eat even more, overnight their insulin levels return to normal quickly.

That is why the defining trait of a metabolically obese person will be low fasting insulin. The study reference that is in my blog somewhere!
http://www.diabetes.co.uk/forum/blog-entry/a-unifying-theory-of-disease.1795/

I do think that finding a way to cross the threshold in terms of insulin sensitivity might be the way to "cure" diabetes opposed to " controlling it " It might be that it is simply rapid weight loss that achieves that as per Prof Taylor.

there is a study that attempts to explore this - but its a paid for one, If I paid every time I came across something I wanted to read I'd be bankrupt !

http://onlinelibrary.wiley.com/wol1/doi/10.1002/mnfr.201400521/abstract

 

[Mbaker]

I think for those who carry the majority of their fat around the middle and are tofi-ish are affected by the fat threshold theory. I say this as it sort of described me; although I was / am overweight many said I didn't look it, hence the surprise about my type 2 diagnosis. Too complicate things I have a very high bone density of 3.8 which does give me a claim to being heavy boned.

My starting A1c was 134 and to get to 42 / 41 I only had to lose 8 kg, although as usual I don't do normal, so was weight training at the same time, so may have been packing on muscle at the same time.

I feel "we" are fortunate after getting such a potentially chronic condition to have several options that can move towards remission.

 

[Guzzler]

In line with my theory about insulin, I think that some people have are very insulin sensitive. Quite why that would be I don't know, though maybe that is genetic? Genetics must play some part in all this, otherwise nearly 100% of the population would already be diabetic given the content of the Western diet and whilst we are moving in that direction quickly we are not there yet.

As such they are able to return quickly to fasting levels of insulin after meals . This means that despite the fact that they are eating way too much and therefore putting on weight and suffering from the wild swings in blood sugar just like the rest of us, causing them to eat even more, overnight their insulin levels return to normal quickly.

That is why the defining trait of a metabolically obese person will be low fasting insulin. The study reference that is in my blog somewhere!
http://www.diabetes.co.uk/forum/blog-entry/a-unifying-theory-of-disease.1795/

I do think that finding a way to cross the threshold in terms of insulin sensitivity might be the way to "cure" diabetes opposed to " controlling it " It might be that it is simply rapid weight loss that achieves that as per Prof Taylor.

there is a study that attempts to explore this - but its a paid for one, If I paid every time I came across something I wanted to read I'd be bankrupt !

http://onlinelibrary.wiley.com/wol1/doi/10.1002/mnfr.201400521/abstract

And your thoughts on the people who are not overweight? And those whose weight loss stalls for no apparent reason?

 

[Guzzler]

I think for those who carry the majority of their fat around the middle and are tofi-ish are affected by the fat threshold theory. I say this as it sort of described me; although I was / am overweight many said I didn't look it, hence the surprise about my type 2 diagnosis. Too complicate things I have a very high bone density of 3.8 which does give me a claim to being heavy boned.

My starting A1c was 134 and to get to 42 / 41 I only had to lose 8 kg, although as usual I don't do normal, so was weight training at the same time, so may have been packing on muscle at the same time.

I feel "we" are fortunate after getting such a potentially chronic condition to have several options that can move towards remission.

I agree that there is no such thing as the perfect diet or one that fits everyone perfectly. The research going on now will only help in that options are clear, varied and should eventually lead to fewer drugs being prescribed and fewer complications. Fingers crossed.

 

[CherryAA]

And your thoughts on the people who are not overweight? And those whose weight loss stalls for no apparent reason?

I would guess

Not overweight , metabolically healthy = fasting insulin low, ( 6 or less) quick insulin reaction to bad food but no overreaction so overeating pattern does not start. i.e. the genetic winners

Not overweight, metabolically unhealthy = fasting insulin high, ( 12 or more) overreaction to bad food, but instead that leading to over-eating it causes some other kind of trigger into all the other diseases quicker than for those who can compensate to some extent for high insulin by storing it as fat. - i.e. these are the genetically unlucky lot and why disease is often more virulent in the slim when it strikes .

Weight stall = fasting insulin now " within range " - probably say 6-12 range , insulin sufficiently in range to not trigger over- eating but because insulin is the weight gaining hormone - too much circulating insulin to allow actual weight loss through tiny trigger of consumption ( that describes me at least) - hence thinking that using a one meal a day regime might work for me. genetically middle lot.

(I'm being very overly simplistic ! ) I'm an accountant not a doctor

 

[Guzzler]

@CherryAA

It all sounds logical doesn't it? To us lay people at least.
I am trying hard not to latch on to this theory too much because, if correct, it means that I, as a TOFI, and slim on diagnosis must end up skinny to go into 'reversal'. That is one big risk to take to lose weight until medically underweight. It does, however, mean that my T2 was possibly due to genetic pre disposition + triggered by a weight gain above my 'Personal fat threshold'.

 

[Dark Horse]

@CherryAA

It all sounds logical doesn't it? To us lay people at least.
I am trying hard not to latch on to this theory too much because, if correct, it means that I, as a TOFI, and slim on diagnosis must end up skinny to go into 'reversal'. That is one big risk to take to lose weight until medically underweight. It does, however, mean that my T2 was possibly due to genetic pre disposition + triggered by a weight gain above my 'Personal fat threshold'.

How do you know you are TOFI? Have you had an MRI scan of your liver and pancreas or are you just assuming you are because you were slim on diagnosis? A small percentage of people diagnosed with type 2 diabetes actually have 'monogenic diabetes' and for them the 'personal fat threshold' and the Newcastle diet is irrelevant. These people are generally slim on diagnosis.
http://www.ncl.ac.uk/media/wwwnclac.../files/Diabetes reversal information 2017.pdf

 

[Tannith]

How do you know you are TOFI? Have you had an MRI scan of your liver and pancreas or are you just assuming you are because you were slim on diagnosis? A small percentage of people diagnosed with type 2 diabetes actually have 'monogenic diabetes' and for them the 'personal fat threshold' and the Newcastle diet is irrelevant. These people are generally slim on diagnosis.
http://www.ncl.ac.uk/media/wwwnclacuk/newcastlemagneticresonancecentre/files/Diabetes reversal information 2017.pdf

So do ND and you'll find out. Or go to the doctor and ask for tests for rarer types of diabetes.

 

[Guzzler]

I was not aware that TOFI was a medical definition, rather, it is a description. I am not considering the ND as LCHF has been successful for me so far. If, and it is a big IF, I continue to lose weight beyond the level of the medical definition of underweight then and only then would I consider asking for further tests. I am not in the business of rushing into possibly unwarranted tests just to be considered 'rare'.

How do you know you are TOFI? Have you had an MRI scan of your liver and pancreas or are you just assuming you are because you were slim on diagnosis? A small percentage of people diagnosed with type 2 diabetes actually have 'monogenic diabetes' and for them the 'personal fat threshold' and the Newcastle diet is irrelevant. These people are generally slim on diagnosis.
http://www.ncl.ac.uk/media/wwwnclacuk/newcastlemagneticresonancecentre/files/Diabetes reversal information 2017.pdf

I do not like PDFs because my old tablet is full to the gills, perhaps an overview?

 

[Kentoldlady1]

I am convinced of the genetics involved in this. My skinny mum, 5 of her 6 sisters and several of my cousins are /were t2d. Some, like me are overweight, others like my mum were normal or even underweight. We also have a smattering of other autoimmune disorders. We also have t1d . Oddly all he t2ds are female and the t1ds are, male.

I am the only one to try the lchf way of eating and I have lost more than 15% of my starting weight. However, I still get a large spike if I eat too many carbs.

I am thinking of doing a nd with real food before Christmas, so watching cherrys thread with interest.

 

[Guzzler]

I am convinced of the genetics involved in this. My skinny mum, 5 of her 6 sisters and several of my cousins are /were t2d. Some, like me are overweight, others like my mum were normal or even underweight. We also have a smattering of other autoimmune disorders. We also have t1d . Oddly all he t2ds are female and the t1ds are, male.

I am the only one to try the lchf way of eating and I have lost more than 15% of my starting weight. However, I still get a large spike if I eat too many carbs.

I am thinking of doing a nd with real food before Christmas, so watching cherrys thread with interest.

Apparently, it is after the eight weeks when the controlled diet has finished which is the hard bit. People have to change their lifestyle to maintain weight loss and controlled bg even if they become 'reversed'. Good luck and well done so far.

 

[Dark Horse]

I was not aware that TOFI was a medical definition, rather, it is a description. I am not considering the ND as LCHF has been successful for me so far. If, and it is a big IF, I continue to lose weight beyond the level of the medical definition of underweight then and only then would I consider asking for further tests. I am not in the business of rushing into possibly unwarranted tests just to be considered 'rare'.


I do not like PDFs because my old tablet is full to the gills, perhaps an overview?

I wasn't suggesting tests for TOFI, I just wanted to raise awareness that not all slim people diagnosed with diabetes are TOFI, i.e. some slim people diagnosed with diabetes do not have excess fat in their liver and pancreas so won't put their diabetes into remission by weight loss.

The pdf contained FAQs from Roy Taylor regarding the Newcastle diet and it says:-

Could it work for me?

 This research is in “type 2 diabetes”, the usual common form of diabetes. There are some rare forms of diabetes which may appear to be type 2 diabetes:
a) Diabetes occurring after several attacks of pancreatitis is likely to be due to direct damage to the pancreas (known as “pancreatic diabetes”)
b) Secondly, people who are slim and are diagnosed with diabetes in their teens and twenties, with a very strong family history of diabetes, may have a genetic form (known as “monogenic diabetes”)
c) Thirdly, type 1 diabetes sometimes comes on slowly in adults, and these people usually require insulin therapy within a few years of diagnosis (“slow onset type 1”)

None of these will respond in the same way as the common, true type 2 diabetes.​

 

[Dark Horse]

I was not aware that TOFI was a medical definition, rather, it is a description. I am not considering the ND as LCHF has been successful for me so far. If, and it is a big IF, I continue to lose weight beyond the level of the medical definition of underweight then and only then would I consider asking for further tests. I am not in the business of rushing into possibly unwarranted tests just to be considered 'rare'.


I do not like PDFs because my old tablet is full to the gills, perhaps an overview?

I've been trying to find a definition of TOFI that doesn't involve pdfs. This 2012 paper by E.L. Thompson et al [http://onlinelibrary.wiley.com/doi/10.1038/oby.2011.142/full ] states:-

• individuals with a BMI 18.5 < 25 kg/m2 with an IAAT/ASAT ratio above 1.0 (males) and 0.45 (females) were classified as TOFI

(IAAT = intra-abdominal adipose tissue, ASAT = abdominal subcutaneous adipose tissue)

- Edited to remove bracket so link works - thanks to No2D for pointing it out.​

 

[Tannith]

I think we can only guess at our personal fat threshold. Pro Taylor estimates it at around 15%, but no one can know theirs for sure without a specialist Newcastle style MRI scan. I think a good guess would be around 15 % of the weight at diagnosis, given that most of us will have had T2 since before diagnosis. Unless we were diagnosed by chance by a random test before symptoms had started, in which case it could well be less. I do wish the NHS would test everyone every 3 years then people would learn they had T2 in plenty of time to reverse it by diet before it had done irreparable damage.

 

[CherryAA]

@CherryAA

It all sounds logical doesn't it? To us lay people at least.
I am trying hard not to latch on to this theory too much because, if correct, it means that I, as a TOFI, and slim on diagnosis must end up skinny to go into 'reversal'. That is one big risk to take to lose weight until medically underweight. It does, however, mean that my T2 was possibly due to genetic pre disposition + triggered by a weight gain above my 'Personal fat threshold'.

I don't think that level of general overweightness has much to do with it. (if you are already slim) If you eat food that does not spike insulin, then you will no longer react to that with high glucose and as a result you should be able to bring down visceral fat. Lots of foods do not spike insulin so it should be feasible to bring down fasting insulin by following a real food diet low in omega 6 fats (vegetable oils) and carbs but high in proteins and the other fats . The first step to finding out if this might work for you, would be to find out what your fasting insulin actually is. Its a standard test.

-optimal would be 2-6 iUI/ml normal 2-25 ( 80% of those over 8 have pre-diabetes or worse) research links are in my blog.

 

[Guzzler]

I suppose time will tell. I have just reached the 15% loss. Still learning about what spikes me and experimenting with the foods I cut out at the begining of LCHF.
It is theoretical at this point, perhaps the Profs theory will be mentioned in December.

 

[Guzzler]

I wasn't suggesting tests for TOFI, I just wanted to raise awareness that not all slim people diagnosed with diabetes are TOFI, i.e. some slim people diagnosed with diabetes do not have excess fat in their liver and pancreas so won't put their diabetes into remission by weight loss.

The pdf contained FAQs from Roy Taylor regarding the Newcastle diet and it says:-

Could it work for me?

 This research is in “type 2 diabetes”, the usual common form of diabetes. There are some rare forms of diabetes which may appear to be type 2 diabetes:
a) Diabetes occurring after several attacks of pancreatitis is likely to be due to direct damage to the pancreas (known as “pancreatic diabetes”)
b) Secondly, people who are slim and are diagnosed with diabetes in their teens and twenties, with a very strong family history of diabetes, may have a genetic form (known as “monogenic diabetes”)
c) Thirdly, type 1 diabetes sometimes comes on slowly in adults, and these people usually require insulin therapy within a few years of diagnosis (“slow onset type 1”)

None of these will respond in the same way as the common, true type 2 diabetes.​

None of those instances are relevant to me. No familial history, no pancreatitis and not T1.

 

[librarising]

although I was / am overweight many said I didn't look it, hence the surprise about my type 2 diagnosis. Too complicate things I have a very high bone density of 3.8 which does give me a claim to being heavy boned.

At diagnosis I was 15 1/2 stone (nearly 6 years ago). Lowcarb took that to a steady 14 stone. The slow 2 1/2 month journey towards a potential DKA, until it was diagnosed with LADA (and put on insulin) took me down to 13 stone. That has re-stabilised at a very steady 14 st 5 lbs.
My weight always astounds people ("you don't look it !")
Two weeks ago I was discussing surgery with the heart surgeon (for aortic stenosis) and he couldn't believe the weight the nurse had recorded. We both seem to hide it well As I work physically I blame my muscles !
Geoff