Reading the details of the goals of the ND study I think one has to be a little careful about what it is designed to achieve and how we can compare it ourselves in terms of telling us that we can use VLC to somehow improve where we already are - (for many of us) .
Co-primary endpoints :
Reduction in weight of 15 kg (assumed equal on average to 15 %) or more at one year;
Remission of diabetes (HbA1c <48 mmol/mol) at 1 year.
Secondary endpoints =Quality of life ,Physical Activity,Serum Lipids,Liver function tests, Urea & Electrolytes, plasma glucose
Programme acceptability.
There are literally dozens of people on here that have already achieved exactly those things, including me, with the low carb approach recommended here. In addition, the vast majority of the people here would already be excluded from the trial simply because they already lost 5 kg from adopting a low carb diet- most of us do that within a very short period.
For all of us who have now brought our Hba1C and weight down sufficient to achieve both the normal and secondary endpoints of the study, we are may also be in a position where we also already recorded the very same changes in insulin responses as are outlined in the study. We do not know because we do not have the before and after tests.
If we are actually starting off our 8 week VLC with having already achieved the parameters set out - then we are not comparing like with like at all.
For me personally I do have blood tests after 8 weeks of LCHF adoption 8 weeks hba1C 92> 64 weight loss 15% of body weight ( 1 yr Hba1C 42 total weight loss 23%). Those show that I was moving closer to achieving both primary and secondary endpoints at 8 weeks and by one year I had done, just as the study hopes it will prove. I just don't have the sophisticated data tables to show what my body did to make that happen including my insulin secretion rates . - I would expect that if I did then it would tell a similar story to the study. I do know that I have got gradually closer to normalising my fasting insulin ( now 8 normal range 2-25 goal 4 iUI/ml )and my HOMA test of insulin resistance which presumably would be entirely consistent with the more sophisticated tests the study has access to .
The actual protocol for dealing with weight regain is frankly quite frightening. I completely understand why Dr Taylor is sticking with the establishment protocol regarding low fat, Eatwell plate recommendations . However we may well find that because he is doing that, the research results will actually result in a delay in doing what really needs to be done- which is to help people change their approach to nutrition overall.
"Relapse management for weight regain or re-emergence of diabetes. If weight regain occurs, or if diabetes is found to have
returned (HbA1c >= 48 mmol/mol) at any time during the 18-month weight loss maintenance stage,rescue plans to reverse weight gain will be offered.
1) Weight regain of >2 kg: offer the use of TDR to replace one or two main-meal per day for 4 weeks,offer orlistat 120 mg tid, with each meal.
2) Weight gain of >4 kg, or to <15 kg below starting weight or if diabetes recurs: offer 4 weeks TDR with fortnightly practice nurse/dietitian review and then a 2 – 4 week FR (as described above). Individualised dietary advice, based on the Eatwell guidelines [24],and physical activity targets will be reinforced for weight loss maintenance. Orlistat treatment, as above, will be offered for the remainder of the weight loss maintenance period, with repeat advice to restrict dietary fat ."
Neither of these remedial actions is close to actually assisting people to properly change their eating habits as opposed to making it some kind of medical intervention.
I personally will be quite surprised if Orlistat remains on the market for too much longer - frankly trying to keep my weight down by preventing fat to be absorbed by a process the involves potential anal leakage, taking a fibrogel supplement whilst also eating the Eatwell plate- full of relatively empty carbohydrates when instead one could recommend a proper nutrient rich real food diet - strikes me as just bizarre. (though understandable in terms of trying to get " buy in" in the current situation )
I am also surprised to find that the testing protocol does not specifically state fasting insulin at the start and end points - though this may be included as a " novel" test.
Whilst I hope the Professor Taylor succeeds in helping those who have not succeeded in losing weight through traditional means, to lose weight using powders - (something that has been use for years as a means of fast weight loss), I think it is a huge pity that if it is successful the focus will turn to yet more industrially produced powder and potions including artificial fibres, as opposed to encouraging a return to eating real foods through a low carb diet as a means of getting rapid weight loss.
The presentation also continues to make the assumption that weight is simply " calories in versus calories out " where you can " eat anything" in his words. I simply don't believe that, that is true. The world has seen a 300% increase in Om6 over 30 years , the human body now has double the insulin response it used to do (both Lustig Fat Chance ) Yes we have seen an increase in diabetes and obesity, but we have seen a huge rise in other things too and that is also a function of the type of foodstuffs one chooses to eat,controlling your weight through continuing to eat it just in smaller quantities is not necessarily going to mitigate the problem with that food ( especially sugar and om6 oils) other than at the margins.
Professor Tim Noakes in South Africa is constructing a trial where he intends to have participants follow an actual LCHF diet, and compare that with an actual HCLF diet (i.e. the ND remedial recommendation).
http://thenoakesfoundation.org/port...-reverseimprove-type-2-diabetes-mellitus-t2dm
That trial is being based on the actual results of self reported LCHF participants ( including me) using real foods. I think that that trial will tell me far more about what actually happened as a result of my own weight loss and whether I can continue that process sufficient to " cure" my diabetes as opposed to simply keeping it at bay than the ND results ever can.
Dr Taylor makes the point that if one can get the weight down and "KEEP IT DOWN" then you can eat anything you want and still keep diabetes in check. I would question whether in fact it is actually possible to keep it down simply by eating smaller proportions of rubbish foods. If it were, then given the focus on being slim that pervades our society, there would be far more examples of people managing to lose weight and keep it down following standard low calorie diets or keeping it off after a period of very low calories.
It is great that Dr Taylor is giving much more publicity that diabetes can be put into remission, just a huge pity the background to it all is a basic misunderstanding about what a healthy diet actually is , which Dr Taylor then has to work with in conducting his study.
