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Prof Taylor on BBC4 soon this lunchtime

phoenix said:
https://link.springer.com/article/10.1007/s00125-017-4504-z
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That is the single most brilliant piece of text I've ever seen on this whole subject. Well I say that, I've just skimmed through on an initial pass, but it's gold for someone like me who is interested in the subject, and who sees an important distinction between avoiding carbs to get healthy blood sugars, and improving one's metabolism to get healthy blood sugars.

I can't thank you enough for posting this.
 
I hate it when I look back at this thread and how angry I got. I don't know if it casts a shadow on a forum like this, but I guess since a moderator stepped in and asked myself and bulkbiker to take it to PM then there's a strong clue there!

I see this forum as being packed full of great people, knowledgeable people, fun people and caring people, and I don't want to drag it down.

As for bulkbiker I appreciate the fact that he's got a lot of experience and tried a lot of stuff and shares his experiences. I also appreciate that he posted in a thread where I asked for help, I thanked him then and I'd like to thank him again. Any words which I use to describe one particular thing that he does most certainly do not reflect what I think of him as a person. There are plenty of disgusting habits that I have but I don't think I'm a disgusting person, for example.

I'm a very overweight T2 who was diagnosed 3 years ago, so this particular research gives me, as it has given many people, hope. The fact that it can't help, or hasn't helped, others, or has pitfalls to be aware of, does not mean it is worthy of ridicule - just discussion.

I do think this forum should be a place where any diabetes-related research, or approaches to tackling it, should be respected and critiqued fairly. I think we have a duty of care to understand, and fully and fairly represent, any research which we pass judgement on, whether favourable or unfavourable. The idea of ridiculing *any* research which could genuinely help *any one* of us, even if it's literally *just one* of us, I find impossibly infuriating.

I don't know what the solution to that is, because I know it will infuriate me every time I see it. I'll try to express myself in a more measured way in future, and I'm going to try to have fun, because there are a lot of fun people here and I'd like to stay, without losing my temper and dragging things down.
 
It is so very difficult to remain dispassionate on a subject you feel so passionate about. This is perfectly understandable.

Edit to add mind you I just thought it a bit of a heated discussion therefore perfectly normal.
 
Adam, I didn't read the posts between you and Bulbiker, because anger upsets me. However, of course, yours was by no manner of means the first angry exchange to take place in this Forum, and even in the few weeks I've been coming here I have seen quite a few posts from people announcing that they are leaving as a response to rows. So I wondered what I would do if anyone replied crossly or rudely to a post of mine and I decided that the best thing to do is just go away, not from the Forum as a whole but from that thread. Leaving the other person the last word does NOT mean that readers will think they are right. On the contrary. So that's what I suggest you do if you feel your outrage getting the better of you another time - just quietly go away and find a more peaceful thread to post on.
 
JohnEGreen said:
It is so very difficult to remain dispassionate on a subject you feel so passionate about. This is perfectly understandable.

Edit to add mind you I just thought it a bit of a heated discussion therefore perfectly normal.
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I'm glad it didn't seem too bad, at least to some people! It felt like I had steam coming out of my ears at the time, and if I'm perfectly honest, I do regret using a word like disgusting, it doesn't seem like the most accurate word to describe what I was thinking and I can see how it seems like name-calling with hindsight.


I think you're right. And in this case, if purely talking about crossness/rudeness, it was me who was guilty of that, so I certainly don't think I'm in the right when it comes to forum etiquette. But I'll definitely try to take the advice about walking away to another thread instead of losing it.

I hadn't been aware of other forum rows and people leaving, clearly I don't read around enough! I sort of feel relieved that I may not be the worst culprit, but then again it would be nice if we could all get along.
 
Thanks for the info. Based on these qualifications I would like or expect his results to be presented in a more scientific way in the emdia. It may be the media sensationalising his works and looking for strap lines such as '800 calories' or 'cures T2' etc. If the low-carb aspect was more visible in his media reports it would help people to be able to continue with the 'ND' long-term rather than it being viewed as unsustainable in the way that a calorie measured diet will be as the fat content may well be too low causing it to be bland for some tastes.
 
@AdamJames, the post above from @Alexandra100 has expressed very well what I was thinking, both at the time of your debate, and now. The only other option that I would add if an exchange starts to become heated, is simply to ignore any further comment from that person, and continue with your own analysis / review / comment. Clearly you are someone with a thirst for knowledge and understanding, and who goes to some lengths to achieve that; I for one very much appreciate your willingness to share your thoughts and your work, (because I don't have that ability) and I would miss your input were not available.

The fact that you have considered things since then, have reflected on what happened and your part in it, demonstrates to me the true measure of the man; and I believe there is nothing wanting.
 

It was actually just a day or two ago that I noticed one article where a very keto-sounding diet was used for the rapid-weight-loss part rather than shakes.

Towards the bottom of the page:

"Henry Cole, 67, from New Jersey, USA, did likewise. He saw a 20-second news clip on TV and took up the diet days later. He stuck rigidly to 600 calories daily from just protein (steak, chicken, turkey or fish) plus green veg, eating his one meal at 6pm most days, with coffee and calorie-counted cream for breakfast and 1.5 litres of water."

https://www.theguardian.com/lifeandstyle/2013/may/12/type-2-diabetes-diet-cure

It stood out because as you say doing it on the type of diet, specifically low-carb, is rarely mentioned. RT certainly doesn't push the idea, he seems to think that the nature of the diet in the rapid weight loss part is pretty much irrelevant, then the for the long-term weight maintenance, (a) The best diet is the one you stick to, low carb if that's your thing, and (b) Exercise only if you want to, and beware that if you exercise, you might accidentally over-eat, so don't get too hung up on the exercise part.
 

It's extremely kind of you to say that. I find myself very wanting I have to say! I'm always saying things that I believe in, but regretting the way I say them. I need to go to charm school I think.
 
I'm doing ND. I'm confident that it will work for me once I reach my weight goal. No amount of sarcasm from the "Low Carb Police " is going to put me off. However hard they try.
 
Constructive criticism should not be viewed as having a closed mind to all but one's own opinion.
The use of terms like 'Low Carb Police' brings nothing to the table except to foster antagonism.

In my personal opinion one should understand fully both sides of an argument, only in this way can healthy debate strengthen understanding and encourage healthy debate. Ad hominem comments get us absolutely nowhere.

Edited for rubbish spelling.
 
Tannith said:
I'm doing ND. I'm confident that it will work for me once I reach my weight goal. No amount of sarcasm from the "Low Carb Police " is going to put me off. However hard they try.
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I'm totally behind you in your efforts and I think I may be following you shortly!

It isn't any of my business to speak for other people at all, but in an effort to rescue as much good will as possible in this thread, I'd like to relay that I recall bulkbiker saying elsewhere that people who do the ND have his respect, or words to that effect, so I don't think there is necessarily a pitched battle going on between ideologies here!

Guzzler said:
The use of terms like 'Low Carb Police' brings nothing to the table except to foster antagonism.
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Totally agree, however

Guzzler said:
Constructive criticism should not be viewed as having a closed mind to all but one's own opinion.
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Key word "constructive" - I think a lot of where this thread went wrong early on is that the criticism wasn't constructive, just flippant.

And my own opinion on matters like this, not related to your comments, just adding my thoughts:

I detest tribal mentality. The whole thing about picking an ideology or group, associating with it, and thinking in terms of "us" and "them". There have been hints of it in this thread well before Tannith's post and perhaps that's part of where it comes from, because as soon as one person starts thinking in terms of groups, it tends to push other people into thinking that they are part of a certain group and all of a sudden rational thought is lost.
 

To be honest, I am finished with this 'debate'. It has descended into acrimony and imo cannot be rescued.
 
I struggle a little with the issues debated between LCHF or the Newcastle diet method .
Looked at rationally if we need say 2200 calories to live on it will come from either our fat or food . Thus any diet with only 800 calories is actually high fat in terms of our bodies consumption . Any diet with only 800 calories will also be low carb just not quite so low carb as LCHF . The difference though isn't likely to be much more than 50 to 100 g carbs which still leaves it at the ' low level '


My own take on this would therefore be that metabolically both diets probably achieve much the same ends . High fat consumption in preference to carbs and Ketosis.
All indications here are that both diets have a similar effect in bringing down hba1c and both lead to weight loss if people can stick to them .

Evidence from here shows that both dietd result in an ability to eat more flexibly once sufficient weight has been lost . So both must trigger improved metabolism which isn't that surprising because of their similarities. The Nd diet might get to more weight faster because it is so extreme . The lchf diet might be easier to adopt long term as a way of eating. But in both instances some people will find it possible to stick to one or the other.

The one thing I truly don't get about all of this would be _ is there any actual benefit in terms of longer term health to adopting slightly more carbs I the starvation phase ?
I have seen comments that this leaves one more insulin sensitive .
Personally I'm not so sure .

I had a carb blow out yesterday . Three huge slices of toast . One after the other . Effect on blood sugars less than 2 mmol. This morning Ketosis still . That would suggest to me that LCHF leaves one similatly as cured as Nd.

I do think it's a great pity that Nd wasn't put forward as a low carb version , I'm guessing the results would have been at least as good as they currently are and this would have prevented the seeming ' rift ' and also given an easier path to weight maintenance thereafter.

May be someone will try a trial of that next as that does seem like the holy grail in terms of speed ; result doability and maintenance to me !
 

Some great points there, particularly the bit about the fact the body is actually using fat as fuel even on the very-low-fat rapid-weight-loss phase of the ND.

On my own personal journey so far, the actual contents of the diet has been largely unimportant. Weight loss by any means is getting me the best blood sugar results. I've tried losing weight, and maintaining weight, on both low carbs and 'standard' diets, and the results in terms of fasting glucose are almost identical. The results in terms of individual spikes after meals are of course a little different, but not remarkably so: when I "low carb" at around 40g a day, it takes less carbs to create large spikes, presumably because of the "last meal effect".

I suspect that when I can no longer afford to lose weight, the nature of the diet then starts to get far more important and I'll need to do further tests. It may be I'll find that the best diet is the one I can stick to in order to avoid regaining weight. Or it could be that, once out of weight loss mode, my metabolism is still so poor that I need to go VLCHF for safety. I guess I'll find out.

I share your suspicion about the lack of importance in carbs in the rapid weight loss phase. On the one hand people seem to think it may keep your pancreas ticking along, but on the other, might it be better to give it a rest for a few weeks while losing weight? All that may happen then is the first few carb loads get big spikes due to the 'last meal effect' but then things settle down, who knows?

I totally agree, the distinction between aims and diets is often so blurred one wonders what the debate is about exactly. People who eat LCHF often talk about trying to lose weight with the diet in the same way people using the ND, so the initial goal is often the same - i.e. people recognise that if they are overweight, losing it is a good idea. And saying that once "ideal" weight is achieved, it's easier to keep it that way on LCHF begs the question "easier than what? There's nothing about the ND approach that says the maintenance phase can't be LCHF".

For me the main distinction that I see is this:

ND = Care a lot about calories and attempting to improve metabolism in terms of both glucose tolerance and insulin resistance. Lose a ton of weight fast with severe calorie restriction, and hope your metabolism improves. If so, that opens up the things you can safely eat to include more carbs, but there's nothing to stop you adopting LCHF. Try to keep the weight off mainly by keeping an eye on calories.

LCHF = Don't care so much about calories or attempting to improve metabolism in terms of glucose tolerance, but maybe just insulin resistance. Likely to lose weight anyway if overweight. Don't care if your glucose tolerance improves, because you don't need it if your carbs are low enough anyway, but it's nice to think you no longer have insulin sloshing around your body.
 
For my personal part, I believe LCHF ( with some kind of restricted eating timing ) is likely to bring down circulating insulin and this itself will improve insulin resistance. When feeling particularly motivated I will try to do that in a very low calorie way in order to bring my weight down if I can , but I won't best myself up too.much about that because I think that the LCHF part is putting my metabolic health back in order .

When I began this journey my hba1c reduction was in lockstep with weight loss. Then my weight loss stalled . My hba1c has continued to improve despite the plateau as long as I stick to LCHF and my glucose tolerance has continued to improve at the same time .

I believe both paths pretty much lead to 'reversal. My only real reservation with ND is that having spent many years eating processed foods with resulting metabolic mayhem , any type of way of eating from.here on in whether trying to lose weight or not is going to be of foods I recognise from when they were alive or growing !
 

If, as I do, you believe that the main problem Type 2's have is over production of insulin and insulin resistance then you are making great efforts to "improve metabolism" by cutting out carbs. Not in terms of glucose tolerance but in insulin production and improving its effectiveness. By not triggering an insulin response you are restoring the mechanism of fat storage and fat usage.
When ingesting higher carb and more often in such protocols as the ND you are not allowing the body to repair itself so effectively. That is one of the reasons I am so sceptical of the long term benefits of the ND. It is often noted that by eating very low calorie diets that metabolic rates often slow down quite appreciably so with the ND you get the double whammy of stimulating insulin production often, with the 3 shakes and veg meal, whilst also not taking in enough calories to support your metabolism correctly.
By stimulating insulin you are making it harder for the body to access fat stores for fuel. In the case of the ND this is to some extent overcome because the body is being starved of nutrition but (and I think this is a big but) once you stop starving it I fear that the body will perhaps slow the metabolism even more leading to ever more problems with weight regain down the line. Low calorie diets are very well know for having this effect for most people who do them. Hence my claim that they seem to rarely work in the long term.
In my eyes a bit of fasting (i.e. not having breakfast) and eating very low carb allows the body to correct itself by allowing access to the fat stored to use it as fuel. This does not lead to metabolic slowdown and thus means the body runs far more effectively with insulin function being returned to normal over time. In my case I can see this has worked quite well. I have a fairly normal fasting insulin level and can "pass" an OGTT.
That fact that you describe LCHF as attempting to improve metabolism by "just" improving insulin resistance seems to me to be the cause of our disagreements. In my view that is the essential thing to do. Once you have "fixed" the insulin resistance then your body seems quite able to sort out the rest.
 
The above analysis is why I would tend to favour the LCHF approach over the ND approach though I can see why the fast weight loss is attractive and quick metabolic results encouraging .
I personally have done a number of ND diets in my life - extreme restrictions to lose weight and indeed I have lost substantial weight as result . At the time I did not know I was doing anything at all to my diabetes and clearly whether it was referring the problem or exacerbating it , it certainly wasn't curing it.

AT this stage of my progress I don't really know whether conversion to LCHF is going to have got me off the weight roller coaster either . I am still capable of binges and I suspect falling off the wagon. Only time ( a lot of time ) will show me the answer . I hope I have enough of it to see.

Fortunately we will be seeing a lot more evidence of the LCHF approach in a clinical setting . Both Virta health and Prof Noakes are doing trials of such .

Like any other protocols or inventions relative success will guide which one receives the most followers.
 

Haha! I know what you mean. I did an ND-style thing for about a week. It seemed horribly unnatural. I was brushing my teeth more because of the sugary shakes, and ended up getting chewing gum as well to help try to prevent my teeth from rotting when having a shake away from home. Also needed to add Milk of Magnesia eventually for reasons you can imagine.

I liked the fact that the shakes were packed, albeit unnaturally, with vitamins and minerals which helped me worry less about working out what foods to buy - on a natural diet at 800 calories I'd be fretting over making sure I'd got the right nutrients in me. I also liked the veg part - 200 calories from veg was a huge amount of veg, and one thing almost all dietitians *don't* attack is non-starchy veg, so I felt I was doing myself some good in that way, if nothing else!
 

That makes a lot of sense. There are so many angles to consider.

To be clear, I didn't write "just" improving insulin resistance because I think it's less important than anything else. I was comparing the fact that someone who wants to eat normal carbs will care about both IR and GT, whereas someone happy on LCHF for life has less need for good GT, but IR is still important to give them healthy insulin levels. I would expect GT to improve as a consequence of improved IR, but their body won't need to make as much use of that fact. I'm quite happy to accept that improved IR comes first and is the main driver for improved GT, the evidence for that seems very good.

One thing is clear: It would be preposterous to think that an ND approach is *optimal* for reversing T2. The shakes and veg meal plan wasn't carefully tailored to that purpose by people in Newcastle, it was created by Optifast for rapid weight loss for any reason. And for the weight maintenance phase, it's impossible for me to believe that ALL diets that prevent weight gain have the same effect on preserving any metabolic gains made during the weight loss phase. The results people get on LCHF seem very good for that purpose also.

I think the word "optimal" is perhaps at the centre of things and why we have discussions like this. I wish there was more data to help us build an idea for an optimal approach, but it's building all the time. I'd say the case for LCHF is looking good at the moment. Of course what's optimal for one person may not be optimal, or even possible, for another.

One of the alluring aspects of the ND is all the data and the graphs from the first experiment, that show what happened to the participants, and show the stunning apparent return to almost normal their metabolisms. People are naturally going to think "Look what happened to those people, I want some of that for myself, so I'll do exactly the same thing."

It's entirely reasonable for someone to think that they may get the same results in the short term, and if they try damned hard, they may be able to preserve the gains for a long time thereafter. But it's also important to put the brakes on such excitement, and to ask questions which distinguish between what can work, and what is optimal, and what is practical, especially in the long term.
 
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