Prof Taylor on BBC4 soon this lunchtime

[ickihun]

Hi Ickihun, perhaps you can help me? I half remember that Prof. Taylor once said that as a bariatric surgeon (?) one of the major problems he faces is trying to operate on patients who have a lot of subcutaneous and visceral fat, that this is in itself a hindrance to swift surgery and can have poorer post op outcomes in terms of healing. Was it Taylor that said this or have I totally misremembered?

I don't know his every word but the reason for ND was to find an op alternative. But have same fantastic success in remission. Evidence is constantly coming out for long term success but ND results a few years behind but not as successful, especially long term.

 

[Guzzler]

I don't know his every word but the reason for ND was to find an op alternative. But have same fantastic success in remission. Evidence is constantly coming out for long term success but ND results a few years behind but not as successful, especially long term.

Thank you.

 

[DavidGrahamJones]

Interesting thread! I did listen to the interview, thanks bulkbiker for posting link.

Shame the prof's "piece" was so short, I'd been getting a bit jealous of all those people saying they ate less and moved more and hey presto, a miracle, they all lost weight. There is no doubt in my mind that consuming less and moving more will have a positive effect and people will lose weight. I've been there there, done that, got the video even, now what?

I now cannot lose weight until I get down to what the professor is talking about, very low calories. I'm pleased others can be successful with what I consider the "easy peasy" bit.

One caller who I remembered was the guy who said he lost 4 stone and reversed his diabetes, I've done that on 2 occasions, fortunately without weight gain in the middle, so 8 stone overall, and haven't reversed my diabetes. The first 4 stone went when I stopped taking Rosiglitazone, that stopped when I was prescribed Gliclazide. The second 4 stone went when I changed to low carbs without increasing calorie intake by increasing fat. That stopped . . . . . . . who can tell why. It goes back to the same old story, we are all so very different.

BTW, day 4 of eating nothing but peppers, courgettes, leaks, cauliflower, broccoli, mushrooms, celery, and still waiting for my BG to behave. It will . . . . eventually. It did the last time I tried this ND thing. At least I can now baked them, "whizz" them in the Nutribullit or utilise my Christmas pressie from MIL . . . . a soup maker.

Belated Happy New Year to one and all.

 

[Daibell]

Very well put I thought. And just for the record, since you mention it, I don't recall ever seeing a post where you seem dogmatic or biased!

Yes Roy Taylor certainly comes across as though he thinks it's all very simple in his interviews. Like you I wondered if it's because he just wants to push the big message home and he's short on time, so I checked the latest version of the web page at Newcastle uni, wondering if, when allowed to be a lot more wordy, the message would be more cautious, nuanced or detail more caveats. Nope:

http://www.ncl.ac.uk/press/articles/archive/2017/09/type2diabetesisreversible/

As a former scientist myself, this sits very unwell with me. Sometimes it seems like advertising, producing a glossy summary and ignoring all else.

I have the same view as a scientist and engineer. I am sceptical about some of the Prof's claims and degree of scientific research. His focus on calories shows a lack of understanding of how the body's metabolism works. The calorie value of food has little relationship to it's energy potential in the body - for example carbs and fats go thru a completely different process and some of fat calorie value is 'lost'. So this '800' calorie thing is very unscientific.

 

[Sue192]

http://www.dailymail.co.uk/health/article-5232269/Best-diets-2018-revealed.html

Then you get simplistic articles such as this. If I could be bothered I wade go through the comments to see how many times 'eat less move more' was trotted out. If only the whole business of weight loss was that simple....

 

[DCUKMod]

Hi Ickihun, perhaps you can help me? I half remember that Prof. Taylor once said that as a bariatric surgeon (?) one of the major problems he faces is trying to operate on patients who have a lot of subcutaneous and visceral fat, that this is in itself a hindrance to swift surgery and can have poorer post op outcomes in terms of healing. Was it Taylor that said this or have I totally misremembered?

Guzzler, I haven't gone and checked Professor Taylor's qualifications, but I feel pretty certain he, himself, isn't a surgeon.

 

[Boo1979]

No hes not a surgeon - he is a professor in metabolic medicine and director of the magnetic imaging centre

 

[AdamJames]

I have the same view as a scientist and engineer. I am sceptical about some of the Prof's claims and degree of scientific research. His focus on calories shows a lack of understanding of how the body's metabolism works. The calorie value of food has little relationship to it's energy potential in the body - for example carbs and fats go thru a completely different process and some of fat calorie value is 'lost'. So this '800' calorie thing is very unscientific.

I've clicked 'agree' with that, as in I agree that fixating on 800 calories and ignoring where those come from is not great science.

I see the 800 calorie thing in the same light as the 15kg thing, and suspect they are numbers that come up regularly just to push the message.

There's no doubt that Roy Taylor feels that fat loss at any rate is a potential road to remission, and I've heard it direct from his horses mouth(!) that a specific calorie intake is not important, so I don't think he's guilty of delusion, just over-simplification, especially when it comes to interacting with the media.

And to be fair, in broad terms, 800 cals restriction is going to result in weight loss for most people in the short term regardless of where the calories come from.

I really wish, however, the DiRECT study had investigated various diet styles. Just off the top of my head, if I was conducting the study, I might do this for example:

1 group doing as they did - 800 cals with HCLF shakes plus veg for a period then stepped re-introduction to standard food with the instruction to try to avoid weight regain.

1 group doing the weight loss part the same way - 800 cals with HCLF shakes plus veg for a period, but then stepped introduction of LCHF food with the instruction to try to avoid weight regain.

1 group doing the weight loss part the same way - 800 cals with HCLF shakes plus veg for a period, but then stepped introduction of LCHF food with the instruction to eat however much of it they want, ignoring calories and weight gain.

1 group who didn't previously eat LCHF, switching to LCHF and eating however much of it they want. Weight loss and calories not important, right from the start.

Monitor the weights, HbA1cs and glucose tolerance levels of participants every 3 months.

The only reason I think that the weight loss part can be the same for the first 3 groups is just because it's so radical that it's likely to cause weight loss for everyone, and the longer-term diet is the more important one anyway.

I don't think there would be too much noise in that data to spot meaningful differences. There would be the same problem as the DiRECT study had - you don't know how well people will be sticking to their plans.

It might also be nice to sub-divide the first 2 groups (i.e. the ones where long-term weight regain is actively avoided) one more level: half left to get on with avoiding weight regain all by themselves, and half given regular access to sessions with practice nurses for moral support, guidance on diet and feedback as to how they are doing.

This access to long-term support was something the DiRECT study thought was important, and it would be nice to have a measure of how effective it is.

 

[DCUKMod]

That would be one massive, horrendously difficult to control and eye-wateringly expensive to sponsor. If I recall correctly, the latest DIRECT Study was over £5m.

 

[Boo1979]

The stats would also be a nightmare and almost ccrtainly meaningless - too may uncontrolled and uncontrollable variables

 

[AdamJames]

That would be one massive, horrendously difficult to control and eye-wateringly expensive to sponsor. If I recall correctly, the latest DIRECT Study was over £5m.

The stats would also be a nightmare and almost ccrtainly meaningless - too may uncontrolled and uncontrollable variables

Yes, even as I was writing it I was thinking that's one of the many reasons to give the DiRECT study a break.

Rather than complaining that it didn't explore LCHF, it should be seen as one study focusing on one approach.

It's for other studies to explore LCHF.

I don't necessarily think the kind of study I mention would be too crazy in price and scope compared to the DiRECT study *necessarily*. I can't remember the exact number but I think there were over 200 people in that. Four groups of 50 people would still be meaningful I think.

I also don't think the results would be entirely meaningless - 50 in each group is not an amazing sample size but it's larger than many similar types of study.

Most of the noise, I expect, would come from the same factor that exists in the DiRECT study - you don't know how well people are sticking to their allotted plans.

Anyway as I say, just trying to think of experiments like this quickly brings into focus that we really need to give each individual study a break, and not complain just because it didn't focus on what we wanted it to focus on!

 

[Tannith]

The stats would also be a nightmare and almost ccrtainly meaningless - too may uncontrolled and uncontrollable variables

All he was initially trying to prove was that a low calorie diet continued for long enough to get the fat off the liver and pancreas, as verified by his scanner, would result in reversal of diabetes. At least in those who had not had the T2 so long that their pancreatic fat had already killed their beta cells, or so many of them that complete reversal was no longer possible.
That is step one. Does it work?- Yes. Step 2 is does it continue to work as long as the person keeps the weight off? Answer - for one year at least, in many subjects, and apparently in one subject from and earlier trial, 10 years - Yes. Step 3 is to devise a support system capable of being administered in NHS Primary care that would ensure that most people were willing and able to keep to the maintenance diet to ensure that their pancreatic and liver fat stayed off and their diabetes stayed in remission, ideally for life.

 

[Boo1979]

All he was initially trying to prove was that a low calorie diet continued for long enough to get the fat off the liver and pancreas, as verified by his scanner, would result in reversal of diabetes. At least in those who had not had the T2 so long that their pancreatic fat had already killed their beta cells, or so many of them that complete reversal was no longer possible.
That is step one. Does it work?- Yes. Step 2 is does it continue to work as long as the person keeps the weight off? Answer - for one year at least, in many subjects, and apparently in one subject from and earlier trial, 10 years - Yes. Step 3 is to devise a support system capable of being administered in NHS Primary care that would ensure that most people were willing and able to keep to the maintenance diet to ensure that their pancreatic and liver fat stayed off and their diabetes stayed in remission, ideally for life.

My comment was in regard to Adamjames suggested reseach not the Direct study

 

[Guzzler]

Guzzler, I haven't gone and checked Professor Taylor's qualifications, but I feel pretty certain he, himself, isn't a surgeon.

Thanks, I wasn't sure at all.

 

[AdamJames]

Thanks, I wasn't sure at all.

Something he said in one of his presentations made me think that he was also a GP. I can't find reference to that but he does apparently to "clinical work" as well as the research:

http://www.bbc.co.uk/programmes/articles/8ZgRfSypm8l8R9ymrTDSg4/q-a-with-professor-roy-taylor

 

[Dark Horse]

Very well put I thought. And just for the record, since you mention it, I don't recall ever seeing a post where you seem dogmatic or biased!

Yes Roy Taylor certainly comes across as though he thinks it's all very simple in his interviews. Like you I wondered if it's because he just wants to push the big message home and he's short on time, so I checked the latest version of the web page at Newcastle uni, wondering if, when allowed to be a lot more wordy, the message would be more cautious, nuanced or detail more caveats. Nope:

http://www.ncl.ac.uk/press/articles/archive/2017/09/type2diabetesisreversible/

As a former scientist myself, this sits very unwell with me. Sometimes it seems like advertising, producing a glossy summary and ignoring all else.

As someone else said, that was a press release - they're not known for being nuanced. In Roy Taylor's FAQ page, he does list the type of people who may have been diagnosed with 'type 2' but wouldn't benefit from the approach:-

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 rare conditions will respond in the same way as the common, true type 2 diabetes.
http://www.ncl.ac.uk/media/wwwnclac...ecentre/files/2017 Diabetes reversal info.pdf​

 

[Alexandra100]

Interesting thread! I did listen to the interview, thanks bulkbiker for posting link.

Shame the prof's "piece" was so short, I'd been getting a bit jealous of all those people saying they ate less and moved more and hey presto, a miracle, they all lost weight. There is no doubt in my mind that consuming less and moving more will have a positive effect and people will lose weight. I've been there there, done that, got the video even, now what?

I now cannot lose weight until I get down to what the professor is talking about, very low calories. I'm pleased others can be successful with what I consider the "easy peasy" bit.

One caller who I remembered was the guy who said he lost 4 stone and reversed his diabetes, I've done that on 2 occasions, fortunately without weight gain in the middle, so 8 stone overall, and haven't reversed my diabetes. The first 4 stone went when I stopped taking Rosiglitazone, that stopped when I was prescribed Gliclazide. The second 4 stone went when I changed to low carbs without increasing calorie intake by increasing fat. That stopped . . . . . . . who can tell why. It goes back to the same old story, we are all so very different.

BTW, day 4 of eating nothing but peppers, courgettes, leaks, cauliflower, broccoli, mushrooms, celery, and still waiting for my BG to behave. It will . . . . eventually. It did the last time I tried this ND thing. At least I can now baked them, "whizz" them in the Nutribullit or utilise my Christmas pressie from MIL . . . . a soup maker.

Belated Happy New Year to one and all.

Interesting thread! I did listen to the interview, thanks bulkbiker for posting link.

Shame the prof's "piece" was so short, I'd been getting a bit jealous of all those people saying they ate less and moved more and hey presto, a miracle, they all lost weight. There is no doubt in my mind that consuming less and moving more will have a positive effect and people will lose weight. I've been there there, done that, got the video even, now what?

I now cannot lose weight until I get down to what the professor is talking about, very low calories. I'm pleased others can be successful with what I consider the "easy peasy" bit.

One caller who I remembered was the guy who said he lost 4 stone and reversed his diabetes, I've done that on 2 occasions, fortunately without weight gain in the middle, so 8 stone overall, and haven't reversed my diabetes. The first 4 stone went when I stopped taking Rosiglitazone, that stopped when I was prescribed Gliclazide. The second 4 stone went when I changed to low carbs without increasing calorie intake by increasing fat. That stopped . . . . . . . who can tell why. It goes back to the same old story, we are all so very different.

BTW, day 4 of eating nothing but peppers, courgettes, leaks, cauliflower, broccoli, mushrooms, celery, and still waiting for my BG to behave. It will . . . . eventually. It did the last time I tried this ND thing. At least I can now baked them, "whizz" them in the Nutribullit or utilise my Christmas pressie from MIL . . . . a soup maker.

Belated Happy New Year to one and all.

Have you seen Jenny Ruhl's book "Diet 101 - the Truth about Low Carb Diets" ? (Diet here means weight loss diet as well as blood glucose diet.) She has struggled for years with her weight AND has been coping with and researching diabetes for years, being now over 70. She talks a lot about stalling and what to do about it. I haven't read those chapters as my problem is being under rather than over-weight, but I think she knows what she is talking about, from her own experience and also from that of the many people who have been in contact with her on the net. You may also be able to find much of what she has to say on her website:

http://www.phlaunt.com/diabetes/sp3index.php

 

[AdamJames]

As someone else said, that was a press release - they're not known for being nuanced. In Roy Taylor's FAQ page, he does list the type of people who may have been diagnosed with 'type 2' but wouldn't benefit from the approach:-

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 rare conditions will respond in the same way as the common, true type 2 diabetes.
http://www.ncl.ac.uk/media/wwwnclacuk/newcastlemagneticresonancecentre/files/2017 Diabetes reversal info.pdf​

Thank you! I recognise that one, I've read it before, but it's good to be reminded that there are some nuanced documents to be had.

I did make the same observation (press release = gloss) in the post after the one you quote. I think that just about can be used as an excuse, but then looking at the document you link to, really, it's size and detail isn't exactly daunting for a lay-person. I'd prefer to see something like that as the introductory overview rather than the press release.

 

[Alexandra100]

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 rare conditions will respond in the same way as the common, true type 2 diabetes.

Thank-you SO much for posting this. I suspect I am LADA rather than T2 and I am very under-weight (BMI 16.5) but I did just wonder whether losing even more weight might resolve my bg problem. Now I know it wouldn't. I did email Prof. T asking him this question. He was kind enough to reply, but oddly he did not give the information above.

 

[phoenix]

I have the same view as a scientist and engineer. I am sceptical about some of the Prof's claims and degree of scientific research. His focus on calories shows a lack of understanding of how the body's metabolism works. The calorie value of food has little relationship to it's energy potential in the body - for example carbs and fats go thru a completely different process and some of fat calorie value is 'lost'. So this '800' calorie thing is very unscientific.

He is a specialist in Metabolism and Diabetes and director of theNewcastle Magnetic Resonance centre He also works as a consultant diabetologist with 3 clinics in Newcastle.
I'm absolutely certain that he has knowledge of how 'the body's metabolism works' and the current understanding in the field. His focus is on producing a negative energy balance. Note he discusses different ways of achieving this including the use of a low carbohydrate diet (along with low fat, med and intermittent fasting)
paper https://link.springer.com/article/10.1007/s00125-017-4504-z

( re calories from fat, have you read https://www.ncbi.nlm.nih.gov/pubmed/28193517 ? It is behind a pay wall but it is well worth reading. If not Stephan Guyenet has a precis of it containing some of the tables https://www.ncbi.nlm.nih.gov/pubmed/28193517)


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