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Prof Taylor on the subject of Reversal.

Discussion in 'Diabetes Discussions' started by Little Bird, Jan 25, 2020.

  1. Little Bird

    Little Bird · Well-Known Member

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    From perusing the forums here I have noticed that a number of people have asked questions about the subject of remission/reversal and weight loss. I recently read the new book out by Prof Roy Taylor which discusses these issues at length and thought it might be useful to some people to relay some of Prof Taylors insights here. My apologies in advance, as I realise it will be old news to some people, but it may be useful to some so I thought it worthwhile.

    From his research into type 2 diabetes, Prof Taylor believes that type 2 diabetes is caused by excess fat in the pancreas coupled with excess fat in the liver. When fat accumulates in the beta cells of the pancreas, he says, it can inhibit their proper functioning i.e. producing insulin, by switching off the genes necessary for this. The excess liver fat, he explains, renders the liver insulin resistant so that it is continually pumping out glucose. The theory posits that these factors combined are what cause type 2 diabetes, this has come to be known as The Twin Cycle Hypothesis. If you accept that excess fat in the pancreas and liver is what causes type 2 then it makes sense that removing that excess fat can reverse the condition, since removing the excess fat removes the apparent cause of type 2, at least for some people.

    To quote Prof Taylors words exactly from his book (page 159):


    "Your type 2 diabetes has been caused by less than half a gram of fat inside your pancreas. That small amount of excess fat is inside the cells, preventing the proper manufacture and release of insulin. There is not only excess fat within the cells of the pancreas, but too much in the blood, continually arriving and adding to the burden. Is there not some clever way of getting rid of this small amount of fat which is in the wrong place?

    Sadly not. the only way of decreasing this burden of fat is to decrease the total amount of fat accumulated in your body - not just by a few kilograms, but by a lot. Once this is crystal clear, escape from type 2 diabetes is within your grasp. You need to lose weight and keep it off
    ."


    Therein lies the sting in the tail! According to the Prof, the typical amount of weight someone has to lose in order to remove that excess pancreatic fat is 15Kg, but he says this can vary from individual to individual, especially if you already have a low BMI.

    He also says quite clearly that it does not matter which diet you follow to lose this weight. Shakes, Low fat, LCHF or any other diet will work as long as you lose sufficient weight to remove that excess pancreatic fat, you have a chance of reversing type 2, but, as I’m sure we all know by now, this chance decreases the longer you have had type 2.

    Having said all that, this is of course, assumes reversal/remission or whatever you want to call it, is the removal of the cause of type 2. Some people define reversal as being able to bring blood sugar levels under control and eliminating medication through diet. I personally think these are slightly different definitions since it is possible to achieve excellent BG control without losing a nanogram of fat from the pancreas or elsewhere and for many people this may be a far more realistic approach. In the final analysis what matters most is finding a sustainable method of preventing the complications of diabetes form happening for as long as possible, and just how is up the individual to decide.

    Whatever your views on the subject of reversal, sustainability is key since, obviously, if you return to doing whatever caused your type 2 in the first place it will inevitably return. Whether LCHF, LFHC, vegan, carnivore or any of the many other paths, all roads converge here! I personally think the term reversal should be revised to provisional reversal as I think this is more accurate and honest, but that’s just me!

    Lastly, it is not my intention here to review or promote Prof Taylors book in any way shape or form, I just thought that some of its contents may answer some peoples questions. Entirely up to you whether you accept or reject any or all of it. :)
     
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    #1 Little Bird, Jan 25, 2020 at 1:05 PM
    Last edited: Jan 25, 2020
  2. aealexandrou

    aealexandrou Type 2 · Well-Known Member

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    Pro. Taylor's research is now becoming widely accepted but he hasn't appreciated the effect of fractose. That sugar is metabolised solely by the liver, which can only turn it into fat and the first place it will dump it is in itself. The logical conclusion for reversing T2D is to drastically reduce fractose and in particular processed sugar and processed sugar related foods as that is comprised of 50% fractose which causes issues in the liver itself and 50% glucose which will create an insulin spike in any event where the excess glucose in the blood is deposited as fat in your other organs, including the pancreas.
     
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  3. Jim Lahey

    Jim Lahey I reversed my Type 2 · Well-Known Member

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    My personal belief is that reversal is defined by not being able to be diagnosed diabetic by any blood test known to medicine. The diet used to achieve this is irrelevant. We don't pull people off the street and declare them diabetic because they're eating a species-appropriate diet and have thus far avoided getting diabetes. And as we know there is no requirement for humans to consume glucose, it's also entirely moot. But that is just the viewpoint that works for me.

    Regarding the ectopic organ fat, I don't think it's really in dispute at this point. But as ever, there is no universal consensus on what causes the deposition of this fat.
     
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  4. LittleGreyCat

    LittleGreyCat Type 2 · Well-Known Member

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    I would like to see more study on the scanning of the liver and pancreas in normal or low BMI T2 diabetics to confirm that they still have fat deposits which could impair metabolic function.

    At the moment it seems to be assumed that fat is always the cause, and if you are skinny then there must be "concealed fat" somewhere causing your T2.

    If this is proved, fine, develop a protocol for TOFI T2s. Including pancreas and liver scans.

    If this is disproved it might stop T2s blaming themselves because however much weight they have lost it obviously isn't enough and they should just try harder.
     
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  5. Walking Girl

    Walking Girl Type 2 · Well-Known Member

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    In addition to a lot of weight loss in general (BMI of 35 down to 22), I did a 5 week very low calorie diet. It was kind of amazing how much faster the very low calorie crash diet caused weight loss in my middle, though I know prof Taylor says that’s not necessary. But it seems it was for me. I’m about as apple-shaped as you can get (gee, thanks Mom and Dad), and even at a BMI of 22, with lots of exercise, I’m only just under the definition of abdominal obesity. So, I think for those with excess weight and/or the dreaded apple shape, it’s certainly worth a shot.
     
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  6. Oldvatr

    Oldvatr Type 2 · Well-Known Member

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    One thing to bear in mind is that the trials run by Prof Taylor were hailed as reversal, but the number reaching that happy state at the end of the trial was something like 47% so it is not working for everyone. Then we have seen sad tales on this website of firstly success stories of reversal that later turn sheepishly into admissions of still being diabetic. I was one of those, since for a brief interlude I was certified as Reversed by two hospital consultants and indeed was able to eat normally like I used to, but now I am back on my diet and close to the Nirvana state, but not actually free to eat the kitchen sink as it were (or the fridge) I accept that I am not cured at all, and will need to keep up a lifestyle to suit my condition,

    What Prof Taylor did demonstrate is that while the rest of the NHS insist that T2D is a progressive journey to insulin injections etc, he found a repeatable method to recover beta cell function, thus demonstrating that it is not beta cell death but some other factor at play (aka adipose fat hypothesis)

    Just a thought: if I reverse my car, then it goes backwards over ground it has already covered. It is not normally thought of as a permanent thing, so why do we expect diabetes reversal to be permanent?
     
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  7. lucylocket61

    lucylocket61 Type 2 · Well-Known Member

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    I have halted my diabetes 8 years ago. I have lost almost no weight, about a stone, and am still morbidly obese. I am not the only one on here to do that. It cant only be about the weight, internal or external. I am waiting for the results of my liver scan. All my other liver function tests are fine.

    I think the success of weight loss depends on how often one has dieted before, and whether ones metabolism has been damaged by the starvation mode which kicks in.

    I still hold to the belief that Prof Taylors diet appears to work due to the lack of calories including low carbing. An effect which can easily be achieved by many by simply reducing carbs alone. Unfortunately the mantra that weight gain leads to type 2 diabetes is still being trotted out as unchallenged, and no proper trials are even being carried out to challenge that assumption.
     
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  8. Caprock94

    Caprock94 · Well-Known Member

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    True, I think the overall reversal percentage was 47%, but that factored in those that lost like 10 pounds, 20 pounds or 30 plus pounds. Those that were in the smallest weight loss category had a reversal rate of less then 47%. Those who lost like 33 pounds or more had an 86% reversal rate. Therefore, it really does seem to tie the results to the amount of weight loss.
     
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  9. Little Bird

    Little Bird · Well-Known Member

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    Hi all, some really interesting and very valid points of view. Though just to clarify i wasn't advocating or trying to promote Prof Taylor's views or advice. Quite simply I'm not enough of a scientist to know how valid it all is. I just thought that it may be of interest to some people. Please don't shoot the messenger!
     
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  10. Jim Lahey

    Jim Lahey I reversed my Type 2 · Well-Known Member

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    Another factor of course is that it's entirely possible (and maybe even enjoyable) to eat LC/Keto for the remainder of one's life. Extreme calorie deprivation not so much.
     
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  11. Brunneria

    Brunneria Other · Moderator
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    ‘Type 2 Diabetes’ is often used as an umbrella term for anyone showing high blood glucose who isn’t easily and cheaply diagnosed with another type of diabetes. So there are many T1s and T3cs, LADAs, MODYs, drug induced, Bronze diabetics (and others) who are lumped in with those T2s whose insulin resistance and beta cell failure is affected by fat in the liver and pancreas.

    While I applaud Professor Taylor’s work, I find it endlessly frustrating that many consider his work to apply to all ‘Type 2s’.

    No.
    It applies to those people with liver and pancreas fat, whose beta cells can return to function if that fat is removed.
    There are many, many people classed as ‘type 2’ for whom weight loss is not going to improve their blood glucose control.
    Indeed, the extreme diet often used to achieve such weight loss may be extremely unhelpful, especially to a patient who didn’t need to lose pancreas and liver fat in the first place.
     
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    #11 Brunneria, Jan 25, 2020 at 3:59 PM
    Last edited: Jan 25, 2020
  12. Jim Lahey

    Jim Lahey I reversed my Type 2 · Well-Known Member

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    I will also add here that I reversed (or whatever we choose to call it) my diabetes whilst gaining weight.

    n=1 and all that, but I doubt I'm alone.
     
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  13. lucylocket61

    lucylocket61 Type 2 · Well-Known Member

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    Is there any information on what the starting and ending blood sugar levels were too?
     
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  14. Little Bird

    Little Bird · Well-Known Member

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    That's particularly interesting @Brunneria I had no idea there were so many different forms of diabetes. There really is nothing straightforward about diabetes is there? No wonder there are so many different and conflicting points of view.
     
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  15. Oldvatr

    Oldvatr Type 2 · Well-Known Member

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    I am of the other opinion. To me it was the depletion of the body fat that led to weight loss. On an ultra restricted diet, the body is tricked into thinking starvation is coming, so it starts raiding the body's long term stores, i,e, the lipids it secreted away for that rainy day. First it depletes the muscle stores, which is glycogen. Now glycogenis a mix of stored glucose and water, so depleting this store results directly in significant and fast weight loss as water is removed. This is how most weight loss diets work, indeed the Prof Taylor diet is the Cambridge Plan of the 80's using Optifast shakes and 800 kcal. the DIRECT plan used currently also uses the Cambridge Plan shakes again.

    So initial weight loss is not what we term as body fat. Once the muscle stores are depeleted then the body raids the lipids stored in the liver (often blamed for the Dawn Phenomenon or Liver Dump) and when this runs out then the interesting stuff begins. There is a clarion call from the hormones for all good fats to come to defend the flag, so now we see adipose tissues such as the brown cells, and the pancreas and liver give up their remaining fat deposits, This is why prolonged use of this type of diet is not recommended since it leads to protein scavenging if fats are not included. That state is starvation.

    Prof Taylor states in the extracted paragraphs in the OP that it is the removal of ALL body fat that does the magic. He also says the diet plan to get there is just a tool and does not have to be ultra low calorie, He used Optifast because it was a recognised diet acceptable to the NHS, and had controlled nutrition which he needed to eliminate confounders from the experiment. In other words, it was convenient.

    Sorry Little Bird, it was the use of the word Reveral that we were critquing, not you. That is an emotive term. and since you were aiming this topic at newbies, it was important for us to make it clear that it is not the silver bullet or holy grail that they may be seeking. The work that Prof Taykor did and continues to do may in rime lead to that happy solution, but it is not yet in our hands, But it has given us another tool we can use.
     
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  16. Mbaker

    Mbaker Type 2 (in remission!) · Well-Known Member

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    I think the opening statement bares accuracy to what the Newcastle Diet is all about; however unless I missed the point, the proponent has to in maintenance eat two thirds of the original amount of foods and exercise, the exercise for me is no problem, but less food is a no go.

    The statement "Whether LCHF, LFHC, vegan, carnivore or any of the many other paths, all roads converge here!" I believe is not entirely accurate, as it suggests all of the protocols can have the same outcome. I have yet to see a high carb diet produce under 42 mmol continuously. Although if stuck to, a low calorie diet can match LCHF for weight loss, a recent study (sorry don't have the reference) shows at least better body composition with LCHF.
     
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  17. Redshank

    Redshank Prediabetes · Well-Known Member

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    As far as I am aware, all of Prof Taylor’s research so far has been carried out on people who were obese. That was one of the criteria for selection in the trial.
    The information gained from that has been extrapolated to people who are not obese or overweight. He is planning research on non obese/overweight people, but at the moment it seems an assumption that the same process will work. This may or may not be the case.
     
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  18. Jim Lahey

    Jim Lahey I reversed my Type 2 · Well-Known Member

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    I believe this is what happened to me. My body composition improved. I gained weight but my waist size shrunk. Presumably as a result of my liver no longer furiously converting glucose into fat and leaving it on the front porch because it had nowhere else to put it (I can't easily get fat). If I'd attempted a low calorie diet I would have just lost more weight. And probably still be diabetic. And hungry.
     
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  19. Oldvatr

    Oldvatr Type 2 · Well-Known Member

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    His original brief was to investigate claims made that bariatric surgery led to diabetes remission in T2D, So he was using a diet plan that mimicked the after effects of that surgery without actually performing it. So his starting point was to take morbidly obese patients and apply the diet and see whether it was the reduction in calories that led to the remission. Simples.

    The offshoot was that now he had a diet that could be used instead of expensive surgery so he could get the NHS and DUK interested for funding further follow on studies namely DIRECT, Which is where we are today.

    Note that by using a recognised diet plan it allowed him to read across some of the safety outcomes that were established by nutritionists in the 80's and 90's without having to get involved any deeper in safety assessments, This is why he does not have a follow on plan to offer since that would need to be tested and evaluated for safety, He ducked out of that by stopping the advice at the end of the trial and saying 'over to you now' whereas in reality a bariatric patient is rather stuck with what they got,
     
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  20. ianf0ster

    ianf0ster Type 2 · Well-Known Member

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    Does it matter if it is Low Carb or Weight Loss including Low Carb that puts T2D into remission? Low Carb 'Way Of eating' provided that the metabolic rate isn't reduced by cutting Calories, generally produces weight loss even in those who are apparently slim.
    As a TOFI when diagnosed I researched alternative 'ways of eating' including 'Crash Diets', High Carb Low fat, Fasting and Low Carb. I decided to try the easiest first - which for me was/is Low Carb High(er) Fat. This was an easy decision since I (wrongly) thought that I didn't need to lose any weight.
    However that was fortunate since it meant I added extra Calories from Fats and Protein to replace those lost by cutting down on Carbs. So I didn't go hungry, yet I still lost weigh at a pace of between 1lb to 2lbs per week.
    It was only later that I discovered the reason for my weight loss - lower Insulin over longer periods. Yet doctors don't seem to accept this as being simple and obvious. - You can't easily lose weight if you are eating carbs in sufficient quantity and frequency that your Insulin is raised at all times except when you are asleep!

    It infuriates me that doctors ad dieticians take a 'Way of eating' which works for lowering excess weight and keeping that weight (LCHF) and then modify it by cutting Calories or other tweaking - making it unsustainable.
     
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