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Reversing T2 versus lowering hba1c, LCHF versus low calorie

I can only speak from my own experience - an experiment on one person only! but here's mine:

Low calorie intake has been a feature of most of my adult life, was incredibly difficult to maintain because of severe hunger and weakness/fatigue, and an utterly miserable process with no time off for good behaviour. Arguably it is almost impossible to maintain it over a lifetime, and I am a nutrition geek with an excellent knowledge of food values. Low carb is really easy, no hunger issues (if I'm hungry I just eat) I have good energy levels, BG in the non-diabetic range, and have lost a considerable amount of weight without expecting I would. Intermittent fasting just happened along the way - I had no intention of actually doing that, but as it offered itself because I didn't get constant hunger problems, I started it. I am now a normal weight for my height. I can keep this up for the rest of my life.

For me it was very much what I ate not how much of it. I realise we are not all the same, and equally not every dietary regime works for everyone. I don't dispute that low calorie regimes cause weight loss, but how many people can stick to those over the rest of their lives? Certainly I am not one of them.
 
A calorie is a "unit of energy equivalent to the heat energy needed to raise the temperature of 1 gram of water by 1 °C"
A calorie from fat is a unit of energy equivalent to the heat energy needed to raise the temperature of 1 gram of water by 1 °C
A calorie from carbs is a unit of energy equivalent to the heat energy needed to raise the temperature of 1 gram of water by 1 °C

It has no magical properties over calories from elsewhere. Cutting out carbs by itself will not produce weight loss. Only if the low carb diet is at the same time a low calorie diet, can that work. If you just replace the carbs calories with calories from other foods your weight will stay the same. I wonder if the "low carb same cals" people on here mistake their lower BGs as being an indicator of Diabetes remission instead of just blood glucose reduction, which is all it is.
 
We are living beings, not a piece of laboratory equipment. Every gram of starchy carbohydrate we consume is turned into Glucose. Starch is a long chain Glucose molecule, that is why it is digested so easily. It WILL reach your bloodstream. Not all fat that is consumed is digested and used.
When on a low carb diet, most of us don't count calories, we don't need to worry about it, like low calorie dieters. If we did, i'm sure most of us would find ourselves consuming a lot less calories than we thought. due to the fact we DON'T usually suffer any hunger pangs, we frequently miss meals altogether, we don't need them because our bodies utilise the stored fat, just the way low calorie dieters do, the difference being we're not hungry, and frequently fretting over food. And our bodies don't reduce our metabolic rate to compensate for reduced calories.
NOBODY knows what actually causes Insulin resistance, if they did, there would be a cure. But hyperinsulimia exacerbates it. Most type 2 diabetics are hyperinsuliemic. That is why reducing the blood Glucose level improves resistance, because the Insulin level drops as a consequence.
Weight CAN ONLY be gained in the presence of Insulin, so by eating low carb, that Insulin level is lower. We are probably eating low calorie at the same time, but it is of no importance to us.
Once diagnosed as type 2, you are ALWAYS type 2. You can control your sugars whichever way you please. With good control, without high levels of Insulin, our resistance should improve, that usually allows some more carbs to be eaten, without detriment. But don't kid yourself you're better, you're improved but still type 2.
 
Calories from all sources have the same effect on weight. This is your fundamental mistake imo. Where is your evidence beyond personal belief in the almighty calorie? I and many others have lost weight without reducing calories (or slowing metabolism) by replacing carbs with other foods. We aren’t lying or mistaken. Many have kept detailed records in fact. A 1000 calories of carbs and a 1000 calories of fat or protein do very different things to my body. Bgl, energy, satiety, hunger signals, fat storage or access etc etc.

As type 2 we cannot process carbs properly. We raise insulin in trying to overcome insulin resistance. Insulin hinders fat burning and aids fat storage. Those carbs we cannot utilise for energy have nothing to do but be stored, as fat. Change the carbs for calories we can utilise and they no longer get stored. We stop adding to the stores and are able to burn the stores.

In test tube you might be correct. But in a flawed human body there are so many confounding factors (not least diabetes and insulin resistance). We simply do not utilise all available fuel to its maximum capacity in light of enzymes, hormones, gut bacteria, and more, working less or more efficiently in each individual. Obviously on one level it is about using more than we take in but we literally cannot use carbs the way we should so the equation needs to consider usable intake not overall in terms of what we then burn to avoid the bypass directly to the backside,hips or belly


Have a read of some of these for a wider view of calories and low carb.

https://www.dietdoctor.com/first-law-thermodynamics-utterly-irrelevant
https://www.zoeharcombe.com/2014/06/the-calorie-theory-prove-it-or-lose-it/

Dietary carbohydrate restriction improves metabolic syndrome independent of weight loss - PubMed

BACKGROUNDMetabolic syndrome (MetS) is highly correlated with obesity and cardiovascular risk, but the importance of dietary carbohydrate independent of weight loss in MetS treatment remains controversial. Here, we test the theory that dietary carbohydrate intolerance (i.e., the inability to...
pubmed.ncbi.nlm.nih.gov

Low-carb diet may reduce diabetes risk independent of weight loss

A low-carb diet may have benefits for people at risk of developing type 2 diabetes even if they don't lose any weight, a new study suggests.
www.sciencedaily.com

Effects of the low carbohydrate, high fat diet on glycemic control and body weight in patients with type 2 diabetes: experience from a community-based cohort - PubMed

In a community-based cohort of type 2 diabetes, the LCHF diet was associated with superior A1C reduction, greater weight loss and significantly more patients discontinuing or reducing antihyperglycemic therapies suggesting that the LCHF diet may be a metabolically favorable option in the dietary...
www.ncbi.nlm.nih.gov

Effects of an energy-restricted low-carbohydrate, high unsaturated fat/low saturated fat diet versus a high-carbohydrate, low-fat diet in type 2 diabetes: A 2-year randomized clinical trial - PubMed

Both diets achieved comparable weight loss and HbA1c reductions. The LC sustained greater reductions in diabetes medication requirements, and in improvements in diurnal blood glucose stability and blood lipid profile, with no adverse renal effects, suggesting greater optimization of T2D management.
pubmed.ncbi.nlm.nih.gov
 
i have read all the articles you posted. Thank you for showing them. Two have seriously dodgy commercial conflicts of interest. All are about improvements in the management of T2 - mainly BG. I have always accepted that low carb improves BG dramatically. But there is nothing anywhere, in any of them, regarding improvement n the root cause of T2 ie Beta cell malfunction. They do also say, - several of them, that low carb improves lipid counts. This was new to me. I am glad to have found this out - thank you. I shall bear it in mind when I consider the content of my new, post-reversal, diet composition which I am working on at the moment. Though I have to say that despite the high carb diet (50% carbs) I am using at the moment, my blood lipids ae tolerably good, especially my triglycerides which these articles suggest are raised by carbs. ie Jan 2023; Hba1c 38; 1Total chol 4.3; hdl 1.3 ratio 3.3; LDL 2.6 Trigs 0.81
 
There is no single acceptance and proven root cause. There is no “cure”. What is the source of your opinions? Taylor‘s theories are still just that. There is some evidence to sort of support them but they do not explain it all even if they are right.

Did you also read the calories stuff?
 
Beta cell malfunction is NOT the cause of type 2 diabetes. It can occur later on due to the Pancreas basically being flogged to death, due to Insulin resistance, and having to over produce to try to cope with the raised sugar levels. Or as a result of drug treatment, to increase the Pancreatic output. This is why things improve when blood sugars are under control. Unless the Pancreas has been pushed too far, for too long, it can recover to some extent. If not you become an Insulin dependent type 2.
2000 Calories of fibre = 2000 Calories of Glucose, according to your thinking. But
2000 Calories of fibre in the human body = zero
2000 Calories of Glucose = 2000 Calories, but in a calorific chamber they are the same.
 
Hear all about from Professor Roy Taylor the 5 minute summary.

Our research has shown that:
• Type 2 diabetes is caused by a small amount of excess fat inside the liver and inside the pancreas
• It is a potentially reversible condition
• If a person has type 2 diabetes, they have become too heavy for their own body (nothing to do with the arbitrary concept of obesity)
• Weight loss of around 15kg is necessary for most people
• This can be achieved using a simple 3-step method: the 1, 2, 3 of diabetes reversal
• Type 2 diabetes is most easily reversed to normal in the early years after diagnosis
• How and why type 2 diabetes happens can now be understood

Read a full account in the book ‘Life Without Diabetes’ (published 2020 by ShortBooks)

Diabetes Remission 17/9

Prof Roy Taylor on Diabetes remission.
nuvision.ncl.ac.uk
bold is mine
 
Have you read the actual papers/books or any of the discussions around this by other experts? I feel like you are swallowing the summary whole and undigested. Or read anyone else’s work on the subject of diabetes that approaches it from another angle or comes to slightly different conclusions? That one body of work might sound definitive but it’s not the only one nor is it completely unchallenged or totally agreed with as proven.

Even within this forum there are plenty of posts with links to back up positions that at the very least ask questions and at the other end ask some serious unanswered questions about his work. Try a few forum searches as a starter on Taylor, Newcastle diet, VLCD (very low calorie diet) and more recent it’s been referred to as the soup and shake diet reflecting how the nhs are introducing it.
 
You are quoting a study (the UK prospective diabetes study) that began in the late 1970s and reported towards the end of the last century. It is more than somewhat dated these days, but if that is your only source of information I can see why you think as you do. It is the "official" line. More recent textbooks and research still confidently state that "T2 diabetes is a progressive disease" - it certainly is, if you do nothing about it or only make useless or harmful lifestyle changes.

You still have not addressed the point reported by many of us that glycaemic control precedes weight loss, rather than follows it: and that significant weight loss is achievable through low carb without ever lowering calorific intake or increasing calorific use. It has been argued that successful (in terms of glycaemic control) low calorie diets work because they are also low-carb: the 800 calorie diet, even if it was entirely carbohydrate (which it isn't) would be met by only 200g carbohydrate /day. If carbohydrate contributes (as recommended) 40-65% of the 800 calories, the intake reduces to a maximum of 130g carb/day, which is certainly low-carb territory.

You are, incidentally, contradicted by the Direct trial's own figures: the numbers are presented artfully to make it seem more succesful than it was: but 93% failure after five years is indeed what their own figures show. So it's a few for whom low-calorie did work, not the other way round.
 
No, that is wrong. You should not dismiss our experience because it contradicts your belief.

A low carb diet for me has produced both glycaemic control, to the point where the NHS judged me to be "in remission" (over two years ago now) followed by substantial weight loss. I certainly have not restricted 'calorie' intake but I have greatly increased my intake of both protein and saturated fat.

I have sufficient experience of (failed) low calorie approaches to be aware of the difference.
 
I would respectfully suggest that it is the opponents of the low cal approach on here who are presenting the figures "artfully". Only the individuals who regained the weight were not still in remission after 5 years. 100% of those who maintained their weight loss were still in remission after 5 years. The method works, The failure of some people to continue to comply with the method after 5 years is not a feature of the low cal diet method but simply an indication of the failure of some of the individuals involved to keep it up it. In a drugs trial you would not include the people who initially started the trial, but then dropped out and stopped taking the drug, in the final results.
Opponents of the diet may be those who have themselves discovered their diabetes too late for it to work for themselves and do not want other newly diagnosed T2s, for whom it will probably work, to try it. Why would anyone want to prevent people who might benefit from it from trying it early while they still can?
Edit to add: Would you expect the low carb diet to work for people who didn't actually DO it/complete it? If not, why would yo expect the low cal diet to work for those who didn't do it?
 
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I have read all the papers you linked. All refer to improvements in the symptoms of diabetes ie BG's and lipid profiles. Excellent in themselves but nothing to do with reversal. If you had any others I assume you would have linked to them. I have read about T2 extensively and not ever found any that say that blood sugar reduction in itself can reverse T2. If it could then wouldn't BG reduction by drugs be preventing T2 from progressing? People have been doing that for decades but still at somewhere around 15 years post diagnosis patients tend to start requiring insulin injections to maintain their BG at safe levels.
 
There are plenty of people (me included) for whom a low-calorie diet would probably end up with them being hospitalised due to malnutrition. I am not and never have been overweight. I don't need to lose any weight but I would still have BG numbers too high without the low-carb approach.

That isn't to say that the low-cal thing isn't a good idea for some people, but clearly there is something else going on.
 
Bad paw said:
If you had any others I assume you would have linked to them.
Click to expand...
No I simply linked to a few I had handy. I’ve read hundreds of papers and articles over the years. I can’t quote them all on demand. You still don’t answer if you have read specifically about low carb/keto or just the negative headlines/articles ?

The progressive management of blood glucose alone you mention, from a few decades ago are based on medicated management not diet. So you are correct there. In fact many of the medications actually make the issues worse in the long term by short term masking the symptoms (by only high blood glucose and ignoring the reason why they are high.

BUT Low carb is not the same and it is not just blood glucose management. It addresses the underlying issue, such as insulin resistance and visceral fat underlying that the drug largely do not, certain not those from the past.

You still fundamentally misunderstand low carb. It is not just reducing blood glucose by intake. It goes way beyond this. Think about its effects on insulin and insulin resistance and the cellular response to that for example. IR is a cause of not just type 2 but other metabolic issues like obesity, high blood pressure, visceral fat, high cholesterol, high triglycerides.


This is bordering on offensive. No one in here wants anyone to suffer unnecessarily. I am not an “opponent”. I’m just not blinding quoting a few lines and believing every word not assuming it’s just a matter of will power and it works. What about those of us that have pointed out to you we lost the weight in the suggested time frames and it didn’t work as promised allowing us to eat anything, carbs included? You don’t respond to that.

It does not probably work. It probably fails. Their own results show that. If a person cannot tolerate a drug or its side effects that’s relevant to the adoption and success of that drug. Same with tolerating the extreme diet.

Can you link to the part that says everyone that remains at the appropriate weight remained in remission please.
 
This is the old fashioned medical thinking, of we gave you a diet, it didn't work, therefore you are lying and weak, and did not follow what what we told you. NEVER their failure, only yours.
Type 2 diabetics problem is HYPERINSULIMIA, caused by Insulin resistance. When treated with drugs, that is exacerbated. The blood Glucose level will drop, but the Insulin level will be sky high. THAT is why remission is unattainable on medication.
Remission, reversal whatever label you want to put on it, cannot be attained UNTIL Insulin levels are dropped, allowing an improvement in Insulin resistance. It doesn't matter HOW you reach that goal. There are probably countless ways, but not all suit everyone. There will be a specific way that works best, for each individual.
Most on here are not blind to the different ways, and don't challenge them, when someone has EXPERIENCED it, and it worked for them.
 
There is a newer trial called "Retune" for people at the lower end of the BMI scale, but who are also T2 because of excess fat deposition on the liver and pancreas. It involves losing only 8% f their weight. These people, though of normal weight, still have too much fat on the pancreas for their particular body type. They represent about 10% of T2s an are sometimes called "TOFIs" Thin on the outside fat on the inside.
  • "Participants’ BMI averaged 22.4 kg/m² at the end of the study (reduced from an average of 24.8 kg/m²).
  • About three quarters (70%) of participants went into remission from type 2 diabetes during the study, with 50% of these going into remission after the first weight loss cycle.
  • People needed to lose on average 8% of their body weight to go into remission.
  • In the 14 out of 20 people who went into remission, their average HbA1c fell from 53mmol/mol at the start of the study to 45mmol/mol. Their blood pressure dropped despite taking less medication to treat this.
  • The participants’ liver and pancreas fat levels were higher than expected at the start of the trial but then decreased to normal levels after weight loss.
Participants reported feeling satisfied with their weight loss and health improvements and didn’t find it hard to keep the weight they'd lost off. "

ReTUNE study shows type 2 remission possible for people with lower body weight

While we know that obesity increases the risk of developing type 2 diabetes, 10% of people with type 2 diabetes have a BMI that is not in the obesity or overweight category.
www.diabetes.org.uk
 
53mmol to 45mmol, is a rather poor outcome compared to many on here. By reducing carbs, i went from 51 to 36, within 12 weeks. Non diabetic numbers, NOT prediabetic. I wasn't worried at all about what i ate, or how many calories, as i knew what NOT to eat.
Suddenly it's dropped from 15% to 8% loss of bodyweight, which proves yet again, the remission comes long before the major weight loss.
The participants Ectopic fat levels were higher than expected, they wouldn't be by me. If you are type 2 and higher glucose numbers, the Ectopic fat is your main problem. Losing that is what does the trick HOWEVER you do it.
 
https://www.tandfonline.com/doi/full/10.1080/00325481.2020.1771047

As is apparent from the diagram high insulin levels only occur in pre diabetes and very early diabetes. After that the beta cells start to fail, and T2's have the opposite problem INSUFFICIENT INSULIN
"The first stage in the development of T2D is insulin resistance. During this time beta cells are stimulated to increase insulin secretion in order to maintain normal glucose levels [Citation10]. By the time T2D is diagnosed, around 40–50% of beta-cell function is already lost, with a further loss of 4–5% expected each year thereafter [Citation11–13]. As such, a better understanding of the pathophysiology of T2D has important therapeutic implications for the timely use of treatments that address insulin resistance and progressive beta-cell failure. For example, rather than relying solely on measurement of A1C, monitoring beta-cell function has the potential to provide invaluable information about disease status" my bold
 
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