Will YOU ask your Dr for the 600 cal diet

[pianoman]

No I do not find an 8 week starvation diet trial of 11 recently diagnosed Type 2s, where 7 out of the 11 show improvement back to Pre-Diabetes levels, which they maintain a month later despite already regaining on average 3Kg, 'compelling' in the least. The A1c is a 3 month average so taking 2 a month apart, is hardly 'compelling' and if you read the full study you will note that their Fasting BGs were starting to creep back up again.

Follow these folks up in a year or two and then let me know.. perhaps try it again with a larger patient group. How often are diet studies dismissed because "there has not been sufficient long-term testing yet"..? And yet this one is plastered all over the media and everyone and their dog is talking about it.

I have achieved comparable results with my own regime over several months without starvation... and I have maintained that improvement for several years now. Not having access to a scanner I have had to rely on the cheap and cheerful LFT blood tests to see how my liver is doing and my BGs to let me know how my pancreas is doing. I find my own results 'compelling'.

Do you know the state of the fat around your organs? If not then how can you be sure it is relevant to you? If there have been no other studies on liver and pancreas fat levels then that is worthy of follow up -- to be sure that the researchers are not speculating on the effect that has -- but so far it tells me nothing decisive.

The study has some merit and may be worthy of follow up but I am just not so easily impressed by all the hype around it.

---

BTW I am still waiting to learn what Type 2 research occurred 16 years ago... or was that just added (and repeated) for effect?

 

[NewdestinyX]

The study has some merit and may be worthy of follow up but I guess I am just not so easily impressed by all the hype.

I'm not the least bit impressed by the hype. But I am compelled by the 'results' and the 'science'. I agree we don't know enough from this study to see its conclusions as a smoking gun for diabetes reversal. We're on the same page there. We'll see what the future holds. And as long as a person can 'bear the rigors' of this kind of diet and their doctor's ok -- there's no harm in trying.

But again -- it's not about hype. It's about results. If they're repeatable and 'with longer lasting results' in any area (which is no fat around organs reappearing) then I'm 'compelled'.

Yes - I know my fatty liver levels. And they've improved hugely in 2 years on my regimen. BUT -- They haven't 'reversed' to 'no fat' there -- as they did with these test subjects. So 'our regimens' I don't think can provide the same results. But it was hard to tell from your post if you said you know your 'fat level' around your liver was 'zero' or not. If you have no measureable fat around your liver and that's a change since your dx - then your experience is as COMPELLING as this study's results.

BTW I am still waiting to learn what Type 2 research occurred 16 years ago... or was that just added (and repeated) for effect?

It would seem you're a 'literalist', Pianoman. It wasn't added "for effect" per se - but it 'is' in the pantheon of 'expressions' you can use when communicating - that's referring to a 'long period of time' from which one's been reading. Fine. Let me say it, more to your liking, this way: "It's some of the most compelling research from the 'recent decades', as I've been reading the major findings from this 'period'".. Is that better??.. :roll: .. my goodness.........

 

[pianoman]

[Vizzini has just cut the rope The Dread Pirate Roberts is climbing up]
Vizzini: HE DIDN'T FALL? INCONCEIVABLE.
Inigo Montoya: You keep using that word. I do not think it means what you think it means.

 

[pixor]

Hi Pianoman - I wasn't aiming my comment at you, I apologise if it seemed that way. I've just read all the threads on this subject, and my comment was a result of reading a number of, in my opinion, hysterical responses by people who hadn't even taken time to read the original paper.

It's also clear that the study was far too small to declare this hypothesis as fact, and that there is more work to be done.

I have a non-medical, but scientific background, and the idea and the methodology certainly looked OK to me, to the extent that I feel encouraged to give it a try. Dr Bernstein was considered a crank when he first proposed his theory of low-carbing. Following his methods has worked well for me for the last 4 years. Something is changing in my condition lately, though, so I feel it's worth looking into this.

 

[pianoman]

Hi Pianoman - I wasn't aiming my comment at you, I apologise if it seemed that way. I've just read all the threads on this subject, and my comment was a result of reading a number of, in my opinion, hysterical responses by people who hadn't even taken time to read the original paper.

It's also clear that the study was far too small to declare this hypothesis as fact, and that there is more work to be done.

I have a non-medical, but scientific background, and the idea and the methodology certainly looked OK to me, to the extent that I feel encouraged to give it a try. Dr Bernstein was considered a crank when he first proposed his theory of low-carbing. Following his methods has worked well for me for the last 4 years. Something is changing in my condition lately, though, so I feel it's worth looking into this.

Many thanks for your response pixor. I also apologise as I can see how my replies might seem brusque. I try to say what I mean and mean what I say. Perhaps I am not so skilled at the word games being played here, but I am more interested in the questions raised by the science.

I wish you well in your own trial but urge caution: I hope you have medical supervision available and I wonder if you have read Jenny Ruhl's assessment of this study? She raises concerns about its safety that go beyond the worst case scenario being just weight loss.
http://diabetesupdate.blogspot.com/2011/06/idiotically-dangerous-diet-reverses.html

Unfortunately I also include the study lead in the hype around this story... he is quoted at WebMD http://diabetes.webmd.com/news/20110624/very-low-calorie-diet-may-reverse-diabetes

"We used the 600-calorie diet to test a hypothesis. What I can tell you definitively is that if people lose substantial weight by normal means, they will lose their diabetes," says study head Roy Taylor,MD, director of the Newcastle Magnetic Resonance Centre at Newcastle University in England.

This is his own conjecture or at the very least falls outside the results provided by this study. I think it is important to separate the results from the opinions. Is he also dismissing the fat in the organs and claiming it is all just about simple weight loss? I am wary of any researcher who seems to have a closed mind.

 

[LittleGreyCat]

<snip>
Unfortunately I also include the study lead in the hype around this story... he is quoted at WebMD http://diabetes.webmd.com/news/20110624/very-low-calorie-diet-may-reverse-diabetes

"We used the 600-calorie diet to test a hypothesis. What I can tell you definitively is that if people lose substantial weight by normal means, they will lose their diabetes," says study head Roy Taylor,MD, director of the Newcastle Magnetic Resonance Centre at Newcastle University in England.

This is his own conjecture or at the very least falls outside the results provided by this study. I think it is important to separate the results from the opinions. Is he also dismissing the fat in the organs and claiming it is all just about simple weight loss? I am wary of any researcher who seems to have a closed mind.

Just dropped in on the tail end of this.
The quote

What I can tell you definitively is that if people lose substantial weight by normal means, they will lose their diabetes,"

is a load of absolute ********.
I guess we all know that - there are plenty of lean T2s on this site.

Having gone to the WebMD site and read their very brief summary I don't believe they have read and understood the report - they say that diabetes is cured and AFAICT the report does not state this at all.

With regards to some other parts of the discussion the main piece of information we are lacking is the extent of fat deposits in the liver and pancreas in lean T2s.
This should indicate if there is any mileage in this approach for the leaner amongst us.

Cheers

LGC

 

[danebabe]

So what happens after 8 weeks?, do you go back to normal 'diabetic' diet, or do you have to live on this strict regime forever?, I have read the article and looked it up on the Uni website, but it does not give any info about the follow up lifestyle?

Or have I missed something again?? (fibro fog does that to me sometimes)

 

[pianoman]

Just dropped in on the tail end of this.
The quote

What I can tell you definitively is that if people lose substantial weight by normal means, they will lose their diabetes,"

is a load of absolute ********.
I guess we all know that - there are plenty of lean T2s on this site.

Having gone to the WebMD site and read their very brief summary I don't believe they have read and understood the report - they say that diabetes is cured and AFAICT the report does not state this at all.

With regards to some other parts of the discussion the main piece of information we are lacking is the extent of fat deposits in the liver and pancreas in lean T2s.
This should indicate if there is any mileage in this approach for the leaner amongst us.

Cheers

LGC

To be clear: the quote is attributed to "study head Roy Taylor,MD" -- I'd hope that he has read and understood the report. To me such throw away lines raise a serious concern as to his ability to perform an impartial and open-minded interpretation of the results.

The WebMD article is brief and misleading: as are so many others out there in the media -- hence my concern... the "hype" I spoke about. Pixor raised the genuine issue of those who have not read the full study dismissing it out of hand, I'd like to raise a similar concern that there seem to be others who have not read the full study but are basing assumptions and in some cases actions on the headlines rather than the results. Grasping at straws and looking for a miracle "cure" in a method that may be potentially harmful.

The fatty deposits in the pancreas are news to me but I thought fatty liver was common amongst newly diagnosed Type 2s -- as part of the metabolic syndrome? I am also not sure to what extent this is associated with the symptom of overweight/obesity and what effect if any it has on Blood Glucose management... yes Blood Glucose improved during this short trial but the fatty deposits were not the only change. It seems reasonable that a reduction of excess fat in the pancreas might allow increased beta cell function but again further study is required. Even accepting that a reduction in the fatty deposits in these organs is a positive health marker (which also seems a reasonable assumption) there is insufficient evidence to show that the best or only way to achieve it is by way of this starvation diet.

 

[phoenix]

The university has added some extra material on it's website at http://www.ncl.ac.uk/magres/research/di ... versal.htm

these are :
FAQs by Professor Taylor
http://www.ncl.ac.uk/magres/assets/docu ... 2study.pdf
info for doctors
http://www.ncl.ac.uk/magres/assets/docu ... torsRT.pdf
the diet and veg recipes
http://www.ncl.ac.uk/magres/assets/docu ... ecipes.pdf
the theory/theoretical background on which the trial was based
http://www.springerlink.com/content/j08 ... lltext.pdf

 

[pixor]

So what happens after 8 weeks?, do you go back to normal 'diabetic' diet, or do you have to live on this strict regime forever?, I have read the article and looked it up on the Uni website, but it does not give any info about the follow up lifestyle?

Or have I missed something again?? (fibro fog does that to me sometimes)

The study states that the participants returned to a normal diet after advice on healthy eating and portion control.

 

[pianoman]

The university has added some extra material on it's website at http://www.ncl.ac.uk/magres/research/di ... versal.htm

these are :
FAQs by Professor Taylor
http://www.ncl.ac.uk/magres/assets/docu ... 2study.pdf
info for doctors
http://www.ncl.ac.uk/magres/assets/docu ... torsRT.pdf
the diet and veg recipes
http://www.ncl.ac.uk/magres/assets/docu ... ecipes.pdf
the theory/theoretical background on which the trial was based
http://www.springerlink.com/content/j08 ... lltext.pdf

Many thanks for these Phoenix.

I'm working my way through them all but the more I read, the more this Doctor reveals his own preconceptions: he talks about fois gras as a perfect model for fatty liver and how farmers have honed this skill over at least 2,500 years. He explains how the ducks and geese are allowed increasing access to "high-carbohydrate" feed during a 12 week period. And how this "first phase... gives all the necessary clues to the genesis of fatty liver in man. Prolonged intake of energy in excess of requirement..."

He then goes on to describe how high levels of insulin in the portal (liver) system rapidly increases fat deposition. Again he sees "excess energy intake" as the cause of high levels of insulin... with no regard for the effect that different macronutrients may have on insulin.

The answers are right there in front of him and yet he is stuck in the "calories in minus calories out" rut.

I noted in his FAQs for patients asking about this intervention he suggests ways to eat less include: "Recognise that the sensation of hunger is a sign of success, not a signal to eat" and "Enjoy that hunger. Celebrate with a glass of water. Maybe fizzy water"

 

[NewdestinyX]

With regards to some other parts of the discussion the main piece of information we are lacking is the extent of fat deposits in the liver and pancreas in lean T2s.
This should indicate if there is any mileage in this approach for the leaner amongst us.

Yes, that indeed is an important challenge to make of this study that isn't answered. What would then be the 'crux' of the issue with lean T2's.

Even accepting that a reduction in the fatty deposits in these organs is a positive health marker (which also seems a reasonable assumption) there is insufficient evidence to show that the best or only way to achieve it is by way of this starvation diet.

We would agree on that point. But we also can't ignore the fact that this 'very lo calories' approach DID achieve the ends reported; lower A1c that didn't go back up even after mild weight gain; and fat deposits on liver/pancreas stayed low/non existant after the 3 months.

And I find it interesting and potentially inconsistent that some people would want to term this a 'starvation' diet, possibly for 'effect' :?: , but then when someone else will use terminology like 'ULTRA LO CARB" or "EXTREME LO CARB' to describe what others would do to starve their bodies of one nutrient (in the otherwise important effort to control their D)- THEY would be considered 'sensationalist' or 'using hyperbole'. 600 calories - though very low would not send all bodies into 'starvation'. I know I could probably not do it - but that's beside the point.

 

[pianoman]

From the Patient FAQs linked above - Dr Taylor writes...

How should the results of the study be put into practice?
1. The particular diet used in the study was designed to mimic the sudden reduction of calorie intake that occurs after gastric bypass surgery. By using such a vigorous approach we were testing specifically whether or not we could reverse diabetes in a similar short time period to that observed after surgery.

2. The essential point is that substantial weight loss must be achieved

3. It is a simple fact that the fat stored in the wrong parts of the body (inside the liver and pancreas) is used up first when the body has to rely upon its own stores of fat to burn. Any pattern of eating which brings about substantial weight loss over a period of time will be effective. Different approaches suit different individuals best.

4. It is also very important to emphasise that sustainability of weight loss is the most important thing to ensure that diabetes stays away after initial weight loss. Previous research has shown that steady weight loss over a 5 – 6 month period is more likely to be successful in keeping weight down in the long term. For this reason I would not recommend a very low calorie diet for most people with type 2 diabetes. Very strict diets may be considered for particular purposes but a steady, patient, sustained approach to restriction of food intake will be best for most people.

...my bold emphasis

 

[NewdestinyX]

Many thanks for these Phoenix.

I'm working my way through them all but the more I read, the more this Doctor reveals his own preconceptions: he talks about fois gras as a perfect model for fatty liver and how farmers have honed this skill over at least 2,500 years. He explains how the ducks and geese are allowed increasing access to "high-carbohydrate" feed during a 12 week period. And how this "first phase... gives all the necessary clues to the genesis of fatty liver in man. Prolonged intake of energy in excess of requirement..."

Though this 'bunny trail' would deserve its own thread - I have to say that that conclusion (prolonged intake of energy in excess.....) -- which I've found to mainly resonate among those with the 'ultra lo carb/high fat' ethos of D control (and often driving that as an 'agenda' for all) - aren't able to explain then why the vast majority of the population of planet Earth takes in 'energy in excess of requirement', in the form of carbs, and never develops D and I'll bet they don't have fatty livers either.

Though I'm a big believer that 'behavior' (in eating) is a contributing factor to the onset of T2, such a theory can't exist without a partner aspect of genetic predisposition. But that's another WHOLE can of worms.

 

[phoenix]

Not really the place for this discussion sorry Ian. (oh and now several more posts have been made)
Re Foie gras
To misquote Hellerstein http://www.ajcn.org/content/74/6/707.full
'de novo lipogenesis is the pathway of last resort and that, at least regarding converting carbohydrates to fats, humans are neither bees nor birds' (pigs in the original)."
The conversion of carbs to fat is a more important pathway in avians (necessary for winter survival)
However the mix for fattening ducks and geese for foie gras is truly excessive and is both high fat and high carb(maize boiled with fat) and increases to more than double that ingested before gavage (source: next door neighbour!)

 

[pianoman]

And I find it interesting and potentially inconsistent that some people would want to term this a 'starvation' diet, possibly for 'effect' :?: ... 600 calories - though very low would not send all bodies into 'starvation'. I know I could probably not do it - but that's beside the point.

Inconsistent indeed... for example a post you made on the 5th July regarding this same diet in the thread '600 Calories to "reverse" Type 2'... http://www.diabetes.co.uk/diabetes-forum/viewtopic.php?f=25&t=22085&p=204282#p202566

An article here, commenting on the "cure", suggests that 600 calories are the requirements of a 4month old baby and recommends a diet of 1200 - 1800 for losing weight and putting diabetes into remission.
http://www.express.co.uk/posts/view/256 ... t-diabetes

Yes, great point. No matter how you look at - we're talking about a starvation diet here -- for an adult that is.
...

or earlier in that same thread...

Problem is ... they didn't follow the test subjects long enough, in my opinion, to make the broad conclusions they're attempting.
...
There are too many 'holes' in this research method to be of any real value to us -- yet. I'm disappointed in this study - though intrigued.
...

I'm wondering what happened to change "disappointed though intrigued" into "how can anyone not find it compelling?" :?:

 

[NewdestinyX]

And I find it interesting and potentially inconsistent that some people would want to term this a 'starvation' diet, possibly for 'effect' :?: ... 600 calories - though very low would not send all bodies into 'starvation'. I know I could probably not do it - but that's beside the point.

Inconsistent indeed... for example a post you made on the 5th July regarding this same diet in the thread '600 Calories to "reverse" Type 2'... http://www.diabetes.co.uk/diabetes-forum/viewtopic.php?f=25&t=22085&p=204282#p202566

An article here, commenting on the "cure", suggests that 600 calories are the requirements of a 4month old baby and recommends a diet of 1200 - 1800 for losing weight and putting diabetes into remission.
http://www.express.co.uk/posts/view/256 ... t-diabetes

Yes, great point. No matter how you look at - we're talking about a starvation diet here -- for an adult that is.
...

or earlier in that same thread...

Problem is ... they didn't follow the test subjects long enough, in my opinion, to make the broad conclusions they're attempting.
...
There are too many 'holes' in this research method to be of any real value to us -- yet. I'm disappointed in this study - though intrigued.
...

I'm wondering what happened to change "disappointed though intrigued" into "how can anyone not find it compelling?" :?:

Nice re-direct of subject! The main point of my challenge to you was about inconsistency in one's reaction to 'hyperbolic wording' in general (i.e. okay to use 'starvation' in contempt for this diet but not ok for a moderate carber to say 'ultra/extreme low carb' when describing how many Ds eat)

For the record I've never once said - this couldn't qualify as 'starvation'. I said a couple posts back that for 'some' it may not push them into starvation . Here's my exact statement - for the record:

600 calories - though very low would not send all bodies into 'starvation'. I know I could probably not do it

Then - as you've correctly shown by your quotes above- my personal position is that this IS indeed a starving the body for a good many of us. I've never claimed otherwise, Pianoman. No inconsistency in my position at all. I try to make my words very clear as to my intent. If I miss my goal - call me on it. I'm open. This isn't one of those times, though.

But nice 'deflect' away from the main challenge I made to you, though..

Expert level redirection!... :wink:

 

[pianoman]

...The main point of my challenge to you was about inconsistency in one's reaction to 'hyperbolic wording' in general (i.e. okay to use 'starvation' in contempt for this diet but not ok for a moderate carber to say 'ultra/extreme low carb' when describing how many Ds eat)

Who (apart from you) is saying anything about 'ultra/extreme low carb' ??? Why expect a response to an unprovoked challenge that is way off the topic for this thread? Goodness............. :shock:

"Moderate", "low", "ultra low", "extreme", "to the maXXX!!!" are all just arbitrary labels -- unless you define them it is ludicrous to try to do any kind of comparison. By many recognised standards your "moderate" or "lowER" carb diet IS a "low carb diet".

I described this study as a "starvation" diet which seems a reasonable description... you may have interpreted that as implying "contempt" but that is all on you, not intended by me.

And I am still wondering about your change of heart over this study from disappointing to compelling..?

 

[NewdestinyX]

I described this study as a "starvation" diet which seems a reasonable description... you may have interpreted that as implying "contempt" but that is all on you, not intended by me.

Fair enough! I accept you at your word there..

And I am still wondering about your change of heart over this study from disappointing to compelling..?

Please don't try and draw inconsistencies where there are none. You are comparing 'single words' used in different sentences with their 'own' "clear and obvious" contexts which may 'contrast' but there are no 'inconsistencies', Pianoman, on that topic. For the record - I 'am' DISAPPOINTED that the study wasn't larger and longer followed -- but I find COMPELLING the results they had - even with only those 11 people over 3 months with regard to the organ fat aspect we've talked about. Any student of science and diabetes should be compelled with what happened. I still maintain that though I know you disagree with me there.

See? No inconsistencies.. Just two words uses in different contexts.

 

[catherinecherub]

Well said Mary.

Perhaps the one upmanship contest could be carried on via p.m.
I am sure that the OP did not expect this thread to become bogged down like this.