Newcastle Study Reverses Diabetes

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Newcastle Study Reverses Diabetes

Post by sharperhawk on Tue Dec 05, 2017 11:20 am

Weight Loss Really Can Reverse Diabetes, New Study Finds
In the study, Dr. Roy Taylor, professor of medicine and metabolism at Newcastle University, and his colleagues randomly assigned nearly 300 people to either a weight management program or their usual treatments, including diabetes medications. All of the people had been diagnosed with type 2 diabetes in the six years preceding the study. The people assigned to the diet group stopped any diabetes drugs they were taking on the same day they began the diet.

The diet, which was designed to help people lose up to 30 pounds, involved three to five months of a strict low-calorie liquid formula diet averaging no more than 850 calories a day, followed by two to eight weeks of reintroducing food, along with nutritional education and cognitive behavioral therapy to help people stick with the new eating plan.

Taylor and his team tracked outcomes including weight loss, diabetes remission and level of fat in the pancreas and liver. After a year, most of the people in the diet group lost about 22 pounds, compared to two pounds in the control group. Nearly a quarter of the people who managed their weight were able to lose 33 pounds or more, while none in the control group were able to lose that much. Most importantly, 46% of the people in the diet group went into remission with their diabetes, compared to just 4% in the control group.
This is the follow-up to the pilot study by Newcastle University researchers. I don't think the results are a surprise to most people here. The researchers used a liquid diet, but I bet that any diet that stuck to the 850 calorie limit and caused comparable weight loss would have the same effect.
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Re: Newcastle Study Reverses Diabetes

Post by Heuristicfireflower on Thu Dec 07, 2017 2:47 am

Interesting!   I'm curious as to the macros of the low calorie diet they were put on.

Excerpts from "Type 2 diabetes is a reversible condition" - Press Office of the Newcastle University:

-   Excess calories leads to excess fat in the liver
   As a result, the liver responds poorly to insulin and produces too much glucose
-   Excess fat in the liver is passed on to the pancreas, causing the insulin producing cells to fail
-   Losing less than 1 gram of fat from the pancreas through diet can re-start the normal production of insulin, reversing Type 2 diabetes
-   This reversal of diabetes remains possible for at least 10 years after the onset of the condition

The study showed a profound fall in liver fat content resulting in normalisation of hepatic insulin sensitivity within 7 days of starting a very low calorie diet in people with type 2 diabetes. Fasting plasma glucose became normal in 7 days. Over 8 weeks, the raised pancreas fat content fell and normal first phase insulin secretion became re-established, with normal plasma glucose control.
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Re: Newcastle Study Reverses Diabetes

Post by Lovebird on Thu Dec 07, 2017 4:12 pm

Heuristicfireflower wrote:Interesting!   I'm curious as to the macros of the low calorie diet they were put on.

"Weight loss was induced with a total diet replacement phase using a low energy formula diet (825–853 kcal/day; 59% carbohydrate, 13% fat, 26% protein, 2% fibre) for 3 months (extendable up to 5 months if wished by participant), followed by structured food reintroduction of 2–8 weeks (about 50% carbohydrate,
35% total fat, and 15% protein), and an ongoing structured programme with monthly visits for long-term weight loss maintenance. All oral antidiabetic and antihypertensive drugs were discontinued on day 1 of the weight management programme, with standard protocols for drug reintroduction under national clinical guidelines, if indicated by regular monitoring of blood glucose and blood pressure."
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Re: Newcastle Study Reverses Diabetes

Post by Heuristicfireflower on Fri Dec 08, 2017 2:41 am

Thanks LB. Even more interesting in that the 850ish kcals a day was significant to normalize insulin and glucose production despite the higher carb intake.

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Re: Newcastle Study Reverses Diabetes

Post by ONTARIO on Fri Dec 08, 2017 8:19 am

I would like to see this study replicated with a higher fat and protein percentage and a slightly higher calorie allotment. I would be curious as to the findings.

I say this because although this study is quite fascinating the participants are not going to be able to maintain a 900ish daily calorie intake.

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Re: Newcastle Study Reverses Diabetes

Post by Lovebird on Fri Dec 08, 2017 9:11 am

AFAIK they only have to follow the very low calorie intake during the first part of the study, like in the 2 month study dr. Roy Taylor did before... ofcourse doing it longterm would be disastrous and/or difficult. FMD is also low fat/protein based BTW.
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Re: Newcastle Study Reverses Diabetes

Post by srinath_69 on Fri Dec 08, 2017 10:23 am

You see - After a year, most of the people in the diet group lost about 22 pounds -
That is rather low, I lost 19 with a sort of low carb diet. As in I cut out rice and bread and other stuff I didn't like anyway.
That same 20lb is what I regained when I went back to eating OMAD. But I gained it from ~145 or so. So unless these people lose another 50-80-100 lb, that 22 lb will come back.


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Re: Newcastle Study Reverses Diabetes

Post by Lovebird on Fri Dec 08, 2017 10:33 am

It's not simply about losing weight... it's about losing ectopic fat from liver/pancreas.

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Re: Newcastle Study Reverses Diabetes

Post by sharperhawk on Fri Dec 08, 2017 4:00 pm

Graph C shows the dose-response relationship between amount of weight lost and likelihood of diabetes remission. In Roy Taylor's personal fat threshold theory, one has to cross back over one's own threshold. We don't know exactly where the threshold is for each individual, but the more weight lost, the more likely that the patient is back on the disease-free side.

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visceral fat

Post by srinath_69 on Fri Dec 08, 2017 4:16 pm

sharperhawk wrote:Graph C shows the dose-response relationship between amount of weight lost and likelihood of diabetes remission. In Roy Taylor's personal fat threshold theory, one has to cross back over one's own threshold. We don't know exactly where the threshold is for each individual, but the more weight lost, the more likely that the patient is back on the disease-free side.


This is what I'd refer to as "visceral fat".
My 145lb reading was 1 on my DSM-BIA. @ 165, I am reading 9. Its almost as if, the last slice of fat to go is visceral fat, and its the first to come back.
When I was posting on trying to get visceral fat to 1 or even 0 if possible on my DSM-BIA scale, lots of people piled on me in one of the other fora because they thought I was talking about BF and well long story short, I got moderated.
Of course now there are several people doing 30 and 50 day fasts on that site. of course they're starting @ 150lb+ over weight. I do a multi week now I'll be summarily dead.

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Re: Newcastle Study Reverses Diabetes

Post by Paysan on Tue Dec 12, 2017 3:48 pm

Visceral fat needs to be the last to go. Last thing I want is to have my kidneys hanging in nothing! OTOH, we are talking here about excess visceral fat hampering the normal functioning of the pancreas. I'm not sure that "normal insulin secretion" was reestablished just because fat was being removed. Or else I would be a very unhappy type2 diabetic at this moment, being by far the heaviest of all my surviving siblings, who are developing diabetes as they age. I am not in an active fat loss phase at present, but am maintaining the entirety of my initial weight loss almost 2 decades ago, with minor spikes up according to my wonky heart and the weather. I lack the stamina for a prolonged fast, but can handle intermittent fasting 2 or 3 times a week once or twice per month.

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Re: Newcastle Study Reverses Diabetes

Post by srinath_69 on Wed Dec 13, 2017 8:51 am

I've not been able to find any real reference to the real world in that DSM-BIA, however it does get affected by intestines being full vs empty. If I drink a lot of water it seems to say my skeletal muscle is higher. So if I am 35% and 160 lb, I can drink a qt of water and get it to 36% and 162 (larger % of a larger number) making a 1.6 lb gain in muscle (something that may take a year of working out)

However Visceral fat in our context refers to fat behind the abdominal wall. None of that AFAIK is good.
The good fat is what is called brown fat. That shields nerves as they go around corners like elbows, and some of it in the neck area doing the same type of work.
That may be a grand total maximum of 5%. Nearly all the rest of the body fat we have is likely not good.
Women have some more fat that they are going to need. Maybe 12% I have heard. I have not researched it in too much detail cos I'm a dude.
I don't believe body organs are encased in fat, but I'll look it up. They are held in place by other connective type tissue. VF is all the fat in them plus all the fat around them.


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Re: Newcastle Study Reverses Diabetes

Post by Paysan on Wed Dec 13, 2017 2:31 pm

OK, Srinath, I'll give you that one. All the reports I looked up say that visceral fat is dangerous, even on thin people. (Whatever they are.) That's why waist size is more important than BMI for diagnosing future problems. In that case, I could have been a poster child as a child for having a large waist in proportion to all else. Mad Mad

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Re: Newcastle Study Reverses Diabetes

Post by srinath_69 on Wed Dec 13, 2017 2:53 pm

My friend who's got no visible or pinchable fat anywhere, and damn healthy for a 60 yr old has a relatively big and hard belly. All his fat is visceral fat. The guy has excellent health is a herbologist (and not the kind that does "herb") but somehow all visceral fat. I am pretty nice and flat stomach and have a few pinches of fat in the "spare tire" sense, but its more of a bicycle tire and not a car tire but I am lower VF.
Its not just food I will tell you. He doesn't eat sugar, eats very very well, fasts a lot, eats good meat and fish, no dairy and isn't addicted to artificial sweeteners or a steady drinker either.
I do all of those bad things and more. we weigh the same. Some other factor is at work outside of just diet and I'd have pinned it on cortisol for him - but he also says he's not stressed at all, he is retired and comfortably so.
Anyway VF is ideally kept in the 0-1-2 range as per my DSM-BIA. I will have to make another run @ that target.
For reference I am a 34-35 waist, he's a 38+.

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Re: Newcastle Study Reverses Diabetes

Post by Paysan on Wed Dec 13, 2017 11:43 pm

That was kind of my point - that more is going on than is obvious to us at this point. My large waist was passed on to  my daughters as toddlers and young children. A friend could identify them as mine  just from their shape. They were all breastfed as babies, and I kept their sugars to a minimum while so young. They had fresh goatmilk, eggs, and ate a lot of fresh veggies. But their diets worsened as soon as they started school. Evil or Very Mad
Anyway, I'll work on my visceral fat till I die - that should take me some time.Wink

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Re: Newcastle Study Reverses Diabetes

Post by sharperhawk on Tue Jan 02, 2018 12:48 pm

Tim Noakes has been throwing some shade on the Newcastle study.





So is it really all about the carbs? Or is Noakes blinded by dogma?
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Re: Newcastle Study Reverses Diabetes

Post by Paysan on Tue Jan 02, 2018 1:15 pm

Dunno, but it wasn't till I cut carbs drastically and upped my protein (should've been fat, but what did I know almost 20 years ago?), that I lost 80 lbs without starvation and feeling totally deprived. I'd tried all the usual dieting advice in years previous, but only total fasting came anywhere near efficacy. Its weight loss effects disappeared as soon as I returned to a "normal" diet which was still lots better than the average. What's more, that weight loss remains lost, as I have never gone back to unrestrained carb intake. I have fluctuations, but within tolerable limits.

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Re: Newcastle Study Reverses Diabetes

Post by sharperhawk on Tue Jan 02, 2018 2:07 pm

The issue is not whether you can lose weight with low carb. Many people have done so.

The Newcastle authors say that body fat over a personal threshold is deposited in the liver and the pancreas and thus leads to metabolic dysfunction and diabetes. The way to reverse it is to lose the fat. The particular method of fat loss is not important. The one they used happened to be good for compliance and consistency.

Noakes is saying that carbohydrates cause diabetes. He says that the one and only way to reverse it without surgery is to minimize carbs. He does not mention weight loss. I don't know whether he would claim that an obese type-2 diabetic who doesn't lose weight (or even gains weight) but is eating low carb would reverse diabetes.
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Re: Newcastle Study Reverses Diabetes

Post by Paysan on Tue Jan 02, 2018 2:32 pm

Nor do I, Sharperhawk. OTOH, I don't know of any lowcarbers who have ditched diet frankenfoods and adhere to a more paleo mindset who have either gained weight, or failed to lose any. As there are several close relatives who have undergone bariatric surgery, I have had occasion to watch what happens to obese individuals who have lost a lot of weight. Whether they were diabetic or not, I don't know, but it's likely, since diabetes 2 runs all through our families. One gained back some lost weight as soon as she resumed eating. One has kept the weight down, but she isn't as healthy as before. The 3rd is as fat as ever she was, having regained it all following her original LCHC dieting plan. I have seen several others who regained ALL their lost weight within a year or two. At one time, I briefly contemplated bariatric surgery; no longer. My farm animals taught me over and over that what we eat has the greatest effect on losing weight. It's a lesson we need to heed, over and over.

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Re: Newcastle Study Reverses Diabetes

Post by srinath_69 on Wed Jan 03, 2018 8:43 am

I think the whole medical community has their heads buried in the sand when it comes to reversing diabetes, and most importantly losing weight.
You dont lose weight and get healthy, you get healthy then lose weight.
Weight loss is controlled by 3 huge factors that can crush all the little good things you are doing. The biggie - and its not even a biggie, its 80% of the game - is insulin.
Guess in any routine physical/blood work what isn't included. Insulin.

That IMHO is purposefully driving blind. You get in your car, dont take the sun shade off and start driving. you may get somewhere without crashing, say 1% of the time, and that person becomes everyone's favorite reference point.
Anyway LC whatever whatever - do they have a starting insulin reading ? an in progress reading ? end point reading ? maintenance reading ? - I'll guess no - cos I dont have those, I just have 2 in progress readings.

Maybe they had inuslin of 100, and it dropped to 50 over the time they tried LC - it wont work till it gets to 10 or less, so they give up.

Worse yet, there is no tests and no reference numbers for cortisol and estrogen, but for someone who's over 30lb overweight, those 2 are minor compared to insulin.

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Re: Newcastle Study Reverses Diabetes

Post by sharperhawk on Wed Jan 03, 2018 10:28 am

srinath_69 wrote:You dont lose weight and get healthy, you get healthy then lose weight.
Newcastle shows a counterexample of weight loss that causes a reversal of diabetes. Give us a peer-reviewed paper that shows an example of your idea.
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Re: Newcastle Study Reverses Diabetes

Post by srinath_69 on Wed Jan 03, 2018 11:39 am

sharperhawk wrote:
srinath_69 wrote:You dont lose weight and get healthy, you get healthy then lose weight.
Newcastle shows a counterexample of weight loss that causes a reversal of diabetes. Give us a peer-reviewed paper that shows an example of your idea.

Superficially it looks like the "weight loss" cured the diabetes.
In reality, lowering insulin which occours first cures diabetes following which weight loss occours if they kept the insulin lowered.

For example - well I have no initial number for this cos that's the beauty of the medical establishment - I was pre-diabetic @ 240 lb jun 1 2016. My next medical exam was oct 26th 2016 when I was 188 lb I was not prediabetic any more. because now my A1c was under 5.6 or something. On that day I also had an insulin of 5.1 after a 5 day fast.
Since I dont have a full on graph of lnsulin vs weight vs A1c all that way, I can only guess - insulin dropping makes you more insulin sensitive and that reverses diabetes, and weight loss follows.

And in reverse, Insulin, cortisol, estrogen (one or more) being high is being unhealthy. You stay that way for a long period of time and that gets you fat.

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Re: Newcastle Study Reverses Diabetes

Post by sharperhawk on Wed Jan 03, 2018 11:54 am

srinath, the Newcastle study didn't have to manage insulin. All it had to do was manage calories. People randomly assigned to the intervention went into remission in direct proportion to the weight lost. So what is the value added of talking about insulin? What evidence do you have that insulin is the driver? I requested a peer-reviewed paper. I know that Fung doesn't have one in this field (though he has published several in nephrology).

High insulin is a symptom, not a cause. The cause is too much energy. Lower the energy (i.e., calories and body fat), and then the insulin can do what it is supposed to do at normal levels, instead of having to be elevated to clear the blood of glucose.
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Re: Newcastle Study Reverses Diabetes

Post by srinath_69 on Wed Jan 03, 2018 12:14 pm

Well unless you want to prove that 800 cal a day produced no reduction in insulin AUC, its an inconclusive and if I may add - poorly designed study intended to confuse people. Right up there with the twinkie diet being an example of "calorie restriction". Sure it is, its 25% cut in calories with likely a 50% lowering of insulin AUC.

Dr Fung has a massive 2200+ patient database and growing for low carb, Intermittent and longer term fasting.
Is it peer reviewed ? I dont know, there isn't too many things to sell to get someone fasting so the prescription writers are likely to not review it.

High insulin does not happen with too much energy. I lose 2lb a day when eating 2500 cal.

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Re: Newcastle Study Reverses Diabetes

Post by Paysan on Wed Jan 03, 2018 12:20 pm

FWIW, I believe that the Study started with otherwise healthy people, and took them off meds the same day they started their extreme liquid diets. With such low caloric intake, strictly monitored, there was no chance for insulin levels to exceed normal parameters, and in the long run, they lost their insulin sensitivity and that was the real factor in reversing diabetes 2. According to Dr Fung and others, diabetes 2 is not a lack of insulin, it's a preponderance of insulin-saturated cells refusing any more. As a result, the excess insulin floats around the blood stream until it finds a resting place among organs, causing lots of havoc as fat deposits. See chapter "What Happens When We Eat? in "The Complete Guide to Fasting" by Jason Fung and Jimmy Moore and Chapter 6: Fasting for Type 2 Diabetes. Fung distinguishes between type 1 diabetes as an autoimmune disease, and type2, which is a lifestyle disease.
So I believe Srinath is partially correct in focusing on controlling insulin to control diabetes, and all those who successfully lost weight and ended up controlling type 2 because their insulin sensitivity had been restored. All part of the same paradigm.

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