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Type 2 diabetes: NHS to offer 800-calorie diet treatment

bbc.com

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Re: Type 2 diabetes: NHS to offer 800-calorie diet treatment

#81
post #64

Earlier quoted context omitted.

Bodybuilders eat plenty of carbs.

No they don't. A bodybuilding diet is mostly protein, then certain fats, then starchy carbs at the right time (breakfast and post-workout).

> A bodybuilding diet is mostly protein

Bodybuilders typically consume about ~30% protein. Where did you get the idea that it is mostly protein? Not to say that there aren't outliers obviously.

Re: Type 2 diabetes: NHS to offer 800-calorie diet treatment

#82
post #71
post #7

I think that this is effective because it reduces the carbohydrate load. Protein and fat consumption also increase insulin response but not nearly as much. Type 2 diabetics could get most of the blood sugar reducing benefit of this by just removing/replacing the carbs. That has been my N=1 experience with both fasting and carb restriction.

Did you see the diet? Another commenter posted it [1], and it has 132g carbohydrates. Doesn't seem like a small load (though it may be an improvement over what they're currently doing!). At 4 cal/carb [2], that's over half the diet's calories. [1] https://news.ycombinator.com/item?id=18571000 [2] https://www.nal.usda.gov/fnic/how-many-calories-are-one-gram...

AFAIK the standard American diet has about 250g of carbs. 132 grams of carbs is about the standard recommendation for T2 diabetes.

That said these recommendations are bullshit. If you have diabetes, you have an insulin problem and it's best to minimize it, so you need to eat the minimum amount of carbs you can get away with, prioritizing the complex carbs with fibers (e.g. spinach and other greens).

Btw, a low calories diet can work even if higher in carbs, because:

1. by losing weight insulin sensitivity goes up afaik

2. at 800 grams per day, that's not much to eat, so those people are probably fasting for much of that day

That's just a guess, but how you distribute your meals also matters just as much as what you eat.

Re: Type 2 diabetes: NHS to offer 800-calorie diet treatment

#83

The 800 calories they are eating doesn't seem terribly healthy: "patients were asked to follow either a ‘home-made’ milk- and fruit-juice-based diet (811 kcal/day, 64 g protein, 132 g carbohydrate, 6 g fat) with a multivitamin/mineral supplement (Forceval® [Alliance]), or a micronutrient-replete commercial LELD (832 kcal/day, 87 g protein, 120 g carbohydrate, 12 g fat). I imagine these people are probably staving...…

Generally agreed, but with a caveat: diabetics are at risk of ketoacidosis on low carb diets. They would need to measure their blood ketones and moderate carbohydrate intake to keep their levels down below dangerous thresholds.

Personally when I went low carb, I got blood (not urine) ketone levels up into the range that would kill a diabetic quickly, think in the 7.0 range. Even as someone well adapted I regularly hit the 3.0s when fasting.

Obligatory: I am not a doctor.

Re: Type 2 diabetes: NHS to offer 800-calorie diet treatment

#84
post #71
post #7

I think that this is effective because it reduces the carbohydrate load. Protein and fat consumption also increase insulin response but not nearly as much. Type 2 diabetics could get most of the blood sugar reducing benefit of this by just removing/replacing the carbs. That has been my N=1 experience with both fasting and carb restriction.

Did you see the diet? Another commenter posted it [1], and it has 132g carbohydrates. Doesn't seem like a small load (though it may be an improvement over what they're currently doing!). At 4 cal/carb [2], that's over half the diet's calories. [1] https://news.ycombinator.com/item?id=18571000 [2] https://www.nal.usda.gov/fnic/how-many-calories-are-one-gram...

How much of those carbs are fiber? I'm trying to find the direct quote and see if more information is there.

Although, given the description of it includes "fruit juice", I am guessing it is a lot of sugar, which seems weird but I can't admit to know enough to say this is bad.

I'd be interested in the efficacy of this sort of diet when applied to a large mass of people as opposed to a very low carb diet. The NHS can "prescribe" these diets, but people may not follow them. It's possible that having a moderate amount of carbs (as sugar) in the diet will actually decrease the chances of a person going in the complete opposite direction and binging on sugar after they get sick and tired of a very low carb diet. I'm curious if they study that effect and "risk" of diets.

Re: Type 2 diabetes: NHS to offer 800-calorie diet treatment

#85
post #37

Earlier quoted context omitted.

Well reversing is different but most cases can be reveresed with dietary/lifestyle changes. On the other hand prevention of type2 is N=100% with these changes. I know people, especially in the US consider it thier right/freedom to eat what they want and live how they want, but in my mind it’s deeply disturbing especially because children don’t have any choice (it’s parental). I think as soon as a child is diagnosed w…

In the US the official nutrition advice has been both wrong and corrupt since the 1970s. Gotten wrong by sincere hard working scientists with the best intentions. Corrupted by corporate capture of regulatory bodies and funding of exculpatory studies. These same forces would choose what is mandated. That is horrifying. Not only could they give bad advice, they could compel ever larger fractions of the population to fo…

>Far better to let parents decide, so when they get it wrong we can learn from it, and don't all get it wrong at once.

The problem is the disease is growing in epidemic proportions, no one is learning from mistakes.

The government got it wrong sure, but let the doctors prescribe the diet and government won’t dictate the diet only mandate following doctor prescribed treatment/diet (and this too I know has flaws).

But here is the thing, say a child does get diabeties and the doctor prescribed insulin, but the parents think they know better and refuse the treat their child. Should government be able to step in or allow the parent to withhold insulin treatment based on their freedom? Legally parents can refuse (life saving) treatment on religious grounds, and that arguement comes into play in diet, but I’ve also been involved in a case where a 13 year old was pregnant with HIV and was refusing court ordered treatments so the baby would be born without HIV, legally and morally they are complex issues.

Re: Type 2 diabetes: NHS to offer 800-calorie diet treatment

#86
post #42
post #36

How will they make sure people don't cheat and eat more anyways? 800 calories a day for an overweight person requires some serious will power.

I found it easier to do via intermittent fasting and then eating all of my calories in one meal per day. Something about completely abstaining from food is easier for me psychologically than having multiple tiny meals and making myself stop eating when I'm not full.

I was assuming these 800kcal were done through OMAD, are they not? I don't see how you could spread that over the day and keep your sanity.

Re: Type 2 diabetes: NHS to offer 800-calorie diet treatment

#87
post #71

Earlier quoted context omitted.

Did you see the diet? Another commenter posted it [1], and it has 132g carbohydrates. Doesn't seem like a small load (though it may be an improvement over what they're currently doing!). At 4 cal/carb [2], that's over half the diet's calories. [1] https://news.ycombinator.com/item?id=18571000 [2] https://www.nal.usda.gov/fnic/how-many-calories-are-one-gram...

How much of those carbs are fiber? I'm trying to find the direct quote and see if more information is there. Although, given the description of it includes "fruit juice", I am guessing it is a lot of sugar, which seems weird but I can't admit to know enough to say this is bad. I'd be interested in the efficacy of this sort of diet when applied to a large mass of people as opposed to a very low carb diet. The NHS can…

Not a lot. The recommendation is mostly liquid calories (think milk and juice), so this is mostly going to be high glycemic fructose, not a lot of fiber.

Re: Type 2 diabetes: NHS to offer 800-calorie diet treatment

#88

The 800 calories they are eating doesn't seem terribly healthy: "patients were asked to follow either a ‘home-made’ milk- and fruit-juice-based diet (811 kcal/day, 64 g protein, 132 g carbohydrate, 6 g fat) with a multivitamin/mineral supplement (Forceval® [Alliance]), or a micronutrient-replete commercial LELD (832 kcal/day, 87 g protein, 120 g carbohydrate, 12 g fat). I imagine these people are probably staving...…

Generally agreed, but with a caveat: diabetics are at risk of ketoacidosis on low carb diets. They would need to measure their blood ketones and moderate carbohydrate intake to keep their levels down below dangerous thresholds. Personally when I went low carb, I got blood (not urine) ketone levels up into the range that would kill a diabetic quickly, think in the 7.0 range. Even as someone well adapted I regularly hi…

You dont get keto acidosis by eating low carb, that is misinformation.

Re: Type 2 diabetes: NHS to offer 800-calorie diet treatment

#89

Earlier quoted context omitted.

How much of those carbs are fiber? I'm trying to find the direct quote and see if more information is there. Although, given the description of it includes "fruit juice", I am guessing it is a lot of sugar, which seems weird but I can't admit to know enough to say this is bad. I'd be interested in the efficacy of this sort of diet when applied to a large mass of people as opposed to a very low carb diet. The NHS can…

Not a lot. The recommendation is mostly liquid calories (think milk and juice), so this is mostly going to be high glycemic fructose, not a lot of fiber.

Yeah, sounds like you're right. Edited my post with a long diatribe! The "juice" part doesn't instill confidence.

Re: Type 2 diabetes: NHS to offer 800-calorie diet treatment

#90
post #55

You absolutely don’t need such caloric restriction to revert diabetes. All it takes is a very low carb or keto diet. Even without exercise.

At that calorie level it's basically a fast mimicking diet, so part of the benefit would be autophagy and the respawning of stem cells. It's hard to tell how much that helps however.

That’s definitely a factor. That and the automatic reduction in carb intake with such a caloric restriction. I mean, if they fed them pure sugar, they’d still be getting “only” 200g of carbs per day which is still less than what a lot of people who developed diabetes used to eat. More realistically they are likely getting significantly less carbs per day with elements of fasting thrown in.
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