Type 2 diabetes: NHS to offer 800-calorie diet treatment • Hacker News Board

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

#91

Post by village-idiot » Fri, Nov 30, 2018, 6:22 PM UTC

will_brown wrote: post #85

hirundo wrote: post #37

Earlier quoted context omitted.

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…

Americans have by and large followed the recommendations of the government: meat and saturated fat consumption is down, and we eat way more “heart healthy” whole grains and polyunsaturated seed (excuse me, “vegetable”) oils.

Lots of people followed the advice, because lots of people wanted to be healthy. The advice was just garbage.

I was under the impression that parents could not decline life saving treatments for minors, and that the state had the right to step in.

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

#92

Post by garenp » Fri, Nov 30, 2018, 6:23 PM UTC

About 3 years ago (late 2015 now) I was quite overweight, had a knee injury that limited my mobility (stairs mostly) and had a fasting glucose and post-meal readings that indicated I was nearly pre-diabetic (T2).

So, I cut out out all sugary drinks, refined carbs, late night eating (!!) and tried various intermittent fasting / time restricted feeding techniques (5:2, alternate day, one-meal-a-day) and after about 3.5 months my glucose readings returned to the "normal" range. (Which is WAY more tolerable than sticking to a low-calorie diet every single day IME. I still had pizza and cheeseburgers on occasion, just no soda, fries, "junk" etc.)

After around 6-7 months I'd lost 40+lbs, my knee stopped bothering me and no longer had to entertain the idea of fixing it with surgery. I'm now down well over 60+lbs without having put in hardly any effort to exercise (occasional walking) - pretty stunning to me.

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

#93

Post by alrehn » Fri, Nov 30, 2018, 6:23 PM UTC

diminoten wrote: post #32

chosenbreed wrote: post #17

Earlier quoted context omitted.

Superb. Clearly in your case you summoned the necessary will to lose all that weight. But I think another important factor is that you established a new lifestyle/better eating habits.

"Summoned" implies it's only possible for people who know the arcane secrets, I'm not personally a fan of removing people's agency when talking about something like this.

Removing agency is exactly what you should do when you're talking about a widespread problem. If I have a personal friend I'm absolutely going to tell them they can make the right choices and overcome their problems, but you can't do that with a society. You have to look at incentives and environment and change those to change widespread behavior.

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

#94

Post by traek » Fri, Nov 30, 2018, 6:25 PM UTC

someone454 wrote: post #88

village-idiot wrote: post #83

Earlier quoted context omitted.

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.

Source? From my read it looks like you absolutely can.

https://www.nejm.org/doi/full/10.1056/nejmc052709

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

#95

Post by village-idiot » Fri, Nov 30, 2018, 6:25 PM UTC

someone454 wrote: post #88

village-idiot wrote: post #83

Earlier quoted context omitted.

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.

I made it very clear that it’s high ketones while diabetic that causes it. If you’d like to correct that in a more constructive way, that would be helpful.

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

#96

Post by GordonS » Fri, Nov 30, 2018, 6:25 PM UTC

virtuallynathan wrote: post #56

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...…

It's going to be extremely difficult to confirm to 800 calories consisting almost entirely of carbs - very few people are going to succeed with this.

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

#97

Post by cowpewter » Fri, Nov 30, 2018, 6:26 PM UTC

village-idiot wrote: post #83

virtuallynathan wrote: post #56

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…

Type 1 diabetics may be at risk for ketoacidosis if they screw up their insulin, but T2 diabetics are not at any risk from just a low-carb diet. The problem is having high blood sugar and high ketones simultaneously, not just having high ketones. And the nice thing about a low-carb diet is that you're not eating carbs, so your blood sugar does not become elevated. If your pancreas can still create insulin at all, you are highly unlikely to go into ketoacidosis.

Keto is a really good diet for both weight loss and correcting insulin resistance for a T2 diabetic.

(Source, I am a T2 diabetic that eats a ketogenic diet. I am losing weight and my A1c is dropping. My doctor is pleased with my diet choices.)

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

#98

Post by chimeracoder » Fri, Nov 30, 2018, 6:26 PM UTC

magnamerc wrote: post #79

chimeracoder wrote: post #20

Earlier quoted context omitted.

> Makes sense, it is a diet related illness, so it should have a diet related treatment. Instead of treating the symptoms, treat the cause. Type 2 diabetes isn't caused by diet. Certain diets can increase the risk of Type 2 diabetes, but it's not a foregone conclusion, and it's not uncommon to develop Type 2 diabetes despite an otherwise healthy diet.

T2D is caused by a combination of genetic and environmental factors such as diet, and you're correct that someone can get T2D based mostly on genetic factors alone. It is however very uncommon, and diet plays a role in the majority of cases. There are several studies that show this.

> It is however very uncommon

It is not very uncommon, and in fact the most recent (last ~decade of) research has actually caused us to question the extent to which people genetically predisposed to diabetes can mitigate their risk through diet and lifestyle choices.

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

#99

Post by ng12 » Fri, Nov 30, 2018, 6:26 PM UTC

village-idiot wrote: post #83

virtuallynathan wrote: post #56

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…

> ketone levels up into the range that would kill a diabetic quickly

That's not how it works. DKA happens because your body is burning fat because it's starving from a lack of insulin. Ketones from healthy weight loss are not dangerous.

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

#100

Post by emersonrsantos » Fri, Nov 30, 2018, 6:26 PM UTC

i_cant_speel wrote: post #48

emersonrsantos wrote: post #35

When people will realize that carbs are the only non-essential macronutrient? The sports community (especially bodybuilding) knows that for decades. If an athlete says to me that a thing he does to his body work 95% of the time, I would consider to try it, and already did, some things against over-the-counter conventional medicine like this no-carb diet.

Where is the connection you're making between carbs being unnecessary and bodybuilders coming from?

Bodybuilders use carbs restrictions (keto, intermittent, kind - complex vs simple carbs) to regulate muscle mass and fat, insulin and GH sensitivity, water retention mediated by glycogen, etc...