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

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

#131

Post by tacon » Fri, Nov 30, 2018, 7:04 PM UTC

SketchySeaBeast wrote: post #25

striking wrote: post #18

Earlier quoted context omitted.

Garry's blog post about this was particularly insightful.[0] He shares a graph of his progress and how it goes both forwards and backwards, as well as the things he's learned along the way. 0: https://garry.tv/2018/10/17/fatty/

> When you’re weighing yourself every day you need to understand that you’re creating a weekly/monthly average. What you ate yesterday isn’t going to show up on the scales the next day. If you ran around the park yesterday, don’t expect to have lost weight today. I only weighed myself once a week for this reason. Every day can be demoralizing if you have a bloat day, but once a week gives enough to have a pretty regu…

I think daily weighing is important because it is hundreds of daily decisions to not eat that need to be made. Our current society makes food available at all times, and daily weighing is one part in actually thinking about our body and being mindful for at least twenty or thirty seconds each day. With the ridiculous calorie density of modern processed foods, a few minutes of mindless eating can add an enormous calorie load, without even beginning to feel full.

We hackers can geek out on the math in the Hacker's Diet[0], which goes into various smoothing algorithms and plotting styles to show the daily weight and smoothed trends.

[0] https://www.fourmilab.ch/hackdiet/

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

#132

Post by bluGill » Fri, Nov 30, 2018, 7:18 PM UTC

jlawson wrote: post #106

i_cant_speel wrote: post #48

Earlier quoted context omitted.

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

Traditional diets include lots of carbs. Bodybuilders realized early that protein is good for muscle growth. So they started eating tons of protein, and reducing other macronutrients. They realized after a while that carbs can actually be cut out totally and indefinitely (which is not true of protein and fat). They discovered this because nobody else had a reason to try to eat such a strange, protein-focused diet. At…

Inuit and other far north people will eat vegetables by preference when they can get them. Sure you can survive on none, I will contend that to thrive you need a balance.

Note than balance does not mean soda is the bulk of your calories (that should be a straw man, but I see many people who drink that much soda).

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

#133

Post by i_cant_speel » Fri, Nov 30, 2018, 7:22 PM UTC

emersonrsantos wrote: post #100

i_cant_speel wrote: post #48

Earlier quoted context omitted.

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...

Leading up to a competition and getting into single digit BF%, yes. But throughout most of the year they are generally consuming a good amount of carbs. I don't think using bodybuilders as an example translates well to good habits for the general population.

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

#134

Post by onetimemanytime » Fri, Nov 30, 2018, 7:23 PM UTC

acangiano wrote: post #51

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.

Problem is keeping it, as almost everyone can keep the diet for a few months. We all know what we should do but don't, sometimes until is too late.

The person that invents a pill to trick our genes not to seek what was once rare (fat, sweets, carbs etc) will be a trillionaire. When our current genes were stamped "we" maybe had to hunt for days to eat once. Now we drive to McDonalds, order our or open the fridge door. Maybe something that puts our metabolism on steroids?

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

#135

Post by tacon » Fri, Nov 30, 2018, 7:24 PM UTC

Type 2 diabetes is currently on track to bankrupt the world's healthcare system. Easily 60% of the US residents reading this comment are already insulin resistant, they just don't know it yet. Many of those will progress to full blown T2DM in ten to fifteen years. It used to take a very expensive sequence of blood tests involving injecting glucose and tracking the concentrations of glucose and insulin over a few hours. Lately the tech has improved and there is a single blood test that can give an "insulin-resistance score", LP-IR[0][1]. While Peter Attia showed this test in a blog post from 2012[2], it seems to be getting more attention lately[3]. Just because your blood glucose after fasting is "normal" does not mean you will not get T2DM. Just ask Tim Noakes, world class exercise scientist and medical doctor, who finished more than 70 marathons and still woke up one day with diabetes, just like his father.[4][5]

[0] https://www.labcorp.com/test-menu/31976/nmr-lipoprofile%C2%A...

[1] https://www.walkinlab.com/media/attachment/file/1/2/123810.p...

[2] https://peterattiamd.com/the-straight-dope-on-cholesterol-pa...

[3] https://www.managedcaremag.com/archives/2018/4/new-test-diag...

[4] https://www.diabetes.co.uk/in-depth/tim-noakes-challenging-d...

[5] https://www.amazon.com/Lore-Nutrition-Challenging-convention...

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

#136

Post by leroy_masochist » Fri, Nov 30, 2018, 7:26 PM UTC

prrls wrote: post #122

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...…

A lot of people here are suggesting, like you, that a low-carbs diet or ketos can help your body "heal" from T2D. I just don't see why starving yourself from carbs, which is like the basis of life for your cells, is going to help. From what I gleaned here and there, T2D is more linked to fat-heavy diet, which clutters blood vessels and keeps yours cells from absorbing the insulin your body produces, thus preventing t…

Those videos were painful to watch (what's up with his intonation, it sounds like he's introducing prizefighters) and the guy looks anorexic and anemic; not someone from whom I'd take nutritional advice.

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

#137

Post by matt4077 » Fri, Nov 30, 2018, 7:26 PM UTC

joecool1029 wrote: post #125

traek wrote: post #94

Earlier quoted context omitted.

Source? From my read it looks like you absolutely can. https://www.nejm.org/doi/full/10.1056/nejmc052709

That's a case study of a single patient. Main takeaway: >Benign dietary ketosis resulting from restricting carbohydrates could, theoretically, cause ketoacidosis in persons with a predisposition to the condition.

That sounds very much like what they were saying. “Theoretically” is closer to “can” than it is to “cannot”.

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

#138

Post by mevile » Fri, Nov 30, 2018, 7:31 PM UTC

garenp wrote: post #92

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…

That's great! That's actually very inspiring. Good work! I do think that exercise is really important and that's something everyone should do.

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

#139

Post by GordonS » Fri, Nov 30, 2018, 7:32 PM UTC

have_faith wrote: post #74

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.

It's only non-essential because your body has backup mechanisms for when carbs aren't available, ketosis for instance. That doesn't mean it's an ideal state to be in constantly.

That's an odd way to look at it - given we need fat and protein, I'd rather think that carbs were the 'backup' mechanism.

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

#140

Post by overgard » Fri, Nov 30, 2018, 7:32 PM UTC

have_faith wrote: post #74

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.

It's only non-essential because your body has backup mechanisms for when carbs aren't available, ketosis for instance. That doesn't mean it's an ideal state to be in constantly.

I'm dubious of the claim that ketosis is a "backup" system. If you think about primitive man, they probably wouldn't have had three regular meals a day. Lots of feast and famine.

I think people need to let go of the idea that ketosis is some sort of "special" state. It's just a metabolic state that's been suppressed by modern eating habits. Three meals a day and snacking is a cultural invention; not a biological necessity.

A lot of athletes prefer to exercise in a ketogenic state. I know personally I'm able to run farther if I've spent the day fasting than if I had a big meal at lunch. (I don't have the same initial burst, but I don't hit a wall either) (Not to mention that digestion is a very expensive process)

I think what's more unnatural is that modern eating habits are designed around blocking any sort of ketogenic state, which is where the easiest weight loss comes from. (Also, I need to lookup a reference for this, but I think I remember reading that fat burns a bit "cleaner" than sugars. Less free radicals I think? Something like that)

[For people unclear what I'm talking about with ketosis: basically, your body burns glucose first for energy. Then when there isn't sufficient glucose, it starts burning fat. The burning of fat for energy is what's known as ketosis. (I know I'm probably vastly oversimplifying). The thing about fat burning is it only kicks in at a significant level when glucose is depleted though. So if you're exercising while eating a chocolate bar and drinking a gatorade... well the exercise is good! But you won't lose weight)