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South Asian people undergo type 2 diabetes remission with low calorie diets

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Re: South Asian people undergo type 2 diabetes remission with low calorie diets

#31
post #18

I read a transcript of an endocrinologist suggesting intermittent fasting (don’t eat after 6 and wait as long as you can before your first meal - start with 10am and keep pushing back as long as you can). Then eat only veggies for your first meal, then veggies and a deck of cards serving of meat for dinner. Honestly, it sounds very difficult, but the doctor seemed very confident that this works. I have started trying…

C-f fasting

You never disappoint, Hackernews.

Re: South Asian people undergo type 2 diabetes remission with low calorie diets

#32
post #6

There's a long history of studies showing Low-Calorie Diets as being effective for reversing T2D. The late Sarah Hallberg wrote a narrative review that I liked a lot a couple years back (see section 3.2 for the part on LCDs): https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6520897/ Hallberg SJ, Gershuni VM, Hazbun TL, Athinarayanan SJ. Reversing Type 2 Diabetes: A Narrative Review of the Evidence. Nutrients. 2019 Apr 1;…

> Furthermore, long-term achievement of diabetes remission, adherence to the diet, and weight loss maintenance after the diet remain a challenge. Studies have also suggested that physiological and metabolic adaptation of the body in response to caloric restriction may shift energy balance and hormonal regulation of weight toward weight regain after weight loss [67,68]. Thus, it is crucial that future studies are dire…

Most people don't announce to scientists that they've lost weight. Lot's of people do lose weight and stay that way, it's just that there are even more who don't.

Consider that the rate of obesity continues to increase in the US. This shows that people are simply eating more and doing less exercise. And of course those that are already obese are the least likley to consume healthy ammounts of food and exercise as needed.

In other words, yes, the issue with overeating is in fact overeating. The only way to solve this problem for the whole population (as in, not for a single individual) is to change society and how it views unhealthy food. Off the top of my head, fast food advertisments should be made illegal. The entire point of those ads to get people to eat fast food. This single step could reduce obesity in the US by a noticable amount and requires no loss of freedom to any individual. A sugar tax or the like is a more extreme solution. But this idea is not unfounded:

>Sugar, rum, and tobacco are commodities which are nowhere necessaries of life, which are become objects of almost universal consumption, and which are therefore extremely proper subjects of taxation.

-Adam Smith

Book V: On the Revenue of the Sovereign or Commonwealth Chapter III: On Public Debts

https://www.adamsmithworks.org/documents/chapter-iii-of-publ...

Re: South Asian people undergo type 2 diabetes remission with low calorie diets

#33
post #20

The amount of calories per day caught my attention, 850kcal/day with diet replacement products. I understand that with medical supervision, there is less risk of malnourishment or nutrients deficiencies. The general advice, even from my primary care physician, has been that anything less than 1200kcal/day is dangerous and is crash dieting. Looking around, I found this other study studying total diet replacement provi…

> The general advice, even from my primary care physician, has been that anything less than 1200kcal/day is dangerous and is crash dieting.

Wouldn't this advise need to keep in mind absolute height? BMI tracks the ratio between the height and weight, but it does nothing to tell the difference between a short thin person and a taller heavier (but same BMI) person. The latter which would need more calories than the former. I know people who eat ~400 kcal less than me per day, because they are shorter and similarly thinner. Following that why wouldn't their crash diet threshold be sufficiently lower?

Re: South Asian people undergo type 2 diabetes remission with low calorie diets

#34
post #20

The amount of calories per day caught my attention, 850kcal/day with diet replacement products. I understand that with medical supervision, there is less risk of malnourishment or nutrients deficiencies. The general advice, even from my primary care physician, has been that anything less than 1200kcal/day is dangerous and is crash dieting. Looking around, I found this other study studying total diet replacement provi…

> The general advice, even from my primary care physician, has been that anything less than 1200kcal/day is dangerous and is crash dieting. Wouldn't this advise need to keep in mind absolute height? BMI tracks the ratio between the height and weight, but it does nothing to tell the difference between a short thin person and a taller heavier (but same BMI) person. The latter which would need more calories than the for…

The argument I've heard is that the other nutriments needs (vitamins, minerals, etc) don't scale as much with height. So even a very short person would have a vitamins/mineral deficit on less than 1200KCal per day.

How true is it? I don't know. But even then I don't see why they couldn't take multivitamins.

Re: South Asian people undergo type 2 diabetes remission with low calorie diets

#35
post #18

I read a transcript of an endocrinologist suggesting intermittent fasting (don’t eat after 6 and wait as long as you can before your first meal - start with 10am and keep pushing back as long as you can). Then eat only veggies for your first meal, then veggies and a deck of cards serving of meat for dinner. Honestly, it sounds very difficult, but the doctor seemed very confident that this works. I have started trying…

The consensus from the most sensible people is, do the diet you can stick to, in the end just eat less. That’s most important.

yep, same deal with exercise. Doesn't matter how, I just wanted some type of movement that I could get into the habit of. Tried a bunch of different activities but was not able to form a habit until I got a rowing machine and even then I still have days where I don't want to use it :)

Re: South Asian people undergo type 2 diabetes remission with low calorie diets

#36

Earlier quoted context omitted.

> Furthermore, long-term achievement of diabetes remission, adherence to the diet, and weight loss maintenance after the diet remain a challenge. Studies have also suggested that physiological and metabolic adaptation of the body in response to caloric restriction may shift energy balance and hormonal regulation of weight toward weight regain after weight loss [67,68]. Thus, it is crucial that future studies are dire…

Most people don't announce to scientists that they've lost weight. Lot's of people do lose weight and stay that way, it's just that there are even more who don't. Consider that the rate of obesity continues to increase in the US. This shows that people are simply eating more and doing less exercise. And of course those that are already obese are the least likley to consume healthy ammounts of food and exercise as nee…

> Off the top of my head, fast food advertisments should be made illegal

This is ridiculous. Nearly everyone I know who is overweight eats hardly any fast food.

What I do see is lots of snacking throughout the day on high carb things (chips, breads, etc) and just way too many calories due to large serving sizes in both regular “slow food” restaurants and meals made at home.

Fast food meals if you skip the sugared soda tend to be closer to proper per meal calorie targets than sit down restaurants because of how cheap they are.

At sit down restaurants the price is higher to support a wait staff and lower throughput so they compensate with ridiculously huge portions.

Re: South Asian people undergo type 2 diabetes remission with low calorie diets

#37
post #18

I read a transcript of an endocrinologist suggesting intermittent fasting (don’t eat after 6 and wait as long as you can before your first meal - start with 10am and keep pushing back as long as you can). Then eat only veggies for your first meal, then veggies and a deck of cards serving of meat for dinner. Honestly, it sounds very difficult, but the doctor seemed very confident that this works. I have started trying…

The consensus from the most sensible people is, do the diet you can stick to, in the end just eat less. That’s most important.

My Candy diet isn’t having the results I desire. It is, however, delicious.

Re: South Asian people undergo type 2 diabetes remission with low calorie diets

#38

Earlier quoted context omitted.

Wait, how long are people expected to be on 600-1100 kcal/day? Just for a little worse than a coin flip? That sounds really miserable. Isn't that basically a crash diet and no one stfus about not doing those because they can mess you up long term? I'm really confused how T2D are special such that crash dieting doesn't mess them up further and put them further in a hole. They're already messed up because of the T2D, a…

VLCDs are very safe, much safer than say all the co-morbidities of obesity. The important thing is to chose the right things to eat for those few calories. It also assumes a sedantary office lifestyle with only minimal exercise. If you work out or run you will need more. With these caveats it is safe and effective and works for obesity, type-2 diabetes and some metabolism problems. It really is that simple. The first…

They sound miserable, though, is what I'm saying. How are VLCD people expected to do any sort of fitness or do any sort of mentally taxing labor if they're hungry and running on little nutrition basically all of the time for months? That seems totally unreasonable unless we send obese people to some kind of clinic like we do for addicts, and then how do they adapt back into the real world? Are there any actual studies of people doing this long-term and how this affects their bodies?

I was always told crash diets fuck you up for years. How can this be true and also people are apparently starving for months and that's totally fine?

EDIT: Wait, is my understanding is that you have to starve for up to 4 months for a worse-than-coinflip chance at diabetes? Do we know if it stays off for 5 years? 10 years? Do you have to coinflip again? What happens if it doesn't work?

Re: South Asian people undergo type 2 diabetes remission with low calorie diets

#39

Earlier quoted context omitted.

Most people don't announce to scientists that they've lost weight. Lot's of people do lose weight and stay that way, it's just that there are even more who don't. Consider that the rate of obesity continues to increase in the US. This shows that people are simply eating more and doing less exercise. And of course those that are already obese are the least likley to consume healthy ammounts of food and exercise as nee…

> Off the top of my head, fast food advertisments should be made illegal This is ridiculous. Nearly everyone I know who is overweight eats hardly any fast food. What I do see is lots of snacking throughout the day on high carb things (chips, breads, etc) and just way too many calories due to large serving sizes in both regular “slow food” restaurants and meals made at home. Fast food meals if you skip the sugared sod…

Apparently one major issue with fast food is the hyperpalatability.

For example, when I visited my family in the states, I ate two double cheeseburgers at a fast food joint at 1000+ calories per burger, and I figured I could probably eat two more in that sitting without issue.

In other words I ate 2000+ calories in a few minutes and could have kept going. Even one burger has more calories than I eat in a single meal.

Meanwhile, I couldn’t eat 15 medium sweet potatoes (1000 calories) in one sitting.

Re: South Asian people undergo type 2 diabetes remission with low calorie diets

#40

Earlier quoted context omitted.

> The general advice, even from my primary care physician, has been that anything less than 1200kcal/day is dangerous and is crash dieting. Wouldn't this advise need to keep in mind absolute height? BMI tracks the ratio between the height and weight, but it does nothing to tell the difference between a short thin person and a taller heavier (but same BMI) person. The latter which would need more calories than the for…

The argument I've heard is that the other nutriments needs (vitamins, minerals, etc) don't scale as much with height. So even a very short person would have a vitamins/mineral deficit on less than 1200KCal per day. How true is it? I don't know. But even then I don't see why they couldn't take multivitamins.

Many American diets are calorie/energy rich and nutrient poor. If you're eating 400 calories of healthy food you're probably getting several times the vitamins and minerals of the average American eating 2500 of fried, sugary food.

It's probably a mistake to connect the two.

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