South Asian people undergo type 2 diabetes remission with low calorie diets • Hacker News Board

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

#111

Post by mmmpop » Mon, Nov 28, 2022, 2:40 AM UTC

eru wrote: post #109

mmmpop wrote: post #24

Earlier quoted context omitted.

I did a lot of ketogenic diets when I was younger in an attempt to shed all of the weight that comes with being raised in Appalachia. It was my experience that it was a great kickstart to a weight-loss plan for someone who was at rock-bottom health and needed fast results while not feeling like you're starving. But I feel like it taught me to be bored with eating, and to establish a more healthy relationship with foo…

> It was my experience that it was a great kickstart to a weight-loss plan [...] Part of that might be from less water retention early on. Your body holds on to more water when your diet is full of carbs. As your liver runs down its glycogen stores and you eventually go into ketosis, you lose a lot of water. That's also there the early 'keto flu' comes from, which is a bit like a hangover; plenty of fluids and electr…

Yup.

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

#112

Post by lotsofpulp » Mon, Nov 28, 2022, 2:59 AM UTC

thelittleone wrote: post #104

lotsofpulp wrote: post #99

Earlier quoted context omitted.

How is Diet Coke related to the conversation? It has zero calories.

Zero calories but some research suggests the sweeteners still trigger an insulin response which is relevant.

I have seen this claim many times, but have never seen a credible source claim it is conclusively known, at least at the amount of low calorie sweetener that are in 1 service if 8oz to 20oz of Diet Coke.

It seems either this is extremely tricky to measure, or it is a myth (like aspartame or MSG or yellow 5 cause cancer or whatever).

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

#113

Post by remarkEon » Mon, Nov 28, 2022, 3:23 AM UTC

harry8 wrote: post #88

remarkEon wrote: post #80

Earlier quoted context omitted.

> It was normal to have incredibly painful teeth, probably not healthy. Is this actually true? I thought archaic humans had much better dental outcomes because their diets had a small fraction of the sugars that modern diets do. Could be wrong but I was definitely under the impression that poor dental health was more a function of modern diet and not something that necessarily existed throughout history.

I'm no expert, this could be wrong, what I was told by an ancient historian was even the Pharohs with all their wealth had terrible painful teeth from sand in food which was ubiquitous until fairly recently. I have recollections of dental records of pre-historic persons being reported as pretty nasty. Feel free to nit-pick that example, there are an absolute plethora of others. When did surviving appendicitis become…

Yeah I should’ve made it clear in my comment that I agree with you, I think the fetishism of pre-historic humans is a little odd. Of course there’s things to learn, but it’s strange to think that a period when you died from something as trivial as a minor infection is somehow ideal. I was only nitpicking on the dental thing, because eating so much sugar really is relatively new in human history and is the source of a number of health problems, beyond bad teeth.

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

#114

Post by abecedarius » Mon, Nov 28, 2022, 3:28 AM UTC

MuffinFlavored wrote: post #60

knaik94 wrote: 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…

dumb question: how easy is it for the average person to go from an “American” diet high in addictive things like bad fats, corn syrups, processed foods, etc. etc. to a “clean” 1200kcal diet? I was under the impression it was like trying to fight drug addiction and the chances of you sustaining it and not relapsing/making up the missed calories later as near impossible for most once you’ve become addicted enough to th…

I don't know. But instead of aiming for a calorie target I'd suggest trying https://www.mostly-fat.com/eat-meat-not-too-little-mostly-fa... for a month. Even if you decide not to stick with it, it's a very palatable break from your addictive foods. (I'm on basically that now, though I didn't come to it directly from a "standard American diet".)

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

#115

Post by browningstreet » Mon, Nov 28, 2022, 3:46 AM UTC

syrrim wrote: post #107

browningstreet wrote: post #56

Earlier quoted context omitted.

David Goggins lost 100 lbs in 3 months on an 800ish calorie diet. I’m not recommending that… but what you can accomplish when you own it versus doing it for other reasons is probably significant too. Especially for when the “diet” (or whatever word is preferred, a la “intervention”) ends. I lost 60 lbs over a couple of years and set a state lifting record for my age group. I love what I do and kept the excess weight…

100 lbs in three months is ~1lb/day, thus a deficiency of 3500Cal/day. His maintenance intake would have been 4300Cals/day. That seems insanely high - what was his weight?

He started north of 275 lbs if I remember. He was working out 3x a day. There are lots of videos out there about it. He was also overweight when he started, and he was going into hell week (military) so the first n lbs of weight would come off “easy”.

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

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Post by knaik94 » Mon, Nov 28, 2022, 4:01 AM UTC

nradov wrote: post #100

knaik94 wrote: post #50

Earlier quoted context omitted.

My understanding is that 1200 kcal is independent of height or weight. I was told that the rough calculation was based on the lower estimate of basal metabolic rate and then subtracting a couple hundred kcal. We both come from a South Asian background and discussed how the number would change for a home cooked vegetarian diet which is more nutrient dense but low in protein, and I was told that would lower it below 12…

Your understanding is incorrect, and not based on any actual science. Energy needs are highly correlated with body size (and other factors like activity level and genetics). There is no reason to avoid resistance training.

The few times I have tried to do intensive resistance training, above 60% of my PR, I have started feeling weak after the second or third day. I don't use caffeine for pre-workout. This might not be common, but I personally experienced a significant increase in exercise induced syncope and near-syncope when fasted.

I also imagined that muscle recovery would be less efficient or take longer from a fasted state. I have hit rowing/ERG goals and made time improvements so I feel comfortable saying that fasting doesn't hinder my cardio.

I understand that energy goals are correlated with body size, we were discussing a general minimum kcal threshold for unsupervised dieting. I am unsure why you feel estimated BMR/RMR - 200 kcal is unscientific. I was told that without supervision, it would be hard to ensure proper nutrition on a very low calorie diet. Additionally, he expected that some people would fall into a binge-restrict cycle because they can't sustain their usual energy level.

I was additionally curious because there have been days I forget to eat, and thinking back I realized my total calories for those 24 hours totaled less than 600 kcal.

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

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Post by kortilla » Mon, Nov 28, 2022, 4:24 AM UTC

Scoundreller wrote: post #95

hombre_fatal wrote: post #39

Earlier quoted context omitted.

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.…

> I ate two double cheeseburgers at a fast food joint at 1000+ calories per burger Where was this? A double quarter pounder BLT at McD with standard toppings is 830 calories. A McDouble is half that.

Yeah, this doesn’t pass the smell test. I love cheeseburgers and would be borderline sick after two double quarter pounders.

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

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Post by panabee » Mon, Nov 28, 2022, 4:35 AM UTC

nradov wrote: post #101

panabee wrote: post #45

1. the conclusions were based on 25 adults. is this a valid sample size? 2. why is liver fat a driver for diabetes? the article and the paper don't address this.

Fatty liver disease is closely linked to type-2 diabetes. https://www.healthline.com/health/fatty-liver-disease-and-di...

interesting. thanks for sharing! the article unfortunately doesn't delve into the mechanics beyond claiming an increase in glucose from more liver fat.

why would more liver fat increase glucose production? if anything, i would expect a negative correlation.

what hypotheses do you think are persuasive?

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

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Post by radu_floricica » Mon, Nov 28, 2022, 5:04 AM UTC

nradov wrote: post #97

ForrestN wrote: post #77

Earlier quoted context omitted.

My doctors have always said that losing weight too quickly results in the metabolization of one's muscles and other important, healthy tissue in addition to fat. Could it be that crash dieting works narrowly to solve, for example, diabetes via the loss of fat, but has other negative consequences for the body? Maybe it's not a "doesn't work" thing, but a "collateral damage" thing or a "makes it harder to keep the weig…

Weight loss always involves some loss of lean tissue in addition to fat. Dieters can mitigate this to an extent by protein intake high and maintaining an exercise program.

And sleep. It's rarely mentioned, but the difference between good and bad sleep may mean the difference of 80/20 fat/muscle loss, and 20/80. If the numbers are true (I know of at least one study, but no meta stuff) it means that crash dieting with bad sleep is actually counter productive, as you lose a lot more muscle than fat.

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

#120

Post by radu_floricica » Mon, Nov 28, 2022, 5:14 AM UTC

panabee wrote: post #45

1. the conclusions were based on 25 adults. is this a valid sample size? 2. why is liver fat a driver for diabetes? the article and the paper don't address this.

Depends on the results. A blinded study which has a strong enough effect can definitely be solid indicator.

> Without diet treatment none of 12 participants in the control group had remission, but after they had also received the diet program, 10 out of a total of 23 participants (43%) were free from diabetes, without need for medication.

That's very unlikely to be due to chance - a difference of 0/12 vs 10/23. Of course, this doesn't protect us from failure modes where the study was set up badly or someone just plain cheated, which is why we do want more than one study, but as far as predictive power goes, this is solid.

And fortunately this is already confirmatory research, not exploratory - we've either known or strongly suspected this for quite a while. Now we're just in the stage where it goes mainstream. And speaking of what we know/strongly suspect, adding muscle building into the mix also helps. Living with 800 calories per day is not sustainable, but losing weight once, then building (a lot of) muscle then maintaining a reasonable body fat is hard, but doable.

Lately I wonder if 3 months on semaglutide, low dose steroids, protein and gym is actually an intervention well worth its risks, at least for some categories. Replacing 10kg of fat with 10kg of muscle is much less likely to yoyo than just losing weight.