Newcastle University research
AdesTheShades
Posts: 1
Hi,
A WORD Of WARNING - the information below relates to a medically-monitored diet which is not for the faint-hearted. It should not be undertaken without the full agreement and involvement with your doctor / practitioner. REGULAR blood tests are required to monitor progress and safety.
I was diagnosed with DM2 (fasting plasma glucose 7.4) and fatty liver last November. My Dr handed me the usual health eating leaflets but she mentioned that Newcastle had done some research which suggested that DM2 could be reversed by a strict diet and she suggested that, as I was determined to do something about it, I take a look.
I had a look at Newcastle University's website - http://www.ncl.ac.uk/magres/research/diabetes/reversal.htm - and downloaded the scientific paper which they published, along with details of the diet, FAQ and the notes for doctors that they had prepared.
The first thing I noticed was that the trial they ran to test the diet used a very low number of people - 15, falling to 11 over the 8 week period of the diet. Also, the "control" group (non-DM2 sufferers of the same age range and body size) were NOT put on the diet. They just carried on their normal lives. I would have expected that they be put on the same diet to see what effect it had on them, if any.
The premise of the trail was to "mimic" the effect of having a gastric band fitted as it had been noticed that glucose levels dropped significantly when those with DM2 underwent gastric surgery. This means a VERY low calorie diet, centered around meal replacement shakes. The team were donated a supply of Optifast meal replacement shakes by the manufacturers Nestle. These are only available in the UK on prescription and are horrendously expensive when buying from abroad. Just look them up on eBay! I did a comparison between the nutrients in Optifast and Slimfast and they were broadly similar, although Slimfast had less protein content.
So, here's the diet:
Meal replacement with Optifast (3 sachets each day) – this provides a total of 600 calories and the necessary daily vitamins and mineral requirements
Eat up to 3 portions of non-starchy vegetables each day (total of 250g each day) (for fibre content) – this will provide another 200 calories
Drink - 3 litres of water or calorie-free beverages each day
During the 8 weeks of the diet;
No poultry or fish or meat
No bread or pasta
No dairy products (even full skimmed milk!)
No root vegetables like potato, sweet potato, turnip
No pulses
No fruits
No alcohol
It really is simple to follow as, apart from weighing-out 250g of vegetables/salad a day, there's no more counting and weighing involved.
I substituted Slimfast for Optifast and went for it. But, I made one other change which, in hindsight, was a big mistake. I got rid of the evening meal shake and had a higher veg intake. Basically, I had no idea then about nutrition or body chemistry and thought that calories were the be-all and end-all. WRONG. This kind of non-meat, non-dairy diet is very low on protein. Not enough protein and you can loose muscle weight; you need to loose fat! Even 3 Slimfast don't provide enough protein but I'll go into this later. I also added 200mg of Omega 3 fish oil, a multivitamin (Berocca), milk thistle and turmeric pills to aid liver recovery.
As the trial subjects had been monitored at Week 1, Week 4 and Week 8 my Doctor had agreed to run blood tests to check fasting blood glucose, liver function and muscle loss at those intervals. At the end of Week 1 I'd lost nearly 5 lbs and went for my first tests. My glucose was back to normal (from 7.4 mmol/L to 5.4 mmol/L) but my ALT level was very high. Time to find out that the hell that meant! Okay - it's "alanine aminotransferase", an enzyme which is tested to check for lever damage. Evidently, this will rise if on a strict diet. Phew...
After Week 2 I'd lost 10 lbs. At Week 4 that had gone up to 20lbs and it was time for more tests. After the tests my Doctor phoned me. This time, my glucose was down to LESS than the normal range - 3.0 mmol/L ("normal" range is 3.9 - 6.1) BUT one of the "safety" tests was abnormal. My Creatine Kinase (aka CK or CPK) levels had gone through the roof. At Week 1 they were 145 u/L and now they were 351 u/L (normal range 38 - 174). I bit of research came up with the answer.
CK is another enzyme. It's produced in high doses when muscle tissue is damaged. It is the first test done when someone is suspected of having a heart attack (when it can reach into the 1,000s). So my muscle tissue was being broken down and it wasn't hard to discover why - I wasn't getting enough protein. For my weight I need roughly 60g per day and 2 shakes were giving me 28g! So, I went straight onto 3 shakes, added 50g of tinned tuna in brine and 50g of cashew nuts to my daily intake (I had been craving nuts all through the diet, odd that). This bumped up my intake to 65g. And, to repair the damage, I spend £8 on a month's supply of BCAAs (Branch Chain Amino Acids). These provide certain amino acids to the muscles that cannot be produced by the body itself and there has been research done that points to their ability to repair muscle damage, prevent damage in the future AND aid weight loss. Body builders take them when in serious training.
My target weight, agreed with my Doctor, is 161 lbs (11 st 7 lbs) and I am 7 oz away. My starting weight was 189 lbs. I will not be able to stick with the whole 8 week programme as I have a week's holiday coming up in about 10 days.
Now the bit I was a bit nervous about - my visit to a local National Health Service dietitian who I saw yesterday. I was expecting the usual "here's a booklet on healthy eating" routine and a few "tut, tuts" about what I've been doing BUT I was sooo wrong. She was familiar with the Newcastle research and even had some printed articles to hand on reactions to the research and work that other dietitians were doing in the same area. I'd taken hard copies of my research and diet spreadsheet which she was very interested to see (and kept). And, more importantly, she endorsed my actions so far and my planned Maintenance Diet. So I'm on the "straight and narrow". I did a home test this morning and is was 4.5mmol/L.
When researching the lack of protein in my diet I came across Lyle McDonalds book "A Guide to Flexible Dieting". In there, he suggests ways of working out a Maintenance Diet, inc re-feeds of carbs every 2 weeks and 1-2 "free" meals per week. There's a bit of maths involved but my Maintenace Diet works out as:
Total calories: 1932
Protein: 93.45 grams = 373.8 cal =19.34%
Carbs: 224.6 grams = 898.4 cal = 46.50%
Fat: 73.31 grams = 659.8 cal = 34.09%
I've used myfitnesspal to look work out some daily plans and its been really helpful. I'm all ready to kick off maintenance from tomorrow - I'll have lost 7 oz by then,,,
I cant recommend McDonald's book enough. He seems grounded and realistic about dieting in the "real world".
I hope you've found this interesting. For more details, I started a blog: http://adestheshadestype2dm.blogspot.co.uk/ which I will be updating as I move into Maintenance. I may mirror that blog to myfitnesspal at a later date.
CU
Ades
A WORD Of WARNING - the information below relates to a medically-monitored diet which is not for the faint-hearted. It should not be undertaken without the full agreement and involvement with your doctor / practitioner. REGULAR blood tests are required to monitor progress and safety.
I was diagnosed with DM2 (fasting plasma glucose 7.4) and fatty liver last November. My Dr handed me the usual health eating leaflets but she mentioned that Newcastle had done some research which suggested that DM2 could be reversed by a strict diet and she suggested that, as I was determined to do something about it, I take a look.
I had a look at Newcastle University's website - http://www.ncl.ac.uk/magres/research/diabetes/reversal.htm - and downloaded the scientific paper which they published, along with details of the diet, FAQ and the notes for doctors that they had prepared.
The first thing I noticed was that the trial they ran to test the diet used a very low number of people - 15, falling to 11 over the 8 week period of the diet. Also, the "control" group (non-DM2 sufferers of the same age range and body size) were NOT put on the diet. They just carried on their normal lives. I would have expected that they be put on the same diet to see what effect it had on them, if any.
The premise of the trail was to "mimic" the effect of having a gastric band fitted as it had been noticed that glucose levels dropped significantly when those with DM2 underwent gastric surgery. This means a VERY low calorie diet, centered around meal replacement shakes. The team were donated a supply of Optifast meal replacement shakes by the manufacturers Nestle. These are only available in the UK on prescription and are horrendously expensive when buying from abroad. Just look them up on eBay! I did a comparison between the nutrients in Optifast and Slimfast and they were broadly similar, although Slimfast had less protein content.
So, here's the diet:
Meal replacement with Optifast (3 sachets each day) – this provides a total of 600 calories and the necessary daily vitamins and mineral requirements
Eat up to 3 portions of non-starchy vegetables each day (total of 250g each day) (for fibre content) – this will provide another 200 calories
Drink - 3 litres of water or calorie-free beverages each day
During the 8 weeks of the diet;
No poultry or fish or meat
No bread or pasta
No dairy products (even full skimmed milk!)
No root vegetables like potato, sweet potato, turnip
No pulses
No fruits
No alcohol
It really is simple to follow as, apart from weighing-out 250g of vegetables/salad a day, there's no more counting and weighing involved.
I substituted Slimfast for Optifast and went for it. But, I made one other change which, in hindsight, was a big mistake. I got rid of the evening meal shake and had a higher veg intake. Basically, I had no idea then about nutrition or body chemistry and thought that calories were the be-all and end-all. WRONG. This kind of non-meat, non-dairy diet is very low on protein. Not enough protein and you can loose muscle weight; you need to loose fat! Even 3 Slimfast don't provide enough protein but I'll go into this later. I also added 200mg of Omega 3 fish oil, a multivitamin (Berocca), milk thistle and turmeric pills to aid liver recovery.
As the trial subjects had been monitored at Week 1, Week 4 and Week 8 my Doctor had agreed to run blood tests to check fasting blood glucose, liver function and muscle loss at those intervals. At the end of Week 1 I'd lost nearly 5 lbs and went for my first tests. My glucose was back to normal (from 7.4 mmol/L to 5.4 mmol/L) but my ALT level was very high. Time to find out that the hell that meant! Okay - it's "alanine aminotransferase", an enzyme which is tested to check for lever damage. Evidently, this will rise if on a strict diet. Phew...
After Week 2 I'd lost 10 lbs. At Week 4 that had gone up to 20lbs and it was time for more tests. After the tests my Doctor phoned me. This time, my glucose was down to LESS than the normal range - 3.0 mmol/L ("normal" range is 3.9 - 6.1) BUT one of the "safety" tests was abnormal. My Creatine Kinase (aka CK or CPK) levels had gone through the roof. At Week 1 they were 145 u/L and now they were 351 u/L (normal range 38 - 174). I bit of research came up with the answer.
CK is another enzyme. It's produced in high doses when muscle tissue is damaged. It is the first test done when someone is suspected of having a heart attack (when it can reach into the 1,000s). So my muscle tissue was being broken down and it wasn't hard to discover why - I wasn't getting enough protein. For my weight I need roughly 60g per day and 2 shakes were giving me 28g! So, I went straight onto 3 shakes, added 50g of tinned tuna in brine and 50g of cashew nuts to my daily intake (I had been craving nuts all through the diet, odd that). This bumped up my intake to 65g. And, to repair the damage, I spend £8 on a month's supply of BCAAs (Branch Chain Amino Acids). These provide certain amino acids to the muscles that cannot be produced by the body itself and there has been research done that points to their ability to repair muscle damage, prevent damage in the future AND aid weight loss. Body builders take them when in serious training.
My target weight, agreed with my Doctor, is 161 lbs (11 st 7 lbs) and I am 7 oz away. My starting weight was 189 lbs. I will not be able to stick with the whole 8 week programme as I have a week's holiday coming up in about 10 days.
Now the bit I was a bit nervous about - my visit to a local National Health Service dietitian who I saw yesterday. I was expecting the usual "here's a booklet on healthy eating" routine and a few "tut, tuts" about what I've been doing BUT I was sooo wrong. She was familiar with the Newcastle research and even had some printed articles to hand on reactions to the research and work that other dietitians were doing in the same area. I'd taken hard copies of my research and diet spreadsheet which she was very interested to see (and kept). And, more importantly, she endorsed my actions so far and my planned Maintenance Diet. So I'm on the "straight and narrow". I did a home test this morning and is was 4.5mmol/L.
When researching the lack of protein in my diet I came across Lyle McDonalds book "A Guide to Flexible Dieting". In there, he suggests ways of working out a Maintenance Diet, inc re-feeds of carbs every 2 weeks and 1-2 "free" meals per week. There's a bit of maths involved but my Maintenace Diet works out as:
Total calories: 1932
Protein: 93.45 grams = 373.8 cal =19.34%
Carbs: 224.6 grams = 898.4 cal = 46.50%
Fat: 73.31 grams = 659.8 cal = 34.09%
I've used myfitnesspal to look work out some daily plans and its been really helpful. I'm all ready to kick off maintenance from tomorrow - I'll have lost 7 oz by then,,,
I cant recommend McDonald's book enough. He seems grounded and realistic about dieting in the "real world".
I hope you've found this interesting. For more details, I started a blog: http://adestheshadestype2dm.blogspot.co.uk/ which I will be updating as I move into Maintenance. I may mirror that blog to myfitnesspal at a later date.
CU
Ades
0
Replies
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Thanks for sharing, it made interesting reading and the diet is something i'd heard of recently. Im not sure if i could do it, although your results are impressive.
I'll definately read your blog0 -
Bloodsugar101.com has a very good article about very low calorie diets and their effect on diabetes
http://diabetesupdate.blogspot.com/2011/06/idiotically-dangerous-diet-reverses.html
It's also interesting to read the comments after the article, especially the interpretation of the post-diet OGTT results.
My MIL, a morbidly obese out-of-control diabetic, had gastric-bypass surgery. Like many who have WLS, she was able to stop using insulin almost immediately after surgery. 5 years later, she's still relatively thin ( I think she's maintained within 15 pounds) but is once again on insulin and her last A1c was 6.9.0
