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NHS to offer 800 calorie meals to reverse type 2 diabetes.

Hi everyone this has been on the news this morning and it looks good news to me for type 2 D sufferers so here's a link to the articles on the BBC Guardian Independent:

bbc.co.uk/news/health-46363869

theguardian.com/society/201...

independent.co.uk/news/heal...

I have also added a diabetes topic section.

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This kind of article makes me really cross, it implies it’s the 800 calories that is the reason behind the success, but if you read it carefully (“So far, more than 250,000 people who were on the cusp of developing type 2 diabetes have been referred to classes which offer advice and support on food, diet and exercise“) it’s the advice and support that makes the difference

Sorry to butt in 😊

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Hey I thought this was good news, I'm not diabetic I just try and help raise awareness of it.

To me it shows that the NHS is doing something positive and proactive to treat type 2 diabetes, so I'm sorry that it made you cross.

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I wasn’t having a go at you Jerry, sorry if it came across that way 😕 I just get cross at the lack of NHS support to the vast majority of people trying to lose weight

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Thanks IndigoBlue61 and there's no need to apologise. I'm neither diabetic or over weight so to me it was this is great Type 2 diabetes can be reversed.

My BMI is 19.5 and I don't have to think about losing weight so am not aware of what advice/support is given. But this is a very important point.

So thank you for your reply. 😊

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well its taken them a long time to realise that Type 2 can be reversed with diet and advice including exercise . There have been so many programmes on TV that have shown how this can be reversed if people change their diet and lifestyle. Unfortunately I dont think giving people 8oo calories a day for however many weeks will do the trick unless people seriously change their lifestyles on a permanent basis

As usual the NHS are always at the tail end of how to treat diseases using dietary reforms..

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the NHS see that as a problem unfortunately as they have to use budgets etc to help overweight people do this through the NHS and perhaps not join a gym etc. but what people dont realise is that unless in the consulting room with a patient there could be a reason/cause for being overweight. i used to work for the NHS and they really do not like spending money but something else they dont realise is that it is there to spent on patients and for whatever they are being treated for!

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I know I almost thought it was good news & they’re almost supporting the 5:2 but daily! I do get confused with this contradictory advise though! I thought we were supposed to be eating our maximum level of food IndigoBlue61 It’s all controversial I suppose. People will need suppose when going back to eating more calories!

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hi is this still available ?I'm type 2 and remained on a diet meds free diabetic regime until i finally gave up due to passing out etc, still on tablets although they are now trying to change to insulin. my levels are within range but due to other conditions i also take other meds which probably affect my levels. i definitely do not want to go onto insulin have tried reversing it through diet and not suceeded

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Hi manisha1, you’ll have to ask your Dr there’s a lot going on to prevent and reverse type 2 diabetes. So good luck as I don’t blame you for wanting to control it with diet and exercise than meds. 😊

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Hi manisha1,

Are you counting carbs. for each meal and snack? When was your last appointment and A1c done? Please take a look at the free leaflets on the Diabetes Research and Wellness Foundation's website. You can download them, read and/or listen to at anytime. drwf.org.uk/understanding-d...

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No i dont, i have a goal weight of 9 stones which i need to keep to although i have noticed that my intake of carbs is quite high probably just to give me some energy but that is worked off as the day goes by. i do however get cravings particularly towards the evening for carbs and sweet things, if i have managed to nap and wake up first thing i do is get into the kitchen and go for something sweet especially chocolate and i dont even realise how much i am eating at that point but it calms me down.

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Would you like me to send a FAKE/SAMPLE menu on how to count carbs.? I'd be willing to send it today, but it'll take some time to type it up.

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no, like i said i'm not too worried about the carbs and no disrespect to you but ive just been given a new diagnosis which i need to start looking into but dont worry at the same time will keep an eye on my diabetes, you're very kind.

how do you feel about your diabetes and are you 1 or 2 and are you on meds?

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Type 1 Diabetic since I was an infant at 2 weeks old. Most of the pancreas was removed and I had to be put on digestive enzymes for food then started also with insulin shots. I'm using a CGM (Continuous Glucose Monitoring) system. Been using the CGM for 3.5 years.

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Poor you and i dont mean to sound rude about this but at least you have had time to get used to it ive had it for possibly 10 years or so. i too have pancreatitis which as you well know is not the nicest of illnesses to have. i have only had this for a few years.

was the pancreas removed due to the diabetes?

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No, it was removed except for a sliver because it put out too much insulin and there were too many islets. Sometimes, what is still there, "wakes up" and the numbers start dropping for no good reason. I could wake up either with an alarm going off because the CGM says that I'm under 80 mg/dl. When the alarm goes off, I test and eat/drink a snack then go back to bed (if it's before 6:30 am).

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i dont know what you're referring to A1c but have weekly check ins with the doc as i have so many conditions to look after we do a weekly review but i also have an emergency call out system at home. i'm based in the UK, where are you?

i have started to eat fruit, try and keep well as possible as i know illnesses can become disabling and and stop you from doing things.

i'd like the idea of reversing but at present have to be content as i am. it also appears that the number of people seem in this day and age is increasing with diabetes simply because they're not looking after themselves and thank you for the information on well being we can never be educated enough on the subject

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An A1c test is done every 3-4 month to see what your blood sugars have been averaging for the last 90 days. A lab/doctor's office does the test. Some people can't fast for the test, but that is put on the test result request form so the lab techs know not to expect the patient to not eat. They ask me all the time when I get an A1c done and I say no since I'm not able to fast (I drop too fast from low blood sugars).

You're welcome! I hope the leaflets can help.

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i dont think would allow me to do one of those TBH because of sugar levels. i have my own machine at home which records all my readings if GP wants to see it i just take it along with me.

i'm always grateful for information as could be something i could have missed etc

tc

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You too! :-)

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been nice chatting to you dont think i have really done this before apart from with my GP so thank you

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You're welcome and I look forward to seeing you around again soon. You can always join the DRWF and DI groups on HU. Lots of support on Diabetes.

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i will look into this possibly later in the week, as i have been the lone ranger on this to date, thanks for your oozing positivity

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Sounds good! :-)

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I think the weight loss due to the 800 calories is the reason for the success of this. Obesity is a major risk factor for diabetes.

They are basically using a restricted diet as a short term medical intervention to fix the diabetes. Of course, what happens after this when the patient resumes their previous unhealthy way of eating that led to the diabetes in the first place is a different matter. That's where the advice and information comes in on how to eat a healthy diet going forward.

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Exactly! 😊

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I wouldn't necessarily say so - my dad is type 2 diabetic, and lost quite a bit of weight to help control the illness, but he never really managed to reverse it, he has always had to remain on tablets.

His weight loss approach was based on limiting carbs and eating smaller portions, but he never really addressed the underlying reasons why he developed the illness in the first place - which ultimately was the result of poor diet, and too much diet coke (which is calorie free).

The original 800 calorie diet works because people that follow it have to learn to cook more healthily. When you realise 2 slices of bread use nearly half your calorie allowance, and a salad bag of salad is only 30 calories, you quickly learn to fill your plate with an abundance of vegetables.

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The original 800 calorie diet in the study was the "counter weight" plan which is based on liquid replacements, so the people wouldn't have needed to cook.

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Sorry, not meaning the original 800 calorie diet in the study, but the original "8 week Blood Sugar Diet" by Michael Mosely.

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thanks for clarifying :) i agree lots of non starchy veggies are a great way of filling a plate at low calorie cost.

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Did your Dad count carbs. for each meal and snack?

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No, I don't think he actually knows how! He just stopped bread, pasta, rice, potatoes, sugar, and starchy veg.

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Would you like to have me help you show him how? I can do a fake/sample menu and send it to you later by Private Message.

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That would be very kind of you, but I just know my dad, and he hates any input like that. Very stubborn! He is quite steadfast in his beliefs on diet, and he'll never really change!

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What does his doctor say about the way he eats?

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I wouldn't know... I doubt the doctor/nurse has ever looked at his diet in depth, other than to ask the question "how's your diet?" And most people answer that with "alright"!

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At the next Endocrinologist appointment, can you please ask the doctor to suggest how many carbs your dad should have for each meal and snack? Then, you can help him keep in these ranges.

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I don't get to attend his appointments I'm afraid - he's very private about his health! But I'll try asking him, to see if he'll tell me anything.

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Ask him if you can sit in the appointment and ask his doctor a few questions that you have during his appointment. It’s better to have a second pair of ears at the appointment in case someone missed something that has been mentioned.😀

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how many diabetic people have you known to be over weight? the NHS/people state that diabetic sufferers are over weight but thats not necessarily true there are other factors you could have diabetes. i cant see an over weight person wanting to change their eating habits reduced to an 800 calorie a day diet and there are people out there who are over weight but do not suffer from diabetes or any other illness at all

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Dear IndigoBlue61,

I spent all day feeling irritated by this headline, I was aware of the previous small piece of research on which this decision was based. If I remember correctly people were given 2 -8 weeks of training in their new lifelong diet at the end of the liquid diet. 2 weeks!! How can that be long enough when we are all spending months or years retraining ourselves to eat a new healthy diet . Today I happily ate unsweetened raspberries with full fat Greek yogurt and a drizzle of honey for breakfast. No hunger pains by lunchtime which was great , but I could never have switched to such a sour breakfast in 2 weeks!!This is just one of the many changes a Type 2 diabetic would need to embrace.

I wonder what these soups and shakes taste like.

The research participants are to be followed up for 4 years, I hope that the results are also published, do any of our experienced maintainers have thoughts about this?

Thank you for the link to the research paper.

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That sounds a good breakfast - I always eat 0% ingrained in me lower cals & I add oats for dairy but I must try the fuller fat but then would maybe leave out the oats 🤔

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Thanks you Alison

I also get a little bemused as I was told categorically you cannot REVERSE diabetes, all you can achieve is remission. 😕

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It sounds to me like a short cut which will produce short term results that everyone is happy with but leave people without the tools to manage their diet for life.

There are some really excellent programmes under the Diabetes Prevention Programme but the NHS is making no move to roll that out over the whole country. They offer the all round support and learning that we all need to make essential changes to our eating and lifestyle generally.

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It hardly constitutes healthy eating :(

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Ironically, the NHS has a web page warning people away from "fad diets" :)

It's all very sad. I mean, healthy eating really isn't difficult. I can't help wondering if they have to make it seem like losing weight and getting healthy is a near-impossible task that can only be achieved with professional support because ... well, if everyone knew it was easy, half their workforce would be out of a job.

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I could not believe it when I read these articles. It sounds like a panic and misguided response to the problem that will work initially and then potentially leave these people with serious problems in the long term.

It is the advice and support that will make a difference, not a gimmick.

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Indeed.

In the short term, a very-low-calorie diet does appear to work, as long as you can lock people in a room and starve them for long enough. It is, however, pointlessly unpleasant, and as you said: when you let them out, then what? Hopefully, somebody will actually tell them why they got diabetes in the first place and advise them how to not let it happen again, but the NHS doesn't have a very good track record with that sort of thing.

I can't remember who it was, but there was another poster here who suggested that if you have something horribly wrong with you the NHS will patch you up with a great deal of skill, but they're very bad at stopping that happening in the first place.

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It's not about starving but stuffing with low carb vegetables. You won't feel hungry for a long time.

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I agree. But that isn't what they did. benwl's link is worth reading in full: it turns out they followed something called "Counterweight-Plus" as the intervention diet, which looks to me like the archetypal example of a Fad Diet:

- Extreme caloric restriction (about 850kCal/day for four months).

- Avoidance of proper food in favour of meal-replacement shakes.

Eventually they let you eat food again, but my main objection would be: why? What's the point, when you can achieve a far better result, without subjecting someone to cruel and inhuman treatment (and probably messing up their heads in the process)? This is dark-ages leeches and bloodletting stuff.

And let's be clear about this: they achieved remission in only 50% of cases. That's a pretty pathetic outcome for such a drastic intervention. And the question remains: if the underlying theory is correct (something they refer to as "the twin cycle hypothesis"), then why didn't it work with the other 50%?

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Sounds like the Cambridge Diet which is definately a gadfly diet! 🙃

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If a person is a Diabetic ( type 1, 1.5 (LADA) or 2), then the person counts carbs. instead of calories since the person may/may not be on insulin shots. With shots, you have to count carbs. for the correct amount of insulin or you can get very low (hypoglycemia) or very high (hyperglycemia).

Thank you for sharing this information with us, Jerry.😀

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I saw that BANT did a statement on this: "Following press reports of NHS England offering Diabetic patients an 800-calorie diet to reverse Type 2 Diabetes, BANT (British Association for Nutrition and Lifestyle Medicine) would like to comment.

Following a trial last year, which helped half of participants living with Type 2 Diabetes, the NHS is now rolling out the low-calorie programme. The treatment consists of 800-calories per day using liquid meals and shake for 3 months.

BANT would like to express concern around the lack of education given to the patients around diet and lifestyle factors that mediate Type 2 Diabetes. There is also reliance on shakes and meal replacements which takes the patient away from a whole-food approach. Often shakes are filled with sweeteners and synthetic vitamins and minerals and therefore not a credible match for quality nutritious food. Finally, there is no mention of calorie quality and it's well-regarded that not all calories are equal and in fact consuming 800 calories of sugary foods may do little with reversing Type 2 Diabetes. The programme may, therefore, only be a 'quick-fix' and creates a high risk of relapse without educating the client on the right foods for prevention of the disease."

The 800 calorie a day diet has been shown to help, but I just can't help thinking they're delivering it in the wrong way. A diet of highly processed foods, won't address underlying causes.

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It is good to see an potentially effective approach to controlling such a damaging condition, but it doesn’t address many of the underlying problems.

There are areas of deprivation and poverty in the U.K. (and no doubt in other countries) that are virtual food deserts. Fresh food supplies are few and far between. The ability to eat a healthy diet is almost impossible. Fast food outlets proliferate with cheap and addictive junk.

I hope the follow up care is substantial for everyone who tries this diet.

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When I was a kid there was a "mobile greengrocer", who drove around the neighbourhood roughly once a day in a van stocked with various vegetables. This would have been the late 70s. I was too young to pay much attention to the quality of his produce or his prices, but he seemed to be enormously popular, especially with the older people.

I wonder why such things no longer exist, and whether the residents of the average "food desert" would be interested, hypothetically, in such a service? It seems to me that food deserts arise because there aren't any potential customers in those areas, and I suspect that has a lot to do with silly ideas, and bad food, that children are fed with at school. Kids who grow up eating rubbish become adults who prefer rubbish.

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The veg van is a thing of the past. It would be a very uncertain way of making a living nowadays.

If you could afford it, you could get a supermarket delivery, but a minimum spend mean that this is beyond the reach of many. Not all areas have a free bus to the local supermarket, in which case you can be left with a long walk or the price of a taxis, which is in effect a lost meal. Schools have minimal budgets with which to feed pupils, it is not seen as an important investment in the health of the nation.

Lots of problems underpin bad food choices, some of them l feel down to government policies. Reports from The Rowntree Trust and recently from the UN highlight the increasing levels of food insecurity in the U.K.

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Yes, it's complex. The school-meals thing gives me high blood pressure. Did you happen to see Jamie Oliver's TV programme about it a few years back? The problem is broad and deep, not simply a money issue; as you said, nobody really considers it an important investment (or even an investment at all).

The annual budget for schools is £3900 per child per year, or £21/day. It doesn't seem like there's a lot of wiggle room there, but I can't help wondering if a lot of kids would do better if they simply cut class time by 10% and gave everyone a proper meal instead.

As for "food deserts" ... well, yeah, life is hard. I get that. I grew up in poverty. But you do what you have to, or you go under. Those are your only two choices. Possibly the government could theoretically make life easier: for example, how hard would it be to set up 'food clubs' where people could pool their shopping orders for free delivery, split bulk orders, or get cooking classes? The problem is, though, nobody would turn up for the classes. Or they'd whine that they have to go pick up their stuff from the food club rather than having someone bringing it to their door. As long as people fundamentally don't want to eat real food, or don't care enough about their own health to make an effort, there will be no incentive for anybody, private or public, to offer it.

My experience is that you can't reach adults. They'll do what they're gonna do.

Five-year-old kids. Decent meals. Indoctrination. That'd work.

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Yes, you need to get to them while they are young.

If you ignore the angry parents in the Jamie Oliver experiment, it achieved quite a lot. The government had to re-introduce (!) minimum nutrition standards for school food and we now have free school dinners in infant schools, after much government resistance. Local initiatives have to be organised by the people who actually want them or they are condemned to failure.

It’s depressing that people living in difficult conditions in many other countries seem to have been able to produce nourishing ways of eating, whereas in the U.K.....

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well I agree but think of the stick that Jamie Oliver got when he tried to reform school meals away from turkey twizzlers etc.There were parents feeding their kids chips and rubbish junk food at the school gates. How unbelievable is that that parents would prefer their kids to eat c***

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Hi Jerry

Thanks for this information, which I will look forward to reading on the weekend.

Zest :-)

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I found the full text of the original study which fills in some of the blanks.

directclinicaltrial.org.uk/...

Here are some of the points i think are salient:

the study was for 12 months, the intervention group followed:

1) meal replacements for 3 months (extendable up to 5) to induce weight loss

2) structured food reintroduction of 2–8 weeks

3) ongoing structured programme with monthly visits for long-term weight loss maintenance

On this site we council against crash diets and short term diets for very good reason. Here the short time weight loss phase was done under medical supervision and was followed by an ongoing supervised maintenance program. I'd hope there will be a follow up to see how the subjects fared over the following year.

And the results, I'll quote part of their summary:

"Remission varied with weight loss in the whole study population, with achievement in none of 76 participants who gained weight, six (7%) of 89 participants who maintained 0–5 kg weight loss, 19 (34%) of 56 participants with 5–10 kg loss, 16 (57%) of 28 participants with 10–15 kg loss, and 31 (86%) of 36 participants who lost 15 kg or more."

Note that the above was for both the control and the intervention group. So basically those that lost the most weight had the best chance of remission, and the group that lost the most a very good chance of it.

I think its good the NHS is trying this kind of thing, and they are trying in a proper way, do a small scale study, measure the results, if they are promising try it on a larger scale.

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I notice they don't mention how many people in the intervention group gained weight. I doubt all of those 76 were in the control group.

What irritates me about this sort of thing is that the study doesn't even consider the possibility that carbohydrates might have some bearing on a disorder of carbohydrate metabolism. In fact it studiously avoids mentioning the possibility, suggesting merely that a mysterious accumulation of visceral fat (causes unknown) is the sole driver of diabetes. Why is that visceral fat there in the first place, people? Do you not think there might be some clues there?

The intervention diet is 50% carbohydrates (100g), presumably as starch and/or sugar if they're using meal-replacement shakes, with approximately 12g of fat/day. Twelve grams. I don't think even our most rabidly-vegan members here would argue that that's healthy, even for only four months. It's actually impossible to find out what's in the shakes: it appears to be proprietary information.

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You're not the only one who's irritated by this study, I'm really surprised by the amount of negativity around this.

This work is being done by NHS, the same NHS that is often said to be a bunch of pill pushers in the pay of big pharma, and they are trying something that we say is a good idea which is a dietary intervention for a serious health issue (let thy food be thy medicine and all that), and it had some success, and we are getting upset.

One reason I think of for the negativity is they didn't follow anyone's favourite approach - no plant based, no paleo, no keto, no intermittent fasting, no detoxes, no fancy middle class eating organic spinach harvested by artisan farmers by moonlight, or drinking unpasteurized milk from grass fed cattle with DNA tests showing minimal changes since ancient Sumar.

Instead all they needed to do was restrict calories to get weight loss, and they did it using - shock horror!!! - unhealthy meal replacements - and after the 3 month restriction period, their weight didn't automatically rebound, and there was good remission.

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Unfortunately this is still a bit of a big pharma approach though, and I think people are upset that the intervention sounds like a quick fix, which, without the right ongoing support, won't actually change the underlying issue (poor diet).

I'm certainly not upset they're not promoting my preferred diet, but that they've come up with a highly processed solution to an illness I believe is caused by a highly processed lifestyle.

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Of course ultimately this is an issue that needs addressing at a society wide level - we need to reduce all the restaurants, fast food outlets, super markets selling unhealthy processed food laden with fat and sugar, and increase the availability of affordable, healthy food.

But in the meantime, what's a GP to do when a patient presents with T2 diabetes - say sorry mate you live in a food desert so you've no chance?

You call it a quick fix, i call it a medical intervention. Who cares if the 3 months of meal replacements were "processed" or not?. They did the job in reducing weight so the diabetes is under control (and quite likely gave the patient a strong motivational boost to continue with the rest of the program), so the real work can be done of changing the patients diet on the ongoing basis so remission doesn't occur. And that is where the NHS's regular advice on healthy eating comes in.

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>> what's a GP to do when a patient presents with T2 diabetes - say sorry mate you live in a food desert so you've no chance?

Are you serious? Is advising someone to take the free shuttle bus to T**co once a week to stock up on proper food a more complex intervention than giving them a big box of meal-replacement shakes and many hours of highly-paid professional time?

GPs don't give out this very very simple advice because it conflicts with Best Practice. Firstly, you're not allowed to tell patients what to do. You have to give them "choice". If they want to subsist on rubbish, you have to work with them to modify their intake of rubbish to alleviate their symptoms. This, obviously, is physically impossible. If they'd rather take drugs than lift a finger to help themselves, you have to accommodate their wishes.

More crucially, if a GP were to tell a diabetic to eat fat instead of starch - on the basis that it's a healthier source of energy for him - he'd be struck off.

Incidentally, real food is very cheap. It's not very good-quality real food (I'm taking about the plain-label meat and Grade B veg), but if you work it out, it's cheaper than stuff in pretty packets and jars.

>> no plant based, no paleo, no keto, no intermittent fasting, no detoxes, no fancy middle class eating organic spinach harvested by artisan farmers by moonlight ...

I'm irritated (and possibly others are too) because the NHS seem determined to reinvent the wheel, and it ain't a very good wheel.

You're lumping in superstition with proven treatments for diabetes. There are clinicians already out there - including some employed by the NHS - who understand how human metabolism works and have used that knowledge to devise effective treatment protocols based on (a) showing people what real food is supposed to look like and (b) bypassing the diabetic's malfunctioning carbohydrate-metabolism subsystem. As Gary Fettke remarked while he was being persecuted by AHPRA (I paraphrase): "I'm telling diabetics to eat meat and vegetables. Exactly what's the problem with this?".

This 800-calorie plan might technically work (in some cases), and you can explain from first principles why it does: it reduces the glycemic load to a level where the body might just barely be able to cope with it, and is thereby given a chance to recalibrate its glucose control loop. You can also explain from first principles why it mostly doesn't work (52% failure): viz., someone with advanced T2D has almost entirely lost the ability to utilize carbohydrates for energy. Giving them a diet with 86% of energy calories from carbs defies all logic. Last I heard, the NHS wasn't a fan of homeopathy, but that's basically what we've got here.

Oh, and on the weight loss aspect: after all that pain, the participants lost an average of 9kg more than the control group over the course of 6 months. That's pathetic. I lost 9kg in three months consuming about 1700kCal/day (and ending up on a lot more). Remember, these guys were on 850kCal/day. Can you imagine sticking with that for four months? Me, I'd be a bawling heap on the floor by the end of the first week, begging for a McDonalds.

It's inhumane, it's unscientific, and I have absolutely no doubt that 90% of the participants will be right back where they started in 5 years time, because if the "cure" isn't based on the correct advice, you can be pretty sure the suggested maintenance diet isn't either.

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One thing that strikes me, is that a lot of the participants had quite a lot of support throughout this study, and I'd question whether people will have the same support when this is rolled out.

I think we would also need to revisit these participants in 5 years time, to see whether they've kept up the diet and remained in remission. A lot of them will have benefitted from the pressure of being monitored, but will tgey have a change in circumstances in the next couple of years, and let their diet slip?

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I agree the support was very likely a big factor - and yes, one can imagine some accountant type suggesting it be tried without so much support when its rolled out.

It would be great to revisit after 5 years, but suppose that we found then that half of them had failed to keep to the diet. What does that tell us - just that healthy eating in an obesogenic environment is hard to do. I don't think it means the original intervention was wrong, it may after all have delayed the progression of the disease.

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I'd support 800 calorie lchf diet because calorie intake too affects blood sugars and the reversal of t2d and weight loss.

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Hi Jerry I think the 800 calorie diet is dangerous in as much that firstly you wouldn't be getting all your nutrients and secondly it doesn't help in educating people into healthy eating where treats are part of a healthy diet also there is no mention of exercise it looks like a knee jerk reaction x

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Hi Sally, when I saw this I thought I'm glad I don't have type 2 Diabetes and have to go on such a drastic diet.

What I did like was the NHS are saying type 2D can be reversed and are offering help. Obesity and type 2D is becoming a world epidemic, in India there are around 75 million and the US has over 100 million diabetics. The population of the UK is 67M so these are staggering figures and if this has raised awareness and made people think it's time to do something then that's good as we're talking about it objectively and I'm fascinated by the replies to this topic.

Obviously I want to encourage others to eat healthily and enjoy real food and be healthy,

So great replies.

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but why has it taken them SO long to realise it can be reversed?!!

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It's for obese diabetics and nothing can beat bad diet.So it's of prime importance to control calories and nutrition as well and supplements may be give during that time. But reversal of t2d is of utmost importance.

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I agree with you but where is the aftercare on a 800 calorie diet in these cases where is the help after 800 calories the person has to starve for 4 months without proper guidance on nutrition and exercise a person can still lose weight without having to go to these drastic measures and ultimately would be more successful in the long run which I am presuming is the goal

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In the case of the NHS study there was 9 months of after care to get people onto a healthy style of eating following the 800 calorie period to induce weight loss.

There was also exercise included in the protocol.

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No starving. Eating a bland diet which can fill the stomach, but won't provide energy.

And post regime care is a different issue. Ultimately one has to learn dietary measurement and management.

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As far as the NHS study is concerned, the intervention consists of both the calorie restriction phase and healthy eating phase. They are linked.

As for the 'bland' nature of the meal replacement shakes I've not tried them so I can't comment though I'd imagine they try and make them flavorsome. Of course, they lack energy, that's the whole point of them! It's that energy imbalance that causes the weight loss.

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Yes. If you want to empty a continuously feeding tank output should be more than input. There has to be negative energy balance, but it's not so simple. Our body compensates less energy intake by reducing bmr. One needs to add exercise to avoid reduction in bmr.

Bland diets are low carb vegetables and salads, etc..

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the NHS intervention also included exercise.

As for low carb vegetables and salads being bland, speak for yourself, I find them anything but bland, but in any case they were not what was used in the study.

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As usual getting WRONG message out. It is carbs and sugar that need to be controlled NOT calories. Sarvation diet will work initially but when you go back to eating if u don’t cut sugar and carbs and replace then with high fat foods you will revert to diabetes.

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If that was true I would have put on weight like crazy over the last couple of years. Instead I have steadily lost weight easily and cheaply for the first time in my 65 yr life.

Carbs per se are not the problem. Refined foods incl refined carbs, cheap meat, processed meat, refined oils, processed foods generally all lead to problems.

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Thanks for that! Interesting read that NHS have gone against what they have been advocating all these years it’s good news. I might try do that a few days a week. 🎉

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Hey

I have not got diabetes type 2 but what i do know is healthy eating and losing weight.

I realised my diet was causing IBS so i went on the 5:2 diet after watching the michael mosley programme about this diet, he changed his diabetes and his ibs problems. So thought what better one to try, so 5 days i would eat 1500 cals and then 2 i would fast, it was HARDEST THING IVE EVER DONE!!

I lost 2 stone in about 3 -4 months which really is not point i am getting at here but what what it did was train me to eat a good diet, what to eat what not to eat, it also shrunk my stomach so on the days i could eat anything i couldnt?

I think this is what there hoping for in long run, that people will retrain themselves as there see there weight loss and wont want to regain it and also there stomach and craving Will change and there b more likely to not over eat anymore.

It is about a total life change. We all know crisp chocolate cola cake = not good food , surely noone needs a government or dr to tell them this... it like saying if u have sex ur get pregnant!! Obvious.

Unfortunately people eat for diff reasons , if u get a emotional eater they will not stick to this as there is a underlying problem that is not actual food so i think the underlying problem need to b addressed

Ie the emotional side ,some counseling.

If u got someone like i was where i just liked my food and basically ate all the bad stuff it will work!

2 years on , 2 stone down i still stick to the same diet.... i cant and do not want to eat as much as i used to as it make me feel sick now.

So it does work...u can b retrained this way to view food differently and it can work with shrinking ur stomach and u not wanting to eat so much....

I dont mean this harshly but what more can goverment do? And what should they do?

There gona pay out on feeding people this low calories diet spend millions when lets face it we can all do that ourselves!

It not rocket science... eat healthy move more , u lose weight....

I know some are gona go “ what a cow” im not, this comes from someone that was overweight and changed for a illness they did not want anymore... same thing.

Also i wander if alot of people do not like it as it entails actually doin it urself NO MAGIC PILL... people know dieting is hard work and it not a QUICK FIX which the older generation want.

I know this as my nan has it and she will not do anything about it, i have tried to make her eat healthy and tried to make her at least walk around block NOTHING!!! She says at her age she cant b bothered . I say do u want to be ill, she says no... she has been told to lose weight but she knows it hard work and does not want to do it she wants a pill to take to get rid of the diabetes but b able to eat what she wants. Thats the real reason alot wont b happy...

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Well done on your weight loss and with keeping it off. I have a friend like your nan whose diabetes is getting worse because she will not change her diet, but wants more medication instead. So sad to watch.

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It sad to see ... and so easily changed if people would put the effort in.. it not a quick fix it a long slow process but it can change ur whole life i feel

So much better and so many other people could b same with effort.

People have got to learn to eat a apple instead of a pie or bar of chocolate... a meal with veg instead of macdonalds... it not hard..

Plus what are u teaching ur children? To eat 💩 and get diabetes later ... it not good.

Plus why should the goverment sort this .. it really is up to a dr to say “ look u eat 💩, it as simple as that, stop it, exercise and ur get better”!!!there so scared to say anything.

Plus i dont get this poverty thing .. i have minimal money i use it to buy veg and a chicken that will last me three days( chicken roast,cold chicken and cous cous and veg then a curry ,spinach and sweet pot) so it cost about 5 quid for a meal that last me and husband 3 days?? Is that more expensive then a takeaway every day....

I just dont get peoples thoughts, noone can help u ... u have to help urself!!!

My nan come from this era that doesnt believe in vitamins, dieting, exercise... it “oh why cant i take a tablet”!

They dont wana put in time...

Im no angel!! I just decided i couldnt go on like this i had so much pain with IBS and knew i was getting FAT, i didnt need help or need to b told i knew!!

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You sound as though you are being really careful with your money. Being in poverty would mean that you couldn’t afford to buy the chicken or afford the fuel bill to cook it.

The government could do more by not allowing lots of fast food outlets on our streets and by not paying so much attention to big food businesses. They could fund adverts on TV to remind people what a healthy diet means, they do this in countries like France.

The government had to be shamed into re-introducing minimum food standards in schools.

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Ok but these people can afford a car and petrol to go to a town or drive through to buy a takeaway....

I have no car as i cant afford one! I couldnt afford car or insurance

Let alone buying a takeaway every day. My 3.99 chicken last me three days. I buy a bag of wonky veg and that last me three days.

I afford my cooker as i go without a car! A takeaway and heating ... most of the time ... but i will refuse to eat 💩.

I cant afford to b out of work or get ill so il do anything i can to make sure im healthy...

No matter what u say u can eat good food!!!

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It’s good to read that you have such determination to manage your meals and health so well.

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Thanku Penel. Way i see it is noone else is goin to do it for us so we need to look after ourselves.

We only live one life , lets make it a healthy and happy one.

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Wheat's one of the main causes of lbs. Try not to eat wheat for a few months and see if it makes any difference in the ibs. Wheat intolerance /allergy has varied presentations right from coeliac disease to mere gastrointestinal disturbances like constipation, diarrhea,flatulance and mere gi uneasiness.

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When I go to the supermarket and see the c**p in other people's trolleys I almost feel they need their heads examined.

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Thankyou!!!! For saying that! Sometimes i think it just me....

I see these big big people walking around supermarkets and there unloading in front of me and they have all this pizza, crisp, chocolate, cakes, chips, chicken nuggets and i just think “ what hope have ur children got if u feed them

This now there gona never know any diff” .

I know friends that have kids and there kids are in the 20s now and they wont eat veg as they never ate it as a child?

Whats that about.... surely as a adult u must think “ my diets terrible it needs to change”!

We cant keep blaming this on anyone else but ourselves we eat ourselves fat ... noone false feeds us...

my shopping when i was fat was double what it is now.. so the poverty thing dont ring true with me...

All i buy is meat and veg! Jobdone.. i make one thing last 2-3 days.

Whereas a £5 pizza used to last me one sitting!

We only have ourselves to blame for this desease.

As my mum always says “ in my day it was meat and veg no takeaways and no 💩”!!

She is 70 and a size 10 and walk 3-5 miles a day for FUN!!!

And now at 40 i am same and can hopefully live a healthier life ahead of me which 2 years ago and 3 stone heavier i was heading for the diabetes clinic!

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Hi Jerry

This has really brought some useful discussion be it frustration, joy or curiosity. Professor Roy Taylor has been working with this one at the University of Newcastle and looks at the results. There are some features of some of his groups on YouTube and some have been televised in the last eight months on both the BBC and ITV here in the UK. Reference typing in "Reversing Type 2 Diabetes - Newcastle Magnetic Resonance..." you will find some basics on this programme.

As a T2 on Insulin and Metformin, I worked on a tight diet which gave me a smoothie in the morning and another one in the evening. I only allowed myself a lunch which was my freedom of the day. I worked my lunches to include five vegs with occasional meat but in small proportions and occasional salads. I stayed on track for two years and brought my BG HbA1c to 53! I was shooting for a 48. I got my weight at a manageable level of 83/4kg or 182 - 185 lbs/13 and 13.14 Stones and I was 5'10/1.76cm but slowly becoming 5'9"/1.74cm as I approach 69 in a week's time.

In America the phrase "reverse" refers to going back the way one was before being diagnosed. Here we use "remission" but it is a matter of semantics depending upon where you are from. It is recommended that when undergoing this diet that there is a physician, trained dietician or Diabetes Specialist Nurse who monitors this programme and person taking it, because although it can be done with great results, it depends upon the stamina of the person either physically or mentally to make it through this programme which can extend 6 - 8 weeks in length.

There can be a small drop out rate, but close monitoring requires some counselling to help those determined to make it through safely. It requires metabolism, exercise and mental determination. I am aware that some will find difficulty in finding some cheaper health foods due to their limited incomes and here is where guidance from an informed source is so important!

When an opportunity like this comes along, you want to grab it with all the strength you have to make a big difference in one's life. I was one that was nearly there having cut my use of insulin to 2-4 units at lunch and none in the morning or evening, and then another disaster hit me in the form of a permanent illness out of nowhere. All that effort felt like it went down the drain. However, life can knock you back sometimes, I just get back up and continue fighting - keeping my diabetes in check versus the meds given and preparing for a stem cell transplant for my newly diagnosed Multiple Myeloma. I'm here to tell you it can work from experience.

If you are exercising and already aware of healthy eating, you are part way there. Here is where a trained dietician, diabetes specialist nurse or doctor can guide you along the way to making this 600-800 calorie diet. There are things to consider like the meds that you are on and certain health conditions so that your health team is available to help you deal with some side effects that could occur. You are on this for a limited time between six to eight weeks until your system learns to accept a different range of foods while you physically change for the better. I would have liked to have been to remission point, but it is tougher after 34 years of having diabetes, but until the recent events, I have to be happy I nearly achieved my goal. Disappointed? Yes, but on the other hand I am still fit and keep exercising and happy to be alive each day.

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Hi Jerry i dont even take 800 calories a day sometimes, simply as i cant, i have a back up which is fortisips but even that does not do the trick! everyone appears to have different types of machines also on reading some posts people are not sleeping i would be lucky to sleep more than 1 hour a day. that is my reason for asking

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see above

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