
Type 2 diabetes: NHS to offer 800-calorie diet treatment - prostoalex
https://www.bbc.com/news/health-46363869
======
garenp
About 3 years ago (late 2015 now) I was quite overweight, had a knee injury
that limited my mobility (stairs mostly) and had a fasting glucose and post-
meal readings that indicated I was nearly pre-diabetic (T2).

So, I cut out out all sugary drinks, refined carbs, late night eating (!!) and
tried various intermittent fasting / time restricted feeding techniques (5:2,
alternate day, one-meal-a-day) and after about 3.5 months my glucose readings
returned to the "normal" range. (Which is WAY more tolerable than sticking to
a low-calorie diet every single day IME. I still had pizza and cheeseburgers
on occasion, just no soda, fries, "junk" etc.)

After around 6-7 months I'd lost 40+lbs, my knee stopped bothering me and no
longer had to entertain the idea of fixing it with surgery. I'm now down well
over 60+lbs without having put in hardly any effort to exercise (occasional
walking) - pretty stunning to me.

~~~
Sohcahtoa82
> I'm now down well over 60+lbs without having put in hardly any effort to
> exercise (occasional walking) - pretty stunning to me.

Losing weight despite not exercising isn't surprising. Exercise, even intense
cardio, burns far fewer calories than most people think. I'm about 240 lbs,
5'8", 36 years old, and according to this calculator [0], if I ran a 5k at a
fast-paced 10 mph (6 minute mile), I'd only burn about 250 calories. That
wouldn't even be enough to burn the calories in the energy drink I might drink
before it!

Great work on the weight loss. I was 255 lbs at the beginning of the year and
switched out my sugary sodas for unsweetened tea or occasionally a diet soda
and lost 15 lbs in 4 months. I plateaued because I haven't changed much else.

[0] [https://www.freedieting.com/calories-
burned](https://www.freedieting.com/calories-burned)

~~~
jaegerpicker
Most exercise based weight loss isn't about the actual exercise it's about the
changes the intense exercise makes to your body that causes you to burn more
calories while resting. Exercise often tunes your body to burn calories at a
higher rate as you gain muscle and / or increase muscle health which requires
more energy to support even while resting. So while you don't NEED exercise to
lose weight it certainly is a super important part of weight lose for most
people.

~~~
GeekyBear
Some recent research contradicts those ideas.

Contestants on an extreme weight loss television reality show saw their
resting metabolism drop after a rigorous program of exercise.

>The group as a whole on average burned 2,607 calories per day at rest before
the competition, which dropped to about 2,000 calories per day at the end.

Six years later, calorie burning had slowed further to 1,900 per day, as
reported in the journal Obesity.

[https://www.scientificamerican.com/article/6-years-after-
the...](https://www.scientificamerican.com/article/6-years-after-the-biggest-
loser-metabolism-is-slower-and-weight-is-back-up/)

Another recent study showed that diet effected metabolism.

>a large new study published on Wednesday in the journal BMJ found that
overweight adults who cut carbohydrates from their diets and replaced them
with fat sharply increased their metabolisms.

After five months on the diet, their bodies burned roughly 250 calories more
per day than people who ate a high-carb, low-fat diet

[https://www.nytimes.com/2018/11/14/well/eat/how-a-low-
carb-d...](https://www.nytimes.com/2018/11/14/well/eat/how-a-low-carb-diet-
might-help-you-maintain-a-healthy-weight.html)

~~~
gamblor956
That research on the biggest loser participants has since been disproven.
Sorry can't pull up those studies easily by mobile do I'll try to update wheni
can.

~~~
lhl
Every time the Biggest Loser study (PMC4989512) gets cited someone pops up and
mentions that it's been disproven but I've never seen any citation or
followup. In fact, from my research I've seen lots of studies that show that
there are long term metabolic changes (PMC6033771) related to adaptive
thermogenesis/fat oxidization that is a fat-free mass independent effect on
REE (doi: 10.3945/ajcn.115.109173).

Other studies seem to show that the lowered RMR doesn't seem to happen either
doing a ketogenic diet (PMC5816424) or with ADF (PMC5042570) vs CR. I also
think that the Biggest Loser results are in large part so unsuccessful due to
their "crash diet" nature and the lack of any healthy habits being built for
maintenance.

* [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4989512/](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4989512/)

* [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6033771/](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6033771/)

* [https://www.ncbi.nlm.nih.gov/pubmed/26399868](https://www.ncbi.nlm.nih.gov/pubmed/26399868)

* [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5816424/](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5816424/)

* [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5042570/](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5042570/)

------
virtuallynathan
The 800 calories they are eating doesn't seem terribly healthy: "patients were
asked to follow either a ‘home-made’ milk- and fruit-juice-based diet (811
kcal/day, 64 g protein, 132 g carbohydrate, 6 g fat) with a
multivitamin/mineral supplement (Forceval® [Alliance]), or a micronutrient-
replete commercial LELD (832 kcal/day, 87 g protein, 120 g carbohydrate, 12 g
fat).

I imagine these people are probably staving... I'd rather go low-carb myself.

This is the study, DiRECT:
[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4754868/](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4754868/)

~~~
village-idiot
Generally agreed, but with a caveat: diabetics are at risk of ketoacidosis on
low carb diets. They would need to measure their blood ketones and moderate
carbohydrate intake to keep their levels down below dangerous thresholds.

Personally when I went low carb, I got blood (not urine) ketone levels up into
the range that would kill a diabetic quickly, think in the 7.0 range. Even as
someone well adapted I regularly hit the 3.0s when fasting.

Obligatory: I am not a doctor.

~~~
someone454
You dont get keto acidosis by eating low carb, that is misinformation.

~~~
traek
Source? From my read it looks like you absolutely can.

[https://www.nejm.org/doi/full/10.1056/nejmc052709](https://www.nejm.org/doi/full/10.1056/nejmc052709)

~~~
joecool1029
That's a case study of a single patient. Main takeaway:

>Benign dietary ketosis resulting from restricting carbohydrates could,
theoretically, cause ketoacidosis in persons with a predisposition to the
condition.

~~~
matt4077
That sounds very much like what they were saying. “Theoretically” is closer to
“can” than it is to “cannot”.

~~~
village-idiot
Also, I said that it’s a risk to be managed. People are acting like I said
that it’s a certainty and that not eating sugar constantly as a diabetic will
kill you instantly or something.

------
hirundo
I think that this is effective because it reduces the carbohydrate load.
Protein and fat consumption also increase insulin response but not nearly as
much. Type 2 diabetics could get most of the blood sugar reducing benefit of
this by just removing/replacing the carbs. That has been my N=1 experience
with both fasting and carb restriction.

~~~
will_brown
Well reversing is different but most cases can be reveresed with
dietary/lifestyle changes.

On the other hand prevention of type2 is N=100% with these changes. I know
people, especially in the US consider it thier right/freedom to eat what they
want and live how they want, but in my mind it’s deeply disturbing especially
because children don’t have any choice (it’s parental).

I think as soon as a child is diagnosed with fatty liver disease...there
should be some mandate on parents to “treat” their child with diet (which I
know is probably equally disturbing to people, government dictated diet).

~~~
hirundo
In the US the official nutrition advice has been both wrong and corrupt since
the 1970s. Gotten wrong by sincere hard working scientists with the best
intentions. Corrupted by corporate capture of regulatory bodies and funding of
exculpatory studies.

These same forces would choose what is mandated. That is horrifying. Not only
could they give bad advice, they could compel ever larger fractions of the
population to follow it.

Far better to let parents decide, so when they get it wrong we can learn from
it, and don't all get it wrong at once.

~~~
will_brown
>Far better to let parents decide, so when they get it wrong we can learn from
it, and don't all get it wrong at once.

The problem is the disease is growing in epidemic proportions, no one is
learning from mistakes.

The government got it wrong sure, but let the doctors prescribe the diet and
government won’t dictate the diet only mandate following doctor prescribed
treatment/diet (and this too I know has flaws).

But here is the thing, say a child does get diabeties and the doctor
prescribed insulin, but the parents think they know better and refuse the
treat their child. Should government be able to step in or allow the parent to
withhold insulin treatment based on their freedom? Legally parents can refuse
(life saving) treatment on religious grounds, and that arguement comes into
play in diet, but I’ve also been involved in a case where a 13 year old was
pregnant with HIV and was refusing court ordered treatments so the baby would
be born without HIV, legally and morally they are complex issues.

~~~
village-idiot
Americans have by and large followed the recommendations of the government:
meat and saturated fat consumption is down, and we eat way more “heart
healthy” whole grains and polyunsaturated seed (excuse me, “vegetable”) oils.

Lots of people followed the advice, because lots of people wanted to be
healthy. The advice was just garbage.

I was under the impression that parents could not decline life saving
treatments for minors, and that the state had the right to step in.

~~~
inapis
Honestly curious, where should a layman go to for nutrition advice if they
can’t rely on their government?

~~~
will_brown
You’re initial steps depend on your starting point/goals.

Are you a body builder trying to go from 10-12% body fat to 7% for
competition.

Are you obese? Do you have chronic diseases or metabolic issues caused by
diet?

I personally focus on ATP/krebs cycle, cellular health, dietary inflammation,
liver/kidney function...I experiment and consume information mostly from
athletes. I myself am a ultra runner but only started running 5 years ago and
wanting to be a better runner is what got my to begging taking nutrition
seriously. I was 192 4 years ago, I’ve been down as low as 133. I experiment a
lot but it’s hard because I feel you must commit months to a diet to really
have insight on the effects on your body combined with lifestyle. That seems
to be the same conclusion as the other reply to your comment, but whereas they
say give is weeks/I’d say give it months.

------
ak39
I am not a doctor. This is what I have learned so far (there are no references
here - sorry, I will need to dig up the material to substantiate this if you
ask):

The upshot: Managing diet is not sufficient (for type 2) remission. The damage
is at cellular level. That damage needs to be reversed. Therefore muscles need
to be rebuilt. Even for the over 60 years!

The thinking: Diabetes Type 2 is the end point of years of abuse the body
endures with elevated insulin and the _extent_ of insulin resistance the body
progresses to. Diabetes therefore is a spectrum - the end point is when the
pancreas bonks out and refuses to produce any more insulin. It's a tiny tiny
organ and I think it's fragile. And it's threshold is also genetically
determined. The interesting thing is that we all (including healthy folks)
have levels and sometimes acute bouts of insulin resistance! The thing that
made sense to me, reading about this, was that insulin resistance is a
function of your _muscle_ cells denying entry to glucose. And the insulin
concentration in the bloodstream is a direct function of the concentration of
free flowing glucose. Poor Pancreas is only doing its job but the muscles are
not taking in any new glucose. They are refusing (resistant). Pancreas tries
its best by pumping more insulin and for longer but the adamant muscles are
the contract breakers in this arrangement - they don't open the gates for
glucose.

The only way to change direction permanently in type 2 is to rebuild muscles
which will have better insulin receptors to allow glucose to be shunted into
the cells. For this to happen you have to do strength training. Lift
sufficiently heavy. (No, not Arnie levels by any measure.)

(I recently read a study that administering testosterone to type 2 diabetics
improved their insulin resistance. What happens with testosterone and anabolic
steroids? New muscles, that's what.)

~~~
matt4077
Yeah... Also get a lawyer, quit Facebook, and start dressing for the job you
want!

~~~
ak39
I don't quite understand.

~~~
matt4077
It's a joke based on the perception of crackpotishhness I got from OP's
advice.

~~~
ak39
I admit that it does sound crackpotish [sic] - I am the OP.

Is this better? ->

The common understanding of T2DM is that it is a problem of sugar and
therefore diet. That's only half of the equation of the physiology leading to
T2DM. We have to also understand the _cause_ of excess free circulating blood
sugar and excess calories: _muscle cells that have lost their ability to
receive sugar_. Muscle atrophy and poor muscle composition has to be the
second half of understanding and therefore part of management of T2DM.

------
megaman8
It's great that they teach the idea that Diabetes (type 2) is preventable and
even treatable with responsible eating habits. Too many people believe it's
just something your doctor is supposed to treat with a pill.

Food companies often push the idea that all you need to do is exercise more.
Whilst exercise might be a great thing: it alone can't fix the problem. You
still need to learn how to eat.

------
arcticbull
Makes sense, it is a diet related illness, so it should have a diet related
treatment. Instead of treating the symptoms, treat the cause.

~~~
chimeracoder
> Makes sense, it is a diet related illness, so it should have a diet related
> treatment. Instead of treating the symptoms, treat the cause.

Type 2 diabetes isn't _caused_ by diet. Certain diets can increase the risk of
Type 2 diabetes, but it's not a foregone conclusion, and it's not uncommon to
develop Type 2 diabetes despite an otherwise healthy diet.

~~~
magnamerc
T2D is caused by a combination of genetic and environmental factors such as
diet, and you're correct that someone can get T2D based mostly on genetic
factors alone. It is however very uncommon, and diet plays a role in the
majority of cases. There are several studies that show this.

~~~
chimeracoder
> It is however very uncommon

It is _not_ very uncommon, and in fact the most recent (last ~decade of)
research has actually caused us to question the extent to which people
genetically predisposed to diabetes can mitigate their risk through diet and
lifestyle choices.

~~~
ConceptJunkie
My Dad and his brother both have T2D. My Dad is 75 and my uncle is going on
60. They are both very active, in shape, and not overweight at all. e.g., My
Dad was playing tennis 4 times a week when he was diagnosed. He's probably cut
down some since, um, he's 75, and has had two hip replacements, but he's in
way better shape than I am.

Neither were significantly overweight when they were diagnosed. In fact, my
Dad has been trim for decades, and while I don't see my uncle often, he was
always thin and very fit-looking when I have seen him.

There _has_ got to be a genetic component independent of lifestyle and diet
choices. Me? I have no excuse. I'm overweight and not active and I know I need
to change that.

edit: Didn't proofread.

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

[0] [https://www.labcorp.com/test-menu/31976/nmr-
lipoprofile%C2%A...](https://www.labcorp.com/test-menu/31976/nmr-
lipoprofile%C2%AE-with-graph)

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

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

[3] [https://www.managedcaremag.com/archives/2018/4/new-test-
diag...](https://www.managedcaremag.com/archives/2018/4/new-test-diagnosing-
insulin-resistance-could-turn-tide-against-diabetes)

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

[5] [https://www.amazon.com/Lore-Nutrition-Challenging-
convention...](https://www.amazon.com/Lore-Nutrition-Challenging-conventional-
dietary/dp/1776092619/)

------
a3n
When I was first diagnosed with T2 I did some reading around. Interesting
history, especially pre- manufactured insulin.

For example, war is "good" for reducing incidence of diabetes, because famine.

~~~
pmiller2
Two minor points: T2 isn’t controlled with insulin; it’s a syndrome of insulin
resistance and other metabolic dysfunctions. And “manufactured insulin” came
on the scene in 1922. Before that, T1 diabetes was universally fatal.

~~~
a3n
My T2 is not treated with insulin today, but it could be later if it gets
worse. And I am indeed talking about history pre-20th century.

For example, diabetes used to be diagnosed by peeing on the ground and seeing
if ants we attracted to it. According to whatever diabetes history book I
checked out of a medical library on inter library loan.

------
emersonrsantos
When people will realize that carbs are the only non-essential macronutrient?
The sports community (especially bodybuilding) knows that for decades.

If an athlete says to me that a thing he does to his body work 95% of the
time, I would consider to try it, and already did, some things against over-
the-counter conventional medicine like this no-carb diet.

~~~
ryanwaggoner
Bodybuilders eat plenty of carbs.

~~~
razakel
No they don't. A bodybuilding diet is mostly protein, then certain fats, then
starchy carbs at the right time (breakfast and post-workout).

~~~
have_faith
> A bodybuilding diet is mostly protein

Bodybuilders typically consume about ~30% protein. Where did you get the idea
that it is mostly protein? Not to say that there aren't outliers obviously.

------
jonteru
This sounds pretty similar to some of the things Dr. Valter Longo has been
mentioning in his book the longevity diet where a part of it are also
occasional 5 day fasts with 800 calories, that (supposedly) have great
benefits. Great to see this being tested with the general public.

------
msiyer
My mother suffered Type-2 diabetes for almost 20 years. I put her on an
extremely strict raw food diet three months ago and stopped injecting insulin.
Her fasting blood sugar level is now in the 90-110 mg/dL range. I now give her
some steamed potatoes also.

I too follow the same diet to give her company.

Elimination of oil, sugar and dairy has helped, I believe. She is a
vegetarian, so flesh was never in the picture. I do not have to restrict
calories with raw food. Eat as much as you can.

No juicing, however. That is a totally not allowed.

~~~
nradov
I'm glad your mother is improving, but there's no real evidence that raw
vegetables are better for blood sugar levels than cooked vegetables.

~~~
msiyer
Raw fruits are what I feed her. No vegetables at all. I started giving her
some steamed potatoes recently. Bananas have become her staple food.

------
belltaco
Losing a lot of weight with very low calorie diets is hard, but not regaining
it over the next couple of years is next to impossible.

Your body will try all the tricks in the book, it will reduce your metabolism
to way below that of the person of the same weight, it will amp up your hunger
hormones so much that you will think and dream about food 24/7.

Only 5 to 7% of people that lose a large amount weight are able to keep it off
successfully in the medium and long term. Hope there is more research into
this mechanism.

~~~
SketchySeaBeast
And that's why weight loss techniques need to be treated like a new lifestyle,
instead of a goal you hit and then finish. I lost 60 lbs a couple of years ago
and found that 20 of those had recently crept back on, so I went on another
shorter diet to get myself back on track. It's totally doable. You have to be
aware and keep correcting.

~~~
chosenbreed
> And that's why weight loss techniques need to be treated like a new
> lifestyle, instead of a goal you hit and then finish. I lost 60 lbs a couple
> of years ago ...

Firstly, fantastic achievement. I'm curious as to what motivated you enough to
put in the effort (I'm assuming it required effort).

Secondly, I wonder if the speed/drastic nature of the weight-loss can be
counter-productive. When you think about people don't become over-weight
overnight. Perhaps a more gradual pace with some time for settling at various
stages of the process...I'm thinking losing weight over a couple of years as
opposed to over a couple of months.

~~~
SketchySeaBeast
It was my health. My snoring was bothering my wife, and I was exhibiting sleep
apnea so I knew I either had to lose weight or go to a doctor, and I hate
visiting the doctor.

And the time is certainly a factor - people have to set up weight loss
scenarios that are sustainable over the long term. My weight loss goal was 1-2
lbs a week, so that was aggressive, but I am large enough that I can lose
weight on enough calories to not feel deprived. By counting calories and
making sure I had enough to enjoy myself it was a relatively easy process,
once I got used to the counting and accountability.

~~~
therealx
For some people, I think they shouldn't be given the false hope that "enough
to lose weight" and "enough to enjoy myself" go together. Part of losing
weight is a fundamental rewiring of what is "enjoying myself".

~~~
SketchySeaBeast
Oh yeah. As a sweet freak, for me "enjoying myself" is a cup of frozen yogurt
at the end of a day full of chicken breasts, not a plate of nachos or a whole
pizza.

------
voidbip
In July I was 203 pounds which for a 5'6" frame, put me in the "obese"
category. It was the highest weight I had ever been, and I felt I occupied
more space than I should in the world ( not in a good way ). I follow a
youtuber on Indian cooking and for whatever reason this woman mentioned how
she recently started eating in a more "Keto" way. This woman is thin as a
rake. She mentioned she was doing this for mental clarity. On a whim, I
decided to try it. I literally threw the little debbie box I had my hand in,
in the garbage that day. Today, I am 166 pounds, still "overweight" but this
is the most amount of weight I have ever lost. I feel so much better and
healthier, and its true about the mental clarity. My unsubstantiated
hypothesis is that it takes away the emotional swings insulin give you. I eat
till I am full. Honestly. There is not a day that I "think" about what I am
eating other than keeping sugar and carbs out my month. I could not be
happier. I am a 38 yo technology professional, and I imagine many others here
are similar. I have nothing to sell. I just want to make people aware of a
lifestyle that may help many of us who sit all day for a living.

------
GreaterFool
From what I've read about starving yourself vs fasting and my own experience
800-calories sounds like HELL.

I can fast for 2 weeks no problem (although that's kinda long and I wouldn't
do it if I didn't have enough body fat to sustain it. If you're skinny and
don't have fat to spare better not stretch it unnecessarily).

I'm eating keto and I usually only eat once a day.

Fasting _feels good_. Starving yourself feel horrible.

------
rkiyer
The 800 calories number indicates that this might be related to the Fasting
Mimicking Diet of Valter Longo. Since actual fasting has a "scary" reputation
among some patients and doctors, Valter Longo developed a 5 day fasting like
protocol with severely restricted calories that appears to have similar
benefits to fully fasting for 5 days. It looks like this modified version of
complete fasting is gaining popularity among the medical establishment.

[https://en.wikipedia.org/wiki/Valter_Longo#Fasting_mimicking...](https://en.wikipedia.org/wiki/Valter_Longo#Fasting_mimicking_diet)

[https://www.marksdailyapple.com/does-the-fasting-
mimicking-d...](https://www.marksdailyapple.com/does-the-fasting-mimicking-
diet-live-up-to-the-hype/)

------
ryanwaggoner
Loving the broscience takedowns of this NHS pilot program about how "this
won't work!", or "low carb / keto is the best way!"

If only doctors knew how to read internet forums, then they'd be as
knowledgable as all the armchair docs here, few (none?) of whom seem to have
any actual training or T2 diabetes themselves.

------
known
Could be feasible due to
[https://www.medicalnewstoday.com/articles/267241.php](https://www.medicalnewstoday.com/articles/267241.php)

------
acangiano
You absolutely don’t need such caloric restriction to revert diabetes. All it
takes is a very low carb or keto diet. Even without exercise.

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

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

~~~
RugnirViking
Many drugs that put our metabolitism on steroids cause deaths from overheating
- the energy has to go somewhere.

------
gregf
Ouch, this is going to be hard on me.

------
lilcorey10
This sounds to be marketed as some scientific potion to cure diabetes or at
least rid the need of medication. All it comes down to is cleaning up your
diet (e.g. eating the right amount of calories for your body and eating
nutrient rich foods). There's no one diet fits all but getting a good balance
of proteins, carbs, and fats is all this is doing for these people. NHS is
simply doing the leg work. I control my weight by counting calories and macro-
nutrients. If people could figure out how to do that own their own we'd see a
huge decrease in Type 2. It's true, a cleaner diet tends to be more expensive
and requires more work than the convenience of a fast food diet - but at the
the end of the day we're trading diabetes so we can be lazy with our diet and
health.

~~~
ryanwaggoner
800 calories per day for three months is hardly just "cleaning up your diet".

~~~
SilasX
Exactly. This seems like an Onion headline: "We have your cure for diabetes!
Just eat a ridiculously low amount of food, fatso."

I don't mean to sound like a whiner, but ... if it were that easy to cut down
my food consumption, I wouldn't be going to a doctor in the first place!

It's like telling people with extreme loneliness or social anxiety to "just
strike up a conversation with someone!" Or PTSD suffers: "Geez, just don't
freak out so much, take a deep breath or something."

Or narcissists/sociopaths: "Just, you know, think more about how your actions
hurt other people."

Given Herculean willpower, most diseases of civilization can be conquered.
Don't pat yourself on the back for calling it "prescription".

~~~
akvadrako
It's not like that because it's all about how you approach the problem. It's
easy to do all those things if you have the right mindset. Creating that
mindset isn't easy, but wording everything in the worst possible manner is a
sure way to make it more difficult.

In the case of diabetes, it's saying: here's an alternative prescription that
will cure you, we have good evidence it will work, you can afford it, here are
the steps to follow, each of which looks easy by itself...

~~~
SilasX
>In the case of diabetes, it's saying: here's an alternative prescription that
will cure you, we have good evidence it will work, you can afford it, here are
the steps to follow, each of which looks easy by itself...

We had "just eat less, weak-willed fatso" fifty years ago. This isn't
progress.

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zavi
How will they make sure people don't cheat and eat more anyways? 800 calories
a day for an overweight person requires some serious will power.

~~~
rufus_2
I found it easier to do via intermittent fasting and then eating all of my
calories in one meal per day. Something about completely abstaining from food
is easier for me psychologically than having multiple tiny meals and making
myself stop eating when I'm not full.

~~~
tchaffee
It's also easier for me. I have no problem skipping breakfast and then
skipping lunch takes a little willpower but I'm often distracted by work. I
have friends who find it easier to eat a big lunch as their only meal. Worth
experimenting for each person to find what works best for them.

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ronreiter
Or in other words: Type 2 Diabetes is a normal metabolic state of humanity (or
at least some significant parts of it), it's just that we're too goddamn fat

~~~
make3
? you mean, it's a consequence of being fat

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philip1209
Calories are not the core problem - carbohydrates are. The research from
VirtaHealth.com makes this clear. They are getting T2 diabetics off of insulin
within a week, while still giving patients the satiety they want from meals.

~~~
Nokinside
Heh. Whole company launched based on single study with short duration, no
control group and big drop-out rate.

But when you add long list of citations for medical literature it looks valid.
Even when those studies don't directly validate your approach. People don't
look at what the studies actually say.

