Sometimes the consensus deniers are right, which is exactly why the term is so pointless and so profoundly unscientific.
The medical associations were unequivocal. Crash diets were a fad, unhealthy, and only slow sensible weight loss could work. So millions of people were fed expensive drugs for decades, monitored, and some even given risky bariatric surgery. Patients with Type II diabetes were expected to be treated for years, or possibly the rest of their lives. Nearly a tenth of the national health budget of the UK was spent managing diabetes. Fully 8% of the population have the condition in the US.
Now a new (albeit very very small) study cured diabetes in some cases in as little as a week with a diet that was thought to be bad.
In the trial the very low calorie diet was done for 8 weeks. Sticking to 600 calories a day is not easy (some reports say it was 800 cals). It’s about a quarter of what a normal guy would eat. But it shrinks fat in the pancreas and liver, and that seemingly returns insulin levels to normal. The really amazing thing is that the benefits turn out to stay around far longer than anyone thought. A word of warning, to anyone on medical treatment: the effect on blood sugar levels can be so dramatic it could be dangerous to start such a drastic diet without talking to the doc first.
The discovery, a “radical change” in understanding of the condition, holds out the possibility that sufferers could cure themselves – if they have the willpower.
Until recently received medical wisdom was that Type 2 diabetes was largely irreversible.
Prof Taylor asked 11 volunteers, all recently diagnosed, to go on what he admitted was an “extreme diet” of specially formulated drinks and non-starchy vegetables, for eight weeks.
After just a week, pre-breakfast (‘fasting’) blood sugar levels had returned to normal, suggesting a resumption of correct pancreas function.
Gordon Parmley, 67, from Stocksfield in Northumberland, one of the volunteers, said: “At the end of the trial, I was told my insulin levels were normal and after six years, I no longer needed my diabetes tablets.
“Still today, 18 months on, I don’t take them. It’s astonishing really that a diet – hard as it was – could change my health so drastically.”
While this study is tiny (11 people), there have been others suggesting something similar, and the idea came from the way people responded to bariatric surgery (it seemed to cure their insulin problems very fast). I think this study might be the first to use MRI’s to look at the fat inside the pancreas which dropped by a quarter over the 8 weeks. Note too, these people ate a lot of salad. Not all crash diets are the same, and some of the criticisms of crash diets are fair. Plus many on the crash diet may have made long term changes after the diet.
I’m not declaring that this is definitely a cure, or that it will work for everyone (it may only apply to a certain group), but I would bet people suggesting a radical low calorie diet would once have been called dangerous quacks (or deniers?). Once again, we see large organizations of well respected people saying that something is a “fact”, when it is merely the best guess they could make at the time.
American Diabetes Association
“Fact: For most people, type 2 diabetes is a progressive disease. When first diagnosed, many people with type 2 diabetes can keep their blood glucose at a healthy level with oral medications. But over time, the body gradually produces less and less of its own insulin,
“While dietary and lifestyle changes are the foundation of the management of type 2 diabetes, these changes are rarely sufficient to maintain adequate glycemic control over the long-term.
“Type 2 diabetes can often initially be managed with healthy eating and regular physical activity. However, over time most people with type 2 diabetes will also need tablets and many will also need insulin. It is important to note that this is just the natural progression of the disease, and taking tablets or insulin as soon as they are required can result in fewer complications in the long-term.
The American Heart Association wrote a whole book called the “No-Fad Diet”.
I would guess that producers of Biguanides, Sulphonylureas, Thiazolidinediones, Meglitinides, Alpha glucosidase inhibitors, DPP-4 inhibitors, Incretin mimetics and insulin will be unenthusiastic about this news. You could hardly blame them when it costs so much to test and trial new drugs. But that is exactly why we need to get the science right at the start. Everyone loses when a fact is not a fact.
*There is a gimmicky element to the promotion of this story in their use of the word “crash” diet and we can argue about the definitions, and also about whether people returned to eating their former diet (I’m guessing they didn’t). It’s possibly that this sudden weight loss may have longer term repercussions, but then we know diabetes does. Only long large trials will settle the long term view, and also find out whether people find sudden extreme diets more workable than long continuous lifestyle changes. Nonetheless, the food police need to stop claiming that all extremely low calorie diets are bad.
UPDATE: Thanks to Ian for the link to the original study, which turns out to be a 2011 work. Apparently the news media fuss now is because there is funding for a larger trial. Thanks to Christopher Dollis in comments for extra links and information.
Lim, L., K. G. Hollingsworth, B. S. Aribisala, M. J. Chen, J. C. Mathers, R. Taylor (2011) Reversal of type 2 diabetes: normalisation of beta cell function in association with decreased pancreas and liver triacylglycerol Diabetologia October 2011, Volume 54, Issue 10, pp 2506-2514, [Abstract]