Taylor uses Optifast (soy and other crap with 17g carbs per serving) to get people to lose weight, but didn't mention what happens after the 8 weeks are up. I suspect many regain everything and more, like Oprah. IFing on real food and higher fat (Fung method) sounds more sustainable to me.

If the dawn phenomenon is adaptive, are higher dawn BG levels really that bad if they drop for the rest of the day and most of the night?

With 40 experts, there will be a lot of disagreement on the most effective diet, but Taylor's in particular seemed out of touch with what might work long term, unless starving appeals. Anyone wanting to do Dr Fung's program, it is only $177 + tax, or C$200 for the long distance version with Megan..for a year. (US$ 160, less than one appointment here)
Dr Fung talked about the insulin index of red meat and a few others I have heard lately suggest eating wild caught fish or pasture raised poultry, particularly to avoid the hormones in CAFO beef and this insulin rise.
And then is whole first and second meal effect is new to me, but then it would not be fasting. Might drive myself crazy if I listen to too many conflicting views

That's what I found happening to me yesterday, so many different views was making me feel so confused. I too wished Jason Fung had talked more about intermittent fasting. although his information about insulin rises was new and interesting to me. And I also wondered whether people using Dr Taylor's approach were able to maintain their weight loss. In that regard it seemed no different than any other low cal diet, no doubt hard to maintain.

I have a general question. When people speak of normalizing blood sugars what measurement do they use? Is it the standard diagnostic criteria? I don't imagine most people mean 83 around the clock like Dr Bernstein says but most people don't seem to specify.

Jean

Another interesting thing that Dr Fung said was that given the population he primarily serves, suggesting a paleo diet might be too confusing or too difficult to understand or implement whereas fasting is easily understood by everyone. Makes me wonder what he believes an optimal diet would be. Is it different than the one that he instructs his patients to follow? Questions, questions, questions.

couple of things: Dr. Fung does mention low carb diet as a good option for eating day. He believes Insulin Resistance is the cause of diabetes 2 and Taylor says that IR is a power source but not the engine. what the engine is I never understood.

The offerings for Tuesday have been fantastic. So agree with comment about so much to take in and process. Lots of notes of material I want to go back and explore more. Just listened to Suzy Cohen. Terrific interview with lots of practical discussion rather than just heavy background. She covers both diabetes and thyroid health. Very conversant. Only have one lest to go but just about out of available time.

Have a lovely day!

For the record I agree with everything said about Dr Taylor - his take that diabetes is from too much food, rather than an intolerance specifically to carbohydrates, seems outdated and a little too close to Stephen Guyenet's take for my taste. The idea of soya and Optifast being acceptable surrogates for food is crazy (and I believe I could hear a bit of skepticism in Mowll's voice as well).

And yes, his notion of eating a small amount of protein in the morning is directly opposed to the concept of fasting. However, I thought it might be an interesting approach for anyone for whom fasting was not getting morning numbers to the normal range. Or maybe timing can be adjusted.....protein snack in the am, hearty meal once the glucose levels stabilize, then fast till the following morning. I'm always suspicious of the one answer that works for everyone.

I happened to listen to Dr Colberg yesterday as well and she too was advocating a tiny bit of food in the morning for those who want to exercise in the morning but experience the dawn effect and don't want to exercise with high glucose levels.

Yes, lots of conflicting ideas and while it makes my head explode short term, it also points out that these are theories. Parts of each doctor's approach is probably true and other parts not so much. I love the diversity and figuring out what parts seem to work for me.

Is anyone getting anywhere near the 50 grams of fiber that Dr Fung recommends (without resorting to pure fiber supplements)?

In my experience a tiny bit of food in the morning can be problematic - for me it just leads to eating all day, like it wakes up my hunger, I certainly couldn't eat a small amount of food and then fast as I don't believe in white knuckling through hunger, just eating to natural hunger.

The other issue I have notice with eating in am is that it will drive my bg up even higher then my already elevated level from dawn phenomenon. Where with my tea and co, my bg will start to drop more quickly.

I have been eating around 20-25 gms of carbs a day and I can't see any way to up my fiber with food and still keep mt carb count low, so no, I get nothing near 50 gms a day.

Jean

Interesting and so instructive to hear from someone who has tried that approach. Dr Taylor was quick to mention that the small breakfast snack should predominantly protein (and agreed with Dr Mowll that an egg would be perfect), but he did not indicate that blood glucose would go up with the protein, only that insulin would be pumped out, resulting in a net lower BG (protein may be high on the insulin index, but low on the glycemic). I wonder what mechanism is sending glucose higher with protein + fat only? There was a YouTube video circulating a month or so ago that contended that faulty glucagon signaling, not insulin resistance, is the TRUE cause of diabetes. Perhaps that is a factor in your case.

Another idea that struck me yesterday was Dr Colberg's contention that there may be many different types of type 2 diabetes, with the implication that treatment for the different types might vary. Yes, probably for most insulin resistance is the root cause of type 2. But I wonder if that is the case for me. I have high-ish Hgb (5.5- 5.9) and FBG (90s-110 if not fasting, 70s-90s when following fasting protocol regularly) and yet my fasting insulin is surprisingly low (3-5 on a scale where 2.7 to 27 is considered normal). Maybe for me it is indeed glucagon signaling, not insulin resistance. Or maybe something else entirely that has not been discovered/explained yet.

I'm had the same dilemma with fiber as you, Jean. Am thinking about adding a bit of legume. I've found recently that I can eat as much as 1/4 medium potato at dinner with no untoward effects on my GB meter. It's all so complex.....

The summit has been really fascinating, looking forward to learning more about the gut today.

Jean,
I'm happy if BG is under 100. Both Bernstein and Kresser talk about around 83 as true normal, but Zoe Harcombe has quite a different perspective on "normal numbers" that was within that cholesterol wrap-up I posted. http://www.zoeharcombe.com/2014/06/...-longer-normal/. I've forgotten what Jenny Ruhl wrote as the level damage starts, but none of these firm and low numbers take account individual variability nor age. Once I saw a study that glucose should rise a bit with age, others say not. So I go with the simple formula, Two digits =

Re fiber, since I started Dr Fung's diet, which already had way more fiber naturally through foods than what I had been eating, I have also supplemented. His "allowed extras on fast" list includes chia, psyllium (I am allergic to that and now substitute acacia). Although there is tons we don't know about the gut microbiome, so many are focussed on it now, e.g. Brenda Watson, Sara Gottfried, Sarah Ballentyne, just about every Paleo guru, that I have been purposely increasing fiber to correct what I may have been missing. I try to get it with food first, and not depend on one fiber or prebiotic like resistent starch. (Ballentyne has said if you depend on just one supplement you may be feeding just one type of bad bugs..use real food first) But just heard Dr Gottfried say she takes fiber supplement 15 minutes before every meal. I take a T of acacia as "lunch"..if I remember. My only issue is I forget all Fung's extras. Not really hungry so get to dinner and realize have added nothing. So usually will take fiber, vinegar and nibble on raw veggies before dinner while making it. (Somewhat off topic, Trader Joes had Beet Hummus...beautiful purple and tasty dip for veg).

The diabetes summit is introducing so many new people to its listeners, and many have books, or at least a website. Suzy Cohen has quite a few books, some are in my library and go back a ways, newest is on Thyroid. Steve Wright has the wonderful SCDLifestyle website. Easy to find more information on anything that peaked your interest, and other podcast interviews. Last year was the first diabetes summit and it had some rough edges, this year's production and interviews are better. Glad you are all enjoying it.

Janet,

I think the difference between what Zoe Harcombe is talking about and what Bernstein and Kresser are talking about is the difference between optimal and normal or average or median in the population. What is normal in the population may not be optimal given the high level of carbohydrates in most people's diets. When you add in governmental dietary guidelines and the setting of standards by medical groups the "scientific" gets all mixed up with the "political". Because it all gets so convoluted, I have decided on the same formula as you have, bg under 100 is my goal.

I don't know what to make of all the gut biome talk. The recommendations seem well ahead of the research, which does not mean they are wrong. For a long time I could not eat much fiber because it irritated my intestinal system but now that I have figured out my food sensitivities that doesn't seem to be a problem any more. I believe Dr Eades once talked about fiber as an irritant. I do make fermented foods. I've been using glucomannan noodles lately. I stir fry small quantities of vegetables in coconut oil and serve them over the noodles, which are 100% fiber. The noodles absorb the oil so it's not like eating veggies swimming in oil. I just ordered some glucomannan powder. I used to make coconut milk pudding to which I added cinnamon, which I had forgotten about until Josh Axe (I think) mentioned cinnamon in his talk. So that will be some more fiber. It's always a work in progress.

Jean

In defense of Dr. Taylor's approach--obviously 600-800 calories a day isn't sustainable long-term, but for that matter, neither is an extended water-fast. Once it's established that Type II can basically be reversed, then there's the matter of figuring out maintenance--and there Dr. Fung definitely has the advantage. Something Dr. Taylor did mention is the idea that when people who have some weight to lose go on very low calorie diets, appetite tends to decrease--as opposed to more moderately lowered calorie diets, where appetite doesn't decrease. There is something to be said for a very low calorie diet, vs. an extended fast--for one thing, the loss of lean mass would be greatly reduced. And while insulin wouldn't be as low as it would be on a total water fast--it would probably compare favourably to intermittent fasting, during the disease reversal stage, and all the same options would be open to the individual during the maintenance stage.

Today's talks are on, Dr Bernstein addresses what the research says about "normal" ...best listen to him, not me!