Sat, Nov-14-20, 07:01
Can the new NHS diet plan reverse diabetes?
‘I never want to go back to being diabetic’ – can the new NHS diet plan reverse diabetes?
November 14 is World Diabetes Day: with type 2 diabetes affecting 3.5 million people in the UK, how effective is diet in controlling it?
For years, type 2 diabetes was considered something of a permanent affliction – once you were diagnosed, you were stuck with it. But over the past decade, studies have shown that it is possible to put it into remission, just by changing – or rather, dramatically cutting back – what you eat.
So compelling is the data that an old-fashioned ‘soup and shake’ plan is now being prescribed on the NHS. In September it announced that after a successful pilot study, in which more than half of patients saw their type 2 diabetes go into remission, 5,000 more patients in 10 areas would be enrolled on the low calorie diet.
Type 2 is a big problem, typically affecting one in 10 midlifers. Nearly 3.5 million people have type 2 diabetes in the UK, and almost a million more live with it but don’t know it while another 7 million are at risk of developing it. The long-term complications that can arise if it is left untreated include heart disease, nerve damage and amputation, and vision problems.
It’s also costly – diabetes is estimated to cost the NHS £10 billion a year, with almost one in 20 prescriptions written by GPs for diabetes treatment. And diabetes is a particularly pressing concern at the moment, because those who have it seem to suffer more severely with Covid. NHS research published earlier this year revealed people with type 2 diabetes are twice as likely to die from coronavirus as those who don’t.
The news that low calorie diets are to be rolled out on the NHS has been welcomed by experts in the field, including Dr Michael Mosley, whose low calorie Fast 800 diet has taken the world by storm thanks to its dramatic results among people with diabetes. Mosley was diagnosed with the condition himself eight years ago. He had been told by his doctor that “there was nothing that could be done apart from taking medication” and that within a decade “there was a 50-50 chance I would be forced to inject myself with insulin.”
Reading that type 2 diabetes could, in some cases, be reversed through diet alone, Mosley created a plan for himself, which involved eating 800 calories of low carb, Mediterranean-style food per day. “In the first four days I lost 6lb, and my blood sugar levels and blood pressure fell very swiftly too. At times my energy levels felt lower, but after two weeks I lost 11lb and tests showed that my blood sugar levels and blood pressure were back to normal,” he says.
Three weeks and five days after he started, he had lost a stone, was back to his previous healthy weight and all his blood levels were back to normal. It is a similar approach that the NHS is now rolling out across the country.
Such crash diets have historically been discredited, but the dramatic reduction in calories and resulting rapid weight loss are proving to be key. Studies have shown this is a more effective way to bring down blood sugars than gradual dieting, because it switches the body over to fat burning, and the quick drop in fat content in the liver resets the way the pancreas produces and regulates insulin. Seeing fast results can also be highly motivating for dieters. Under the NHS plan, patients are helped to reintroduce a healthy balanced diet once they’ve reached their desired weight.
Leading the research is Professor Roy Taylor at the University of Newcastle who has studied diabetes for more than 43 years. In 2011, he enrolled patients to try very low-calorie diets – consuming around 850 calories a day, made up of meal replacement shakes. After one year, 46 per cent of his volunteers had put their diabetes in remission, with a third still in remission after two years. The results achieved were comparable to those with people who undergo bariatric surgery – but without the risk or expense of surgery. Taylor went on to conduct larger trials, and says the participants have all found “that perhaps they were a little bit hungry in the first few days, but that soon disappeared. In fact, they had less tiredness and felt better.”
While type 2 diabetes is closely linked with obesity, it can affect relatively slim people too: one in two people who develop type 2 diabetes has a BMI of less than 30. “There is no good reason to be any heavier in your 40s, 50s or 60s than you were in your 20s,” adds Taylor. It’s even more important now. Statistics show that 30 per cent of the UK put on an average of 6lbs during the spring lockdown; Taylor worries that further lockdowns and restrictions will see a similar rise in comfort eating.
He is delighted that the NHS is offering his diets to a wider cohort of patients. “The most common comments we get from people after they’ve lost weight is that they say: ‘I feel 10 years younger.’ Isn’t that marvellous? They realise they’ve discovered the elixir of eternal youth,” he jokes. “But really, what do we really want a doctor for? To feel better. Losing 15kg does just that. It’s a good news message and it needs to be taken seriously.”
‘I’m no longer on medication’
Michael Cunningham, 68, had a powerful motivation to lose weight to reverse his type 2 diabetes. When she was only 45, his youngest sister Angela had died from a complication related to the disease. “She was 16 weeks in intensive care and I remember her saying to me at one point, ‘I’m not coming out of here’ Mike,” says the former headteacher from Cumbria.
Years later, in 2009, Cunningham was told that he had type 2 diabetes and was put on the drug metformin. His weight had crept up to 15st 4lb. “It was a bit of a shock finding that out, as I’d been active all my life,” he recalls. “But the stress of the job, with long hours, meant I was eating the wrong things at the wrong times.” He tried several recommended diet plans, “but they weren’t really working for me. I was watching what I was eating, but the weight wasn’t coming off quick enough,” he says.
Soon Cunningham was on three different types of medication, including slow release insulin. “The combination of them left me feeling really foggy and just not myself,” he says. In October 2016 a friend told him about Mosley’s Fast800 plan, which he had heard could help reverse his diabetes. He signed up for the next available support programme, and in the meantime tried to follow the diet from the book at home, with the support of his partner Rachel.
“By January, I’d already dropped to just over 14st and my blood sugars had fallen,” he says. “It was really motivating to see such quick results – but it was still hard, especially over Christmas with no booze.”
At the end of the programme he weighed 11st 5lb. “I was a bit too thin, but it had the desired effect because it put my diabetes into remission and I’m no longer on any medication,” says Cunningham.
His weight now hovers between 11st 10lb and 12st. The couple have kept a healthy regime up. “There were times, especially over lockdown when it crept up a few pounds, but we know what to do now. If there’s a blip, I just go on a fast for a couple of days over the week and it adjusts so quickly. I don’t want to go back to being diabetic.”
The Fast800 Plan