What About the Newcastle Diet?

Posted on May 19, 2016 | 3 comments
Some of these are Newcastle-compliant

Some of these are Newcastle-compliant

In 2011, Prof. Roy Taylor and colleagues found they could “reverse” type 2 diabetes with a very low-calorie diet. How low? 600–800 per day for eight weeks. His program—often called the Newcastle diet—has achieved some prominence in the United Kingdom but I don’t hear about it much over here across the pond. The clinical study in support of the program was very small—only 11 participants: 9 men and 2 women (with an average BMI of 33.6). I’m sure hundreds, if not thousands, have tried it since then.

I’m not endorsing or recommending the Newcastle diet at this time. I haven’t studied it in detail. It probably requires careful medical and dietitian supervision. Prof. Taylor says:

Our research subjects found the diet challenging to stick to. Motivated people were selected, and support from the team was given frequently. Support from the families of the research volunteers was very important in helping them comply with the diet. Hunger was not a particular problem after the first few days, but the complete change in social activities (not going to the pub, not joining in the family meals etc.) was a challenge over the eight weeks.

The purpose of this post is simply to collect a few informational links for my own records and for my readers who want to know more.

Links:

The original program utilizes Optifast liquid meals (600 calories/day) plus vegetables for another 200 calories. Prof. Taylor notes that products equivalent to Optifast may be more readily available and just as effective, but I don’t know what those are. Ensure? Carnation Instant Breakfast? Boost? Jevity?

Very low calorie diets like this are often referred to as starvation diets or crash diets. Starvation diets can cause weakness and easy fatigue, headaches, dizziness, hair loss, gallstones, electrolyte (blood mineral) disturbances, palpitations, nutritional deficiencies, skin problems, gout, kidney failure, or worse.

Even if successful, transitioning away from the eight-week Newcastle diet better be done carefully or the diabetes will return. Prevention of weight regain is harder than losing weight.

Steve Parker, M.D.

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Is Insulin Making You Hungry All the Time?

Posted on May 8, 2016 | 7 comments
So easy to over-eat!

So easy to over-eat! Is it the insulin release?

No, insulin probably isn’t the cause of constant hunger, according to Dr. Stephan Guyenet. Dr. G gives 11 points of evidence in support of his conclusion. Read them for yourself. Here are a few:

  • multiple brain-based mechanisms (including non-insulin hormones and neurotransmitters) probably have more influence on hunger than do the pure effect of insulin
  • weight loss reduces insulin levels, yet it gets harder to lose excess weight the more you lose
  • at least one clinical study (in 1996) in young healthy people found that foods with higher insulin responses were linked to greater satiety, not greater hunger
  • billions of people around the world eat high-carb diets yet remain thin

An oft-cited explanation for the success of low-carbohydrate diets involves insulin, specifically the lower insulin levels and reduced insulin resistance seen in low-carb dieters. They often report less trouble with hunger than other dieters.

Here’s the theory. When we eat carbohydrates, the pancreas releases insulin into the bloodstream to keep blood sugar levels from rising too high as we digest the carbohydrates. Insulin drives the bloodstream sugar (glucose) into cells to be used as energy or stored as fat or glycogen. High doses of refined sugars and starches over-stimulate the production of insulin, so blood sugar falls too much, over-shootinging the mark, leading to hypoglycemia, an undeniably strong appetite stimulant. So you go back for more carbohydrate to relieve the hunger induced by low blood sugar. That leads to overeating and weight gain.

Read Dr. Guyenet’s post for reasons why he thinks this explanation of constant or recurring bothersome hunger is wrong or too simplistic. I agree with him.

The insulin-hypoglycemia-hunger theory may indeed be at play in a few folks. Twenty years ago, it was popular to call this “reactive hypoglycemia.” For unclear reasons, I don’t see it that often now. It was always hard to document that hypoglycemia unless it appeared on a glucose tolerance test.

Regardless of the underlying explanation, low-carb diets undoubtedly are very effective in many folks. And low-carbing is what I always recommend to my patients with carbohydrate intolerance: diabetics and prediabetics.

Steve Parker, M.D.

front cover

front cover

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Accidents Replace Stroke as 4th Leading Cause of Death in U.S.

Posted on May 2, 2016 | 2 comments
Nothing to do with accidents

Nothing to do with accidents

For most of my medical career, stroke was the third leading cause of death in the U.S., behind heart disease and cancer. Just a few years ago, chronic lower respiratory tract disease surpassed stroke.

Stroke continues to fall in rank and fell recently to fifth place, overtaken by accidents (unintentional injuries).

Even non-fatal strokes can be devastating.

Reduce your risk of stroke by maintaining normal blood pressure, not smoking, exercise regularly, living at a healthy weight, limiting your alcohol consumption, don’t get diabetes, and limit your age to 55. It’s also important to seek medical attention if you have a TIA (transient ischemic attack).

I wouldn’t be surprised if the paleo diet helps prevent stroke, but we don’t have much evidence yet.

Steve Parker, M.D.

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Are Cities Driving Us Crazy?

Posted on April 22, 2016 | 1 comment

Evolutionistx thinks so. She started pondering this in view of the fact that 25% of women in the U.S. are on medications for depression or anxiety. Why so many drug users? A quote:

People seem to do best, emotionally, when they have the support of their kin, some degree of ethnic or national pride, economic and physical security, attend religious services, and avoid crowded cities. (Here I am, an atheist, recommending church for people.) The knowledge you are at peace with your tribe and your tribe has your back seems almost entirely absent from most people’s modern lives; instead, people are increasingly pushed into environments where they have no tribe and most people they encounter in daily life have no connection to them. Indeed, tribalism and city living don’t seem to get along very well.

RTWT.

Over the course of the last 200,000 years, tribes were probably no more than 150 people.

Steve Parker, M.D.

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Do Diet Beverages Hinder Weight Loss?

Posted on April 11, 2016 | 2 comments
ppp

That looks more like a beer than a diet soda bottle

Overweight and obese women who habitually drank diet beverages lost more weight if they substituted water for the diet beverage. Over the course of 24 weeks on a reduced calorie diet, the water drinkers lost an extra 1.2 kg (2.6 lb) compared to those who continued their diet beverage habit.

Furthermore, the researchers found that the water drinkers had healthier values on insulin levels, HOMA-IR (a measure of insulin resistance), and after-meal blood sugar levels.

I wonder if the sweet taste of diet drinks triggers an insulin release that inhibits fat-burning.

This was a small study with only about 30 in each experimental group. Whether similar results would be seen in men is unknown to me.

In the past, I’ve advised dieters it’s OK to drink diet drinks in moderation while trying to weight. I may have to revise my recommendations. On the other hand, if diet drinks help keep you happy and on a successful weight-loss journey, they may be helpful. The diet beverage consumers still lost 7.6 kg (16.7 lb) compared with 8.8 kg (19.4 lb) in the abstainers. But diets don’t work, right?

Steve Parker, M.D.

PS: I haven’t read the full text of the article; just the abstract.

PPS: Steven Novella at Science-Based Medicine blog concludes that low energy sweeteners probably help with weight control.

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One Man’s N=1 Experiment Comparing Lower- Versus Moderate-Carb Diet For His Diabetes

Posted on March 11, 2016 | 2 comments
Use the search box to find the recipe for this low-carb avocado chicken soup

Use the search box to find the recipe for this low-carb avocado chicken soup

Read his amazingly detailed post at Diatribe. Adam, who has type 1 diabetes, figured out during his college days that eating no more that 30 grams of carbs at a time was “a complete gamechanger” for improving his blood sugars. He experimented on himself to see if there was a difference between his usual lower-carb diet (146 grams/day) versus 313 grams/day.

A quote:

To my utter surprise, both diets resulted in the same average glucose and estimated A1c. But there were major tradeoffs:

The higher-carb, whole-grain diet caused four times as much hypoglycemia, an extra 72 minutes per day spent high, and required 34% more insulin. (A less healthy high-carb diet would have been far worse.)

Doubling my daily carbs also added much more effort and produced far more feelings of exhaustion and diabetes failure. It was not fun at all, and the added roller coaster, or glycemic variation, from all the extra carbs made it more dangerous.

See more at: http://diatribe.org/low-carb-vs-high-carb-my-surprising-24-day-diabetes-diet-battle#sthash.pZOgCWVl.dpuf

I think the lower-carb approach is healthier over the long run. Check with your own healthcare provider before making any drastic change in your diabetic diet.

Steve Parker, M.D.

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Posted in Diabetic Diet, Dietary Carbohydrate, Low-Carb

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Natural Versus Drug Therapy for Metabolic Syndrome

Posted on February 15, 2016 | 2 comments
"These are flying off the shelves!"

“But selling drugs is good for the economy!”

Have you heard that 60% of adults in the U.S. are taking prescription drugs? That’s up from 50% a decade ago. UPI has the pertinent details. A snippet:

Many of the most used drugs reflect the effects of metabolic syndrome, a group of conditions tied to obesity and diet.

“Eight of the 10 most commonly used drugs in 2011–2012 are used to treat components of the cardiometabolic syndrome, including hypertension, diabetes, and dyslipidemia,” researchers wrote in the study, published in the Journal of the American Medical Association. “Another is a proton-pump inhibitor used for gastroesophageal reflux, a condition more prevalent among individuals who are overweight or obese. Thus, the increase in use of some agents may reflect the growing need for treatment of complications associated with the increase in overweight and obesity.”

I’m not anti-drug, generally. Lord knows I prescribe my fair share. But in addition to the cost of drugs, we have side effects and drug interactions to worry about. If we in the U.S. would effectively attack overweight and obesity, we’d be much better off.

But it’s a lot easier to just pop a pill, isn’t it?

Especially if someone else is paying for the pill.

Steve Parker, M.D.

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Posted in Diabetes Complications, Overweight

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Obesity Soon to Affect Average Life Span in U.S.

Posted on February 3, 2016 | Comments Off on Obesity Soon to Affect Average Life Span in U.S.
That excess weight can shorten your life

That excess weight can shorten your life

“The medical community seems to be under a fog that we can constantly and forever reduce death rates, and that’s simply not true,” said Professor Olshansky, who published a study in 2012 showing that life spans for white women without a high school diploma had declined, a rare event in developed countries.

“You need to look at the health status of the living,” not the mortality statistics of the dead, he said, adding that obesity is afflicting younger generations in a way that will eventually make the numbers worse.

RTWT at The New York Times. 

Do something about your obesity before it’s too late.

Steve Parker, M.D.

 

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If You’re Interested In Human Evolution, You Need to Know About the Denisovans

Posted on January 28, 2016 | Comments Off on If You’re Interested In Human Evolution, You Need to Know About the Denisovans

So here’s a 10-minute video from Pique. Denisovans are a hominin group, some remains of whom were discovered in the 1970s in or near Russia. Modern native Tibetans share at least one gene with the Denisovans, a gene that helps them tolerate hypoxia (low tissue levels of oxygen).

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Paleo Diet Pioneer Melvin Konner’s Latest Thoughts on Healthy Eating

Posted on January 23, 2016 | 7 comments

Back in 1985, Melvin Konner and S. Boyd Eaton got the ball rolling on the current Paleolithic diet movement. Thirty years later, what would Konner say is a healthy way to eat?

Recent data on these issues make me more comfortable today saying what not to eat. Our ancestors had no refined carbs, which are killing us. We’d be wise to limit salt and saturated fat, which our ancestors’ prey had little of, and fiber and omega-three fatty acids seem to be good. Most humans have to avoid dairy; many must avoid wheat. Find out if you’re one of them. Exercise. That’s about it.

I’ve seen good data saying salt restriction is both harmful an helpful. So flip a coin or talk to your personal physician. If I were looking at starting a drug for hypertension, I’d certainly cut back on salt first and see if that cured me.

Recent clinical studies show that saturated fat isn’t harmful to most of us.

Steve Parker, M.D.

No link to suicide

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