Dieting Reverses Diabetes
By: Rob Clarke
Some brand new research has backed what I’ve written several times previously in the Driven Blog regarding metabolic syndrome and dieting. In fact, it is something many nutritional writers and researchers have been well aware of for a long time now. That is that dieting and losing weight goes a very long way to fixing problems of poor health. When I say “dieting” I don’t mean avoiding junk food, eating more fruit, or just “tidying up” the ol’ diet. I specifically mean calorie deficit. I hate sounding like a broken record but calorie flux is what determines whether you lose or gain weight. When you are in an energy deficit your body is forced to call upon its stores of fuel. This seems to make the whole system work a little more efficiently, and things that can be problematic when in calorie surplus are much less so. For instance saturated fat was once defiled for the negative effects it can convey, but it has been found that in calorie deficit it does not bestow these issues. This is largely because in calorie deficit the fat does not get a chance to build-up or accumulate, mostly because it is being used for fuel.
This actually reminds me a lot of the concept of calorie restriction (CR) and how people following this dietary design show big improvements in certain health profiles.
From a health perspective there is something to be said about calorie restriction aiding with health parameters, but ultimately I am not impressed with their physiques in the slightest. A bodybuilder or athlete can simply not succeed during long-term calorie restriction like this. And when I say long-term I am talking years. A standard period of several months dieting for a show or to make weight is not the same, nor do they reduce calories as low as CRers and if they are sensible they have periodical high-calorie days. But I digress.
Onto the study, which is to be published in the journal Diabetologia, has shown that a low calorie diet can reverse type II diabetes. I must be specific here, because although the phrase diabetes is thrown around fairly haphazardly, the difference between type I and type II is massive. I’ve probably defined them in a previous post will do so now again anyway.
Type I is a genetic issue where the pancreas simply does not produce sufficient insulin. The outward appearance of this tends to be a frail and weak person. Insulin injections are prescribed to keep a type I diabetic alive and they are required several times daily for life.
Type II diabetes, on the other hand – and it kinda bugs me that science didn’t give this a name so similar to type I – is where cells are resistant to the effects of insulin. The result of this tends to be that more insulin is pumped out to make up for this (a vicious cycle). The cause of this in most cases in this day-and-age is poor diet, lack of exercise and being overweight. It plays a huge part in defining metabolic syndrome. As you may expect, the outward appearance of type II diabetes tends to be a fat person. What I am getting at here is that while some people may have genetic tendencies to ebb nearer poor blood-sugar control, for the most part type II diabetes is a response to a poor diet and sedentary lifestyle. People don’t get fat and unhealthy because of type II diabetes, type II diabetes arises because people don’t look after themselves.
So if you can develop type II diabetes by becoming overweight, can you reverse type II diabetes by losing weight?
This is precisely what the researchers at Newcastle University in the UK wanted to find out. In order to do this they recruited eleven participants with type II diabetes and had them follow a low calorie diet for eight weeks. When I say low calorie I really mean low calorie – they consumed a mere 600 calories per day. This is a lot like the typical calorie intakes of the CRers. The calories were consumed by means of a 520 calorie shake, called Optifast (46.4% carbohydrate, 32.5% protein and 20.1% fat with some added vitamins and minerals). For diet adherence they were allowed upwards of 90 calories of non-starchy vegetables over three portions.
For the effects, let’s begin with the outward appearance changes. As expected the participants lost weight. They couldn’t not lose weight really, they were only taking in 600 calories each day. They lost about 33lbs on average over the eight weeks, and of this about 27lbs were from body fat. This manifested as about five inches off their waist lines. Pretty visually significant effects overall.
What about the internal environment? After only seven days on the diet the elevated blood-glucose levels returned to normal value and stayed there for the remainder of the study. The amount of fat stored in their liver and pancreas of each participants had also reduced somewhat, and continued to lower for the duration of the trial. This improved insulin production significantly. After the eight weeks the participants were allowed to return to a more normal diet, however they were educated on healthy eating and portion control. Three months after the trial the subjects were still free from the condition of type II diabetes, so they obviously stuck to their new healthy lifestyles.
This trial was extreme, and to mimic the improvement in health parameters does not require such an extreme calorie level. In fact, all you need to ensure is a sufficient calorie deficit (a few hundred calories perhaps) and then to stick with it for extended periods of time. Going extreme may make results manifest quicker, but realistically speaking complete lifestyle overhauls are usually required to get people healthy for life, not just short-term fixes.
Like I said at the beginning, this is really nothing most of us didn’t already know. To be honest, it probably won’t change anything either, for two reasons. First, big pharmaceutical companies can’t really sell low calories (although calorie-restriction mimetics are being investigated). Their ideal business model is to design and sell a pill that someone can take and continue their usual lifestyle, all while reversing their health issues. Second, they can’t sell willpower, and linked fairly tightly to point number one, people would rather take a pill and change nothing than have to put the effort in. It is simply the nature of the beast. When it comes down to it more effort needs to be made to educating people into new mindsets of lifestyle, and this needs to be done starting at a young age.
Source: Lim EL, Hollingsworth KG, Aribisala BS, Chen MJ, Mathers JC, Taylor R. Reversal of type 2 diabetes: normalisation of beta cell function in association with decreased pancreas and liver triacylglycerol. Diabetologia. 2011 Jun 9.