Years of research and trials have shown the benefits to be had from periodically reducing your calorie intake. These include not only weight loss but improvements in mood, memory and blood sugar levels which may allow you to delay or cut back on medication. Dr Michael Mosley.
It has been a great year for those of us who have been arguing that it is possible to halt the epidemic of type 2 diabetes. In the summer there was the news that the NHS may soon encourage patients with type 2 diabetes to try a rapid weight-loss diet – the sort I have been advocating in my book, The Week Blood Sugar Diet.
Then Labour’s deputy leader Tom Watson appeared on TV, showing off his new slimline figure and telling the world how he had got off all medication and brought his bloodsugar levels back to normal by losing nearly 100lb. Tom had struggled for years with his weight. When he hit 22st he was diagnosed with type 2 diabetes and immediately went into denial. “My condition was so frightening, I just pretended I didn’t have it,” said Tom, before finally accepting he had to act. His starting point was reading all Dr Michael Mosley’s books. He cut down on sugar and processed food, took up exercise and lost an incredible 7st.
I first got really interested in type 2 diabetes in 2012. I had been for a blood test to check my cholesterol levels and afterwards my doctor rang me to say that although my cholesterol was ok my blood sugars were too high and I should come in for repeat tests. I did so and my doctor confirmed that I had type 2 diabetes and suggested that I might want to start on medication.
I shouldn’t have been surprised. Blood sugar problems are often inherited, and when my father died at the relatively early age of 74 he was suffering from a wide range of diseases, including Type 2 diabetes, heart failure, prostate cancer and what I now suspect was early dementia.
Rather than start on a lifetime of medication I decided to make a documentary in which I would seek out alternative ways to improve my health. While making that documentary Eat, Fast, Live Longer, I came across the work of scientists researching something called ‘intermittent fasting’.
Years of animal research and numerous human trials have shown the multiple benefits to be had from periodically reducing your calorie intake. These include not only weight loss but improvements in mood and memory.
So I went on what I called the 5:2 diet (eat normally five days a week and cut calories to around 600 on the other two days) and found it surprisingly manageable.
I lost 20lb in 12 weeks and my blood sugar levels returned to normal, where they
It was only later that I met Professor Roy Taylor, Professor of Medicine and Metabolism at Newcastle University, who explained to me just why that rapid weight loss had resulted in ‘curing’ my diabetes.
As he explained my problem had been that prior to the weight loss I had too much visceral fat, fat which lies inside the stomach, invading internal organs like the liver and the pancreas. Once these organs get clogged up with too much fat they stop communicating with each other. Eventually your body stops producing insulin and you become a type 2 diabetic.
When I lost all that weight I drained away my visceral fat, allowing my pancreas to start working again.
A key warning sign of visceral fat is having a big belly. Ideally your waist (when measured by the belly button) should be less than half your height.
Professor Taylor had seen other patients like me with type 2 diabetes who had managed to lose a substantial amount of weight and who had returned their blood sugar levels to normal, without medication. But because so many other doctors were sceptical, he knew he was going to have to put together a very convincing case.
One of the first things he did was a small pilot trial, for which he needed money. “I was very fortunate,” he told me, “to get money from the charity Diabetes UK. They thought it was extremely unlikely to work, but one particular person thought it sounded interesting and managed to persuade therest of the committee. It wasn’t much. Enough for a small one-year study.”
With the funding in place they recruited 11 patients, who were taken off their normal diabetes drugs and put on a strict regime of 800 calories a day, which consisted of liquid diet drinks and non-starchy vegetables.
In the first week the patients lost an average of 3.9kg (8lb) and most reported finding the diet surprisingly easy. “Much to my astonishment the hunger seems to disappear in 48 hours.” Professor Taylor told me.
As the fat clogging up their livers melted away, their symptoms improved. The liver seemed to be fine after seven days and got better as time went by. The pancreas was slower to respond. It was a little better after seven days and then steadily improved over the next eight weeks – and that was the magic thing.
The volunteers stuck to the 800-calorie regime and in just eight weeks – a remarkably short time – lost an average of 15kg (33lb). They also lost nearly 5in round the waist. By the end their blood sugar levels were all back in the non-diabetic range.
Professor Taylor was astonished. “It was electrifying. Amazingly more definitive than I ever dreamt it would be.”
When I told my wife, Dr Clare Bailey, about this research, she immediately began to offer this approach to her patients with great results. People like Dave who lost nearly 20kg in 12 weeks and came off all medication. This was more than three years ago and he has not only managed to keep the weight off, but lost a bit more. His blood sugars are now entirely normal.
Professor Taylor knew that if he was going to really convince his colleagues and the NHS to embrace this radical idea he would need to do a much bigger trial.
So, together with a friend and colleague, Professor Mike Lean of Glasgow University, he persuaded the charity Diabetes UK to give them substantially more money to run a study which they called, DIRECT (DIabetes REmission Clinical Trial)
They started by recruiting nearly 300 patients from GP practices in Scotland and the North East. The patients were then randomly allocated to either going on an 800 calories-a-day diet for up to 20 weeks or to following the best conventional advice and support. The patients were then followed for at least a year.
When the results were published in a leading medical journal, the Lancet, in February 2018, they were astonishing.
• Those on the 800 calorie diet had lost an average of 10kg, compared to 1kg in the control group
• A quarter of those on the 800 calorie diet had lost more than 15kg. None of those in the control group managed this
• Nearly half of the 800 calorie group managed to bring their blood sugars back down to normal despite coming off all their diabetes drugs. The more weight they lost, the higher their chance of bringing their pancreas back to life. 86% of those who lost more than 15kg went into remission (their blood sugars returned to normal despite the fact they had come off all medication).
Prof Lean was delighted with their findings and told me: “Given our results, it should be considered unethical NOT to give people with type 2 diabetes access to the necessary support for at least a good try at a remission. Most patients want to try, and it would save the NHS a lot of money.”
Prof Taylor was also thrilled by just how clear their findings were. He thinks this study will really change the treatment of diabetes but acknowledges that there are still important questions that need to be answered. The scientists will continue to track patients to see how many keep the weight off and diabetes at bay.