The 800 calorie study

Big New Study Shows how readily Type 2 Diabetes can be Reversed

The new study, called DiRECT (Diabetes Remission Clinical Trial), which involved people with type 2 diabetes who had been diabetic for less than 6 years, was published online on Tuesday in the leading medical journal, the Lancet. The 298 patients who agreed to take part in the study were randomly allocated to either getting standard diabetes care from their GP, or going on a rapid weight loss diet. On this diet they were asked to stick to 800 calories a day for up to 20 weeks, then switch to a programme of long term support to maintain weight loss.

The results were remarkable. Many patients commented on how easy the diet had been to stick to and though not everyone succeeded, those who did saw dramatic weight loss. One in four people lost more than 15kgs, which was impressive, particularly when you consider that many of the patients came from areas of severe deprivation.

What was even more impressive was that nearly half the patients (46%) who were allocated to the rapid weight loss regime managed to get their blood sugars back to normal, without medication, compared to only 4% of those getting standard diabetes care.

A key finding of the study was the more weight people lost, the more likely they were to get their blood sugars under control without medication. 86% of those who lost 15kg or more put their diabetes into remission. This fell to about 7% in those who lost less than 5kgs.

I have been reporting medical breakthroughs for many years but this study, which shows just how possible it is to prevent and reverse a widespread, devastating disease, is one of the most exciting I have come across. It really could revolutionise the treatment of obesity and type 2 diabetes, improve the lives of millions and save the NHS billions of pounds.

My interest in diabetes began five years ago when I discovered, after a routine blood test, that I was a type 2 diabetic. This was a particularly nasty shock as my father had died at the relatively early age of 74 from complications of diabetes. Rather than start on medication, which is what my doctor advised, I decided to find something I could do to overcome diabetes without drugs.

In the course of my research I came across “intermittent fasting”. The ideas is that instead of dieting every day you cut your calories a few days a week. After talking to lots of experts I ended up creating what I called the 5:2 diet, where I cut my food intake to around 600 calories a day, two days a week, and ate as healthily as possible on the other five days. Using this approach I rapidly lost 10kgs and returned my blood sugars to normal, where thanks to my maintaining this weight loss, they have stayed ever since. I later wrote a book with journalist Mimi Spencer, “The Fast Diet”, all about the benefits of intermittent fasting. It became an international best seller.

But why did losing weight make such a big difference to my blood sugar levels? Soon after writing The Fast Diet I met leading diabetes expert Roy Taylor, Professor of Medicine and Metabolism at Newcastle University. He said the main reason so many people develop blood sugar problems later in life is because we put on too much visceral fat, fat around the gut. This not only makes us look chubbier but clogs up our liver and pancreas. “Get rid of that fat”, he told me, “and most people can get their blood sugar levels back to normal without medication”.

This was a remarkable claim because I was taught at medical school that type 2 diabetes (the type that tends to occur later in life and which is linked with lifestyle) is incurable and invariably progressive. Most of the doctors I spoke to were sceptical that patients would start a rapid weight loss diet, let alone stick to it. One man I spoke to said he’d been told by his GP that it would never work and he should not be worried “when you fail”.

But there is an urgent need to do something other than simply keep dishing out the pills for diabetes. These can have significant side effects and once you start taking them you often need to progress to stronger and stronger medicines, until you end up injecting insulin.

There are currently over 4.5m diabetics in the UK, and a further 12 million of us have pre-diabetes, where blood sugar levels are raised but not yet in the diabetic range. Very few people with pre-diabetes are aware they have it, let alone that they will probably develop the full blown disease.

Complications of diabetes include an increased risk of going blind, having a heart attack, going into kidney failure, becoming demented and losing a limb. It’s also a very expensive disease, costing the the UK around £20bn a year.
Professor Mike Lean, one of the authors of the new study, told me he thinks that supervised rapid weight loss could be a real game changer for patients and the NHS. “Instead of telling people they have an incurable disease which requires a lifetime on medication we can now tell them they have a problem with their weight, which is causing a serious metabolic problem, but if they want we can help them deal with it.”

He also argues that a rapid weight loss programme, like the one they used in this trial, can be a more successful strategy than trying to lose it gradually. “Doing it slowly is torture. Contrary to the belief of many dieticians, people who lose weight more quickly, more emphatically, are more likely to keep it off long term”.

Professor Taylor adds that motivation is critical; “What doctors in general haven’t recognised is how much people with type 2 diabetes hate having it. In my experience people will jump for it given the chance.”
In this trial patients were put on a low calorie diet regime of shakes and soups, followed by a reintroduction of real food and weight loss maintenance advice from a dietician or primary care nurse. But it can be done entirely with real food.

Two years ago I wrote a book, The 8 Week Blood Sugar Diet, which includes recipes and a detailed programme for reversing pre-diabetes and type 2 diabetes, based on Professor Taylor’s work. Since the book was published I have received thousands of letters and emails from people who have lost lots of weight and are now back to full health. People like Cassie, a nurse, who within weeks of starting was able to come off insulin injections. In a couple of months she lost over 20kg and then managed to get pregnant. “You have helped make a little miracle possible”, she wrote, “for which I can’t thank you enough”. As I pointed out, she should really be thanking the scientists and doctors whose research made this breakthrough possible.