Protein possibility for T2D remission without weight loss?

[Eddy Edson]

Oxford's Dr Nicola Guess https://twitter.com/Dr__Guess talking about her group's research re amino acids stimulating beta cells even if they are too far gone to respond to glucose even with substantial weight loss, and applying this to patient care. And about T2D diets in general.

 

[Spathiphyllum]

Oxford's Dr Nicola Guess https://twitter.com/Dr__Guess talking about her group's research re amino acids stimulating beta cells even if they are too far gone to respond to glucose even with substantial weight loss, and applying this to patient care. And about T2D diets in general.

I've only listened to the first five minutes so far, but it seems what she's saying is:

1) Weight loss is the key to remission. (She seems very clear about that.)

2) But-- what about those people who lose enough weight and still don't achieve remission? Increasing protein intake may be the additional step they need, to get them over the line.

So, if you want the best chance of remission-- lose weight *and* eat more protein!

Many of us should be eating more protein anyway, whether or not we have T2. In recent years, a lot of research evidence has come out showing that people over 50 need to eat *much* more protein than had previously been thought-- if we want to avoid muscle wasting and frailty and disability in later life. As we age, our bodies simply get less efficient in turning dietary protein into muscle; we need to compensate for that by eating something in the region of 1.2-2g of protein per kilo of body weight per day. And, even if you're under 50, if you're doing a good deal of exercise, you may need a lot more protein than you think.

I found this out about 9 months ago and have been trying to put it into practice. Unless you use protein supplements (which I don't), it does take some effort! Even for a small person, and even at the lower end of the recommendations. I'll watch the rest of the video later-- it looks as though she's going to give some good tips on how to boost your protein intake.

 

[bulkbiker]

some good tips on how to boost your protein intake.

Eat more meat.. although I think that Dr Guess verges on the vegetarian so she likely won't say the obvious...

 

[Deleted member 21371]

Oxford's Dr Nicola Guess https://twitter.com/Dr__Guess talking about her group's research re amino acids stimulating beta cells even if they are too far gone to respond to glucose even with substantial weight loss, and applying this to patient care. And about T2D diets in general.

Sounds sensible.
Especially the tweaking everything to fit yourself.

Have you found the diet sheet she refers to anywhere?

30/30/40 split on carbs, proteins, healthy unsaturated fats.
600/600/800 calories
150/150/90 g of carbs, proteins, healthy fats.

 

[Eddy Edson]

30/30/40 split on carbs, proteins, healthy unsaturated fats.
600/600/800 calories
150/150/90 g of carbs, proteins, healthy fats.

30% of energy from protein seems really high! FWIW I think it was Christopher Gardner who did some work showing that humans seem to naturally tend towards something like 15%-22% across broad ranges of diets and lifestyles. Anyway, I wonder how sustainable?

This is Guess' review paper from last year on dietary possibilities for T2D improvements regardless of weight loss: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8991239/pdf/13300_2022_Article_1220.pdf

FWIW, the evidence for a high protein strategy seems to me a bit weak; not really surprised at apparent lack of interest from other groups in this. A plausible mechanism often doesn't translate into a clinically meaningful outcome. But ineteresting and maybe her studies will show something robust.

To date, five well-controlled studies [8, 10, 36–38] by two independent research groups have shown that increasing the protein content of the diet from 15% to 30% kcal lowers blood glucose in T2D. These studies carefully controlled body weight, provided full food provision throughout each dietary intervention and measured multiple parameters of glycaemic control. The reduction in glucose is clinically significant: up to a reduction of 2–5 mmol/L during the 4-h period after a meal. In each of these studies the carbohydrate was also reduced and represented between 20 and 40%kcal. Therefore, the relative contribution of increased protein and carbohydrate restriction to the improvements in glycaemia are unknown. It is also important to reference studies [39, 40] which tested a similar dietary composition and did not find any superiority on glucose lowering while also noting that these studies did not provide the dietary protocol or control the confounding variables, including body weight.

 

[Eddy Edson]

I found this discussion between two leading researchers really useful for insights into protein recommendations.

Also for how disgusting the foundational nitrogen balance studies were back in the 70's & why they will never happen again.

(Try to ignore Simon Hill's dumb hat.)