Yesterday, the government launched One You, a huge campaign that hopes to encourage middle-aged people to take more responsibility for their health in later years by adopting a better diet and leading a less sedentary lifestyle.
The news stories reminded me of a documentary I saw recently called Fixing Dad, which told the moving story of Geoff Whitington and his two sons, Anthony and Ian. Geoff, an overweight security guard, developed type 2 diabetes in his early fifties. Although he was on medication, his condition got worse. Within a few years he had become depressed, with loss of sensation in his fingers and an ulcer on his foot that wouldn’t heal. There was talk of amputation.
Then his sons came across research that showed that putting people on a rapid-weight-loss diet could reverse type 2 diabetes. They persuaded their dad to give it a go and to let them film his transformation. In his first two weeks on the diet Geoff lost 18lb (8kg). In all he lost a staggering 6½st (42kg). His diabetes is a thing of the past. This year he will compete in the RideLondon-Surrey 100; a 100-mile bike ride through the capital and into the countryside with plenty of lung-testing climbs on the way.
I find Geoff’s story particularly moving because his sons were able to save their dad while I, despite my medical training, was unable to save my own. Like Geoff, my overweight father developed type 2 diabetes in middle age. At the time I was in medical school, so I told him what I was being taught (and which is still taught): that diabetes is an irreversible disease that you must learn to live with. The best way to delay the inevitable progression to heart disease and stroke is to take the medication and try to lose a bit of weight by going on a low-fat diet.
So my dad took the pills and started the recommended diet, but neither helped. He put on weight, went into heart failure (heart disease is twice as likely if you have diabetes) and started showing signs of dementia (also nearly twice as common in diabetics). He died early from complications of the disease, 12 years ago.
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My father left me money, some baggy suits and warm memories of a cheerful, gregarious man. He also bequeathed me a few dodgy genes, which predispose me to obesity, heart disease and diabetes. At his funeral his friends commented on how like him I had become.
“My father’s genes predispose me to heart disease and diabetes
I could easily have gone down the same road as my father, but I was saved by television. A few years after my dad’s death I was making a documentary about weight loss. As part of it I had a scan in an MRI machine. Afterwards, looking concerned, the doctor who had done the scans showed me the images. They made grim viewing. My internal organs, including my liver and pancreas, were coated with white fat. It turns out that the reason I didn’t look particularly overweight at the time was because I was a TOFI — “thin outside, fat inside”.
The expert told me that the build-up of internal fat meant that I was at high risk of metabolic syndrome, a condition that includes heart disease, high blood pressure and high blood sugars. Despite his warning I did nothing much about it until two years later, when I had a blood test that showed I was a type 2 diabetic.
I was finally shocked into action. Rather than start on medication, as my doctor recommended, I began looking for alternative approaches. I soon came across something called “intermittent fasting”. The idea of intermittent fasting is that by cutting your calories a few days a week you can shock your body into better health.
There was a lot of good science behind this claim so I decided to make a documentary about it, with myself as the subject. While making Eat, Fast and Live Longer, I invented a new diet that I called the 5:2 diet. Five days a week I ate normally, but on the other two I cut down to about 600 calories a day. Within 12 weeks of starting the 5:2 diet I had lost nearly 20lbs (9kg) and 4in off my stomach. Even better, my blood sugar levels went down to normal, where they have stayed ever since.
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A few months afterwards I wrote a book, The Fast Diet, which became an international bestseller. It has been embraced by a surprising number of doctors and celebrities, ranging from Beyoncé to Benedict Cumberbatch (“You have to, for Sherlock”). Political opponents the chancellor George Osborne and the former SNP leader Alex Salmond have done well on this diet. Even more encouraging, dozens of people have contacted me to say that they had not only lost a lot of weight on the 5:2 but they had also reversed their diabetes.
It was later, when I came across the work of Roy Taylor, the professor of medicine and metabolism at Newcastle University, that I understood what is going on. Using advanced MRI technology, Taylor and his colleagues have shown that we each have a personal fat threshold, a point at which the fat we are piling on starts to fill the liver and pancreas. Once these organs become clogged up with too much fat, your body is no longer able to control your blood sugar levels and you tip over into type 2 diabetes.
For some this fat threshold is high; for others it can be set surprisingly low. A third of type 2 diabetics are what would normally be considered a “healthy�� weight. The good news is that a low-calorie diet will rapidly drain the fat from your liver and pancreas, improving their function.
Over the past five years Taylor and his team have staged a number of successful trials with overweight diabetics. Asked to go on a diet of 800 calories a day for eight weeks, most have managed to lose at least two stone (13kg), come off all medication and return their blood sugar levels to the normal range. His approach challenges long-held beliefs about diabetes and about weight loss; in particular that type 2 diabetes is an irreversible condition and that rapid weight loss diets don’t work. Neither seems to be true.
As Carlos Cervantes, whose blood sugar levels were literally off the scale, put it, “This diet cleaned out my liver and pancreas. It’s not easy for me to gain weight any more. It’s as though my body is working metabolically like a young man’s again, and I like the person I see in the mirror now.”
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Funded by Diabetes UK, teams from Newcastle and Glasgow University are running DiRect (Diabetes Remission Clinical Trial), a study that involves patients from over 30 GP practices in Scotland and the north of England. The patients who agree to take part are randomly allocated to either an 800-calorie diet or standard medical care. It will report in 2018.
It’s not just type 2 diabetics, though, who would benefit from significant weight loss. If, like more than a third of adults in the UK, you have pre-diabetes (blood sugar levels that are raised but not yet in the diabetic range), then you can cut your risk of developing diabetes by 85 per cent if you lose 10 per cent of your current body weight. The problem is that pre-diabetes is often symptomless. Most people only find out they had it when they cross the threshold into diabetes.
The 8-Week Blood Sugar Diet by Michael Mosley is published by Short Books. More information is available at thebloodsugardiet.com