I’ve just finished reading Roy Taylor’s book ‘Life Without Diabetes,’ and I wholeheartedly recommend it. Dr Taylor is a professor at Newcastle University, and he has arguably done more for diabetes remission than anyone. His studies, including DIRECT, proved to the world that a 3-month restricted-calorie diet can put 50% of people with diabetes into remission. Given that before his work, diabetes was considered incurable and progressive, it’s excellent news.
“…if blood glucose is returned to normal, then the risk of damage to eyes, nerves, feet, kidneys, heart, and brain returns to the same level as for people of similar age and weight without diabetes. From the point of view of the person staring down the barrel of a gun, that is a miracle.”
While I had read articles mentioning the 50% remission number, averages can be misleading. In the book, Dr Taylor writes that almost everyone can achieve remission within 4 years of diagnosis, 50% after 10 years, and it gets progressively more difficult from there. Almost everyone?!? In my opinion, that kind of success rate makes any doctor or diabetic nurse that doesn’t try remission with newly diagnosed patients borderline negligent.
Here are a few things in the book that caught my attention:
1. He writes that while diabetes is characterised by too much glucose in the bloodstream, it is caused by a single factor: excess fat in the liver and pancreas.
2. He believes that everyone has a personal fat threshold, that varies from person to person, the point at which the organs are likely to become fatty. If you have been diagnosed with T2 diabetes, you have passed that threshold. For some people, the threshold might be very low (50% of people diagnosed with diabetes are not obese), for others very high.
3. He writes that we gain slowly weight over a lifetime of eating too much. The topping point is reached as our liver starts to become fatty and insulin resistant. If our pancreas is sensitive to fat, it stops producing enough insulin, and our blood glucose shoots up.
4. A quick loss of weight – 15KG on average – is often enough to put diabetes into remission.
5. To achieve remission, Dr Taylor uses a calorie-restricted diet (700-800 calories per day), for 2-3 months. It includes a shake and a portion of vegetables for fibre. He says patients feel hunger for the first 36 hours, and then it diminishes.
6. Regular meals that total 700 calories a day can achieve the same result, but it can be more challenging in terms of planning, balance, and not being tempted into overeating.
7. Once the weight is off and remission is achieved, he reintroduces food, minimising sugar and high much starch. Weight becomes the metric. If it creeps up, he reintroduces the 700 calorie diet until it stabilises.
8. Dr Taylor views alcohol as ‘liquid fat’ as well as having too many calories, and he suggests cutting it out or curtailing it severely.
9. There is no good biological reason people put on weight during an adult life. There is no biological reason you shouldn’t be the weight you were at 25.
10. He says that different diets and methods work for different people. For some, low carb works better, for others fasting is the way to go. The key is weight loss (rapid seems to work better) and keeping it off.
My wife is Italian, so of course I have a soft spot for Italian food. That might sound difficult for someone who has giving up rice (risotto), bread, and pasta, but Italian meals are far more balanced than one might expect. The pasta course in Italy is a course between the appetiser and main course and can be left away with out losing much from the meal.
At home, I often make pasta dishes without pasta. That might sound silly, but take lasagne – the pasta is not my favourite part of the dish, especially since it’s usually over or undercooked. No, I love lasagne for the melted mozzarella, ricotta, and rich tomato sauce or spinach, sometimes made more luxurious with meat.
The good news is those ingredients are low carb, so I still make lasagne with just the filling. Some people like to add slices of courgette as ‘pasta,’ but I prefer to keep just my favourite bits without adding anything at all. My family doesn’t seem to mind either.
One of the key components of many Italian dishes is a good tomato sauce, and tomato is one of my 125 delicious low carb foods. Here’s how I do it…
1 can chopped tomato (Mutti is a great brand, if you can find it)
2 cloves of garlic, chopped
100ml good olive oil
Oregano to taste
What to do:
Combine the first three ingredients in a sauce pan.
Cook for a few minutes to soften the garlic.
Blitz with a mixing stick or blender until smooth
Cook, covered, over low heat until the oil separates from the tomato (ca. 30 minutes, depending on the heat).
Blitz again to combine.
Stir in the oregano.
Notes: 1. Garlic is relatively high in carbs, but it tastes wonderful and a clove doesn’t weigh much, so I keep using it… 2. Add some chilli pepper (chipotle is especially good) and the herb epazote to turn it into a yummy Mexican type sauce.
Before I started eating a low carb diet, I can’t say I knew much about chia seeds or chia pudding. Chia showed up in the odd dish out of the house, but I had never bought them – how that has changed! Chia seeds saved me in the early days, when my carb cravings were most severe and they continue to be an almost daily part of my diet (and hence on my list of 125 Delicious foods).
Chia seeds are from the plant Salvia Hispanic, which is in the sage family. Like many delicious foods (including chocolate), they are native to Southern Mexico. They are high in fibre, full of Omega-3 fatty acids, are provide protein and amino acids (especially useful if you’re vegetarian or vegan).
If you have a spice grinder, you can grind them before using, which gives you a smooth finished product. If you don’t grind them, they have a consistency similar to tapioca, which is also lovely. I enjoy them both ways, depending on my mood.
One note: watch the price, which can vary dramatically. If you’re not careful, you can pay through the nose. If you find them as useful as I do, consider buying in bulk – I buy organic seeds for far less than you’d find non-organic in the supermarket or health food store.
Here are ways I enjoy them
1. Unground, with cream
Use 20gm of chia seeds and 150gm cream. Stir regularly until it thickens (if you don’t stir at the beginning, it will clump up and be hard to break up). It has a mousse-like consistency.
Things to add for variation: 5gm pure cocoa, 1/4 tsp cardamom, 1/2 tsp cinnamon, 1/4 tsp pure vanilla extract
2. Ground, in a blender, with cream
Grind 50gm seeds with your spice grinder. Stir in 225gm cream, then give a blitz or two until solid. This is a thicker dessert, since the cream whips up. It’s very filling, and it lasts me a couple of days.
3. With coconut milk (or coconut cream)
I make a whole can of the milk (400ml) with 100gm ground chia. Make sure you get a good coconut milk. Many of them are mostly water. Thai Gold is almost all coconut and is excellent. My local supermarket stocks it.
Things to add for variation: Toasted, desiccated coconut to bring out the coconut taste, lime juice, drop of rum if you’re feeling naughty.
4. With water
This sounds boring, but it’s so guilt free that Dr Jason Fung says it can even be used while fasting (if you have a wobble) without wrecking the fast. It also travels well, so you can bring some along incase you get hungry on the road.
I use 20gm chia with 100gm of water. Again, you need to stir it regularly.
Things to add for variation (though not if you’re fasting): Juice of half a lemon, a few raspberries, coffee.
5. With Mascarpone
I use 25gm ground chia with 250gm mascarpone. This makes a very dense, decadent dessert. If you prefer it less solid, you can loosen it with some cream or full fat yoghurt. With a bit of coffee and pure cocoa, it has some of the flavour notes of tiramisu.
6. With almond milk
Make sure you use unsweetened almond milk! I use 20gm chia with 100gm almond milk. It’s also good with 5gm pure cocoa.
In Irish, ‘cream’ is ‘uachtar,’ and our president is ‘Uachtarán.’ I imagine the president has an endless supply of fresh Irish cream in the presidential fridge. ‘Pannacotta’ means ‘cooked cream’ in Italian, and it’s a dessert from Piedmont. It doesn’t have much sugar, so I leave it away completely. I use vegetarian gelatine (from carrageenan). It’s naturally salty and amplifies the flavour of the cream. You might have to play with the quantity, depending on the brand.
227 ml full-fat cream.
1/4 teaspoon vegetarian gelatine.
Vanilla to taste.
Warm the cream and gelatine over low heat, stirring, until the gelatine is completely dissolved.
Remove from the heat. Pour into two moulds or ramekins.
Refrigerate until set.
Gently transfer onto a plate and serve with berries, with a squeeze of lemon, or on its own.
Variations: 1. Add pure cocoa to taste. 2. Cook with a crushed cardamom pod. Strain after cooking. 3. Add cinnamon. 4. Add a shot or two of espresso. 5. Add whiskey.
I wrote an article in the Irish Times about my experience of remission. In case you can’t access it via the link above, I’ll reprint it here.
‘Hope’ is a beautiful word, with a soft start, an assertive end, and cosy roundness in the middle – round in the middle like middle-aged me. In the ice cream profession, portliness could be considered appropriate and even reassuring. If my paunch betrayed excess consumption of sugar and a fondness for cream, that luxurious, white emulsion permeated with the goodness of our Irish farming heritage, what harm? Did my expanding waist and extra chin (or two) not intimate culinary zeal – the crème de la crème, the cream of the crop, the cat that got the cream? I thought so until I was diagnosed with Type II Diabetes. Then, for the first time, I felt fat. On the scale, I felt ashamed.
Anyone with a dire diagnosis knows that words can change everything. One day last November, I breezed into an examination room for blood test results and a top-up of my hypertension medication. Sun flooded through the skylight, warming the white walls. I was thinking about new flavours and not expecting the word ‘diabetes.’ Weighed and measured like a foreign object, my body began to sag under the accumulation of the ensuing words: ‘obese,’ ‘disease,’ ‘degenerative,’ and ‘medication.’ Finally, I heard, ‘serious, progressive, and incurable, I’m afraid.’ I stumbled home, prescription in hand, feeling emotional and hopeless.
An internet search didn’t cheer me up – Type II diabetes is the leading cause of non-traumatic amputations, with a million legs lost a year, and it is the leading cause of adult-onset blindness. We are more than twice as likely to die of heart, liver, and kidney failure, and we suffer a greater incidence of stroke, cancer, dementia, and Alzheimer’s. COVID-19 is lethal for us, especially if we are obese. We have a life expectancy 13 years less than the general population. The numbers afflicted are astonishing – more than 400 million people worldwide, including 200,000 in Ireland. At least double that number are pre-diabetic. I spent the next day in bed, too depressed to move.
Luckily, I’m not the type to stay down, and since the antidote for angst in Dingle was often found in the camaraderie of O’Flaherty’s pub, I arranged to meet a friend there. Perched on a stool, I gazed mournfully at my pint, trying to accept that water would likely be my lot from now on. I had read that diabetics shouldn’t drink. The talk ranged from politics to Kerry football to local history, and my friend raised a hand to order another round. He is a doctor, and while I don’t like making things awkward by discussing personal medical issues, I had to explain my sudden abstemiousness.
‘I have diabetes,’ I blurted out. The conversation paused, moved on. Later, he leaned in.
‘It can be reversed, you know.’ Just like that, the world looked brighter.
Unfortunately, not everyone has such a friend. The self-fulfilling paradigm that Type II diabetes is incurable informs the usual treatment – drugs, a dose of scare tactics and blame, and outdated, contradictory advice on eating (such as, ‘Carbohydrates raise blood sugar. Include them with every meal.’) Studies such as the ACCORD trial show that lowering blood sugar with drugs doesn’t help outcomes, and contradictory advice doesn’t help either. As frightened patients do as they are told and deteriorate, as they are blamed every step along the way, their clinicians don’t seem to question the failure of the treatments. Instead, with circular logic, it reinforces the paradigm.
The next morning, I searched ‘diabetes reversal.’ It didn’t take long to find testimonials of people who had achieved remission. According to the incurable paradigm, reversing diabetes is impossible. Yet patients are doing it by rapidly losing weight, and trials, including DIRECT (sponsored by Diabetes UK), show a success rate of 50% is possible. The ramifications of this are staggering – 100,000 people could be saved in Ireland, just for starters, as could almost a quarter of a billion worldwide. Half a million legs could remain attached to their owners.
We could gain 2.6 billion years of human life while also saving a fortune in drug and other health-related costs.
I kept studying – lectures by Dr Sarah Hallberg, the excellent Diabetes Code by Dr Jason Fung, work by Dr David Unwin, Dr Malcolm Kendrick, Dr Roy Taylor, Dr Michael Mosely, and Tom Jelinek, PhD. I learned about the futility of the ‘eat less, exercise more’ mantra. I learned how carbohydrates convert to sugar and how excess fructose is dangerous since only the liver metabolises it. I learned how hormones drive behaviour and how insulin and cortisol (the stress hormone) impact body fat. I learned about insulin resistance – the real cause of both obesity and diabetes. Too much sugar causes too much insulin, which eventually causes insulin resistance.
I learned three methods seem to work best for losing weight quickly – a low carbohydrate diet, a severely restricted-calorie diet, and intermittent fasting. I decided to combine two of them – low carb and fasting, as suggested by Dr Jason Fung. The fat melted away so quickly that I don’t know why health professionals don’t offer this as the first course of treatment. In just three months, I lost 21kg and brought my blood sugar into the normal range. I even lost a chin (or two). Since then, the weight has stayed off, my hypertension resolved, and my subsequent blood tests have been excellent.
Now and then, I still feel emotional. I miss ice cream, for I have taken a break from making it. I miss pastries, cake, rice, bread, pasta, and many other foods I loved. On the other hand, my culinary zeal remains, and I’ve become more mindful about eating. With dark chocolate, raspberries, butter and lobster on my list of low carbohydrate foods, I don’t feel too sorry for myself. I probably shouldn’t admit this, but I continue to enjoy a pint with my friend when I can, to keep the angst in check. Best of all, I learned that cream has an undeserved reputation for being unhealthy. I still consume it liberally. Each luxurious taste reminds me that there is always hope.
These helped me survive the early weeks of carb cravings and bread withdrawal, and I still make a batch every week. With a crunchy crust and light and fluffy crumb, they are adapted from Maria Emmerich’s bread recipe. They are best served warm or toasted, slathered with lots of melting butter.
Note: Because of the psyllium, drink plenty of water with them, and limit yourself to one or two rolls a day. Psyllium has laxative properties, which I have found beneficial on a low carb diet, but it can block the gut if you eat too much or forget to drink.
Delicious Light and Fluffy Rolls with a Crunchy Crust
150gm almond flour
40gm psyllium husk
2 tsp baking powder
1 tsp sea salt
3 egg whites
200 ml boiling water
50 gm unsweetened, full fat yoghurt
Sesame seeds (optional)
What to do:
Turn on the oven to 175C
Combine the dry ingredients
Mix in the egg whites (don’t over mix)
Mix in the hot water (don’t over mix)
Stir in the yoghurt
Form into six rolls
Roll tops in sesame seeds (optional)
Bake for 1 hour
Cool for 5 minutes
Variations: 1. Add 1 tsp cumin and 1/2 tsp turmeric to the dried ingredients. 2. Add 1 tablespoon poppyseeds to the dried ingredients. 3. Add 1 tablespoon caraway seeds to the dried ingredients. 4. Add 2 tablespoons ground flax seeds to the dried ingredients.