A diabetes-busting diet hailed as a landmark breakthrough in treatment of the condition would be unsustainable for many due to busy lifestyles and malnutrition concerns, doctors said.
Results of a Diabetes Remission Clinical Trial (Direct) in the UK showed some patients who stuck to an 800 calorie liquid diet of soups and shakes over a three-month period were able to reverse a diagnosis of type two diabetes.
The average recommended daily calorie intake to lead a healthy life is around 2,000 calories for women, and 2,500 for men, dependent on activity levels.
Research funded by Diabetes UK showed around a quarter of people who started a low-calorie diet then returned to a normal calorie consumption remained in remission three years later.
We should be careful with weight loss advice, particularly when it is clear a diet with fewer than 1,000 calories a day can be problematic
Dr Ajith Kumar,
consultant endocrinologist at Burjeel Hospital, Dubai
But doctors advised caution on replicating the calorie crunching diet, outside of a controlled setting.
“Although weight loss is crucial to reversing diabetes, I usually don’t recommend extreme diets, such as liquid only diets or those that are carb free or meat only,” said Dr Idrees Mubarak, an endocrinologist at Saudi German Health in Dubai.
“Our lifestyles need to be sustainable lifelong, not just for three months or a year.
“Whenever the person comes off the diet, there is usually a reoccurrence of diabetes.
“800 calories a day is very low — it is bordering on starvation and that can have issues in itself.”
In the study, funded by Diabetes UK, 298 people recruited from GP surgeries received standard diabetes care, while the other half were put on strict calorie controlled diets.
Foods that help tackle diabetes — in pictures
Supported by dieticians, the second cohort consumed nutrient-packed soups and shakes for between 12 and 20 weeks at a time.
Those who managed to maintain a healthy weight after the trial were free from symptoms and no longer required diabetes medication, five years later.
The initial study that began in 2017 showed 46 per cent of patients who stuck to the low calorie diet for three to five months were still in remission a year later, while 36 per cent remained free from diabetes after two years.
After five years, 23 per cent of the study group who had an average weight loss of about 9kg continued to be free of symptoms.
Study authors said results were significant, as the five-year milestone was common with other diseases such as cancer, where the chance of it returning also dramatically falls after five years of remission.
“We have seen weight loss be effective in diabetes treatment, even in bariatric surgery,” said Dr Mubarak.
“Weight loss is never easy and should be a long-term process, to have a liquid diet for three months is not a solution.
“A fair target is to lose 10kg in a year, it should be a gradual process — after three years they will be a different person and have a sustainable healthy lifestyle.”
Around one in five have diabetes in the UAE, with that number expected to double by 2040.
The condition is usually associated with obesity, a sedentary lifestyle and poor diet.
Scientific breakthrough
The current scientific understanding of diabetes is that insulin resistance is a body fat issue.
When people lose their visceral belly fat and gain muscle mass, it improves their biology of carbohydrate metabolism and insulin sensitivity.
“The original study showed that almost half of patients became non-diabetic and no longer required medication using this method,” said Dr Aswin Pankajakshan, an endocrinologist and diabetic specialist at NMC Royal Hospital in Dubai.
“They were checked five years later, and it showed that the three-month 800 calorie diet had been effective at them losing visceral fat and then insulin resistance.
“The study was extremely positive and shows that weight loss can be very effective.
“Whenever a patient is diabetic there is an impact on multiple organs so even if it is reversed for just five years, it means they will not have the associated complications during that time.
“In the future, we could have similar programmes in place here.”
Malnutrition risk
Consuming fewer than 1,000 calories a day can lead to protein energy malnutrition and contribute to behavioural changes such as apathy, poor attention, anxiety and irritability.
An ultra low-calorie diet outside of a controlled setting can also bring changes to the skin, temperature regulation and how protein is metabolised.
“It is not practical or feasible to consume just 800 calories a day (outside of a clinical trial) as according to Dubai Health Authority regulations, daily diets should contain at least 1,000 calories,” said Dr Ajith Kumar, consultant endocrinologist at Burjeel Hospital in Dubai.
“It is also not legal to prescribe a diet with fewer calories than that.
“In the UK, it was a government NHS supported trial, where patients were monitored and followed up on.
“After the short period of meal replacement drinks, they returned to a regular diet," Dr Kumar said.
“The problem with trying to translate the same method to other countries is that we are unable to do it safely.
“If patients try to follow the same diet on their own, it can lead to consequences.”
“It (low calorie diet) can be a good thing for a short period, but this study was a meal replacement programme to achieve short term weight loss,” said Dr Kumar.
“We should be careful with weight loss advice, particularly when it is clear a diet with fewer than 1000 calories a day can be problematic.”
PRISCILLA
%3Cp%3EDirector%3A%20Sofia%20Coppola%3C%2Fp%3E%0A%3Cp%3EStarring%3A%20Cailee%20Spaeny%2C%20Jacob%20Elordi%3C%2Fp%3E%0A%3Cp%3ERating%3A%203%2F5%3C%2Fp%3E%0A
Killing of Qassem Suleimani
KILLING OF QASSEM SULEIMANI
The Voice of Hind Rajab
Starring: Saja Kilani, Clara Khoury, Motaz Malhees
Director: Kaouther Ben Hania
Rating: 4/5
Mohammed bin Zayed Majlis
Zayed Sustainability Prize
Ultra processed foods
- Carbonated drinks, sweet or savoury packaged snacks, confectionery, mass-produced packaged breads and buns
- margarines and spreads; cookies, biscuits, pastries, cakes, and cake mixes, breakfast cereals, cereal and energy bars;
- energy drinks, milk drinks, fruit yoghurts and fruit drinks, cocoa drinks, meat and chicken extracts and instant sauces
- infant formulas and follow-on milks, health and slimming products such as powdered or fortified meal and dish substitutes,
- many ready-to-heat products including pre-prepared pies and pasta and pizza dishes, poultry and fish nuggets and sticks, sausages, burgers, hot dogs, and other reconstituted meat products, powdered and packaged instant soups, noodles and desserts.
Freezer tips
- Always make sure food is completely cool before freezing.
- If you’re cooking in large batches, divide into either family-sized or individual portions to freeze.
- Ensure the food is well wrapped in foil or cling film. Even better, store in fully sealable, labelled containers or zip-lock freezer bags.
- The easiest and safest way to defrost items such as the stews and sauces mentioned is to do so in the fridge for several hours or overnight.
Killing of Qassem Suleimani
Killing of Qassem Suleimani
UAE currency: the story behind the money in your pockets
LILO & STITCH
Starring: Sydney Elizebeth Agudong, Maia Kealoha, Chris Sanders
Director: Dean Fleischer Camp
Rating: 4.5/5
The specs
Engine: 2.0-litre 4cyl turbo
Power: 261hp at 5,500rpm
Torque: 405Nm at 1,750-3,500rpm
Transmission: 9-speed auto
Fuel consumption: 6.9L/100km
On sale: Now
Price: From Dh117,059
Farage on Muslim Brotherhood
Nigel Farage told Reform's annual conference that the party will proscribe the Muslim Brotherhood if he becomes Prime Minister.
"We will stop dangerous organisations with links to terrorism operating in our country," he said. "Quite why we've been so gutless about this – both Labour and Conservative – I don't know.
“All across the Middle East, countries have banned and proscribed the Muslim Brotherhood as a dangerous organisation. We will do the very same.”
It is 10 years since a ground-breaking report into the Muslim Brotherhood by Sir John Jenkins.
Among the former diplomat's findings was an assessment that “the use of extreme violence in the pursuit of the perfect Islamic society” has “never been institutionally disowned” by the movement.
The prime minister at the time, David Cameron, who commissioned the report, said membership or association with the Muslim Brotherhood was a "possible indicator of extremism" but it would not be banned.
Law%2041.9.4%20of%20men%E2%80%99s%20T20I%20playing%20conditions
%3Cp%3EThe%20fielding%20side%20shall%20be%20ready%20to%20start%20each%20over%20within%2060%20seconds%20of%20the%20previous%20over%20being%20completed.%0D%3Cbr%3EAn%20electronic%20clock%20will%20be%20displayed%20at%20the%20ground%20that%20counts%20down%20seconds%20from%2060%20to%20zero.%0D%3Cbr%3EThe%20clock%20is%20not%20required%20or%2C%20if%20already%20started%2C%20can%20be%20cancelled%20if%3A%0D%3Cbr%3E%E2%80%A2%09A%20new%20batter%20comes%20to%20the%20wicket%20between%20overs.%0D%3Cbr%3E%E2%80%A2%09An%20official%20drinks%20interval%20has%20been%20called.%0D%3Cbr%3E%E2%80%A2%09The%20umpires%20have%20approved%20the%20on%20field%20treatment%20of%20an%20injury%20to%20a%20batter%20or%20fielder.%0D%3Cbr%3E%E2%80%A2%09The%20time%20lost%20is%20for%20any%20circumstances%20beyond%20the%20control%20of%20the%20fielding%20side.%0D%3Cbr%3E%E2%80%A2%09The%20third%20umpire%20starts%20the%20clock%20either%20when%20the%20ball%20has%20become%20dead%20at%20the%20end%20of%20the%20previous%20over%2C%20or%20a%20review%20has%20been%20completed.%0D%3Cbr%3E%E2%80%A2%09The%20team%20gets%20two%20warnings%20if%20they%20are%20not%20ready%20to%20start%20overs%20after%20the%20clock%20reaches%20zero.%0D%3Cbr%3E%E2%80%A2%09On%20the%20third%20and%20any%20subsequent%20occasion%20in%20an%20innings%2C%20the%20bowler%E2%80%99s%20end%20umpire%20awards%20five%20runs.%0D%3Cbr%3E%3C%2Fp%3E%0A
Killing of Qassem Suleimani
Mohammed bin Zayed Majlis
More coverage from the Future Forum
What sanctions would be reimposed?
Under ‘snapback’, measures imposed on Iran by the UN Security Council in six resolutions would be restored, including:
- An arms embargo
- A ban on uranium enrichment and reprocessing
- A ban on launches and other activities with ballistic missiles capable of delivering nuclear weapons, as well as ballistic missile technology transfer and technical assistance
- A targeted global asset freeze and travel ban on Iranian individuals and entities
- Authorisation for countries to inspect Iran Air Cargo and Islamic Republic of Iran Shipping Lines cargoes for banned goods
BMW M5 specs
Engine: 4.4-litre twin-turbo V-8 petrol enging with additional electric motor
Power: 727hp
Torque: 1,000Nm
Transmission: 8-speed auto
Fuel consumption: 10.6L/100km
On sale: Now
Price: From Dh650,000
Day 1, Abu Dhabi Test: At a glance
Moment of the day Dimuth Karunaratne had batted with plenty of pluck, and no little skill, in getting to within seven runs of a first-day century. Then, while he ran what he thought was a comfortable single to mid-on, his batting partner Dinesh Chandimal opted to stay at home. The opener was run out by the length of the pitch.
Stat of the day – 1 One six was hit on Day 1. The boundary was only breached 18 times in total over the course of the 90 overs. When it did arrive, the lone six was a thing of beauty, as Niroshan Dickwella effortlessly clipped Mohammed Amir over the square-leg boundary.
The verdict Three wickets down at lunch, on a featherbed wicket having won the toss, and Sri Lanka’s fragile confidence must have been waning. Then Karunaratne and Chandimal's alliance of precisely 100 gave them a foothold in the match. Dickwella’s free-spirited strokeplay meant the Sri Lankans were handily placed at 227-4 at the close.
Lexus LX700h specs
Engine: 3.4-litre twin-turbo V6 plus supplementary electric motor
Power: 464hp at 5,200rpm
Torque: 790Nm from 2,000-3,600rpm
Transmission: 10-speed auto
Fuel consumption: 11.7L/100km
On sale: Now
Price: From Dh590,000
How will Gen Alpha invest?
Mark Chahwan, co-founder and chief executive of robo-advisory firm Sarwa, forecasts that Generation Alpha (born between 2010 and 2024) will start investing in their teenage years and therefore benefit from compound interest.
“Technology and education should be the main drivers to make this happen, whether it’s investing in a few clicks or their schools/parents stepping up their personal finance education skills,” he adds.
Mr Chahwan says younger generations have a higher capacity to take on risk, but for some their appetite can be more cautious because they are investing for the first time. “Schools still do not teach personal finance and stock market investing, so a lot of the learning journey can feel daunting and intimidating,” he says.
He advises millennials to not always start with an aggressive portfolio even if they can afford to take risks. “We always advise to work your way up to your risk capacity, that way you experience volatility and get used to it. Given the higher risk capacity for the younger generations, stocks are a favourite,” says Mr Chahwan.
Highlighting the role technology has played in encouraging millennials and Gen Z to invest, he says: “They were often excluded, but with lower account minimums ... a customer with $1,000 [Dh3,672] in their account has their money working for them just as hard as the portfolio of a high get-worth individual.”
Another way to earn air miles
In addition to the Emirates and Etihad programmes, there is the Air Miles Middle East card, which offers members the ability to choose any airline, has no black-out dates and no restrictions on seat availability. Air Miles is linked up to HSBC credit cards and can also be earned through retail partners such as Spinneys, Sharaf DG and The Toy Store.
An Emirates Dubai-London round-trip ticket costs 180,000 miles on the Air Miles website. But customers earn these ‘miles’ at a much faster rate than airline miles. Adidas offers two air miles per Dh1 spent. Air Miles has partnerships with websites as well, so booking.com and agoda.com offer three miles per Dh1 spent.
“If you use your HSBC credit card when shopping at our partners, you are able to earn Air Miles twice which will mean you can get that flight reward faster and for less spend,” says Paul Lacey, the managing director for Europe, Middle East and India for Aimia, which owns and operates Air Miles Middle East.
The burning issue
The internal combustion engine is facing a watershed moment – major manufacturer Volvo is to stop producing petroleum-powered vehicles by 2021 and countries in Europe, including the UK, have vowed to ban their sale before 2040. The National takes a look at the story of one of the most successful technologies of the last 100 years and how it has impacted life in the UAE.
Read part four: an affection for classic cars lives on
Read part three: the age of the electric vehicle begins
Read part one: how cars came to the UAE
ICC Awards for 2021
MEN
Cricketer of the Year – Shaheen Afridi (Pakistan)
T20 Cricketer of the Year – Mohammad Rizwan (Pakistan)
ODI Cricketer of the Year – Babar Azam (Pakistan)
Test Cricketer of the Year – Joe Root (England)
WOMEN
Cricketer of the Year – Smriti Mandhana (India)
ODI Cricketer of the Year – Lizelle Lee (South Africa)
T20 Cricketer of the Year – Tammy Beaumont (England)
UAE currency: the story behind the money in your pockets
Electric scooters: some rules to remember
- Riders must be 14-years-old or over
- Wear a protective helmet
- Park the electric scooter in designated parking lots (if any)
- Do not leave electric scooter in locations that obstruct traffic or pedestrians
- Solo riders only, no passengers allowed
- Do not drive outside designated lanes
The%20specs%3A%20Taycan%20Turbo%20GT
%3Cp%3E%3Cstrong%3EEngine%3A%20%3C%2Fstrong%3EDual%20synchronous%20electric%20motors%0D%3Cbr%3E%3Cstrong%3EPower%3A%20%3C%2Fstrong%3E1%2C108hp%0D%3Cbr%3E%3Cstrong%3ETorque%3A%20%3C%2Fstrong%3E1%2C340Nm%0D%3Cbr%3E%3Cstrong%3ETransmission%3A%20%3C%2Fstrong%3ESingle-speed%20automatic%20(front%20axle)%3B%20two-speed%20transmission%20(rear%20axle)%0D%3Cbr%3E%3Cstrong%3ETouring%20range%3A%20%3C%2Fstrong%3E488-560km%0D%3Cbr%3E%3Cstrong%3EPrice%3A%20%3C%2Fstrong%3EFrom%20Dh928%2C400%0D%3Cbr%3E%3Cstrong%3EOn%20sale%3A%20%3C%2Fstrong%3EOrders%20open%3C%2Fp%3E%0A
Killing of Qassem Suleimani
The years Ramadan fell in May
The five pillars of Islam
Red flags
- Promises of high, fixed or 'guaranteed' returns.
- Unregulated structured products or complex investments often used to bypass traditional safeguards.
- Lack of clear information, vague language, no access to audited financials.
- Overseas companies targeting investors in other jurisdictions - this can make legal recovery difficult.
- Hard-selling tactics - creating urgency, offering 'exclusive' deals.
Courtesy: Carol Glynn, founder of Conscious Finance Coaching
