By losing nine kilograms in eight weeks and normalising his blood sugar levels through a “lowish-carb, Mediterranean-style” of eating and intermittent fasting, Mosley was able to “drain the fat” from his liver and pancreas and regain his health.
This is because too much body fat blocks the production and function of insulin, the blood sugar regulating hormone.
As the research progressed, Mosley kept writing on the subject of dietary interventions to treat diabetes and other chronic health conditions.
The latest iteration was The Fast 800, which has sold 100,000 copies in Australia.
Comprising of three stages, the program involves an initial period of intensive weight loss where calories are capped at 800 a day for up to 12 weeks. The second stage involves a 5:2 intermittent fasting ratio of 800 calories for two days a week and whatever you want for the other five. Finally, the maintenance phase involves portion control but no calorie counting, eating to a lowish-carb, Med-style diet and optional time-restricted eating.
The recipes in The Fast 800 Easy, developed by his GP wife Dr Clare Bailey, follow the style of eating and provide a calorie count for those on any stage of the program.
Over the phone from the UK, Mosley says most people find the diet “fairly easy” because their hunger subsides after several days, they are eating whole foods and eating enough protein to keep them satiated.
It is not a fad diet, Mosley insists: “The vast majority I speak with… have a metabolic problem and they want to know how to get rid of it: They don’t want to end up on medication and sick. That’s why they’re doing it. It’s not the bikini gang. It’s people with serious issues.”
Plus, he says, it’s based on science.
The latest research on the approach includes a small University of Oxford study published in the April 2020 edition of Diabetes, Obesity and Metabolism. It found participants who ate an 800 to 1000 calorie-a-day Med-style diet for eight weeks lost an average of 9.6 kilograms and improved their blood sugar more than those on medication and with traditional diabetes care.
Though the diet “leads to rapid weight loss” the study authors acknowledged it was a “very demanding” regime.
A separate study published in The Lancet last June found that more than 60 per cent of participants on the 800 calorie a day plan, which was followed by a maintenance phase and lifestyle support, were able to reverse their diabetes and maintain results over the course of a year.
“The vast majority I speak with… have a metabolic problem and they want to know how to get rid of it: They don’t want to end up on medication and sick.”
DR MICHAEL MOSLEY
Despite such research, the US News health review scored it near the bottom of the rankings as a program to help prevent or control diabetes.
According to the panel of health experts, the drop in caloric intake could put diabetics at risk for hypoglycaemia, or low blood sugar. ”Also, diabetes medication would require adjustment on this diet.“
Another concern is its sustainability, says Dr Nicholas Fuller of the University of Sydney’s Boden Collaboration for Obesity, Nutrition, Exercise & Eating Disorders.
“People come into our clinic who have been on these intermittent fasting approaches and every other diet,” explains Fuller, author of Interval Weight Loss for Life. “We know people can lose weight, that is the easy thing.”
In his experience, these patients have lost and then regained the weight because the regimes are too hard to maintain and they end up struggling with both physical and mental health.
“It’s no better.”
Instead, Fuller suggests focusing on forming healthy habits including nutrition, sleep and exercise for longer-lasting results with healthier weight being a byproduct.
Dr Joanna McMillan doesn’t consider the Fast 800 an “easy” diet, if there is one.
“If the diet is too severe (800 calories is not much food) generally that makes it harder to stick to,” she says. “I’m not a fan of anything that is a quick fix if it only leads to devastation later when you regain the weight with interest.”
That said, McMillan “completely agrees” with the Med-style approach, adding: “Overall it makes sense to me that we have feast and famine type cycles instead of the modern eat all day type of diet.”
A fan of intermittent fasting, she says the research doesn’t indicate that any one form of fasting is superior: “I suspect it is the one you can stick to that will work, as with any dietary approach.”
Dr Mosley dismisses the US News criticisms, saying the reviewers “haven’t bothered” to look at the research. Besides, he adds, when he originally wrote The Fast Diet intermittent fasting was “strictly for crazies”.
“Since then time-restricted eating has become enormously popular both in the US and Australia.”
While he says he would like to see people simply shift to a Med-style diet, the “vast majority” of those with type 2 diabetes require a more stringent approach initially if they are to go into remission: “You need to lose about 10 per cent of your body weight.”
He anticipates that, given the promise of the ongoing science and research programs, the Fast 800 approach will become mainstream as a dietary intervention for chronic diseases like diabetes.
“In the UK the NHS just started rolling it out, in September, to 5000 people,” says Mosley, who is touring Australia in April and May.
The reasons for these statistics are a messy interplay of genetics, behaviour, environment and socioeconomic status.
Many, including Dr Mosley, are trying to find solutions to a complex problem. No one has a perfect answer but they are all tools that may help. It’s a challenge and the recipes in the new book might just be the only “easy” bit there is.
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Sarah Berry is a lifestyle and health writer at The Sydney Morning Herald and The Age.