Britain’s NHS to fight diabetes with very low-calorie liquid diet

September 14 2018 by , medical review by in Diabetes, News
NHS liquid diet for diabetes

As rates of type 2 diabetes soar, and the disease affects younger and younger patients, British doctors will begin a staged rollout of a trial prescribing a liquid diet of four daily servings of “fat-free shakes and soup.” The prescribed drinks, intended to be the only food consumed, will provide patients with just over 800 calories per day. Participants will follow the liquid diet for up to 5 months, and then carefully transition back to real food.

This approach showed promise in the DiRECT trial, published in The Lancet last December. DiRECT was a well-designed trial, randomized by physician practice, and showed 46% of patients treated maintained remission from diabetes at 1 year, versus just 4% of control patients receiving the standard of care.

It is terrific to see physicians and health systems treating type 2 diabetes as a reversible condition rather than a progressive, chronic disease. However, remission with this approach is highly dependent on maintaining weight loss. Over the long term, maintaining weight loss by restricting calories has a very poor track record. And just about nobody wants to be on a liquid diet for life.

We believe restricting carbohydrates rather than calories is a more promising method for diabetes reversal. (This trial showed 60% reversal at one year.) It’s more sustainable and yummier, too!

The Daily Mail: Radical NHS plan to tackle Britain’s diabetes ‘epidemic’

Earlier

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1-year results of the Virta Health keto study

How Tom Watson reversed his type 2 diabetes

New study: even a liberal 130 g/day low-carb diet beats calorie restriction for type 2 diabetes

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13 comments

  1. 1
    Kenrick
    September 15 2018
    NHS - still thinks Low Calorie diets work ...lol
  2. 2
    Cassieoz
    September 15 2018
    Aargh! Weight loss misery followed by weight gain! Which VLCD manufacturer got to them? Not helping people find a sustainable way-of-eating for the rest of their lives. They've seen the remarkablw results Dr David Unwin is getting and they STILL haven't learned 😡
  3. 3
    Marilyn
    September 15 2018
    So sad that this is another costly diet intervention that will inevitably fail when people return to eating food. Instead of low cal/low fat soups & shakes just tell patients to cook & eat LCHF REAL FOOD.
  4. 4
    Brigitte
    September 15 2018
    To those that criticize this approach: Prof Taylor from Newcastle has used it with good results. I think this approach has its merits for short term weight loss and reversal of diabetes.
    However, to maintain the result longterm the patients need to be educated on good nutrition and exercise together with longterm follow up. Knowing the NHS, they will either skip education and follow up completely, or send the patients to a dietitian that has to follow the standard guidelines of whole grain "healthy" carbs, thus undoing the benefits of the short term intervention.
    Plus, the food environment in Britain is one of the most toxic ones I have come across (deep fried Mars bars anyone?). As long as this does not change and a white bread sandwich followed by a bag of potato chips is considered a good lunch (this is also handed out to hospital patients who missed a regular meal), Britain will continue to see a rise in obesity and diabetes.
  5. 5
    Robbie Beechey
    September 15 2018
    Professor Taylor's work, which was largelysuccessful lead directly to Michael Mosely's 8 week blood sugar diet, which does lower carbs and cut out the nasties but is far better balanced and much easier to follow. Its also very successful long term too
  6. 6
    Jane
    September 15 2018
    Yes, but Michael Moseley’s BSD is a cop-out in that it is still very low calorie - 800kcal/day. Thus he sits on the fence between restricted calorie [thereby not flouting UK government guidelines] and HFLC which, it is clear, he truly believes in but is too radical for most medical practitioners.
  7. 7
    Una
    September 15 2018
    Well they do work to lose weight as I'm a prducit of counting calories - not low calorie but fewer and Ive never put the weight back and I'm not a diabetic or on any drugs for any illness or condition. But counting calories and low fat is not the answer for T2 diabetes or for heart problems. Tom Watson's testimony in Britain, who is not out there to make money on the latest diet but fight elections - ha, ha, - is very powerful and got me thinking differently even though I do not have weight to lose and was never in my life as obese - just a little overweight from a knee injury. Certainly worth a read whatever country you live in. People are scared to go cold turkey. We are sceptics by nature in Britain and yet we have been indoctrinated into this low fat-fewer calories-exercise like mad menu by the three major fat clubs we have, all allegedly making money. Also worth looking at our own NHS doctors - and not even London-based - Dr David Unwin and Jen who have had great success at swimming against the dietary tide, so to speak. The ethics of the NHS do not allow profiteering or self-promotion in any way as is allowed in the American medical system, or you get struck off here! So a leap of faith for me as well as anyone else here.
  8. 8
    Francoise
    September 15 2018
    This approach will always fail because they do not teach people which foods to consume to retain health and weightloss. So sad because it does not tavkle the root cause.
  9. 9
    Ariane
    September 16 2018
    I had read the nutrition facts for 1 serving of Optifast :
    Fat 3.5 g
    Net carbs 15 g
    Protein 16 g
    You have to take 4 servings each day : Carbs 60 g + carbs from 2 plates of vegetables +20g
    total carbs 80 g

    Sample of Ingredients (chocolate Shake mix)

    Chocolate Shake Mix Ingredients: Maltodextrin, Milk Protein Concentrate, Soy Protein Isolate, Calcium Caseinate, Isomaltulose, Canola Oil, Cocoa Processed With Alkali, Gum Acacia, Fructooligosaccharides, And Less Than 2% Of Inulin (From Chicory), Potassium Chloride, Potassium Phosphate, Salt, Calcium Phosphate, Magnesium Oxide, Sodium Caseinate, Soy Lecithin, Mono And Diglycerides, Choline Bitartrate, Ascorbic Acid, Stevia Leaf Extract (Sweetener), DL-Alpha Tocopheryl Acetate, Ferrous Sulfate, Sucralose, Corn Starch, Natural And Artificial Flavor, Niacinamide, Vitamin A Palmitate, Zinc Sulfate, Vitamin K1, Vitamin D3, Calcium Pantothenate, Manganese Sulfate, Medium Chain Triglycerides, Copper Gluconate, Thiamine Hydrochloride, Pyridoxine Hydrochloride, Riboflavin, Folic Acid, Potassium Iodide, Sodium Selenite, Chromium Chloride, Sodium Molybdate, Biotin, Vitamin B12
    Contains: Milk and Soy ingredients

    Conclusions : a lot of artificial components, no natural food !

  10. 10
    Andrew
    September 20 2018
    Imagine only drinking liquids for 6 months Ughhhhh awful

    of course anyone will lose weight with only600 calories a day but they will be constantly hungry

  11. 11
    Cate
    October 2 2018
    I have an older brother who has had schizophrenia for over 20 years. The medications cause severe weight gain (well established) as well as heart problems. As a result he has been on a liquid diet for over 3 years. Yes, he's lost weight but it doesn't seem like a great way to live life, especially when he already has so many barriers due to his illness. But of course, people treat you worse when morbidly obese than when not...
  12. 1 comment removed
  13. 13
    Irene
    January 30 2020
    I've been very successful on low carb before, however, having been given a T2 diabetes tag, I tried this approach for rapid weight loss. I used Cambridge (paid for it myself, not through the NHS), but they are really all the same (Exante, Slimfast, Lighter Life), just some products taste better than others. Each meal pack has roughly 200 calories and average of 22g of carb each. Even on 88g of carbs a day I lost weight at the rate of around 5 pounds per week. But the reason I lost the weight was the calorie restriction, not the carb restriction. The path back to normal eating with Cambridge is low carb - this is why moving up the steps worked, because although you are increasing your calorie intake, you are reducing your carb intake at the same time. So by the time you get to maintenance phase you are following a low carb way of eating. My diabetes benefited (from 22 down to 7.7 in the time I was on the "plan"), but my every day routine now is back to keto. I would recommend it to anyone trying to loose weight rapidly to help with T2 as it is a motivator.
  14. 14
    J Bruce
    February 3 2020
    I cannot believe the NHS recommend the liquid diets. Apart from the hunger cravings, the ingredients of the liquids are loaded with chemicals that are unhealthy. The level of stress must increase the cortisol and the free insulin on the body. Arethey testing insulin levels or just glucose?

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