News broke today that the NHS will begin offering a prescribed diet of shakes and soups to those with type 2 diabetes.

NHS England announced the plan today, saying that 5,000 diabetic people would be offered the diet in order to help them ‘to help people stay well, maintain a healthy weight and avoid major diseases.’

According to trials, 46% of those who tried the regimen went into remission from type 2 diabetes after a year.

Given diabetes has been shown to be a major risk factor for serious coronavirus symptoms it makes sense to try to help.

But the diet has been billed as a ‘very low calorie’ one that is often made up of just shakes and soups, which has sparked concern among some.

We look at what the regime will actually entail and how healthy it is long-term.

What will the diet be?

At the start of the scheme, patients will be given Total Meal Replacement (TMR) which will normally comprise of shakes and soups instead of normal meals (although some people will also be given specially-designed snacks).

An example of past TMR diet recommendations show a typical day for someone following the regime:

• One chocolate-flavour skimmed milk and soya protein shake mix (145kcal)
• One chicken-and-mushroom-flavour skimmed milk and soya protein soup mix (138kcal)
• Skimmed milk and multi-wholegrain porridge mix (149kcal)
• Lemon-flavour soya and milk protein bar covered in yoghurt-flavour coating (150kcal)

That totals at 582 calories per day. According to an NHS spokesperson: ‘Some providers will give prescriptions for four week blocks; others for 12 weeks’. The full programme lasts for a year.

Throughout the prescribed time there will be regular health checks, and eventually solid foods will be gradually reintroduced along with guides to help exercise.

At the six month the patient will be asked to come in for ‘a review of the impact and efficacy.’

Who will be recommended for the diet?

As confirmed by a spokesperson from NHS England, some of the criteria include:

• Must have recent type two diabetes diagnosis
• Must not be pregnant or breastfeeding
• Must have a BMI of 27kg/m² or higher (adjusted to 25kg/m² or higher in people of black, Asian and minority ethnic (BAME) origin)
• Need to commit to ongoing review and monitor meetings with clinician and to have attended previous reviews
• Not eligible if dealing with or having just experienced a major disease including cancer or heart attack, or currently taking insulin

At present, 10 areas of England will be allowed to offer the scheme to patients.

Is it good for you?

As mentioned before results from one trial showed almost half (46%) of those who completed the scheme achieved remission of their type 2 diabetes after one year.

Bev, one of the patients who took part in the trials, said: ‘My goal for the first eight weeks of the low-calorie diet was to lose 5% of my body weight – which I achieved in six weeks – and in total I’ve lost over 10kg, my type 2 diabetes is now in remission and I no longer have to take any medication – I am over the moon.

‘Since the low-calorie diet programme, my mindset has totally changed for the better and I look at food differently now – my shopping habits are far healthier and, when I eat out, I’ll go for a healthier option.

‘The programme has taught me moderation.’

Professor Francesco Rubino, Consultant Bariatric and Metabolic Surgeon at London Bridge Hospital (part of HCA UK) tells Metro.co.uk that the plan is ‘well-intentioned and could be beneficial for some patients’.

However, he adds: ‘This approach cannot be a solution for many – perhaps most – people with type 2 diabetes.’

Professor Rubino explains that scientific evidence does show that this can ‘improve or reserve abnormal blood sugar levels in patients with recent-onset diabetes’ but that ‘we do not know if the effect can be sustained beyond one or two years nor if [a very low calorie diet] can reduce diabetes-related complications such as heart attacks, stroke, and others…

‘My hope is that this strategy is applied properly to treat patients with recent onset diabetes who are most likely to benefit from it and that the plan will not confuse or mislead both physicians and the public and delay other evidence-based treatment options that for other patients have life-saving implications.’

He also highlights that not all cases of diabetes are caused by people’s habits, saying: ‘For people with full blown disease, changing habits can only be part of a broader strategy but cannot be considered the main treatment, let alone the only treatment.

‘As an example, smoking cessation can prevent cancer but does not cure it. Likewise, diet approaches do not cure type 2 diabetes in most people with full blown disease. In these cases, pharmacologic approaches, or surgery are necessary.’

So, if your doctor believes this is the right treatment for you and you meet all the criteria it could be part of a long-term solution. But it won’t be a catch-all one that suits and benefits everyone.

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