NHS GPs to prescribe 800 calorie ‘liquid diet’ of soups and shakes to tackle type 2 diabetes

Replacing all meals with diet drinks could help one in eight put condition into remission, experts say

Alex Matthews-King
Health Correspondent
Friday 30 November 2018 08:00
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NHS England’s pilot will see 5,000 patients offered the diet
NHS England’s pilot will see 5,000 patients offered the diet

Thousands of NHS patients are set to be prescribed a “liquid diet” of soups and shakes which limit them to just 800 calories a day in a bid to address soaring rates of type 2 diabetes.

Very low-calorie diets will be available with a GP referral for the first time as NHS bosses say they are “ramping up” action to prevent hundreds of thousands of obesity linked diseases.

NHS England’s pilot will see 5,000 patients offered the diet, which substitutes all meals with nutritionally balanced drinks for three months before gradually returning to a regular diet with support to adopt healthier eating habits.

Experts told The Independent that around one in eight patients offered the diet could “reverse their diabetes” and reduce the risk of amputations and other complications.

However, it is not an option that is attractive to everyone – and while it appears to be more effective than other diet trends, patients’ ability to keep weight off longer term is still being reviewed.

“This is not for Mr Joe Bloggs who is a bit overweight and doesn’t have diabetes,” Professor Naveed Sattar, an expert in metabolic medicine from Glasgow University, told The Independent.

“This is for people with diabetes who have a strong incentive to lose that weight.”

Mr Sattar was part of the initial trial that showed the scheme can induce diabetes remission and said that while it isn’t cheap – the drinks cost around £40-50 a month and there needs to be significant support from staff – it was “definitely cost-effective for the NHS”.

“If this works it might end up reversing diabetes in one in eight, that’s a best-case scenario, but it does work in people who are motivated and want to take it up.”

The escalation of the NHS fight against type 2 diabetes comes as a group of doctors and researchers, including Mr Sattar, said the government is not doing enough to counter the obesity epidemic.

In the same mould as the sugar tax, they called for more legislation to force food manufacturers to reduce fat and label calories in takeaway meals, and challenged “conspiracy thinking” which is causing a boom in high fat diets.

One consequence of rising obesity is that diabetes rates have doubled since 1998. The condition now affects 3.7 million people in the UK and nine in 10 of these patients have type 2 diabetes, which is closely linked to weight and diet.

Treatment and complications of diabetes account for 10 per cent of the NHS budget, and the health service predicts the disease will contribute to 39,000 heart attacks, 50,000 strokes and a host of cancers by 2035.

To curb this NHS England is doubling the size of its diabetes prevention programme, which the 800 calorie diet is part of, and will offer 200,000 people who are obese and at risk of diabetes weight loss support.

Diabetes UK was one of the funders of the DiRECT trial, which helped established the benefits of the very low-calorie diet, and said it was “delighted that NHS England have been inspired by this work to pilot a type 2 remission programme through the NHS”.

The trial showed that around a quarter of patients were willing to try the diet, and half of those achieved remission of their diabetes – while a quarter lost 15kg or more over the year.

NHS England will evaluate its own pilot findings after a year before deciding on whether to expand the scheme.

“The NHS is now going to be ramping up practical action to support hundreds of thousands people avoid obesity induced heart attacks, strokes, cancers and type 2 diabetes,” NHS England chief executive Simon Stevens said.

“What’s good for our waistlines is also good for our wallets, given the huge costs to all of us as taxpayers from these largely preventable illnesses.

“However, this isn’t a battle that the NHS can win on its own. The NHS pound will go further if the food industry also takes action to cut junk calories and added sugar and salt from processed food, TV suppers and fast food takeaways.”

This echoes the words of Professor Christine Williams, a specialist in human nutrition at Reading University, who told a briefing in London that on average the public under-report the calories they consume by 34 per cent.

“It’s quite extraordinary. We’re fooling ourselves – if you want to be polite,” she said.

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“Calorie labelling on food eaten outside the home is a really important measure, and they [ministers] need to get on with it.”

She said people were increasingly being given the impression that fats were healthy, despite containing pure calories and there being good evidence that saturated fats, in dairy and meat, are linked to heart disease.

“People almost want to hear the opposite of what they’ve been doing is true,” she said. “It’s like a conspiracy theory.”

Mr Sattar told the same meeting there “needs to be legislation to change food formulations”, and called for a taskforce to be set up to address this.

“The food and drink companies want to make a profit, they’re making huge profits, they’re not going to take advice to change formulations,” he added.

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