BBC story on "shake and soup" diet

[chiefsub68]

This sounds encouraging if you can stick with it: https://www.bbc.co.uk/news/articles/czjyy7280lzo

 

[Melgar]

The Guardian is running the story too.

 

[KennyA]

It's a standard low-calorie approach.

 

[lovinglife]

Its nothing new the BBC ran a story on it in 2020 the link to the article is actually at the bottom of the page for this article

Shake diet offered on NHS to fight type 2 diabetes

Thousands more people in England will be encouraged to try the weight loss plan.

www.bbc.co.uk

 

[Rachox]

My problem with these soup and shake type low calorie diets is what you do when you’ve done the eight weeks, to keep your weight and blood sugars under control. A plan is needed otherwise the temptation is to go back to your old diet and undo any gains you’ve made.

 

[KennyA]

There is a much longer thread on the research (and its very low success rate) somewhere on the forum - can't find it at the minute. I notice that the study published in the Lancet again muddies the waters by omitting from the percentage calculations the 45% of the sample who dropped out of the trial part way through and only reports "success" against the people completing it. So - out of 1740 who started, 945 completed the programme and of these 145 had two HbA1c measures of less than 48. That's just over 8% of the starting group.

 

[Outlier]

It's very difficult for people to stick to 800 cals a day for the rest of their lives. I did between 500-800 daily for years, but in the end had to give up. It's pretty difficult to stick to 800 cals per day just for a few weeks. No wonder people put the weight back on (always stated in an accusatory manner in the reports). Low-carb using real healthy food is much more flexible, and can be curated to the individual. Oh, and it's not unhealthy processed-to-the-Nth-degree food either.

 

[Lamont D]

What is not realised with these type of calories controlled diets, shakes and soups.
The concentration of the ingredients will still be too much if the patient is prone to any abnormal high glucose levels.
The imbalance of the reaction in hormones will be too much. As would be the sugar and carbs in such concentration.
If you have something akin to Orange juice, the amount of water required for some would be 99%.
Someone else could be 95%. The weaker the dilution, the less of the glucose spike.
If you're diabetic stay away from any shakes and most industrialised soups.

 

[Lamont D]

There is a much longer thread on the research (and its very low success rate) somewhere on the forum - can't find it at the minute. I notice that the study published in the Lancet again muddies the waters by omitting from the percentage calculations the 45% of the sample who dropped out of the trial part way through and only reports "success" against the people completing it. So - out of 1740 who started, 945 completed the programme and of these 145 had two HbA1c measures of less than 48. That's just over 8% of the starting group.

How many had T2?

 

[Melgar]

So what happens if you fall outside these categories ? Are you on your own with managing your blood sugars.

• between 18 and 65
• have been diagnosed with type 2 diabetes within the last six years
• have a body mass index (BMI) over 27 kg/m2 (if from white ethnic groups) or over 25 kg/m2 (if from black, Asian and other ethnic groups)

 

[filly]

I have always thought that this way of eating is still processed. Also 800cals is not sustainable.

 

[Lamont D]

I have always thought that this way of eating is still processed. Also 800cals is not sustainable.

Not if you are physically active.

 

[KennyA]

How many had T2?

I think they all had, it was a criterion for entry, providing it was diagnosed in the last six years. But I wouldn't have been eligible, being over 65 and having a BMI under 27.

 

[PurpleArmadillo]

So what happens if you fall outside these categories ? Are you on your own with managing your blood sugars.

• between 18 and 65
• have been diagnosed with type 2 diabetes within the last six years
• have a body mass index (BMI) over 27 kg/m2 (if from white ethnic groups) or over 25 kg/m2 (if from black, Asian and other ethnic groups)

My thoughts exactly! I was diagnosed 8 years ago, which apparently makes me a lost cause. With how stretched my gp surgery is now I am very much on my own

 

[Melgar]

They want to increase their chances of publishable success by excluding diabetics who don’t fit the over weight, newly diagnosed , 40-50’s set , in other words they are only interested in those who would likely benefit anyways with weight loss and a reduced carbohydrate diet.
The rest of us, whether we are lean, over 65 or have been diabetic for over 6 years would likely increase the statistical failure of their diet. Which to be honest failed anyway despite the enthusiastic summary in The Guardian and the BBC .

 

[_Steve_]

There's a story published by diabetes org uk 6 days ago saying saying one third of people who complete this go into remission? Surely if it's that many then it isn't a failure?

 

[KennyA]

There's a story published by diabetes org uk 6 days ago saying saying one third of people who complete this go into remission? Surely if it's that many then it isn't a failure?

But it isn't a third of the people who started - around 1740. It was a third of the people who finished, ie did not drop out earlier. It explicitly uses "survivor bias" to produce a more palatable result, as did the DIRECT trial on which this is based.

Nearly half (45%) dropped out. We're not told why there is such a large drop-out, but I would find an 800 calorie diet extremely challenging for any length of time and I guess many of the participants did too.

If you recalculate success based on the number of "remissions" against the number of people who started the program, it drops to 8%.

Secondly "remission" in this case means two A1cs of under 48, without glucose-lowering medication, three months apart. Nothing about symptoms etc whatsoever.

 

[_Steve_]

Should people who drop out be counted though? It is extremely difficult but so is going to the gym and changing your lifestyle, if you quit anything you by definition won’t succeed at it.

I’ve lost around 4st doing low carb, ~1500 calories a day and daily exercise, I’m due to start this program next Monday as it’s taken so long to from asking about it until starting, so halving calories to 800 I assume will mean a drop in energy.

Of the ones who stuck it out, one third of remission is still good. Even if the rest lost weight as the only benefit, anyone losing visceral fat and getting slightly more healthier must be a bonus.

I might be being optimistic but I see a lot of negative comments towards the program when it is actually helping people.

 

[KennyA]

Should people who drop out be counted though? It is extremely difficult but so is going to the gym and changing your lifestyle, if you quit anything you by definition won’t succeed at it.

I’ve lost around 4st doing low carb, ~1500 calories a day and daily exercise, I’m due to start this program next Monday as it’s taken so long to from asking about it until starting, so halving calories to 800 I assume will mean a drop in energy.

Of the ones who stuck it out, one third of remission is still good. Even if the rest lost weight as the only benefit, anyone losing visceral fat and getting slightly more healthier must be a bonus.

I might be being optimistic but I see a lot of negative comments towards the program when it is actually helping people.

Of course they should. They started the program, and their experiences in not being able to live with it are equally valuable.

Suppose there was a study on a medical procedure involving a thousand people, and we were told that all the people who had had the procedure and had been checked after a year were reporting a huge improvement in health and well being. 100% success rate claimed.

And then it was revealed that 900 of the people undergoing the procedure had died within that year. Would that not throw the claimed success into a slightly different light?

If people benefit from a low cal (which is also a low carb) diet, and are in the very small minority that can stick with it, no problem. My issue is that the research is consistently overclaiming a very limited improvement (under 48 is better than over 48 but it's definitely not normal BG level) rather than reporting its results transparently. It gets enthusiastic take-up from an uncritical media - and people sign up unaware of the real chance of achieving what they think they're going to achieve.

 

[_Steve_]

Fair enough, when you put it like that it makes sense. I still believe it gets a lot of negativity though, even partial completion and some weight loss is a benefit if people are struggling with diets, losing weight etc.

I’ll see how it goes, but have every intention of completing it fully