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ND DiRECT updates

Discussion in 'Low Calorie Diets' started by bulkbiker, Dec 2, 2018.

  1. ringi

    ringi Type 2 · Well-Known Member

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    Counterpoint is the complete package a CCG buys, it includes the shakes, training for the practice nurse, paperwork to be given to the "victims" etc. It also covers the cost of running meatings etc for GPs to trying to get them being willing to adjust drugs etc for people doing it.

    The "control arm" of this sort of study is always hard, as everyone is told what the study is before signing up, hence some people in the control group may have done it themself. It is not possible to do a long term "double blind" randomise trail on diet......
     
  2. Indy51

    Indy51 Type 2 · Expert

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    I'm still wondering what happens if the surgery offers this "miracle" and people refuse it. Will they be labelled "non-compliant"?
     
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  3. kokhongw

    kokhongw I reversed my Type 2 · Well-Known Member

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    All that drum beating...a final desperate attempt to stay relevant and capture slice of the T2D remission market that has gone wild over the last few years.

    Good luck with their maintenance using the EatWell plate...
     
  4. Mbaker

    Mbaker Type 2 (in remission!) · Well-Known Member

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    I do that amount of calories in nuts (admittedly now just at the weekends).
     
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  5. ringi

    ringi Type 2 · Well-Known Member

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    Unlikely, but anyone who regains the weight after doing it will be.
     
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  6. Dark Horse

    Dark Horse · Well-Known Member

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    Where does it say that maintenance is based on only 1200 kcals/day? I can see a slide which says add an approximately 400 kcal approx meal every 2-3 weeks but this was during the Stepped Food Reintroduction phase. There are no specific Calories mentioned in the section on Weight Loss Maintenance, which is what one would expect - different people would require a different number of Calories to maintain weight, based on total body mass, muscle mass, activity levels etc. The original trial protocol says, "Participants will be advised to follow a food based diet and will be provided with an individually tailored energy prescription, to support weight stabilisation and prevent weight regain. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4754868/
     
  7. bulkbiker

    bulkbiker Type 2 · Oracle

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    1. Food Reintroduction: The Counterweight–Plus programme includes a structured approach to reintroduce meals (breakfast, lunch, evening meal at 2-week intervals), exploring different food choices, within about 400 kcal each meal. This leads to a new normal eating pattern with new food choices (it MUST contain less calories than before losing the weight).


      From here

      https://www.directclinicaltrial.org.uk/Documents/Patient Info Website Feb 2018.pdf

      Counterweight seems to be the preferred partner for the therapy..

      400k per meal 3 times a day ...
     
  8. Dark Horse

    Dark Horse · Well-Known Member

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    There's not enough detail there to conclude that total Calorie intake is about 1200 kcals in the final weight maintenance phase. Agreed that it will be less than before the weight loss. (From memory, I think that the rule of thumb was about 2/3 of previous intake.)
     
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  9. bulkbiker

    bulkbiker Type 2 · Oracle

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    Possibly... depends on your view.. to be honest since delving into the site a bit more I still find it both badly designed and a bit patchy in real world terms. If the NHS is hoping that people will follow this regime without a lot of support I hope they sort it out and make it far easier to understand because from the organisational mess that the site is it will be quite a hard task to see it through.
    I also find it odd that one company "Counterweight Ltd" seem to have the sole commercial dibs on the trial website.
    Profs Lean and Taylor have used various shakes in the past but these guys seem to be all over this one...
    It will be interesting to follow it through in future.
     
  10. Oldvatr

    Oldvatr Type 2 · Expert

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    The CEO and top staff at Counterweight all went to Robert Gordon university, and have all been employed by the NHS prior to joining Counterweight Ltd. which was founded in 2011. Incidentally some of the authors of the DIRECT study seem to have strong links to Cambridge Diet company as well as Counterweight , either as employees of said or as ex employees.

    Edit to add that Counterweight began as a collaboration between 7 universities, and is headed up by RGU as lead. The research academics were all working on obesity issues, and they 'own' the plan used in DIRECT.
     
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    #50 Oldvatr, Dec 4, 2018 at 10:15 AM
    Last edited: Dec 4, 2018
  11. bulkbiker

    bulkbiker Type 2 · Oracle

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    I was quite surprised not to see the names Lean and Taylor there I must admit...
     
  12. ringi

    ringi Type 2 · Well-Known Member

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    Given that Counterweight was set up due to the NHS no longer having any national wide teams who can do that type of work, and that they will be working very closely with CCGs, I would expect most of their staff to be ex NHS.

    I think Tayler has done consulting for Cambridge Weight Plan and it is the same shakes then Counterweight is using.
     
  13. Oldvatr

    Oldvatr Type 2 · Expert

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    Look in the conflict of interests section of the study report - they get a mention or two as receiving funding

    I would suggest that Newcastle was one of the collaborating 7 uni's that ended up with Counterweight Ltd but no evidence for this yet.

    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2486382/
     
    #53 Oldvatr, Dec 4, 2018 at 10:38 AM
    Last edited: Dec 4, 2018
  14. DCUKMod

    DCUKMod I reversed my Type 2 · Master
    Staff Member Administrator

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    Do you have a link to the list of "interested parties". I don't be curious to read it.
     
  15. DCUKMod

    DCUKMod I reversed my Type 2 · Master
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    Ringi - I'm in bluethingywhatsitmode at the moment, so forgive my queries, but where does it talk about being formed due to a lack of nationwide teams?

    I need to make some personal reading time.
     
  16. ringi

    ringi Type 2 · Well-Known Member

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    It does not, but nearly all "national" staff in the NHS was transferred to local organizations or to the regulator a few years ago. The department of health now mostly just gives out money to the different independently run organizations that get to use the NHS logo.

    (Even support for NHS accountants doing the job have to now be brought by the hospital/CCG from an independent organization)
     
  17. DCUKMod

    DCUKMod I reversed my Type 2 · Master
    Staff Member Administrator

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    I thought that, but we can't ascribe an action to a feeling without justification in this case. Who knows why who did what, when we weren't there.
     
  18. Oldvatr

    Oldvatr Type 2 · Expert

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    Iinkedin is often a good source.
     
  19. Oldvatr

    Oldvatr Type 2 · Expert

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    What worries the heck out of me is that here we have 7 universities apparently collaborating together to solve obesity epidemic with government funding, and here in their latest offering to issue forth we have a solid return to Eatwell and Low fat,with emphasis on fat reduction. No wonder our nutritionists are confused about new diets since the academics who produce the evidence based results are still churning out the old mantra's with complete disregard to any new studies since 2000 that do not enforce this belief. Until the academics wake up then there will still be Snafu in charge. Even ND (as has been pointed out) is using a diet plan that was commerically on the market some 20 years ago, and relies on the cal_in = cal_out model of homeostasis
     
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  20. Oldvatr

    Oldvatr Type 2 · Expert

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    Is that an XMAS onenesie?
     
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