NHS Shake and Soup Meal Plan Trials

[ventra]

That's the problem with eating.. it's something we have to do so trying to reduce amounts drastically is hard.

Low carb means you are less likely to get hungry so less likely to want to go "off piste".
Eating mainly fat and protein means you are satiated more easily, stay fuller for longer and brings blood sugars down nicely.
Win, win, win!

Yeah! Got bored with that!

 

[MrsA2]

Yeah! Got bored with that!

I find testing my bg when I eat soon brings my boredom back on track. The spikes when I eat anything off track must be doing me harm, even if I don't get symptom or signs immediately.
I find being bored with the food means I eat less of it, and less often. I try to find new recipes to dress up the same ingredients. The odd wobble off track must be better than staying off track for miles

 

[daifly]

Hi all, new to the forum but I’m one of the lucky 5,000 - I started my programme yesterday.

It’s fine so far, and the first bit is about weight loss and I guess the shakes and soups (which actually taste nice) are really all about kicking that off properly. I’ve honestly not felt hungry yet - which hopefully continues...!

The powders are calorie and carb limited - I’ll let you know how they are after 12 weeks!

The programme itself lasts 12 months, with weekly one-to-one coaching, apps and support groups and, which is the bit I need, full re-education about food and eating. There’s also loads on exercise and getting active again.

I guess going into it you really do have to fix something in your head about why you want to do this. I’m 44, I don’t want to be on tablets for diabetes - it feels like it’s all self-induced after 44 great years of not looking after myself - and I need the re-education as much, if not more, than the initial diet itself.

I don’t want to end up with complications (particularly having my legs off seems to be the main thought - a childhood memory of an old family friend) and so I’ve got that motivation in my head to just try and keep my fixated on the reasons why this 3 months of weirdness is worth it. I’ve never had motivation in the past so I’m surprising myself feeling like, currently anyway, this is achievable.

Am sure (as I can see above) that you’re all far wiser than me on various diets and lifestyle changes and I guess they have to work for you, but this plan so far isn’t just the diet and a wave goodbye, it’s 12 months of re-education.

will let you know how it goes!

 

[Ronancastled]

Taylor has been clear that the method of weight loss is not important.

First weight loss doesn't work for those with long term organ impairment.
These patients should be recognised early & removed from the trial.

It's the long term weight maintenance of the successful candidates where the key lies.
We are preset to want a certain amount of calories per day & eat accordingly.
I lost 5.5st post diagnosis but now have to fight against putting it back on.

Bariatric surgery has greater long term success due to the patients inability to overeat even though they might want to.
Many with 15+ years remission of T2 recorded in the Swedish Obesity Study (SOS) Trial following bariatric surgery.

 

[HSSS]

Taylor has been clear that the method of weight loss is not important.

Very old thread I realise but do you know where this record of him saying this is please? I’m struggling to find it even though I’ve seen it before

 

[Oldvatr]

Very old thread I realise but do you know where this record of him saying this is please? I’m struggling to find it even though I’ve seen it before

I know he did say it, but not sure when. I am also not sure he is correct in that. If it was simply weight loss then other diet plans such as WW, Slimming world, South Beach and other vlcal diets would also be able to claim diabetes remission, but all I have seen is a one liner saying to the effect that their diet can reduce blood glucose levels. WW say their plan can help you reach your goals.

Even slimfast and Optifast do not claim remission.

ND was funded originally by the NHS to explore a cheaper alternative to bariatric surgery. The diabetes aspect was funded by DUK since surgery does offer a possible route to Remission. What Roy Taylor did was produce a turnkey solution that anyone could use. Simple instructions, minimum preparation and easily controlled. He made it a simplle wash-rinse-repeat procedure that the NHS is able to offer to the primary care patients that is relatively cheap and effective. The magic lies in the repeatability and formulaic procedure, but anyone can buy shakes and do the diet at home. The work Taylor did proved it was safe to use, was within nutritional guidelines (by using pre approved shakes) and broke no taboos.

ND has only ever done the diet using commercial shakes as meal replacements. It has not proven any other pathway to remission. So his comment is out of his ???? and not substantiated by other diets. The closest alternative is the Fast 800 series of diets and they have no scientific study to prove safety or efficacy to the same extent. Low carb is (as readers of this site will know) following on and believed to be a contender but until there is a study done to prove it, then the NHS will not endorse it. However, the NHS does accept low carb as being an acceptable tool and this website does offer a diet plan that is approved by the NHS but it cannot claim Remission. Only Control.

Personally I think what Taylor said is true, but his plan is the only one so far to tick all the political nutritional boxes for the NHS. And thats how Prof Mike Lean wants it. He is offering the Mike Lean Eat Balanced Diet which is an offshoot from his ND work.

 

[lessci]

Have a look at the "Newcastle Diet" thread, all the science behind it is there. When I was 1st diagnoses I used it as a "kick start" lost approx 3stone on the 8week plan, then transitioned to a lower carb WOE. Currently down 5ish stone (10 years on) and HBAc1 slowly (very slowly) coming down, for those of us who experience weight gain as a symptom of insulin resistance it can work, as shifting the visceral fat/liver fat reduces this

 

[HSSS]

Have a look at the "Newcastle Diet" thread, all the science behind it is there. When I was 1st diagnoses I used it as a "kick start" lost approx 3stone on the 8week plan, then transitioned to a lower carb WOE. Currently down 5ish stone (10 years on) and HBAc1 slowly (very slowly) coming down, for those of us who experience weight gain as a symptom of insulin resistance it can work, as shifting the visceral fat/liver fat reduces this

I’ve searched a heap of threads and keep seeing references to him saying it but can’t find the actual source. I understand the concepts, I’m just looking for his comments about the method of weight loss used. It may have been on twitter but I‘ve barely ever been on there and simply can’t work out how to search effectively on it. So if anyone fancies a challenge……

 

[Oldvatr]

Prof Roy Taylor

Has anyone read his book? I thought it was really interesting but I am curious about his take on low carb. He says it doesn’t matter whether you are low carb or not it just matters that you lose weight. Any opinions? I must confess I feel my brain is in a pickle. I managed gestational diabetes...

www.diabetes.co.uk

There are clues here. I do not have his book, but therein may lay the answer.

 

[Ronancastled]

Very old thread I realise but do you know where this record of him saying this is please? I’m struggling to find it even though I’ve seen it before

It was is his Reddit AMA
https://www.reddit.com/r/IAmA/comments/47psga

 

[NathonalCoalBoard71]

I think its national, i would guess it will be those with a high BMi, High HBA1c and on Medication will be the target. They will prob target a mix of age groups but more likely target people who are younger.

Good Morning,

Just been reading about the NHS Shake and Soup plan in this mornings news! Does anyone have any experience of it? How is it going and what sort of GP support is offered?

ATB

Bill

I don't think it is nationally available yet. I think they rolled out in places with high rates of diabetes first but I am sure this will follow.
The Direct study is the evidence base behind the 800 kcal diet and they've just reported 23% remission rate at 5 years. This is comparable to Virta Health (keto). The difference is keto doesn't require nutritional deprivation and starvation! Yes it works but the other implication of dropping calories is that Prof Taylor et al believe you would then need to eat a fairly moderate calorie total for life or you will regain both body fat and diabetes.
The method isn't so much about losing weight but is about the loss of the fat around the pancreas and liver though it could be argued that the maker of visceral fat is a high carb diet (nothing to do with calories other than that if you eat 800 calories you're going to be low carb de facto if you are not just eating crumpets!)
For those that aren't overweight but are type 2 the next research is the Retune research which is hoping to show that a less drastic version of the Newcastle diet will be effective!

 

[KennyA]

I don't think it is nationally available yet. I think they rolled out in places with high rates of diabetes first but I am sure this will follow.
The Direct study is the evidence base behind the 800 kcal diet and they've just reported 23% remission rate at 5 years. This is comparable to Virta Health (keto). The difference is keto doesn't require nutritional deprivation and starvation! Yes it works but the other implication of dropping calories is that Prof Taylor et al believe you would then need to eat a fairly moderate calorie total for life or you will regain both body fat and diabetes.
The method isn't so much about losing weight but is about the loss of the fat around the pancreas and liver though it could be argued that the maker of visceral fat is a high carb diet (nothing to do with calories other than that if you eat 800 calories you're going to be low carb de facto if you are not just eating crumpets!)
For those that aren't overweight but are type 2 the next research is the Retune research which is hoping to show that a less drastic version of the Newcastle diet will be effective!

Actually, they have NOT reported remission at 23% after five years.

They have reported that at five years 23%, of the 36% (of the 298 original subjects) who were still in remission after two years, were still in remission.

Basically at the extended stage they excluded anyone not still in remission. That all translates to 24 or 25 people from the original 298 in remission after five years - about 8% of the original group.

My opinion is that the figures are being reported in this slightly odd way to make the results look better and to make people think there is a 23% success rate after five years. It does sound a lot better than 8%.

 

[HSSS]

It was is his Reddit AMA
https://www.reddit.com/r/IAmA/comments/47psga
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Amazing. Thank you. I also found some papers of his saying much the same.

 

[HSSS]

Actually, they have NOT reported remission at 23% after five years.

They have reported that at five years 23%, of the 36% (of the 298 original subjects) who were still in remission after two years, were still in remission.

Basically at the extended stage they excluded anyone not still in remission. That all translates to 24 or 25 people from the original 298 in remission after five years - about 8% of the original group.

My opinion is that the figures are being reported in this slightly odd way to make the results look better and to make people think there is a 23% success rate after five years. It does sound a lot better than 8%.

Yep my calculations were similar

149 people Started

1 yr success 68 people (46%)
2yrs 48 people (32%)
5 yrs 11 people (7%)

only 85 were tracked for the last 3 yrs so 23% of those, not the original cohort

eta slight errors in the figures see below

 

[ravensmitten]

Very old thread I realise but do you know where this record of him saying this is please? I’m struggling to find it even though I’ve seen it before

I don't know if this is what you are referencing but had a quick search through his ebook reveals

And, happily, the data from these real experts confirmed the findings of Counterpoint. The average weight loss achieved by people just armed with the basic information was the same as in Counterpoint – 15kg. At home and at work, going about their daily lives, people had replicated our research findings. And what emerged was that it was the weight loss that mattered, not the particular diet the participants went on or how they did it. Around half of the group had used a liquid formula diet – as in Counterpoint – and the other half had merely cut back drastically on their normal eating. A high proportion had sought individual advice as advised on our website and had been told by their doctor or diabetes nurse in no uncertain terms not to try to lose weight rapidly. But they were so highly motivated to get rid of their diabetes that they had emailed me on hearing news reports, and understandably they had gone ahead anyway.

Prof Roy Taylor - Life Without Diabetes 2019

I'm pretty sure I'd seen it said before this book was published, as I had a crack at the diet in 2016 and remember such a thing being said, possibly paraphrased by a journalist who undertook a food based 800 very low calorie diet themselves.

Fake preview edit: oh, I see new posts have happened since I've been away from the computer.

 

[ravensmitten]

23%, of the 36%

lol, amazing

 

[KennyA]

Yep my calculations were similar

149 people Started

1 yr success 68 people (46%)
2yrs 48 people (32%)
5 yrs 11 people (7%)

only 85 were tracked for the last 3 yrs so 23% of those, not the original cohort

It's a bit of a red flag when numbers in this study are very small and percentages of percentages are quoted without mentioning the actual numbers involved at each point. It seems also that some sources are giving 149 as the number of participants while elsewhere (eg the Times story) the 298 figure is quoted. Percentages are also slightly tweaked.

It's possible that this is all the fault of the media's reporting - and that's possible - but the media normally just print what the press release says, so I suspect this is deliberate obfuscation.

It seems that it would be equally valid to say that 93% of people in this study either never achieved remission, or maintained remission to the five year point. But no headlines in that and probably no NHS contracts either.

 

[HSSS]

direct (accidental pun) from the lancet without media journalist show my figures were a little off.

Durability of a primary care-led weight-management intervention for remission of type 2 diabetes: 2-year results of the DiRECT open-label, cluster-randomised trial

The DiRECT programme sustained remissions at 24 months for more than a third of people with type 2 diabetes. Sustained remission was linked to the extent of sustained weight loss.

www.thelancet.com

start of trial 149 in each group (298 total)
1yr 46% (68/149 people) in the intervention group were in remission
2yr 36% (53/149 people) in the intervention group were in remission, 5 (3%) of the control group
40% of intervention participants were on meds compared to 84% in the control group.

From DUK
The extension began with 95 but only got data from 85
At 5yrs 11 of the 85 (23%) in remission which is just 7% of the original intervention cohort.
Oddly more of the control group were in remission at 5yrs (3.4%) without support than at 2 yrs.

I wonder what they did yrs 3-5?

 

[Oldvatr]

It's a bit of a red flag when numbers in this study are very small and percentages of percentages are quoted without mentioning the actual numbers involved at each point. It seems also that some sources are giving 149 as the number of participants while elsewhere (eg the Times story) the 298 figure is quoted. Percentages are also slightly tweaked.

It's possible that this is all the fault of the media's reporting - and that's possible - but the media normally just print what the press release says, so I suspect this is deliberate obfuscation.

It seems that it would be equally valid to say that 93% of people in this study either never achieved remission, or maintained remission to the five year point. But no headlines in that and probably no NHS contracts either.

Speaking of obsfurcation, I discovered a simple but significat fiddle factor in the trial data report. In the claims being made for improvement of insulin response, the insulin rate is expressed in umol/sec/m^2 which looked to me to be suspect. rates are usually just x per sec. In all the other insulin secretion trials I have looked at they use just umol/sec as I would expect. Further investigation of the Taylor formula showed that he was dividing by a new term called Body Surface Area (BSA) Now BSA is derived from the BMI which includs body weight. So by using the Taylor formula, then the insulin secretion rate will vary directly by body weight, so in a weight loss study, it automatically magnifies the rate so that a 15% weight loss is actually directly creating an 8% increase in insulin secretion.
I contacted Roy about this and he claims the effect is insignificant. I am sceptiical about this. I have not seen anyone else use this method of declaring insulin secretion rates.

 

[lessci]

I’ve searched a heap of threads and keep seeing references to him saying it but can’t find the actual source. I understand the concepts, I’m just looking for his comments about the method of weight loss used. It may have been on twitter but I‘ve barely ever been on there and simply can’t work out how to search effectively on it. So if anyone fancies a challenge……

As i understand it, the effects on insulin resistance of a very low calorie diet (800ish) were discovered as a side effect of gastric surgery patients follow one pre-op to reduce the fat around and in the liver. Their HbAc1 dropped. Prof Taylor at Newcastle University (hence the name) did some limited studies and found that an 8 week VLCD using meal replacement shakes & 1 meal of 200cal veg produced a dramatic drop in liver fat, and reduction in HbAc1, which was still lower after 2 years than at initial diagnoses