NHS soups and shakes diet: Second Nature’s response

Where did this come from?

The rationale behind launching this plan comes from the DiRECT trial. This was the first ever high-quality dietary and lifestyle intervention trial with type-2 diabetes remission as the primary goal. This is a very large-scale, ongoing study where participants are followed up after 2 years.

This trial demonstrated that dramatically reducing energy intake (to around 850 calories per day) and then slowly reintroducing a healthy, balanced diet, led to significantly more individuals achieving remission compared with those receiving standard NHS care.

The results so far are incredibly promising, as they tell us that significant weight loss can result in type-2 diabetes remission and potential reductions in medications for some, even if the individual had been diagnosed up to 10 years ago.

So what’s the issue?

It’s really encouraging to see the NHS using the latest research to inform their strategy and actively trying to tackle the condition, especially given the recent links to poorer outcomes from coronavirus (COVID-19).

However, there are some challenges with how this approach has been depicted in the media.

Calorie-counting alone isn’t healthy

This sort of science often gets mistaken for evidence that ‘eating a very low-calorie diet is healthy’. Calorie counting alone pays little attention to the nutritional benefits of different foods. Media coverage of the ‘800-calorie NHS diet’ has failed to provide information on the other aspects involved in this approach.

For example, people who choose to participate in the new NHS scheme will be medically supervised and fully supported by healthcare professionals to reintroduce foods in a healthy way once they’ve completed the 3-month meal replacement phase.

The media focus on the number of calories that the NHS diet provides might send the wrong message to the public – that calorie-counting alone is an effective and sustainable weight loss tool.

Simply cutting your diet in half without supervision from a medical professional to reach your ‘calorie goal’, isn’t a healthy way to achieve weight loss in the long term. In fact, doing so can result in nutritional deficiencies, hunger, and a higher likelihood of regaining the weight lost in the long run.

There are other ways to lose weight

The DiRECT trial is a high-quality study showing the effect that significant weight loss can have on type 2-diabetes, but a liquid diet isn’t the only way to lose weight. At the end of the day, we’re all unique and the best ‘diet’ is the one that you can stick to in the long term.

Some people won’t mind consuming meal-replacement shakes and soups for 3 months before reintroducing food, whereas others might really struggle to do so.

Evidence suggests that a lower-carbohydrate diet is an extremely effective alternative for weight loss. As a lower-carbohydrate diet is naturally higher in protein and fat, you’re not left feeling hungry, which means you’re more likely to stick to your healthy eating plan in the long term.

We’d also argue that long-term weight loss and lifestyle change is far bigger than nutrition and exercise alone. Evidence suggests that accounting for our sleep, stress, and mindfulness habits, as well as focusing on motivation, is key to achieving long-term results.

That’s why we take the full picture into account on the Second Nature programme and combine each piece of the puzzle with support from a registered dietitian or nutritionist.

Take home message

• The new NHS low-calorie shakes and soups diet is based on high-quality evidence
• It’s really encouraging to see the NHS actively trying to tackle the condition, but there are some negative consequences with how this approach has been depicted in the media
• Patients enrolled in the NHS initiative are medically supervised and offered a lot of support from health professionals
• Calorie-counting alone isn’t an effective and sustainable weight loss tool
• We’re all unique and the best ‘diet’ is the one that you can stick to in the long term
• Evidence suggests that a lower-carbohydrate diet is effective for long-term weight loss
• Nutrition and exercise are just two pieces to the puzzle when it comes to health; sleep, stress, motivation, and mindfulness are just as important.