The latest follow-up to the DIRECT study shows that only 11 out of 149 were still in remission after 5yrs and several of those had had to do the 12 weeks of 800 calorie shakes several times during that period.
So for the vast majority, it isn't as straightforward as you suggest.
Prof Tim Spector says the DIRECT shakes method is unsustainable (at least in his opinion)!
On the other hand, that was "was more than three times" the proportion of people in the control group who achieved remission and sustained it for 5 years:
https://www.ncl.ac.uk/press/articles/latest/2023/04/type2diabetesintoremissionfor5years/
(The full study doesn't appear to have been published yet; this article says the results "will be presented at the Diabetes UK Professional Conference 2023 in Liverpool on 26 April." I hope the Diabetes UK site will report on the highlights of this conference!)
Also-- I can't find any evidence that Prof Spector has ever done any research on remission of Type 2.
When you say "Prof Tim Spector says the DIRECT shakes method is unsustainable", that sounds like a misunderstanding. The idea is not that people should use total meal replacements-- the shakes-- forever; the idea is that a short period with the shakes kick-starts your loss of visceral fat, and then you move to a normal healthy diet to lose more weight and keep it off. The problem is that, unfortunately, many people find a normal healthy diet unsustainable.
Having done a little searching, I think you may be thinking of this article in the Daily Mail?
https://www.dailymail.co.uk/health/...ams-NHS-soup-shake-diet-REVERSE-diabetes.html :
"Professor Tim Spector, co-founder of nutrition company ZOE, told MailOnline that ... it is 'completely the wrong message' to give people who are desperately trying to slim down that they can use ultra-processed substitutes to do so".
Well, from everything I've read, of course he's right that in general ultra-processed foods are bad for us! But-- again, the idea is *not* that people use these shakes forever. The idea is a short, sharp kick-start, and then you move to a normal healthy diet, which of course means (amongst other things) not eating too many ultra-processed foods.
Oh, and, hmm ... I hadn't realised Prof Spector had set up his own "nutrition company" ...
The NHS Low Calorie Diet Programme-- based on the research done by Prof Taylor and others around the world, *specifically* on remission of Type 2 diabetes-- is free.
Prof Spector suggests that you can lose a lot of weight without reducing your calorie intake-- and his company will tell you how, if you pay them a minimum of £25 per month plus £300 for testing (and it's only as little as £25 per month if you pay upfront for 12 months):
https://joinzoe.com/faqs/gb#pricing ...
Which is not to say that there is nothing in Prof Spector's ideas! The actual scientific research done by him and his colleagues makes some very important and interesting points. But then so does Prof Taylor's work. It's a shame to see Prof Spector adopting the sort of tone he used in the Daily Mail article, when, in an ideal world, he and Prof Taylor would be collaborating.
But-- this sort of thing tends to happen when a lot of money is involved. Prof Spector's company, Zoe, has raised over £70 million in venture-capital funding:
https://techcrunch.com/2022/12/01/z...s-30m-at-a-303m-valuation-to-track-nutrition/ . Venture-capital investors don't just want their money back, they want it back plus a huge profit. So of course they want to persuade people that the free NHS programme isn't even worth trying; to them, the UK's 4 million Type 2 diabetics are a valuable market. (If even one in eight of them could be persuaded to sign up to Zoe even just for a year-- that would be £300 million.)
Doesn't mean there is anything wrong with trying the Zoe plan, or that it won't work for some people; just means a little scepticism is in order.
