Is the NHS 'soup and shake' type 2 diabetes diet really the solution we've been waiting for?

[Amity Island]

Four months of 800 calories a day were far from easy. June recalled being 'always hungry', except for an hour after every shake, and occasionally having a lettuce leaf or small stick of celery to curb her stomach pangs.

What kept her going was focusing on what really mattered – being free of diabetes and off medication at the end of it all.

And when she managed it, she felt euphoric. Her blood sugar levels, which had been 'very high', fell so significantly that her GP stopped prescribing her daily dose of type 2 diabetes drug metformin.

With the weight off, she felt 'healthier than ever,' taking daily walks and playing golf.

But today, three years on, things are not quite so rosy.

Is NHS 'soup and shake' diabetes diet the solution for we need?

Lynne Lewis (pictured), 70, from Pontypool in South Wales, regained weight - and her type 2 diabetes - after her husband's death. She started the soup and shakes diet in 2015 after experience cataracts.

www.dailymail.co.uk

 

[bulkbiker]

" June is now heavier than she was before she started the diet"

because as we all know for most people crash diets do not lead to long lasting sustainable weight loss.

" so I eat porridge for breakfast, lots of salads and fish. I don't even eat cakes or biscuits. But bread is my downfall. Now I have to try to lose the weight again. It's maddening.'"

Bread and porridge ...

 

[childofthesea43]

" June is now heavier than she was before she started the diet"

because as we all know for most people crash diets do not lead to long lasting sustainable weight loss.

" so I eat porridge for breakfast, lots of salads and fish. I don't even eat cakes or biscuits. But bread is my downfall. Now I have to try to lose the weight again. It's maddening.'"

Bread and porridge ...

But to be fair, even had she achieved remission by any other means, including a well-designed low carb scheme, the subsequent distress could still have prompted a lapse to previous poor eating habits. We cannot use her example to cast the Newcastle route in a negative light, it is not good reasoning.

 

[Dragonheart]

But to be fair, even had she achieved remission by any other means, including a well-designed low carb scheme, the subsequent distress could still have prompted a lapse to previous poor eating habits. We cannot use her example to cast the Newcastle route in a negative light, it is not good reasoning.

Whilst thats true and any method that isn’t maintained causes relapse I keep reading phrases like

“enough, experts say, for most people to reverse the condition.”

Actually none of the results of trials showed “most”. At best at the end of the first year with perfect support and fully motivated volunteers it was less than 50%, declining rapidly thereafter.

Yes it’s important that it proves remission via diet is possible. Yes it is valuable for reductions in hba1c and weight even if remission isn’t actually reached. Yes it’s a kick start and important for motivation when people have previously struggled. But unless the issues that were present before the intervention (disordered or inappropriate diets) are addressed and eliminated for good and long term sustainable alternatives are identified then it’s always going to fail. The danger lies in it being seen as a “quick fix and back to normal” and the media I’ve seen so far before this article are a bit short on either the limitations or the alternatives.

 

[childofthesea43]

Whilst thats true and any method that isn’t maintained causes relapse I keep reading phrases like

“enough, experts say, for most people to reverse the condition.”

Actually none of the results of trials showed “most”. At best at the end of the first year with perfect support and fully motivated volunteers it was less than 50%, declining rapidly thereafter.

Yes it’s important that it proves remission via diet is possible. Yes it is valuable for reductions in hba1c and weight even if remission isn’t actually reached. Yes it’s a kick start and important for motivation when people have previously struggled. But unless the issues that were present before the intervention (disordered or inappropriate diets) are addressed and eliminated for good and long term sustainable alternatives are identified then it’s always going to fail. The danger lies in it being seen as a “quick fix and back to normal” and the media I’ve seen so far before this article are a bit short on either the limitations or the alternatives.

Yes, I agree with all of that. The point about the Newcastle method is that the first phase is tightly and uniformly characterised, just like a packet of Metformin pills. The doctor knows what the patient is doing, provided they comply. So it is easy to prescribe and, to an extent, to monitor. The patient doesn’t have to understand, learn, know anything to take it up in that first phase. It does not greatly tax the doctor’s time. So it seems an attractive option to the NHS. I don’t expect impressive outcomes from it. I am not even sure the NHS should be involved at all with T2Ds once first diagnosed, unless already presenting symptoms. It is an educational issue and that is not something that doctors have the time for. I would bet that almost all of us who have got our figures back to normal have done so because we had the capability of self-education.

 

[everydayupsanddowns]

I feel sorry for June. It’s a real shame she wasn’t better supported in switching back to a maintenance diet after successfully doing the hard yards of the weight loss

It’s a shame @travellor felt it necessary to leave the forum as a member of the forum with directly relevant experience here.

This is one of his posts from another thread

I originally was diagnosed a while ago.​

I took all the meds offered, did all the NHS courses, and used the time to look at what I wanted to achieve.​

I decided weight loss would help, not just with diabetes, but general health.​

I did a low fat, low calorie diet, exercised, then the Newcastle diet just hit the news, which is eight weeks of shake based 800 calorie restricted diet, so I finished with that.​

(There are some that claim any weight loss is always a yo-yo diet, I would say it's experienced based, it does for them, but not for all of us, so you need to look at that)​

The break from food was good for me, it was a reset, so I looked at different foods for afterwards.​

Low fat, minimal saturated fats, minimal processes foods are probably the main target, but I can, and do eat anything when I need to now.​

All I do is keep the weight in my target band.​

(Mostly, like normal people, I often do a dry January, and diet, to recover from an excessive Christmas!)​

(my emphasis)

It seems June wasn’t able to make the ‘break from food’ that Travellor was.

 

[bulkbiker]

It’s a shame @travellor felt it necessary to leave the forum as a member of the forum with directly relevant experience here.

Indeed, however just because he claimed he was one of the lucky 11% that had longer term success we must remember that the 89% who did not have that success are still out there.
He also never shared his results so we can't know if he was still in the pre-diabetic as many of the "successful" participants in DiRECT were.

 

[childofthesea43]

Indeed, however just because he claimed he was one of the lucky 11% that had longer term success we must remember that the 89% who did not have that success are still out there.
He also never shared his results so we can't know if he was still in the pre-diabetic as many of the "successful" participants in DiRECT were.

Were the 89% unlucky or did they not achieve or maintain weight loss?

 

[bulkbiker]

Were the 89% unlucky or did they not achieve or maintain weight loss?

There are quite a few people in remission through low carbing who haven't had significant weight loss.
personally I think it's because crash diets rarely wok long term and that Taylor's theory is severely flawed.

 

[childofthesea43]

There are quite a few people in remission through low carbing who haven't had significant weight loss.
personally I think it's because crash diets rarely wok long term and that Taylor's theory is severely flawed.

I have seen nothing in Taylor’s views that a long term crash diet is needed. On the contrary, he advocates a short-term diet followed by a moderate eating pattern thereafter. I am not sure that low carbing without weight loss will restore pancreatic function, but obviously it reduces A1c by not generating much glucose, but what has that got to do with diabetes?

 

[childofthesea43]

There are quite a few people in remission through low carbing who haven't had significant weight loss.
personally I think it's because crash diets rarely wok long term and that Taylor's theory is severely flawed.

As I see it, the powerful outcome of his work is to demonstrate how to recover beta cell functioning.

 

[AndBreathe]

I have seen nothing in Taylor’s views that a long term crash diet is needed. On the contrary, he advocates a short-term diet followed by a moderate eating pattern thereafter. I am not sure that low carbing without weight loss will restore pancreatic function, but obviously it reduces A1c by not generating much glucose, but what has that got to do with diabetes?

Frankly, T2 is such a catch-all diagnosis (in many instances, that means it isn’t T1, ergo must be T2) that

As I see it, the powerful outcome of his work is to demonstrate how to recover beta cell functioning.

Do we have proof beta cells regenerate, or is it that our insulin sensitivity improves by (often a combination of) trimming up and easing up on the kicking our pancreas is getting from insulin resistance?

I don’t think simplifying T2 into a simple lose weight and it’ll all get better condition is helpful.

Edited to correct my stooooopid typo.

 

[Bubbleblower]

recover beta cell functioning.

What mechanisme is behind that?

 

[Callista]

Surely there are two separate questions here?

1 - Does this diet work? And if so, will the improved BG levels be sustainable once the diet period is finished?

2 - Can you bear to do this diet?

For me, even if the answer to (1) is yes, on both counts, my answer to (2) is NOOOOOO!!!!!!!!!!!!!!!!!!!!!!

It seems an utterly unbearable diet to do. I couldn't do if for a day, let alone any longer, however good or effective it might be.

However, for those for whom it is bearable (brave, brave folk!), I think the interesting point raised in the posts so far is the comment that it gave the dieter 'a break from food' - and that seems highly significant to me.

One of the things that makes dieting hard (and being female, oh boy, it has been part of my life 'for ever' as, sadly, female beauty is defined by slimness etc, and most women are not naturally slim - though a few can eat what they like and stay thin....)(OK, they'd never survive a famine, I know!!!!).....is that unlike going teetotal we can't just 'give up' food completely. I've been 'dry' since New Year (when I got my pre-D DX), and I can honestly say I've 'made that break' from alcohol. I've had one glass of white wine at lunch for a family gathering, and that was it. Now, I don't want to be teetotal for the rest of my life, but I won't go back (I hope!) to the daily 'cheer-me-up' glass I'd slipped into in my retirement.

But we can't go teetotal on food (or we die). So, in that respect, if those on the Newcastle diet can bear it, then I would think that that 'break from food' could be brilliant - but WHAT happens when you come off the liquid diet?


(By the way, if it's all liquid, what effect does that have on one's gut??)


I suppose my bottom line is that the Newcastle diet is simply one option in the fightback against diabetes battle?

 

[childofthesea43]

Frankly, T2 is such a catch-all diagnosis (in many instances, that means it isn’t T2, ergo must be T2) that

Do we have proof beta cells regenerate, or is it that our insulin sensitivity improves by (often a combination of) trimming up and easing up on the kicking our pancreas is getting from insulin resistance?

I don’t think simplifying T2 into a simple lose weight and it’ll all get better condition is helpful.

Taylor’s team has proved that the beta cells, relieved of the burden of excess internal fat, will for most people recover normal secretion levels and normal dynamics in the first-phase response.

 

[childofthesea43]

Surely there are two separate questions here?

1 - Does this diet work? And if so, will the improved BG levels be sustainable once the diet period is finished?

2 - Can you bear to do this diet?

For me, even if the answer to (1) is yes, on both counts, my answer to (2) is NOOOOOO!!!!!!!!!!!!!!!!!!!!!!

It seems an utterly unbearable diet to do. I couldn't do if for a day, let alone any longer, however good or effective it might be.

However, for those for whom it is bearable (brave, brave folk!), I think the interesting point raised in the posts so far is the comment that it gave the dieter 'a break from food' - and that seems highly significant to me.

One of the things that makes dieting hard (and being female, oh boy, it has been part of my life 'for ever' as, sadly, female beauty is defined by slimness etc, and most women are not naturally slim - though a few can eat what they like and stay thin....)(OK, they'd never survive a famine, I know!!!!).....is that unlike going teetotal we can't just 'give up' food completely. I've been 'dry' since New Year (when I got my pre-D DX), and I can honestly say I've 'made that break' from alcohol. I've had one glass of white wine at lunch for a family gathering, and that was it. Now, I don't want to be teetotal for the rest of my life, but I won't go back (I hope!) to the daily 'cheer-me-up' glass I'd slipped into in my retirement.

But we can't go teetotal on food (or we die). So, in that respect, if those on the Newcastle diet can bear it, then I would think that that 'break from food' could be brilliant - but WHAT happens when you come off the liquid diet?


(By the way, if it's all liquid, what effect does that have on one's gut??)


I suppose my bottom line is that the Newcastle diet is simply one option in the fightback against diabetes battle?

Agreed, it’s a formidable option and compliance may be poor. But it’s simple to prescribe and even if its results are very poor that will be a stupendous improvement over what the NHS has achieved for type-2s in the last few decades, which has been to lock hundreds of thousands of people into a one-way street of ever worsening medication and complications. So it’s the difference between bad and horrendous.

 

[Callista]

Good point. Poor old NHS is fighting a battle stacked against them by the food industry etc etc.

These days, when I go into my supermarket I look around me and think '99% of the food on sale here is forbidden to me'.....(And that's ignoring the cheese counter!)

I do think the point made earlier in this discussion that what is vital is to manage the transition OFF the Newcastle diet. And for folk to understand there is NO 'going back to normal' . We have to accept a 'new normal'. Yes, hopefully a maintenance diet regime will be less onerous than the 'slam down those soaring BG levels!' regime, but never again can we revert to a pizza-and-coca-cola couch-potato lifestyle....

 

[childofthesea43]

I don’t think simplifying T2 into a simple lose weight and it’ll all get better condition is helpful.

In my own case - and I would not generalise to all by any means - I simply lost weight and it all got better. So for me it was as helpful as anything could be, other than a miracle of rejuvenation.

 

[Dragonheart]

In my own case - and I would not generalise to all by any means - I simply lost weight and it all got better. So for me it was as helpful as anything could be, other than a miracle of rejuvenation.

And yet for me the weight loss wasnt enough to magically fix me as Taylor promises. I must maintain low carb to maintain bgl.

I seriously believe type 2 is at least two different classes of diabetes. One caused and solved almost entirely by weight and another that is far less weight dependent. Genetic in some way I guess or perhaps my beta cells are dead not dormant who knows? Not the research so far anyway.

 

[Chris Hobson]

As I recall from reading Taylor's book, the drastic milkshake diet was initially used because the clinical trial had to be carried out over a limited time. Less drastic weight loss programs could still be used outside of the trials, the significant part was that the target weight is your weight as it was when you were a young adult, usually people would be happy just to have lost some weight, being the size that you were at age seventeen is usually going to be taking things quite a bit further.

Last year I lost weight by swimming 500 miles for charity. I was averaging about thirteen miles per week and, as a result, my weight went down to 70 kilos, five kilos below my weight as a young person. Despite only being on Linagliptin, the mildest of diabetes meds, I have started experiencing hypos. I am seeing the specialist nurse later this morning to discuss this so I will post an update when I know a bit more.