Diabetes is a prevalent condition, with a staggering one in 10 Americans affected, according to the Centers for Disease Control and Prevention. In the UK, a recent study examined the effect of the NHS soup and shake diet on weight loss and its capacity to reverse type 2 diabetes, a disease affecting 4.3 million people in the UK. This article delves into the details of the soup and shake diet, exploring its potential benefits, risks, and practical considerations.
Understanding the Soup and Shake Diet
Soup and shake diets, also referred to as soup and smoothie diets, are meal replacement plans that have gained popularity as weight loss programs. These diets involve replacing conventional foods with semi-liquid alternatives like soups, shakes, and meal replacement bars, designed to provide a balanced nutrient profile while restricting calorie intake.
The soup and shake diet is an example of total diet replacement, where typical foodstuffs are replaced with easily consumable semiliquids, designed to include the correct balance of nutrients, but restrict energy (calories). Total diet replacement plans remove the element of choice for patients, making a diet easier to follow and increasing the chance that patients will stick with it.
The Science Behind the Diet
The NHS England has announced plans to roll out its new 'Type 2 Diabetes Path to Remission' programme, based on the results from Diabetes UK'S DiRECT study, advocating the benefits of 'soups and shakes' diets to those living with type 2 diabetes. The DiRECT Study found that "weight loss can put Type 2 Diabetes into remission for at least 5 years".
Research on the effectiveness of the diet to manage diabetes initially began with promising results from randomised control trials. The diet was then rolled out to larger scale trials in clinical practice, implemented via the NHS. The results confirmed that total diet replacement plans can induce weight loss as well as a decrease in HbA1c. In some patients this was enough to induce diabetes remission. Great news indeed.
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Diabetes mellitus is a condition where blood glucose (sugar) levels rise higher than normal. Excess sugar is lost through urine, drawing water with it, so symptoms include tiredness, increased urination and thirst. There are many different types of diabetes, varying in their causes and treatment. However, of all the patients diagnosed with diabetes, more than 90% are type 2. The condition is caused by problems with insulin, a hormone produced by the pancreas. In type 1 diabetes, insulin levels fall because the body attacks the pancreas. But in type 2 diabetes the cause is either diminished insulin levels or decreased sensitivity to its effects.
Potential Benefits
Weight Loss
The primary benefit of the soup and shake diet is its potential to promote significant weight loss. By drastically reducing calorie intake, the body is forced to burn stored fat for energy, leading to a reduction in body fat. Clients lose an average of 3.8kgs with us in their first month on an Intelligent Weight Loss Programme.
Reversal of Type 2 Diabetes
A recent study examined the effect of the NHS soup and shake diet on weight loss and its capacity to reverse type 2 diabetes. For a disease affecting 4.3 million people in the UK, the potential to reverse type 2 diabetes through diet alone could be exciting news indeed.
The NHS Type 2 Diabetes Path to Remission programme is one year long, and offers people recently diagnosed with type 2 diabetes nutritionally balanced, low-calorie meal replacement products (soups and shakes) for up to 12 weeks to kick-start weight loss. A Diabetes-UK-funded study found that maintained weight loss can put type 2 diabetes into remission for at least five years.
Improved Blood Sugar Levels
The study found that, of those who completed the programme, 32% (one in three) put their type 2 diabetes into remission and had an average weight loss of 16kg. Researchers measured participants’ average glucose (blood sugar) levels, and found their results had noticeably improved by the end of the program.
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Structured Approach
Total diet replacement plans remove the element of choice for patients, making a diet easier to follow and increasing the chance that patients will stick with it.
Risks and Considerations
Not Suitable for Everyone
Extreme diet restrictions are unsuitable for some patients. For example, if using insulin, calorie restrictions may lead to hypoglycaemia, where blood sugar levels fall too low. Other unsuitable patient groups include pregnant or breastfeeding women, children and teenagers, and patients with eating disorders. Patients with chronic diseases - those which impair immunity or bone health, for instance - should consult medical advice before embarking on any diet.
Psychological Issues
Psychological issues with food, such as emotional eating, aren’t necessarily fully addressed by the programme, so - even for those who’ve followed the plan successfully - once the 12 months have finished, if the patient returns to their usual eating habits then they’ll regain weight and the diabetes could return.
Nutrient Deficiencies
Some meal replacement diets provide only the minimum requirement of protein, rather than what nutritionists consider to be optimal. Very low calorie diets can often not provide enough fat so make sure you scrutinise any diet you consider carefully.
Potential for Rebound Weight Gain
As a dietitian I do not believe it’s good to make drastic diet changes,” Feder says. “It creates unhealthy eating habits and often can lead to a rebound effect where you gain even more weight back.
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Practical Tips for Adopting a Soup and Shake Diet
Eligibility for NHS Support
To be eligible for the NHS soup and shake diet, you need to meet the following criteria: aged 18 to 65 years, diagnosed with type 2 diabetes within the last six years and have a BMI over 27 kg/m². If you meet these criteria, you can discuss participation with your GP or healthcare provider.
Choosing Quality Products
It’s important to ensure meal replacements are carried out in a healthy way and that high quality products are used. These diets are not all created equal.
Ensuring Adequate Protein Intake
Protein intake is an important consideration for anyone wishing to lose weight. It’s essential for many aspects of health. It fills us up, keeps us satisfied and helps to prevent hunger and low energy levels. Protein helps prevent sagging skin by supporting collagen and elastin production and is integral to preserving muscle mass. This is important because protein deficient diets can result in muscle loss and therefore a reduction in metabolic rate (the rate at which we burn calories). This means that the chance of rebound weight gain is much higher.
Incorporating Healthy Fats
It is essential to have an adequate intake of healthy fats in your diet, including omega 3. If you’re considering a meal replacement diet, make sure your plan includes an optimal amount of healthy fats. It may be a good idea to take a high quality omega 3 supplement.
Maintaining Optimal Vitamin and Mineral Levels
Achieving and maintaining optimal levels of essential vitamins and minerals is vital. It’s not just about losing weight - optimising health and wellbeing and maintaining good energy levels are also a key. Some meal replacement products have added vitamins and minerals, while with others, you’ll need to take a separate supplement.
Seeking Professional Guidance
Don’t try and go it alone. Seek support from a qualified nutritionist to make sure this approach to weight loss is right for you. An expert will ensure your plan, whether or not it is a soup and shake diet, is tailored to your individual needs. They should support you throughout the programme and make sure you transition off it in a healthy way.
Addressing Underlying Issues
The diet itself is often only part of the solution. Many of our clients benefit from coaching to help overcome self-sabotaging behaviours, unsupportive habits and underlying causes of emotional eating. Our practitioners are not only qualified nutritionists, they are also trained in behavioural coaching too. We weave coaching into our consultations to ensure you’re supported with overcoming any self sabotaging eating behaviours.
Developing a Maintenance Plan
To ensure successful long term weight loss it’s important that you have a clear plan in place to maintain your results. A comprehensive maintenance plan detailing how to structure healthy, nutritionally balanced meals is key. Meal ideas and practical strategies for handling events like holidays and Christmas are also important considerations.
The NHS Type 2 Diabetes Path to Remission Programme
The NHS England Type 2 Diabetes Path to Remission programme is a joint initiative between NHS England and Diabetes UK. It provides a low-calorie diet and support to people recently diagnosed with type 2 diabetes who are living with obesity or overweight. Inspired by our DiRECT study, the year-long programme offers participants nutritionally balanced, low-calorie meal replacement products (soups and shakes) for up to 12 weeks to kick-start weight loss, with careful support from expert healthcare professionals. After this, people receive support to reintroduce healthy, solid foods and maintain their weight loss. This includes help to increase physical activity levels.
How to Take Part
To be referred, you will need to fit a set of criteria, which includes:
- Aged 18 to 65 years
- Have been diagnosed with type 2 diabetes within the last six years.
- BMI of 27kg/m² or higher if you’re White, or 25kg/m² if you’re from an ethnic minority group
- Have had an HbA1c measurement taken within the last 12 months and the results were 43-87 mmol/mol, if on diabetes medication, or 48-87 mmol/mol, if not on diabetes medication.