Liquid food has had a bad rap over the years for its so-called yo-yo dieting effect. But not all meal replacement diets are created equal. Amanda Cassidy speaks to nutritionist Kim Pearson about the advances in diet medicine, and why soup and shake diets are now being used in the fight against obesity.
There is a cynicism in the ‘quick-fix’ mentality when it comes to the secrets of weight-loss. As a society, we have become a good deal more skeptical of the detox teas and diet shakes that promise much and deliver little except to lighten our wallets.
But advances in this area over recent years have begun to shift some meal replacement diets further away from the silver-bullet of the beauty industry and closer to a clinician-led health solution. And the NHS in the UK is leading the way.
This week the UK health service announced plans to offer ‘soup and shake diets’ to those with type 2 diabetes. The very-low-calorie diet (around 800 calories) will be tested in 10 areas of England to see whether results in the 'real world' match a trial in which more than a third of people with type 2 diabetes maintained remission after 2 years.
People living with type 2 diabetes who are an unhealthy weight and have been diagnosed with the condition in the last six years will now be considered for the scheme.
The idea is that, after a few months on the shakes and soups, when some weight loss has been achieved, solid foods are reintroduced, with support to help the person maintain a nutritious diet and regular exercise.
Experts say they want to help people to be as fit as possible, particularly during the coronavirus pandemic as obesity and type 2 diabetes are linked and increase the risk of complications from Covid-19.
"The programme has taught me moderation"
One of the first patients to benefit from the diet on the trial was quoted in the BMJ which featured the study. "My goal for the first eight weeks of the low-calorie diet was to lose 5% of my body weight —which I achieved in six weeks — and in total, I've lost over 10kg, my type 2 diabetes is now in remission and I no longer have to take any medication.
I am over the moon. My mindset has totally changed for the better and I look at food differently now — my shopping habits are far healthier and, when I eat out, I'll go for a healthier option. The programme has taught me moderation."
This focus on mindset is what differentiates the 'soups and shakes' diet which we've been told is a no-no over the years.
Nutritionist Kim Pearson has been working with quality meal replacement diets for over a decade. "I've seen the life-changing results these diets can deliver. 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! It’s also key to ensure those losing weight are comprehensively supported in optimising their health, lifestyle and mindset to ensure lasting success.”
"These participants saw a trained counsellor every week for 24 weeks, to help them stick to the diet plan and keep the weight off after the meal replacement plan finished"
So far, the news from the NHS has been welcomed by those supporting people with Diabetes. Director of Diabetes UK Bridget Turner issued a statement saying the charity was pleased that more people would have the opportunity to put their diabetes into remission.
"We know that some people with type 2 diabetes want and need support from healthcare professionals to lose weight effectively, and now as these programmes are piloted across the NHS they will. People with type 2 diabetes who have put their diabetes into remission frequently tell us how it has changed their lives."
One of the studies that prompted the medicalisation of ‘soups and shakes’ dieting found that out of 278 people across 10 GP practices in Oxfordshire, half the participants followed a meal replacement programme of soups and shakes for eight weeks.
This diet saw them limiting their daily calorie intake to 810kcal per day for eight weeks, after which other foods were gradually reintroduced over four weeks. These participants saw a trained counsellor every week for 24 weeks, to help them stick to the diet plan and keep the weight off after the meal replacement plan finished. The remaining participants in the study followed the usual weight management advice and support from their GP.
Throughout the study, participants following the meal replacement programme lost more weight than those in the control group. One year on, they had lost on average 1st 9lb (10.7kg) compared with half a stone (3.1kg) for those in the usual weight loss group.
The meal replacement programme group also showed noticeable improvements in blood pressure and cholesterol, while type-2 diabetes patients in the group were also able to reduce their medication
But Kim Pearson says that such an intense change in your diet must be closely monitored by a professional; "Protein intake is an important consideration for anyone wishing to lose weight. Not only is it 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 something to keep in mind because protein-deficient diets can result in the loss of muscle which can lead to a reduction in metabolic rate (the rate at which we burn calories) meaning the chance of rebound weight gain is much higher.”
It is also key to ensure an optimal intake of essential vitamins and minerals.
“If you’re considering a meal replacement diet, it is a good idea to take a high-quality Omega 3 supplement,” explains Kim. "Very low-calorie diets can often not provide enough fat so make sure you scrutinise any diet you consider carefully.
“It’s not just about losing weight – optimising health and wellbeing and maintaining good energy levels are also key. Some meal replacement products have added vitamins and minerals, while with others, you’ll need to take a separate supplement”.
Kim also warns of some nutritionally unsound products which are billed as healthy food alternatives but which have far too much sugar. “In my clinic, we use Proteifine which is a very effective and nutritionally-balanced approach to weight loss bu many others are not as nutritionally sound and are often lacking in protein and healthy fats, for a start.
“The meal replacement programme mentioned in the article, Cambridge Diet, is not something I would recommend. Consider this – one of their shakes (Chocolate Velvet) contains a startling 24.7g sugar per serving. That’s over six teaspoons and more than that found in a two-finger Twix bar!”
Finally, Kim says that without behavioral coaching to understand the underlying causes of emotional eating or education about nutrition and how to build structurally healthy balanced meals, such diets can fail.
“You may benefit from coaching to help overcome self-sabotaging behaviours, unhealthy habits, and underlying causes of emotional eating.
“Remember, the diet itself is only part of the solution.”
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