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Very low-calorie diets set to tackle obesity and diabetes

After successful pilot, approach to be scaled up from next year

Caroline White

Friday, 30 November 2018

Very low-calorie liquid diets are set to be used more widely by the NHS to curb the rising tide of obesity and type 2 diabetes in the UK after a successful trial run of the approach.

The expansion of the NHS Diabetes Prevention Programme (NHS DPP), a joint effort between Public Health England, NHS England and Diabetes UK, comes after it proved even more successful than planned, with patients losing, on average, a kilo more than expected.

The nine-month DPP programme helps people to: achieve a healthy weight; improve overall nutrition; and boost their physical activity levels.

The move is part of the NHS Long-Term Plan, due to be unveiled next month, which has a greater focus on prevention.

The intention is not just to improve the health of patients but also save the NHS money that can be reinvested in frontline care. Currently, the health service in England spends around 10% of its total budget on treating diabetes.

From next year, eligible patients will be prescribed a liquid diet of just over 800 calories a day for three months followed by a period of support and monitoring to help them achieve remission of their type 2 diabetes.

The approach will initially be piloted in up to 5,000 people after the Diabetes UK funded DiRECT trial showed that almost half of those who went on a very low-calorie diet achieved remission of their type 2 diabetes after one year.

One in four participants lost 15 kg or more of weight, and in 86% of these cases, their type 2 diabetes went into remission.

A more recent trial of very low-calorie diets, DROPLET, has shown similar levels of weight loss in obese people.

Online versions of the DPP, which involve wearable technologies and apps to help those at risk of developing type 2 diabetes, will also be provided for patients who find it difficult to attend sessions because of work or family commitments.

NHS chief Simon Stevens said: “The NHS is now going to be ramping up practical action to support hundreds of thousands people to avoid obesity-induced heart attacks, strokes, cancers and type 2 diabetes.

“The NHS Long-Term Plan is going to give people the power and the support to take control of their own lifestyles – so that they can help themselves while also helping the NHS. Because what’s good for our waistlines is also good for our wallets, given the huge costs to all of us as taxpayers from these largely preventable illnesses.”

He continued: “However, this isn’t a battle that the NHS can win on its own. The NHS pound will go further if the food industry also takes action to cut junk calories and added sugar and salt from processed food, TV suppers and fast food takeaways.”

Recent projections estimate that the growing number of people with diabetes could result in nearly 39,000 of them having a heart attack by 2035 and over 50,000 people having a stroke.

Professor Jonathan Valabhji, national clinical director of diabetes and obesity for the NHS in England, added: “Around two-thirds of adults and one-third of children are now overweight or obese, driving higher and higher rates of type 2 diabetes that we are now focusing huge efforts to address. Our work so far in this area has been producing really positive results and today’s announcement will allow us to go even further.”

Chris Askew, who heads up Diabetes UK, commented: “The first-year results of Diabetes UK DiRECT study showed that – for some people with type 2 diabetes – an intensive, low-calorie weight loss programme delivered with ongoing support through primary care could put their condition into remission.

“Plans to double the size of the NHS Diabetes Prevention Programme are excellent news. The programme is already the largest of its kind globally and shows England to be a world leader in this area. The ambition being shown by the NHS needs to be matched across all government policy – we need stronger action on marketing to children, and clearer nutritional labelling to support people to make healthy choices.”

Tam Fry, chair of the National Obesity Forum, said: “This upgrade to the Diabetes Prevention Programme can only be good news. There is good science behind it and the need to act decisively to prevent obesity and the diseases it triggers is unquestionable. Would that successful action to get the food industry to reformulate could be achieved next year!”

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