A diet plan announced by the UK’s National Health Service (NHS) to tackle Type 2 diabetes with “soup and shakes” has been criticised for promoting ultra-processed foods shown to harm gut health, and linked to a range of range of chronic illnesses. 

The high profile NHS diabetes trial will use a combination of ‘total diet replacement products’ (TDRP) and an exercise programme over a one-year period. 

£10 billion bill
The initiative, being made available to 5,000 patients in 10 areas following a pilot study, is designed to reduce the UK’s epidemic of diabetes, which costs the NHS an estimated £10 billion a year and accounts for one in 20 GP prescriptions.

The NHS says that results from an earlier trial showed “almost half of those who went on the diet achieved remission of their Type 2 diabetes after one year following the ‘total diet replacement products’ (TDRP) and exercise intervention”. 

The new low-calorie trial was launched to considerable media fanfare last week. But one prominent researcher and author has criticised the initiative for its focus on ultra-processed meal replacement products. 

Waiting in the The Times, Tim Spector professor of genetic epidemiology at Kings College London (and the author of Spoon-Fed: Why Almost Everything We Have Been Told About Food is Wrong), acknowledges that diet plans with simple rules are easier to administer. But he says the NHS plan is likely to be undermined by four problems. 

Unrecognisable as food
“First, only one in four people offered the diet in the trial agreed to try it. Second, the shakes and soups are ultra-processed and unrecognisable as normal food, with dozens of mysterious chemical ingredients added. We know that ultra-processed food can cause long-term harm to your gut health and microbes.

A third problem, Spector argues is that “once successful slimmers switch back to solid foods after 12 weeks, many will revert to cheap ready meals with attractive low-cal labels”. Britons, he points out, already consume more highly processed food than anyone else in Europe. The meal replacement reliance of the NHS trial therefore reinforces a culture that has increasingly abandoned cooking and meal times. 

A fourth problem, says Spector, is that this type of diet (low-calories, Low-fat) “may not help many of us lose weight at all”. He notes: “50% of people in the trial had lost weight and were off their medication by the end of one year. That figure had dropped to a third after two years.”

Spector says one-size-fits-all diets often fail because they ignore the fact that we each off us respond differently (for example in blood sugar and fat levels) to eating identical food. 

Photo by Kelly Sikkema on Unsplash