UK weight-loss diet plan sparks fortification versus clean label debate

07-Sep-2020 - Last updated on 07-Sep-2020 at 16:05 GMT

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A soup and shake weight-loss diet prescribed by the UK National Health Service to tackle type 2 diabetes has stirred a row over long ingredients lists.

The NHS announced that 5,000 more people in England with type 2 diabetes will be offered the chance to try the ‘life-saving’ soup and shake diet weight-loss plan for free.

Diabetes is estimated to cost the NHS £10 billion a year, while almost one in 20 prescriptions written by doctors is for diabetes treatment. NHS research earlier this year also revealed people with type 2 diabetes were two times more at risk of dying from coronavirus.

Some NHS patients have already benefited from the year-long diet and exercise plan, consisting of ‘total diet replacement products’ such as shakes and soups alongside support to increase their exercise levels, so NHS England wants to offer the scheme to more people.

Results from one trial showed almost half of those who went on the diet achieved remission of their type 2 diabetes after one year.

The programme is in addition to the Healthier You NHS Diabetes Prevention Programme, which has had over 600,000 referrals.

Professor Jonathan Valabhji, NHS national clinical director for diabetes and obesity said: “This is the latest example of how the NHS, through our Long Term Plan, is rapidly adopting the latest evidence-based treatments to help people stay well, maintain a healthy weight and avoid major diseases.

“There has never been a more important time to lose weight and put their type 2 diabetes into remission, so it’s good news for thousands of people across the country that practical, supportive measures like this are increasingly available on the NHS.”

Bev, who was one of the first patients to benefit from the diets during trials, said: “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 10kgs, my type 2 diabetes is now in remission and I no longer have to take any medication – I am over the moon.

“Since the low-calorie diet programme, my mind set 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.

“My skin is clearer, and people say that I’ve got my sparkle back – I didn’t realise that I’d lost it but now I see that I definitely had. I can honestly say that the low-calorie diet programme changed my life for the better.”

Bridget Turner, Director of Policy Campaigns and Improvement at Diabetes UK, welcomed the move to expand the scope of the soup and shake diet. “We know that some people with type 2 diabetes want and need support from health care 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. We are so pleased to see that others will now have the same opportunity and hope that it won’t be too long before more remission programmes are rolled out across the country.”

But some took aim at the number of ingredients in the meal plans, complaining people should be encouraged toward shorter, cleaner labels and more recognisable ingredients in order to eat more healthily.

Thank you @SamFeltham been waiting to see this. Ultra-processed, unhealthy unreal food, can it even be called food???? The quick fix does not always =longterm health gain, just financial gain @Food_campaignUK
— ION (@ion_nutrition) September 2, 2020

The British Association for Nutrition and Lifestyle Medicine (BANT), a professional body for Registered Nutrition Practitioners, said it continues to advocate for better nutritional guidance to encourage British people to eat more individual ingredients and unprocessed food.

“Going back to some old-fashioned values, such a family meal times, and improving the nation's cooking skills to use fresh ingredients, will go a long way to help the obesity targets and health of individuals,” a spokesperson told FoodNavigator.

They added nutritional therapy -- the use of foods, diets, fasting, supplements, functional foods and dietary counselling -- also “helps individuals make lasting lifestyle adjustments to their diet in support of health rather than calorie controlled short-term solutions”.

All that is natural is not necessarily good or safe

But apart from featuring hydrogenated oil, which can have unhealthy trans fats, the ingredients in the shake and soup diet, while long, are otherwise mainly all salts and fortified ingredients.

The soups and shakes have got all the vitamins and minerals needed in a low calorie shake and needs that fortification to be a complete source and offer balanced nutrition.

Jon Poole, Chief Executive of the Institute of Food Science & Technology, couldn’t comment specifically on the NHS weight loss products but told us: “There is a perception issue which many consumers have which is that ‘natural’ is good. There are many examples in the world of highly toxic natural substances to prove this is not always the case.

"Some consumers also react negatively to references to E-numbers whereas this classification is also used for natural additives, for example beetroot extract (E162) adds colour to confectionery, yogurt and soft drinks.”