If people living with type 2 diabetes who are overweight or obese can lose weight and transition to a healthy eating lifestyle, their condition could be significantly improved — or even go into remission.
It goes without saying that we should be eating a healthy and nutritious diet, says Dr Jamy Ard, Professor, Epidemiology and Prevention at Wake Forest School of Medicine, USA.
“The nutrients and nourishment in our food provide nourishment essential for growth development and healthy aging,” he explains. “Too many refined grains, added sugars and excess calories — and not enough fruit, vegetables and wholegrains — can significantly increase risk of disease.”
Eating a healthy and nutritious diet can help promote weight loss and support weight management, which is extremely beneficial to individuals that have overweight, obesity or associated conditions such as type 2 diabetes.
By losing a significant amount of weight — and then keeping your weight under control — your condition may improve, or even go into remission.
“There is good evidence that weight loss can improve glycaemic control (i.e. blood glucose levels) which in turn can help and so reduce the risk of diabetes complications, such as damage to eyes, kidneys and nerves,” notes Dr Basil Issa, Consultant Endocrinologist at Manchester University NHS Foundation Trust.
In the recent years, much has been publicised about reversing or even putting type 2 diabetes remission with dietary interventions including the use of meal replacement drinks or nutritional bars. These have been proven to be useful in helping people with diabetes achieve substantial weight loss.
Yet there are nutritional interventions available, including one in the form of meal replacements, that can help achieve the ultimate goal of weight management.
The benefits of meal replacement diets
The benefits of intermittent dieting versus continuous low energy dieting with meal replacements has been assessed by Dr Michelle Harvie; Co-chief Investigator of the Manchester Intermittent and Daily Diet Diabetes App Study (MIDDAS).
On the MIDDAS study, one group of patients followed a continuous daily low calorie diet every day for eight weeks, restricting their intake to nutritionally complete meal replacement shakes, supplemented with eight portions of vegetables.
The other group followed an intermittent low-calorie diet, restricting their intake to the meal replacement shakes plus vegetables for two days a week across 28 weeks.
Initial findings show that a nutritious intermittent low-calorie diet using meal replacement products can be a successful way to achieve and maintain weight loss.
“The people following the daily meal replacement low cal diet for eight weeks lost a significant amount of weight which can be very motivating for them, while the intermittent group kept going and caught up by 28 weeks” says Dr Harvie.
Dr Ard agrees with this assessment. He was the Principal Investigator of the US-based OPTIWIN study, which evaluated the effectiveness of total meal replacement programmes.
“They are easy to implement because patients don’t have to calculate calories or worry about portion sizes,” says Dr Ard.
Results of his study were positive, too. “We saw a significant improvement in body composition, including a greater loss of fat mass,” recalls Dr Ard. “And while only a low percentage of individuals within the study had type 2 diabetes, we also saw improvements in glycaemic control.”
Industry and academia working together
This is not to say that a meal replacement programme is a simple weight-loss fix, cautions Dr Harvie. “It can be very challenging, particularly for the first week or so,” she says.
“Patients are, after all, removing themselves from a food-based diet. However, with proper planning and the right expectations it can become easier.”
Dr Issa — also Co-chief Investigator for MIDDAS — stresses that people on in the study were supported by a multidisciplinary team of practitioners for optimum delivery of care.
He also stressed that meal replacement interventions can’t be used indefinitely. “They should be used as a tool to help transition to a long-term, nutritious, healthy eating lifestyle,” he says.
Hans-Juergen Woerle, Chief Scientific & Medical Officer at Nestlé Health Science, agrees that there is no “one-size-fits-all dietary answer” and that different solutions are required to address different patient needs.
He also believes that the best way to improve nutrition and control type 2 diabetes is for industry and academia to work closely together.
“Good collaboration helps us create innovative solutions,” he says. “This, in turn, helps doctors treat their patients more effectively.”
