Type 2 diabetes can be reversed with very low-calorie diet

Study shows that it is possible to achieve remission from type 2 diabetes by dieting | The Lancet | via National Institute for Health Research

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Type 2 diabetes is a growing epidemic, costing the NHS £23.7 billion per year. By 2016 there were nearly 3.6 million people diagnosed with diabetes in the UK and a further one million estimated to have undiagnosed type 2 diabetes. Rates of diabetes appear to be increasing.

This study aimed to see if a very low-calorie diet program delivered in primary care could lead to at least 15kg weight loss and remission of type 2 diabetes.

The study found that by 12 months:

  • Weight loss of 15kg or more was achieved by 24% of the intervention group compared to none of the usual care group. Average weight loss was 10kg in the intervention group versus 1kg in the usual care group.
  • Diabetes remission occurred in 46% of the intervention group compared to 4% of the usual care group. It only occurred in people who had lost weight.
  • Remission was 20 times more likely with the intervention.
  • Better adherence to the regime increased the amount of weight loss and the chance of diabetes remission.
  • Diabetes medication did not need to be reintroduced for 74% of the intervention group. This was compared to 18% of the usual care group who were able to stop them. Blood pressure tablets were also no longer required for 68% of the intervention group compared to 39% of the usual care group.

Full reference: Lean MEJ, Leslie WS, Barnes AC, et al. |  Primary care-led weight management for remission of type 2 diabetes (DiRECT): an open-label, cluster-randomised trial.  | Lancet. 2017. [Epub ahead of print].

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Reducing sugar in manufactured foods

The World Health Association has published Incentives and disincentives for reducing sugar in manufactured foods: an exploratory supply chain analysis. 

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This report investigates why producers use sugar in foods and why they use it in large amounts.  The report, prepared together with the Centre for Food Policy at City, University of London, reveals that producers and retailers of food with high sugar content currently have many more incentives to continue using sugar than to limit its use or substitute it completely.

These incentives include:

  • the perception that sugar is the gold standard for sweetness;
  • sugar’s availability as a relatively cheap and abundant ingredient from multiple sources;
  • manufacturers’ and retailers’ focus on maintaining competitiveness;
  • manufacturers’ and retailers’ desire to maintain “choice” for consumers who still want to buy sugary foods;
  • sugar’s provision of essential functional qualities for manufactured foods; and
  • consumer concern about the use of artificial sweeteners.

The report concludes that a comprehensive approach covering the whole food system is needed in order to reduce sugar intake.

Full report: Incentives and disincentives for reducing sugar in manufactured foods: an exploratory supply chain analysis (2017)

Preventing malnutrition in later life

State of the Nation: an overview of older people and malnutrition in the UK today | The Malnutrition Task Force. 

This report focuses on the scale and challenges of malnutrition in later life in the UK. Research shows that 1 in 10 people over the age of 65 are malnourished or at risk of malnutrition. This silent and often hidden condition can seriously affect an older person’s health and wellbeing and increase hospital admissions and long-term health problems.

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Image source: http://www.malnutritiontaskforce.org.uk

The report examines the causes and consequences of malnutrition in the UK. It also looks at economic costs and pressures, and whether the NHS and social care services are currently able to support older people at risk and how invested they are in this issue.

It brings together information, statistics and evidence from across the health and social care system to highlight what is happening to older people who are malnourished or at risk of malnutrition in England.

Full report: State of the Nation: an overview of older people and malnutrition in the UK today 

Healthy people, healthy planet

Healthy people, healthy planet: The role of health systems in promoting healthier lifestyles and a greener future | Organisation for Economic Cooperation and Development 

This report was produced to inform the 2017 meeting of the G7 ministers of health. It provides a broad overview of the main policy actions that G7 countries can take to improve population health and to decrease the human footprint on the environment.

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Image source: http://www.oecd.org

The report makes the following policy recommendations:

  • Support the development and implementation of nutritional guidelines promoting healthier food consumption – as this can lead to less stress on the environmental resources used in food production – as well as reduce the environmental footprint in hospitals and in nursing homes by encouraging healthier food consumption, waste reduction and cleaner energy generation;
  • Create partnerships with various national and local stakeholders, including local city authorities and ministries of industry, environment, transport, and agriculture, in order to incorporate health and environmental considerations into urban planning schemes;
  • Implement public health actions encouraging more physical activity and greater reliance on active modes of transportation, such as through physical activity-promoting mass media campaigns, bike sharing schemes and creating low-emission zones.

Full report: Healthy people, healthy planet

Trends in child BMI

This report uses National Child Measurement Programme  data to examine the changes in children’s body mass index (BMI) between 2006 to 2007 and 2015 to 2016

The report explores trends in obesity, overweight, excess weight and underweight prevalence, as well as changes in mean BMI over time. It is aimed at local authorities and other organisations who want to examine detailed trends in child weight category prevalence over time, and how these vary by health inequality.

Trends within different socioeconomic and ethnic groups are examined to determine whether existing health inequalities are widening or becoming smaller.

The report is accompanied by a summary of main findings and a supplementary dataset.

National Child Measurement Programme: changes in children’s body mass index between 2006 to 2007 and 2015 to 2016:

See also: National child measurement programme

‘Upselling’ adding to the UK obesity crisis

Published by the Royal Society for Public Health and Slimming World, ‘Size Matters’ reveals that the average person consumes an additional 330 calories each week as a result of businesses upselling high calorie food and drink

This report, which includes a survey of 2,055 UK adults, shows that consumers face an average of 106 verbal pushes towards unhealthy choices each year as they are asked whether they would like to upgrade to larger meals and drinks, add high calorie toppings or sides to their order or take advantage of special offers on unhealthy food and drink.

It reveals that, in the course of a week, upselling techniques used by businesses resulted in 34% of people buying a larger coffee than intended, 33% upgrading to a large meal in a fast food restaurant, 36% buying chocolate at the till at a newsagents or petrol station and 35% adding chips or onion rings to the side of their pub or restaurant meal.

The findings showed that young people are even more likely to be exposed to upselling, with 18-24 year-olds experiencing it 166 times each year – nearly every other day – and going on to consume an extra 750 calories per week as a result. This could lead to an estimated weight gain of 11lbs (5kg) over the course of a year.

 

Full report: Size matters: the impact of upselling on weight gain. | The Royal Society for Public Health | Slimming World

See also: BBC News: Public ‘tricked’ into buying unhealthy food 

Next stage of childhood obesity plan

Public Health England (PHE) announces plans to consider the evidence, set guidelines and closely monitor progress on calorie reduction.

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One year on from the publication of the childhood obesity plan, Public Health England has announced it will consider the evidence on children’s calorie consumption and set the ambition for the calorie reduction programme to remove excess calories from the foods children consume the most.  Ready meals, pizzas, burgers, savoury snacks and sandwiches are the kinds of foods likely to be included in the programme.

In addition, the Department of Health has announced £5 million of funding for a new Obesity Policy Research Unit to provide resources for long term research into childhood obesity.  Also, the Obesity Health Alliance has published a report card assessing progress during the first year of the childhood obesity plan.