Each week we analyse some of the hot headlines in health and nutrition news. This week we look at type 2 diabetes reversal through weight loss, the rise in childhood obesity and raw flour health risks.



This week we have the BBC (‘I beat type 2 diabetes with 200-calorie drinks’), The Guardian (Radical diet can reverse type 2 diabetes new study shows), The Daily Mail (Three month diet reverse Type 2 diabetes), The Sun (Millions of diabetics could be cured by losing weight and eating healthier) and The Express (Type 2 diabetes symptoms diet reverse) reporting that it may be possible to reverse type 2 diabetes by following a ‘crash diet.’

The findings come from a study called DiRECT (Diabetes Remission Clinical Trial), where it was found that by following an intensive low-calorie diet for three to five months people could put their diabetes into remission. Nearly half of the study participants were in remission after one year. There was a close link found between amount of weight lost and remission of type 2 diabetes.

Here are the results for the percentages of people who were in remission after one year based on the amount of weight lost:

  • 86% of people who had lost over 15kg (2.4 stone) in remission
  • 57% of people who lost 10-15kg (1.6-2.4 stone) in remission
  • 34% of people who lost 5-10kg (0.8-16 stone) in remission

There was also a control group who did not follow the low calorie diet, but were given the best diabetes care available and only 4% went into remission.

Behind the headlines: the Nutrilicious dietetic view
Firstly, it should be recognised what is meant by ‘putting diabetes into remission’. In this study being in ‘remission’ was defined as having a HbA1c level below 6.5% (48mmol/mol) after 12 months, with at least two months without diabetes medication. HbA1c is a measure of blood glucose levels over the past two to three months and can be used to diagnose diabetes. It should be noted that being in ‘remission’ does not necessarily mean the diabetes has gone completely and hence people still need regular check-ups.

This research backs up previous studies investigating the potential of reversing type 2 diabetes. This DiRECT study recruited many more participants (298 recruited vs 11 and 30 in the two previous studies), making it much more reliable, and testing was carried out over a much longer period.

Points to note

  • While this is a very promising piece of research and extremely exciting for people with type 2 diabetes, it should be noted that the study is not over yet. It is unclear at this stage how long the remission will last for; whether it will reduce the risk of long term diabetes related complications; and whether this type of treatment could be feasible within the NHS.
  • The people involved in the study had been diagnosed with type 2 diabetes for up to six years and so the findings may not apply to those have had the condition longer. Participants also were not included if they were taking insulin.
  • The diet involved was intensive. Participants followed a daily diet of around 800kcal diet (made up of four soups or shakes fortified with vitamins and minerals) for between 8 and 20 weeks, followed by a long-term programme of weight loss maintenance. Certainly not an easy fix!
  • The headlines alert us to the positive findings of the study but one person in fact developed severe abdominal pain, related to gallstones. This was thought to be possibly caused by the intervention. Further studies are required to ensure the diet is safe for widespread use.
  • The weight management programme was delivered with medical supervision and dietitians were involved to help support long term weight management. While it may seem possible to put type 2 diabetes into remission, this type of diet should certainly not be undertaken alone and anyone attempting to do this should ask for help from a GP and dietitian.

The Deputy Head of Care at Diabetes UK provided this useful statement: “If you’re thinking about trying a low-calorie diet, it’s really important you speak to your GP and get referred to a dietitian. This is to make sure you get tailored advice and support.

“It’s also important to bear in mind that if you’re treating your Type 2 diabetes with certain medications, such as insulin or sulphonylurea, a low-calorie diet can make hypos more likely. So you’ll need support to make changes to your medications and check your blood sugar levels more often.”

For more information, go to Diabetes UK and the Newcastle University study



We are being alerted by the BBC (‘Stark’ increase in overweight youngsters), The Times (A fifth of children are obese by 14) and the Daily Mail (Now one in three British teenagers is already overweight) of the increasing prevalence of obesity in children.

Data from the Millennium Cohort (a group of more than 10,000 children born between 2000-2001 who have been followed for years) revealed that 25% were overweight or obese at age 7, increasing to 35% by age 11. Little change was found between age 11 and 14 years.

There were notable differences found between different nations and there were links found between the mother’s education level, whether the child was breastfed and whether the parents owned their own home. Full results are discussed by the Institute of Education.

Behind the headlines: the Nutrilicious dietetic view
The headlines alert us to the growing problem of obesity in children and action clearly needs to be taken. The following risks are associated with it:

  • Higher chance of premature death and disability in adulthood
  • More likely to stay obese in adulthood and develop noncommicable diseases such as diabetes and cardiovascular disease at a younger age
  • Muscoskeletal disorders in adulthood (e.g. osteoarthritis)
  • Certain cancers in adulthood (endometrial, breast and colon)

Source: World Health Organisation

It is unclear from this research why there is such an increase in rates of obesity between ages 7 and 11, which then levels off. Children may start to make more of their own choices past 11 years and this is thought to potentially have a role.

In view of these recent findings, we should be reminded of the action that is planned to help combat obesity in the UK. These are discussed in full on the UK Government’s website. Key examples from this plan include:

  • The Sugar Tax – The government plan to introduce a soft drinks levy to be enforced from April 2018. Producers and importers have been given two years to lower the sugar appropriately in their drinks to allow them to not face the levy. Our blog Draft Soft Drinks Levy – Objectives, Thresholds, Exemptions & Impact? discusses this further. This is a very encouraging and hopeful move considering that the latest National Diet and Nutrition Survey highlighted that soft drinks are a major contributor to sugar in children’s diets.
  • Taking out 20% of sugar in products – firms have been called to cut sugar by 5% by the end of this year and by 20% by 2020. We discussed on last week’s blog the action that Kellogg’s have been taking on their top selling cereal products to cut the sugar.

There are also new rules due to be implemented on food advertising. Last month the BBC reported on how young children are being bombarded with adverts for high fat, high sugar foods, which is more than likely to be having a negative influence on food choices. The news rules are discussed in our blog New rules on food advertising to help tackle childhood obesity.

It is interesting to note that Amsterdam is the only European country that has successfully managed to reduce obesity rates in the last five years with a range of programmes, mainly through schools. Clearly, many measures will need to be employed to help combat childhood obesity in the UK. Let us hope that the actions due to be undertaken in UK will help improve the current rather desperate situation. Monitoring of the effectiveness of such actions will be of key importance in the future.

For more information, go to NHS and UCL



Also in the news this week is the warning over eating raw cookie dough. This was reported by The BBC, The Telegraph, The Evening Standard, The Sun and The Daily Mail.

The UK Foods Standards Agency have now provided guidance that we should not eat raw flour, including cookie dough. This is due to outbreaks in the US of food poisoning caused by E.Coli.

Behind the headlines: the Nutrilicious dietetic view

E.Coli is a type of bacteria that can cause diarrhoea, blood in faeces, stomach cramps, fever and vomiting. Before this guidance on raw flour, it was understood that E.Coli could be caught from infected foods such as raw leafy vegetables, undercooked meat or raw milk products.

We now must ensure we are aware of the potential risk associated with raw flour, including cookie dough and cake mixture for example. We may think we shouldn’t have a taster of these due to the raw egg. However, in October 2017, the Foods Standards Agency published advice that runny eggs are safe to eat for all, so long as they are stamped with the British Lion Code of Practice.

So now the reasoning behind avoiding having a taster of dough is down to the raw flour contained within it. It is also advised to wash hands thoroughly before and after using flour and to ensure worktops are wiped afterwards. Rest assured that cooking the flour will kill the bacteria that causes the infection.

It is important to be aware of this new advice from the Foods Standards Agency to reduce any complications caused E.Coli. Certain groups of people should take particular note of this new guidance, such as those with a weakened immune system and pregnant women, where food poisoning can cause harm to the unborn baby. When giving food safety advice to such groups, this latest advice on flour should be included.

For more information, go to NHS


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