Comparing the acceptability of total diet replacement and food-based low-calorie diets for type 2 diabetes remission amongst Southeast Asians: a public and patient involvement activity

Basil Issa,Martin K. Rutter,Sajda Majeed,Michelle Harvie,Grace Farhat

doi:10.3310/nihropenres.13233.1

Abstract

Background: With type 2 diabetes prevalence rising at alarming rates, low-calorie diets (total diet replacement and food-based low-calorie diets) are increasingly used to induce weight loss and achieve diabetes remission. The effectiveness of these diets has been primarily tested in the UK white population but not in the Southeast Asian population at high risk of diabetes. Obtaining the opinion of members of the community on what would constitute a culturally acceptable diet is essential for successful interventions aiming to achieve diabetes remission in the southeast Asian population. Methods: We organised two patient and public involvement activities in the North West of England to understand views of people from the Southeast Asian population on whether low-calorie diets (850 Kcal) in the form of total diet replacement or food-based meals, are acceptable dietary interventions to achieve diabetes remission. Results: Thirteen people, with either type 2 diabetes or having someone with diabetes in the family attended a virtual or a face-to-face meeting. Low-calorie total diet replacement in the form of soups and shakes was considered unacceptable, while there was a preference for a culturally tailored low-calorie food-based diet. Ready-made portion controlled catered meals were suggested as an excellent approach to improve adherence. Conclusions: This work provided valuable insights to shape a future study looking at the feasibility to reverse diabetes in primary care through dietary intervention in the Southeast Asian population.

Highlights

Type 2 diabetes has gained significant research interest due to its emergence as a global epidemic, causing significant health and economic impacts1,2
Diabetes UK-funded primary-care based trials were the first to report that type 2 diabetes can be reversed through weight loss brought about through low-calorie diets (~850 Kcal) in the form of total diet replacement (TDR)4,5, and efforts are made to provide isocaloric low-calorie (850 kcal) food-based alternatives in primary care6
These approaches have been shown to be effective primarily in the White population in UK studies, and were shown to achieve diabetes remission in a Middle Eastern population7. Their value has not been considered in the Southeast Asian population, the second largest ethnic group in the UK, who have significantly higher prevalence of diabetes compared to the White population8,9

Summary

Introduction

Type 2 diabetes has gained significant research interest due to its emergence as a global epidemic, causing significant health and economic impacts. Diabetes UK-funded primary-care based trials were the first to report that type 2 diabetes can be reversed through weight loss brought about through low-calorie diets (~850 Kcal) in the form of total diet replacement (TDR), and efforts are made to provide isocaloric low-calorie (850 kcal) food-based alternatives in primary care6 These approaches have been shown to be effective primarily in the White population in UK studies, and were shown to achieve diabetes remission in a Middle Eastern population. With type 2 diabetes prevalence rising at alarming rates, low-calorie diets (total diet replacement and food-based low-calorie diets) are increasingly used to induce weight loss and achieve diabetes remission The effectiveness of these diets has been primarily tested in the UK white population but not in the Southeast Asian population at high risk of diabetes. Low-calorie total diet replacement in the form of soups and shakes was considered unacceptable, while there was a Invited Reviewers version 1

Methods

Results

Conclusion