The 1:1 Diet – Evidence-Based, Dietary Intervention for Diabetes

The 1:1 Diet has been shown in gold-standard, randomised, controlled trials to be effective in pre-diabetics, diabetics and those with severe, long-established diabetes, who were on insulin. Expert groups, including the British Dietetic Association, the British Medical Association and Diabetes UK have evaluated this research in a number of studies and reports and come to the same conclusion.

The PREVIEW study, conducted in seven European countries, New Zealand and Australia and with over 2000 subjects was “to date, the largest, multinational study concerning prevention of type-2 diabetes”¹. Using a low-energy, nutritionally-complete diet – Cambridge Weight Plan (now The 1:1 Diet) products and based upon our protocols – subjects lost over 10 percent of their body weight and over one third reversed their pre-diabetes in eight weeks.

The DiRECT trial used products supplied by The 1:1 Diet and based upon our protocols, in 298 subjects². At one year, 46% of subjects achieved diabetes remission in the low-calorie diet group, versus only 4% in the ‘usual care’ arm of the study. At two years, 36% of subjects were still in remission (versus 3% in usual care). We are expecting five-year results from DiRECT imminently³.

In a similarly-conducted trial, undertaken in Quatar (called “DIADEM-1”), in a Middle Eastern and North African population, 61% of subjects in The 1:1 Diet group reversed their diabetes at one year⁴.

When the diet was tested on Obese, insulin-using, type-2 diabetics, insulin was able to be discontinued in 39% (versus 6%) in those in The 1:1 Diet group. HbA1c and quality of life were also substantially improved only in The 1:1 Diet group⁵.

In the University of Oxford DROPLET study, the group that got The 1:1 Diet experienced significant improvements in multiple clinical measures (fGlucose, fInsulin, HOMA-IR, HOMA-S, diastolic blood pressure and triglycerides), and, in the authors words, had: “substantially greater weight loss and improvements in the risk of cardiometabolic disease.”⁶

In July, 2021, a group of specialist dietitians and medical practitioners was convened, supported by the UK dietetic authority – the British Dietetic Association – and the UK’s top diabetic charity – Diabetes UK. This expert group reviewed over 90 published studies on the best dietary approaches to reverse diabetes⁷. When the investigation was complete, the group concluded that nutritionally-complete, meal-replacement foods worked at least twice as well as the next best dietary approach to reverse diabetes. Importantly, the major focus of this review was the results of the DiRECT study and two of the other diabetes studies referred to above, all based upon our products and protocols.

A recent report, called Turning the Tide: A 10-year Healthy Weight Strategy, has been published by the Obesity Health Alliance, a coalition including the British Dietetic Association and the British Medical Association, which influences government policy on reducing obesity levels.

The report states…

“Analysis suggests that including [the types of nutritionally-complete, meal replacement products we make] in a behavioural programme for adults results in greater weight loss (10.3kg) than the behavioural programme alone (6.4kg).”

“Evidence shows that a weight-management programme [referring to The 1:1 Diet Studies, including DiRECT, DROPLET and DIADEM-1] leads to significant weight loss and diabetes remission in some adults with type 2 diabetes who have obesity and overweight.”

The above studies averaged over 10 kilograms weight loss and other studies have shown improvements in multiple measures of glucose control, blood pressure, blood lipids, sleep apnoea, skin conditions, osteoarthritis, inflammation and others. These studies are available upon request.

References:

1. Christensen P, Meinert Larsen T, Westerterp-Plantenga M, et al. Men and women respond differently to rapid weight loss: Metabolic outcomes of a multi-centre intervention study after a low-energy diet in 2500 overweight, individuals with pre-diabetes (PREVIEW). Diabetes Obes Metab. 2018 Dec;20(12):2840-2851.
2. Lean ME, 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. 2018;391(10120):541-551.
3. Lean, MEJ, et al. Durability of a primary care-led weight-management intervention for remission of type 2 diabetes: 2-year results of the DiRECT open-label, cluster-randomised trial. Lancet Diabetes Endocrinol. 2019 May;7(5):344-355.
4. Shahrad Taheri, Hadeel Zaghloul, Odette Chagoury, et al. Effect of intensive lifestyle intervention on bodyweight and glycaemia in early type 2 diabetes (DIADEM-I): an open-label, parallel-group, randomised controlled trial. The Lancet Diabetes & Endocrinology, 2020. 8(6), 477-89.
5. Brown A, Dornhorst A, McGowan B, Omar O, Leeds AR, Taheri S, Frost GS. Low-energy total diet replacement intervention in patients with type 2 diabetes mellitus and obesity treated with insulin: a randomized trial. BMJ Open Diabetes Res Care. 2020 Jan;8(1).
6. Astbury, N.M. et al. Doctor Referral of Overweight People to Low Energy Total Diet Replacement Treatment (DROPLET): Pragmatic Randomised Controlled Trial. BMJ. 2018 Sep 26;362
7. Brown A, McArdle P, Taplin J, Unwin D, Unwin J, Deakin T, Wheatley S, Murdoch C, Malhotra A, Mellor D. Dietary strategies for remission of type 2 diabetes: A narrative review. J Hum Nutr Diet. 2021 Jul 29.
8. http://obesityhealthalliance.org.uk/wp-content/uploads/2021/09/Turning-the-Tide-A-10-year-Healthy-Weight-Strategy.pdf