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Written by Nyomi Graef
Weight loss shakes, diet shakes, liquid meal replacements... whatever name we call them, no doubt they are quick, easy and convenient. But how good are they for weight loss and reversing type 2 diabetes? A recent study, published in the Lancet, decided to find out. The study's participants were 306 adults across England and Scotland. They were all overweight or obese with type 2 diabetes, and for three to five months they went on a strict liquid diet of weight loss shakes. So, what were the results? Kathleen Doheny from EndocrineWeb reported that the study found that: "an intensive weight loss diet, totaling about 825 calories a day, can send type 2 diabetes packing.” With obesity and type 2 diabetes increasing worldwide, this appears to be great news. But are weight loss shakes a good long-term solution for these health problems? Well, this is debatable. Even with these advantages, these drinks have plenty of negative qualities. To name just a few, they are often highly processed sugary drinks with too many food additives, as opposed to natural/“real foods” (such as fresh fruit and vegetables) that many nutrition experts recommend we mostly eat. Studies have found that when people stop drinking the weight loss shakes, and stop the nutrition education and supervision from health professionals, most people regain the weight that they lost, and their diabetes returns. What other pros and cons do weight loss shakes have? Read on. What are some positive aspects of weight loss shakes?
What are some negative aspects of weight loss shakes? Weight loss shakes have many negative qualities. Below are some key ones to be wary of. Do your own research on the topic for more, if you’re interested. Weight loss shakes are not “real foods” Two cornerstones of a healthy diet are 1) eat plenty of vegetables, and 2) eat mostly “real foods”. Real foods are natural/unprocessed/minimally processed foods. These include fresh fruit and vegetables, fresh fish, eggs, healthy unrefined cold-pressed oils, nuts, and seeds. For optimum health, many nutrition experts, including leading dietitian Dr Joanna McMillan and top obesity and diabetes expert Dr Sarah Hallberg, say that we should eat real foods. The healthiest eating patterns in the world are based around eating real foods. The traditional Mediterranean diet, for instance, is a testament to this. Read the ingredients list on the packets of weight loss shakes. Notice that they look a lot like a multivitamin and mineral tablet mixed with, for example, sugar, milk/milk products, some sources of fibre, fat and protein, and food additives. Think this sounds reasonable? Think again. Here are some of the unhealthy and questionable ingredients often added to weight loss shakes:
Thus weight loss shakes can be highly processed sugary/artificially sweetened drinks with unhealthy trans fat, dubious quality sources of protein, and too many food additives. Such drinks are not real foods. How would our bodies react to eating too many “fake foods” – like many weight loss shakes are – for months or years? How balanced weight loss shakes really are is debatable The packets on weight loss shakes can claim that the drinks are nutritionally balanced, but are they really? A number of past and present leading health experts, including leading UK nutritionist Patrick Holford, say that as we are each biochemically unique. This means, among other things, that the amount of various vitamins and minerals that we each need every day for optimum health varies from person to person, and this variation can be substantial. According to Holford, the recommended dietary allowances (RDAs) for vitamins and minerals don’t cover nearly every adult for optimum health; the RDAs are designed to prevent severe (not mild) nutrient deficiencies in most people. Does this matter? Yes. Mild nutrient deficiencies can cause many different health problems, from lack of energy to irritability, headaches, skin problems and much more. It depends on many factors, for instance which nutrients people lack, and how many of them. People who often need more than the RDAs, for a number of vitamins and minerals, include people who:
So how accurate (and honest) are the shakes' packets that claim that these drinks are nutritionally balanced? For which people in particular? Those who eat a “perfect diet”, and are not too stressed, and don’t drink too much alcohol, and so on? The nutrients added to weight loss shakes can be poorly absorbed The nutrients added to weight loss shakes can be less well absorbed compared with other forms of these nutrients. For example, these drinks can contain added calcium carbonate and magnesium oxide. These forms of nutrients are less well absorbed (and cheaper) than, for instance, calcium citrate and magnesium citrate respectively. Most people are probably unaware of this, so is this why the companies that make weight loss shakes add the cheaper forms of these (and often other) nutrients? And is this important? Yes. Many of us don’t receive enough calcium and magnesium (among other nutrients) from our diets, so it’s important to have well absorbed nutrients. Weight loss shakes vary substantially in quality/how healthy they are Is that popular brand of weight loss shake in our supermarket healthy or unhealthy (or somewhere in between)? Are the type of fat(s) and protein(s) added good quality? Is the drink low in sugar? Are the additives safe if we consumed them for months/years? These are just a few questions that come to mind about the quality of weight loss shakes. With so many of these shakes to choose from, unless we have, for instance, a good checklist/nutrition knowledge in the area, many of us can be forgiven for not knowing which ones are better quality than others. Weight loss shakes are impractical/unsuitable when dining out/eating meals with others Thinking of eating out at a café or restaurant? Maybe enjoying a shared meal with friends or family? Weight loss shakes aren’t very practical nor suitable on these occasions. Weight loss shakes don’t educate us about long-term weight control, and might only be effective short term Taken on their own, weight loss shakes don’t help us learn about and select healthy foods when eating out. These drinks also don’t help us prepare, buy and cook healthy meals and snacks, nor learn good portion control – all vital skills for long-term weight control and good health. This makes the transition from drinking liquid “meals” to eating real foods hard for many people. The result? After stopping drinking the shakes, the lost weight is quickly regained; people often turn to quick and easy unhealthy fast foods and pre-prepared meals. This is because they are used to the quick and easy aspects of the shakes, and might lack the time, skills etc. to prepare healthy foods. As briefly stated earlier, the Lancet study mentioned above found that both weight loss and diabetes reversal are possible when weight loss shakes are taken along with medical supervision and education from health professionals about healthy eating. But how long is the weight loss maintained after the medical supervision and education ends, and participants are not made accountable for their eating habits? Dr. Scott Isaacs is the medical director of Atlanta Endocrine Associates in Atlanta, Georgia, USA. He said that the weight loss shakes study found similar results seen in previous research, and in many clinics around the country. "Remission was closely related to the degree of weight loss at 12 months," noted Dr. Isaacs. EndocrineWeb says that: "Dr. Isaacs has seen these results in his own clinic, as he has been providing a similar program for nearly 20 years." He has: ""... seen temporary diabetes remission rates similar to this study," ... However, he has an important caveat, noting that ''the vast majority of patients regain all the weight when they discontinue the meal replacement diet," ... and the diabetes returns quickly." Leading US obesity and type 2 diabetes expert Dr. Sarah Hallberg said very low calorie (VLC) diets (so this would include VLC liquid weight loss diets) work short-term, i.e. for a few months. In fact they cause rapid weight loss. But when the extreme calorie restriction ends, the “quick drops [in body weight] lead to quick rebound”. Dr. Hallberg said, “In summary, they [VLC diets] work really well in the short term. The question is the rebound, and what’s going to happen long term.” Summary Weight loss shakes have a number of advantages. These include being quick, easy and convenient, and containing a variety of nutrients. But the drinks often can, and do, have many disadvantages, which can cause problems, especially when they are a key part of people’s diets. These disadvantages include not being “real foods”; often being high in sugar and artificial food additives; being highly processed; having poorly absorbed nutrients; and not educating people about portion control, meal planning, and healthy choices when dining out and eating at home. Good portion control and being able to select/prepare/cook healthy snacks and meals are vital skills for long-term health and weight control. Weight loss shakes can lead to weight loss and the reversal of type 2 diabetes, among other health benefits, when taken under medical supervision and with appropriate education. But studies have found that when people stop drinking weight loss shakes and stop receiving help with their eating habits from health professionals, most people regain the weight that they lost, and their diabetes returns. Key qualities of healthy eating habits include being low in highly processed foods and low in added sugar, but high in real foods. Real foods are natural/unprocessed/minimally processed foods, such as fresh fruit and vegetables. For good health and long-term weight maintenance, many nutrition experts recommend eating real foods. References Cheraskin, E, Ringsdorf, WM and Brecher, A, 1974, Psychodietetics, New York, USA: Stein and Day Doheny, K, 2019, 12 Weeks on a Strict Liquid Diet Program Reverses Diabetes, EndocrineWeb, https://www.endocrineweb.com/news/diabetes/58738-12-weeks-strict-liquid-diet-program-reverses-diabetes Hallberg, S, 2019, Dr. Sarah Hallberg - 'Low Carbohydrate Diet for Type 2 Diabetes Reversal', YouTube, https://www.youtube.com/watch?v=Q_6dKfHApC0 Hallberg, S, 2015, Reversing Type 2 diabetes starts with ignoring the guidelines, TEDx Talk Purdue University, YouTube, https://www.youtube.com/watch?v=da1vvigy5tQ Hoffer, A and Walker, M, 1978, Orthomolecular Nutrition, Connecticut, USA: Keats Publishing Holford, P, 2003, Optimum Nutrition for the Mind, London, England: Piatkus Holford, P, 1994, Optimum Nutrition, London, England: ION Press McMillan, J, 2014, Eat for real change, TEDx Talk Macquarie University, YouTube, https://www.youtube.com/watch?v=fbeFn1Xcqo4 Sandhu, HS, 2019, Osteoporosis: Calcium and Magnesium, SpineUniverse, https://www.spineuniverse.com/conditions/osteoporosis/osteoporosis-calcium-magnesium Webb, D, 2018, Liquid Meal Replacements, Today’s Dietitian, Jan; 20(1): 20, https://www.todaysdietitian.com/newarchives/0118p20.shtml
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Written by Nyomi Graef
Some people might think that it’s fine to replace fresh fruit with 100 per cent fruit juice from the supermarket. Why? Both have fruit in them. Both claim to be all natural. And both apparently have no added sugar. But 100 per cent fruit juice and fresh fruit are not the same. Fruit juice contains many calories, and a similar amount of sugar as soft drink. Most Australians and people in USA, among other nationalities, consume too much sugar. A high-sugar diet increases the risk of obesity, inflammation, type 2 diabetes and other health problems. Shop-bought fruit juice is often highly processed, and it usually contains little or no fibre. But fresh whole fruit is a “real” unprocessed food with fibre and other vital nutrients that fruit juice can lack. So for good health, eat mostly fresh whole fruit as our source of fruit. How does fruit juice and whole fruit affect our blood sugar levels? Fruit juice causes our blood sugar level to rise quickly and then fall quickly. Over time, too many sharp highs and lows in our blood sugar levels increases the risk of type 2 diabetes. Why? The pancreas stops working well because it gets over stressed having to produce so much of the hormone insulin to deal with the sugar. Insulin resistance results. The body makes more and more insulin, but the body's cells don't respond to insulin properly, leading to type 2 diabetes. Whole fruit contains dietary fibre. Many fruit juices contain little, if any, fibre. Fibre slows down the absorption of fruit sugar into the bloodstream (among many other health benefits). This means that the highs and lows in blood sugar levels from eating whole fruit are less sharp than when drinking fruit juice, so eating whole fruit is better for balancing blood sugar. Both fibre and having balanced blood sugar levels are important for people of every shape and size, people with and without diabetes, and for those wanting to lose excess weight. What about the calories in fruit juice? It’s quick and easy to drink large amounts of fruit juice, so end up consuming lots of fruit sugar and calories over a short space of time. If people do this too often, they increase the risk of weight gain, type 2 diabetes and other health problems. But consuming the same number of calories from whole fresh fruit can take more time, and it’s more difficult. For example, two cups of 100 per cent orange juice is made from the juice of about five oranges (depending on the type of orange, fruit juicer and so on). Many of us could quickly and easily drink this amount of juice. But who can eat five whole oranges in one sitting? The fibre in whole fruit, and the need to chew whole fruit, makes consuming too much fruit sugar (and too many calories from this sugar) more difficult. On a side note about sugar in fruit juice, beware: even though fruit juice packets might claim there is no added sugar in the juice, this might not always be the case. When I was at a lecture at university, my class was told that 100 per cent no added sugar fruit juice can contain some added sugar to account for the seasonal variation of fruit. “Real” food vs processed food Fresh fruit is a “real” unprocessed food. Many fruit juices are heated to prolong their shelf life, otherwise they would go stale quickly like freshly squeezed fruit juice does. Examples of heat-treated fruit juices are UHT and pasteurised fruit juices from the supermarket. Heating destroys vital enzymes and other goodness in the juice, which we need for good health. Check out the below examples of eye-opening articles about fruit juices. They describe how fruit juices can be unhealthy, artificial and over-processed. Fruit Juice Is Just as Unhealthy as a Sugary Drink, published on Healthline Why ‘100% Orange Juice’ is Still Artificial, by the Huffington Post V8 Splash is ‘artificially-flavoured sugar-water labelled as if it were fruit juice,’ alleges lawsuit, says Food Navigator USA How fruit juice went from health food to junk food, The Guardian reports Do your own research into fruit juice and fruit drinks, if you’re interested. You might be surprised what you find on these topics. How much fruit juice is good for us? The Australian Government Department of Health recommends only occasionally drinking 125mL (half a cup) of no added sugar fruit juice. It says: “Fruit juice should only be drunk occasionally as it is acidic and can increase the risk of dental erosion. Fruit juice also has less fibre and other healthy nutrients than the whole fruit provides.” What about fruit drinks from the supermarket? These are mostly water and sugar/artificial sweeteners, with some additives to, for instance, preserve and flavour the drinks. Many fruit drinks contain very little actual fruit juice. Avoid these drinks altogether. They are “lolly water”. What are bad alternatives to fruit juice? Avoid cordial, soft drinks, sports drinks, energy drinks, and artificially sweetened drinks. These can be bad for weight loss, might increase our appetite, rot our teeth, and more. What are good alternatives to fruit juice? For better health and easier weight loss, drink no more than half a cup (125mL) of no added sugar fruit juice a day. If you can, avoid fruit drink altogether. Good alternatives to fruit juice include:
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