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

Abstract

Background: With type 2 diabetes prevalence rising, low energy diets (total diet replacement and food-based low energy 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 south 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 south Asians. Methods: We organised two patient and public involvement activities in the North West of England to understand views of people from the south Asian population on whether low energy diets (850 Kcal) in the form of total diet replacement or food-based meals, are acceptable dietary interventions to achieve type 2 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 energy total diet replacement in the form of soups and shakes was considered unacceptable, while there was a preference for a culturally tailored low energy food-based diet. Ready-made portion controlled catered meals were suggested as a likely approach to improve adherence. Conclusions: This work provided valuable insights to shape a future study looking at the feasibility of a catered meal low-energy dietary intervention to induce T2D remission in primary care within the south Asian population.

Dietary weight-management for type 2 diabetes remissions in South Asians: the South Asian diabetes remission randomised trial for proof-of-concept and feasibility (STANDby)

“…Furthermore, recent qualitative research suggested that total dietary replacement (TDR) approach might be less acceptable to South Asians seeking T2D remission, and sub-optimal engagement, and outcomes with weight management among South Asians. 5 , 6 , 7 Few Asians, the largest UK ethnic minority, 6 or their health care workers, prioritise effective weight management or seek remission of T2D by weight loss. Without appropriate research and development, their T2D rates and early onset of complications will continue to rise.…”

South Asian individuals’ experiences on the NHS low-calorie diet programme: a qualitative study in community settings in England

“… 41–43 Furthermore, research exploring acceptability of TDR and low energy diets in South Asian populations found participants had a preference for culturally tailored low energy food-based diet and that spices needed to be included to support with their home culture. 44 …”

“…[41][42][43] Furthermore, research exploring acceptability of TDR and low energy diets in South Asian populations found participants had a preference for culturally tailored low energy food-based diet and that spices needed to be included to support with their home culture. 44 Recommendations for practice Specific recommendations to improve uptake and outcomes for people of South Asian ethnicity include: ► Incorporating a diverse flavour profile and variety of products during TDR such as food-based items to improve the taste, choice and allow for eating socially with family and friends. ► Working with local communities and utilising existing literature for tailored resources such as ethnic-specific Eatwell guides.…”

Effect of a Low-Calorie Dietary Intervention on Liver Health and Body Weight in Adults with Metabolic-Dysfunction Associated Steatotic Liver Disease (MASLD) and Overweight/Obesity: A Systematic Review and Meta-Analysis

“…First, our review finds that no studies were conducted in Black African populations, and only one study, STANDBY, was conducted in a South Asian population [40]. Different cultures may find different dietary interventions acceptable; for instance, in a recent qualitative study, TDR was considered unacceptable for people with T2D of South Asian ethnicity [64]. This is important, as an unacceptable intervention will negatively impact patient experience, retention and, therefore, clinical outcomes.…”