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The history of the Cambridge Diet
The Cambridge Diet stems from the early 1960's when Dr Alan Howard, then a research scientist at the University of Cambridge, developed an interest in overweight and obesity.
He began to investigate methods of weight reduction, using himself as one of the guinea pigs. Together with Dr Ian McLean-Baird of the West Middlesex Hospital, in 1968 he organised a National Symposium on Obesity, the first ever held in the UK. They went on to a collaborate and develop the perfect diet. Successful trials led to the introduction of the Cambridge Diet.
With Dr McLean-Baird, Alan Howard set up a research project at the West Middlesex Hospital. What they wanted was a formula food with:
The first formula produced excellent weight loss results, and further work by food technologists enhanced flavours and led to the first commercial version of the Cambridge Diet. The effectiveness and safety of this revised formula was tested both in hospital and with outpatients.
This study demonstrated three important factors:
and led to the Diet becoming more available in obesity clinics in London and Cambridge. Long term safety was assessed and confirmed by further independent research in the UK, the USA and across Europe. The Cambridge Diet was launched commercially in the USA in 1980 and has been available in the UK since 1984.
An advisory note on gallstones
Gallstones form when crystals of cholesterol and/or bile pigments form in the gall bladder. Risk of forming stones is higher when there is a family history of gallstones and when the client or patient is overweight or obese.
During weight loss the risk of forming stones and having symptoms [usually pain under the right rib margin] is higher than usual – this is just an inevitable consequence of changes in bile composition and reduction of flushing of the gall bladder as a result of reduced food intake. It is possible that the risk of forming gallstones and/or having symptoms is greater when rates of weight loss are faster, but this has not been established scientifically.
Theoretically the risk of forming gall-stones once a new lower weight has been achieved and is effectively maintained should be reduced.
It is always wise to advise everyone, even those with no personal or family history of gallstones that gallstones can form or cause symptoms during weight loss. It is difficult to reduce the risk of gallstones without use of medications* but clients/patients concerned about this can consult their GP.
Clients should be advised to follow instructions for the programme since breaking the diet suddenly with a ‘binge’ may precipitate gall stone symptoms for which hospital treatment may be necessary.
*Ursodeoxycholic acid may help dissolve cholesterol gallstones or reduce risk of their formation.
Bibliography: Andersen T Liver and gall-bladder disease before and after very-low-calorie diets. Am J Clin Nutr 1992; 56: 235S-9S
Anthony R Leeds, Medical Director, 21st February 2008
These notes are intended to help guide decision making with regard to the management of clients on the Cambridge programme. They are written in general terms and should not be used as a substitute for specific guidance from a medical practitioner or other health care professional who is fully informed of the individual’s case details.The Diet was launched in the UK in 1984 and is marketed and distributed throughout the UK and Eire by Cambridge Health & Weight Plan (CHWP). CHWP is a division of Cambridge Manufacturing Co. Ltd (CMC), which until the middle of 2005 was wholly owned by The Howard Foundation.
The Foundation is a charitable trust established in 1982 by Dr Alan Howard (the creator of the Cambridge Diet). Its aims are to provide funding for biomedical research in the fields of obesity, nutrition and key areas of health. Further aims include the funding, the construction and maintenance of buildings at Downing College, Cambridge University, and the establishment of scholarships for international students.
At the beginning of 2005, Dr Howard made the decision that he wished to pursue other charitable and business interests and expressed the desire to sell CMC. He felt that the best way forward for the company and the Cambridge Diet brand was for it to be offered to the current senior team through a management buyout.
Negotiations were completed in September 2005 and Cambridge Nutritional Foods Ltd, a new company wholly owned by the three managers of CMC (Eileen Skinner, Rob Thompson and John White - who between them have worked within the group for more than 50 years!) acquired the share capital of CMC, together with the trademarks and intellectual property relating to the Cambridge Diet brand.
CHWP remains a trading division of Cambridge Manufacturing Co Ltd, and the company continues to operate without disruption.
Cambridge Evolution
The Diet was launched in the UK in 1984 and now the Cambridge Diet is produced and distributed by Cambridge Manufacturing Company Limited (CMC), which is part of the Howard Foundation Group.
The Wider World
But Cambridge is not just a UK phenomena, and is now available around the world in more than 25 countries. This expansion began in 1985, with the launch of Cambridge Kuren in Denmark and other parts of Western Europe, such as Germany, France, Sweden and Norway. A little later came The Netherlands and Belgium, Austria, Malta and, most recently, Iceland. Cambridge first arrived in eastern Europe in 1990, when Cambridge Dieta was launched in Poland. The Czech Republic and Russia followed.
In 1995, Cambridge was first introduced into Asia, where it is now available in Singapore, Malaysia, Thailand, The Philippines, Indonesia, Hong Kong and Taiwan. In the Middle East, distributors have been appointed in Oman, Lebanon, Turkey and Egypt.
On the other side of the Atlantic, Cambridge has distributors in Canada, Brazil and Mexico, whilst it remains available in USA under the name 'Dr Howard's Success'
The Cambridge Diet is probably the most researched diet in the world. Extensive research on nutritionally complete very low calorie diets (VLCDs) has confirmed their safety and efficacy in assisting weight loss and weight maintenance.
Many studies have been carried out into the effects of very low calorie diets. One of the most sophisticated was a clinical trial that examined body composition and metabolic studies with VLCDs. The results of the trial were presented in a book:'The Swansea Trial' edited by Dr Stephen Kreitzman and Dr Alan Howard.
Recent Research Results and the Importance of DataClick Clinical Papers for a list of other clinical papers relating to VLCDs.
Listed here are just a few of the many clinical papers which demonstrate the health benefits and safety of using VLCDs in the treatment of obesity. Please contact Cambridge for a complete listing or further details of the papers summarised here.
Lessons from Obesity Management Programmes:
Great Initial Weight Loss Improves Long-term Maintenance: By A Astrup and S Rossner of Sweden. Obesity Reviews 2000. It is a common myth (belief) that weight loss achieved at a slow rate is better preserved than if the weight is lost more rapidly. However, this review of the literature shows that initial weight loss is positively, not negatively, related to long-term weight maintenance. There is evidence from randomised intervention trials to support the view that a greater initial weight loss induced without changes in lifestyle – eg liquid formula diets improves long-term weight maintenance, providing it is followed by a 1 – 2 years integrated weight maintenance programme consisting of lifestyle interventions involving dietary change nutritional education behaviour therapy and increased physical activity.
Conclusion: "Greater initial weight loss as the first step of weight management may result in improved weight maintenance".
Long-term Efficacy of Dietary Treatment of Obesity:
A systematic Review of Studies published between 1931 and 1999 by C Ayyad and T Andersen of Denmark Published in Obesity Reviews 2000. A MEDLINE survey was carried out to identify publications on long-term outcome for dietary treatment of obesity. 898 papers were identified and of these 17 met the criteria for inclusion: Dietary treatment Adults Follow up period more than 3 years Follow up rate more than 50% of original study group Information in one of the success criteria was either:- Maintenance of all weight initially lost or Maintenance of at least 9 to 11 kg of initial weight loss. These 17 papers reviewed 3,030 patients, with over 2000 being followed up for 3 – 14 years. Mean initial weight loss ranged from 4 to 28 kg (with a median of 11kg). The report shows that diet combined with group therapy leads to better long-term success rates – median 27% (as opposed to 15% on diet alone). Active (rather than passive) follow-up was generally associated with better success rates - 19% versus 10%. This again stresses the importance of support during maintenance. Although conventional diet seemed to work best when used with group therapy, VLCD apparently was most efficacious when combined with behaviour modification and active follow-up.
Conclusion: "VLCD was most efficacious if combined with behaviour modification and active follow-up. The literature on long-term follow-up of dietary treatment of obesity points to an overall median success of 15% and a possible adjuvant effect of group therapy, behaviour modification and active follow-up."
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Better % |
Same % |
Worse % |
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General well being: |
74 |
26 |
0 |
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Feeling tired: |
63 |
22 |
15 |
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Physical condition: |
59 |
33 |
8 |
Very Low Energy Diets
in the Treatment of Obesity:
by P Mustajoki and T Pekkarinen of Finland Published in Obesity Review 2001 - This research looks at the current status of VLCDs in the management of obesity. Some 80 papers were reviewed with different VLCD formulations and different modes of delivery – including inpatients and outpatients. A total of 59 patients (with BMI of 32 – 40) showed an average weight loss over 8 – 9 weeks of nearly 12 kg. In one study, 62 subjects were asked their feelings during the last week of an 8-week VLCD period:
Re-feeding following VLCD was recommended at 3 to 8 weeks to prevent abrupt fluid retention and abdominal discomfort – which is in line with our own recommendations.
There is a general agreement that VLCDs should not be used alone but in connection with cognitive and behaviour counselling for permanent lifestyle changes. Without it there is a real risk of weight regain. Those studies with 1 or 2 year follow-up show a mean weight loss of 7.2 to 12.9kg with VLCDs and 5.7 to 9.5 without.
The paper states that: "Maintenance is the greatest problem in all approaches to obesity management." It also says there is no evidence that VLCD-programmes lead to worse long-term results than programmes with low calorie or other dietary approaches." It emphasises that cognitive behavioural counselling should be included in a weight reduction programme using a VLCD.
Conclusion: "VLCDs accomplish maximum initial loss and can be conducted safely in patients with obesity associated diseases – diabetes, hypertension, or other chronic diseases".