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For heart health specifically, the NHS and NICE recommend that any calorie-reduced diet should: Include a wide variety of nutrient-dense foods lean proteins, wholegrains, fruits, vegetables, and healthy fats Avoid prolonged fasting or meal skipping , which can cause symptomatic low blood sugar, particularly in people with diabetes or those taking glucose-lowering medicines Maintain adequate hydration the NHS recommends approximately 6 to 8 cups or glasses of fluid per day (NHS: Water, drinks and your health) Be combined with regular, moderate physical activity in line with UK Chief Medical Officers' physical activity guidelines, rather than extreme exercise regimens that further increase caloric demand Individuals with pre-existing cardiovascular conditions, diabetes, or a history of eating disorders should seek personalised guidance from their GP or a registered dietitian before beginning any calorie-restricted programme

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Stage 2: Decreased levels of B12 and metabolic abnormalities such as high homocysteine or methylmalonic acid (MMA) levels

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A: In 2026, research continues to refine our understanding, particularly regarding long-term effects and personalized dosage strategies

Bloodwork is the only way to confirm a diagnosis