Long-term Efficacy of Soy-Based Meal Replacements vs. an Individialized Diet Plan in Obese Type 2 DM Patients: Relative Effects on Weight Loss, Metabolic Parameters, and C-Reactive Protein

Li Z, Hong K, Saltsman P, DeShields S, Bellman M, Thames G, Liu Y, Wang HJ, Elashoff R, Heber D. Eur J Clin Nutr. 2005;59(3):411-418.

Objective

To evaluate the long-term effectiveness of using a meal replacement approach for weight loss in obese people with type 2 diabetes as compared to a reduced-calorie diet using the American Diabetes Association (ADA) exchange plan.

Methods

A total of 104 obese male and female subjects were randomized to receive either a meal replacement diet plan (Slim•Fast®) or an individualized reduced-calorie ADA exchange diet for 12 months. Each subject received periodic individual counseling from a registered dietitian.

Results

Seventy-seven subjects completed the 1-year weight loss phase. The meal replacement group lost significantly more weight (4.57 +/- 0.81%; p<0.05) than the reduced-calorie diet group (2.25 +/- 0.72%). Fasting plasma glucose levels were significantly reduced in the meal replacement group as compared with the reduced-calorie diet group (152.5+/- 6.6 mg/dl; p<0.0001) at 3 and 6 months, but not at 12 months. A significant number of subjects in the meal replacement group had a reduction in their oral diabetic medication use by the end of the study period.

Other Key Findings

A separate study compared the glucose and insulin response of one serving of either Slim•Fast® Soy or Glucerna® (Ross Laboratories), a nutritional supplement specifically designed for people with diabetes. Eighteen subjects were enrolled in a randomized, cross-over study design, which showed that consuming the Slim•Fast Soy meal replacement resulted in similar effects on glucose levels and no statistically significant differences in the area under the curve (AUC) for glucose or insuliin.

Conclusion

Obese people with type 2 diabetes show good compliance to a weight loss regimen using liquid meal replacements, resulting in effective weight loss and significant improvements in diabetes control, including a reduction in the use of diabetes medications.

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