Meal Replacements in Weight Intervention

Ashley JM, et al. Obes Res. 2001;9:312S-320S.

Objective

To determine the effect of a meal replacement strategy on fruit and vegetable intake, weight management, and biomarkers of health over a 2-year period.

Methods

One hundred thirteen overweight premenopausal women were randomly assigned to 3 treatment modalities and followed for 1 year. Subjects in Group A participated in a 1-hour group session led by a registered dietitian (RD), which included behavioral modification, exercise recommendations, and a reduced-calorie diet. Group B subjects received the same treatment but were instructed to replace 2 of their daily meals with meal replacements (MR, Slim·Fast). Group C subjects saw a physician for a 10-minute visit every other week and were provided with the same instructional materials as the RD-led group, but were also instructed to replace 2 meals per day with MR.

Forty-nine of the original 113 women completing the 1-year study agreed to continue in the program for a second year. The intervention modality during this time was the same for all groups in that they met with an RD monthly while maintaining their original dietary assignment, (ie, reduced-calorie diet vs meal replacements).

Results

Those who met with the RD as a group and used meal replacements (Group B) maintained significantly (P=0.001) greater amounts of their lost weight than those provided the same intervention but using a reduced-calorie regimen (Group A) (-8.5 ± 7.0% vs -1.5 ± 5.0%). The physician-led group using MR (Group C) maintained -3.0 ± 7.0% of their lost weight.

Those who met with the RD as a group and used meal replacements (Group B) significantly increased their combined fruit and vegetable intake from baseline (2.7 ± 0.4 vs 5.1 ± 0.8 servings/d). Corresponding values for the women in the RD-led group using a reduced-calorie regimen (Group A) were 2.9 ± 0.5 vs 3.9 ± 1.0 servings/d. The physician-led group remained unchanged over the 2 periods at 3.3 ± 0.7 servings/d.

Other Key Findings

Compared with baseline values, subjects in Group A (within group analysis) experienced improvements after year 1 in body weight, body mass index (BMI), and waist circumference. A decreased waist circumference was maintained in the second year. Similar analyses for Group B found improvements in weight, BMI, and waist circumference at 1 and 2 years and plasma insulin and total cholesterol at 1 year. Body weight, BMI, and waist circumference improved in year 1 whereas waist circumference, systolic blood pressure, and LDL-C showed improvements in year 2 for the physician-led group (Group C).

Conclusion

A meal replacement strategy was not only effective for sustained weight loss - over 2 years - but also improved biomarkers of disease risk. Incorporating meal replacements into a traditional weight management program can improve food choice - such as increased fruit and vegetable consumption - and help meet recommended nutrient requirements.

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