Metabolic and Weight-loss Effects of a Long-term Dietary Intervention in Obese Patients

Ditschuneit HH, et al. Am J Clin Nutr. 1999;69:198-204.

Objective

To assess the long-term effects of an energy-restricted diet (using 1 or 2 daily meal replacements) on body weight and biomarkers of disease risk.

Methods

One hundred obese male and female patients (BMI > 30) were prescribed a weight reducing diet of 1200 to 1500 calories. During the first 3 months (weight loss phase [WLP]) patients were randomized (n=50 per treatment) to a diet using traditional foods (control) or to the same diet but with the instruction to replace 2 of the daily meals with a nutrient-dense meal replacement (MR, Slim·Fast). Both groups received regular instruction from a dietitian on their respective diets. Upon completion of the WLP, all patients were instructed to continue the same caloric prescription but were to replace 1 meal each day with a nutrient-dense meal replacement. Patients were followed for a 2-year period (maintenance phase [MP]).

Results

During the WLP, average weight loss in the control and MR groups was 1.3 ± 2.2 kg and 7.1 ± 3.5 kg, respectively. During the MP, both groups lost an additional 0.07% (P=0.01) of their body weight each month for the next 24 months, resulting in a total percentage weight loss by the end of the study (27months) of 5.9 ± 5.0% and 11.3 ± 6.8% for the control and MR groups, respectively. Based on the percentage of total weight loss, 7 of 50 patients (14%) in the control group and 21 of 50 (42%) in the MR group lost >10% of their initial body weight.

Other Key Findings

During the WLP, the MR group showed significant improvements (P<0.0001) in triglycerides, blood glucose, and insulin in both male and female patients compared with baseline values. MR females also showed a significant improvement in total cholesterol (P<0.001). There was no improvement in the control group during this time period. During the MP, groups either lost additional weight or maintained the original weight loss, resulting in an overall weight loss of 8% in the control group and 11% in the MR group (P<0.01). Both groups showed significant improvements (P<0.01) in systolic blood pressure (-1% and -11%), plasma concentrations of triacylglycerol (-17% and -37%), glucose (-10% and -11%), and insulin (-26% and -38%).

Conclusion

These significant findings support using meal replacements for successful, long-term weight control as well as improvements in biomarkers of disease risk.

Return to: Previous Page

Back to: Articles and Abstracts