Metabolic and weight-loss effects of a long-term dietary intervention in obese patients

Background: Obesity is a chronic disease that has become one of the most se rious health problems in Western society. Objective: We assessed the long-term effects of an energy-restricted diet c ombined with 1 or 2 daily meal replacements on body weight and biomarkers o f disease risk in 100 obese patients. Design: Phase 1 consisted of a 3-mo, prospective, randomized, parallel inte rvention study of 2 dietary interventions to reduce weight. The energy-rest ricted diet (5.2-6.3 MJ/d) consisted of conventional foods (group A) or an isoenergetic diet with 2 meals and 2 snacks replaced daily by energy-contro lled, vitamin-and-mineral-supplemented prepared foods (group B). Phase 2 co nsisted of a 24-mo, case-control, weight-maintenance study with an energy-r estricted diet and 1 meal and 1 snack replaced daily for all patients. Results: Total weight loss (as a percentage of initial body weight) was 5.9 +/- 5.0% in group A and 11.3 +/- 6.8% in group B (P < 0.0001). During phas e 1, mean weight loss in group B (n = 50) was 7.1 +/- 3.5 kg. with signific ant reductions in plasma triacylglycerol, glucose, and insulin concentratio ns (P < 0.0001). Group A patients (n = 50) lost an average of 1.3 +/- 2.2 k g with no significant improvements in these biomarkers. During phase 2, bot h groups lost on average an additional 0.07% of their initial body weight e very month (P < 0.01). During the 27-mo study, both groups experienced sign ificant reductions in systolic blood pressure and plasma concentrations of triacylglycerol, glucose, and insulin (P < 0.01). Conclusion: These findings support the hypothesis that defined meal replace ments can be used for successful, long-term weight control and improvements in certain biomarkers of disease risk.