- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT02779790
Meta-analyses of the Effect of Liquid Meal Replacements on Cardiometabolic Risk
Effect of Liquid Meal Replacements on Cardiometabolic Risk Factors: A Series of Systematic Reviews and Meta-analyses of Randomized Controlled Trials
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Background: Liquid meal replacements (LMRs) provide a mixture of carbohydrate, fat and protein, along with added vitamins and minerals in liquid ready-to-drink form or powder formulas that require mixing. They are designed to mimic a low-calorie meal and serve as a quick and easy source of calories to consume. Behavioral strategy tools are important to assist obese individuals in losing weight and maintaining weight loss. There is evidence that LMRs contribute to weight loss and may reduce related cardiometabolic risk factors.
Need for proposed research: An earlier meta-analysis demonstrated that partial meal replacement plans produced significant weight loss and improved weight-related cardiometabolic risk factors. Several controlled trials have since investigated the effect of liquid meal replacements on body weight and weight-related risk factors for disease. There is a need to update of the evidence of the effect of LMRs on cardiometabolic risk to inform dietary guidelines and public health policy development.
Objective: To synthesize the evidence of randomized controlled trials of the effect of LMRs on body weight, blood pressure, glycemic control and established lipid targets.
Design: The systematic review and meta-analysis will be conducted according to the Cochrane Handbook for Systematic Reviews of Interventions and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA).
Data sources: MEDLINE, EMBASE and The Cochrane Central Register of Controlled Trials (Clinical Trials; CENTRAL) will be searched using appropriate search terms supplemented by manual searches.
Study selection: The investigators will include randomized controlled trials of >= 2-weeks duration that assess the effect of LMRs versus control diets on body weight, blood pressure, markers of glycemic control and lipid profile.
Data extraction: Two or more investigators will independently extract relevant data and assess risk of bias using the Cochrane Risk of Bias Tool. All disagreements will be resolved by consensus. Standard computations and imputations will be used to derive missing variance data.
Outcomes: Four sets of outcomes will be assessed: (1) Markers of adiposity (body weight, BMI, body fat, waist circumference), (2) glycemic control (HbA1c, fasting glucose, and fasting insulin), (3) Established therapeutic lipid targets (LDL-cholesterol, non-HDL-cholesterol, apolipoprotein B, HDL-cholesterol, triglycerides), and (4) blood pressure (systolic blood pressure and diastolic blood pressure).
Data synthesis: Pooled analyses of the mean difference will be performed using the generic inverse variance method. Random-effects models will be used even in the absence of statistically significant between-study heterogeneity because they yield more conservative summary effect estimates in the presence of residual heterogeneity. Fixed-effects models will be used only if there are less than 5 included trials. Crossover trials will be assessed via paired analyses. Heterogeneity will be assessed by the Cochran Q statistic and quantified by the I2 statistic. To explore sources of heterogeneity, the investigators will conduct sensitivity analyses, in which each study is systematically removed. If there are >= 10 trials, the study investigators will conduct apriori subgroup analyses by liquid meal replacement type (diabetes-specific formula, soy-based formula and fiber-containing formula), age, health status (presence/absence of type 2 diabetes), comparator, dose, baseline measurements, study design (parallel, crossover), follow-up (<= 3 months, > 3 months) and risk of bias. Meta-regression analyses will assess the significance of categorical and continuous subgroup analyses. When >= 10 trials are available, publication bias will be investigated by funnel plots and formal testing using Egger and Begg tests. If publication bias is suspected, then the investigators will attempt to adjust for funnel plot asymmetry by imputing the missing study data using the Duval and Tweedie trim and fill method.
Evidence assessment: The strength of the evidence for each outcome will be assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE).
Knowledge translation plan: The results will be disseminated through interactive presentations at local, national and international scientific meetings and publication in high impact factor journals. Target audiences will include the public health and scientific communities with interest in nutrition and obesity. Feedback will be incorporated and used to improve the public health message and key areas for future research will be defined. Applicant/Co-applicant Decision Makers will network among opinion leaders to increase awareness and participate directly as committee members in the development of future guidelines.
Significance: The proposed research will synthesize the highest quality evidence from randomized trials and aid in knowledge translation of the effect of LMRs on body weight and related cardiometabolic disease risk. It will strengthen the evidence-base for guidelines, improve health outcomes, by educating healthcare providers and patients, stimulating industry innovation, and guiding future research design.
Study Type
Enrollment (Anticipated)
Contacts and Locations
Study Locations
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Ontario
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Toronto, Ontario, Canada, M5C 2T2
- The Toronto 3D (Diet, Digestive tract and Disease) Knowledge Synthesis and Clinical Trials Unit, Clinical Nutrition and Risk Factor Modification Centre, St. Michael's Hospital
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
- Child
- Adult
- Older Adult
Accepts Healthy Volunteers
Genders Eligible for Study
Sampling Method
Study Population
Description
Inclusion Criteria:
- Trials in humans
- Liquid meal replacement intervention
- Presence of a comparator diet (control diet)
- Diet duration >=2 weeks
- Viable outcome data
Exclusion Criteria:
- Non-human trials
- Observational studies
- Lack of suitable comparator diet
- No viable outcome data
Study Plan
How is the study designed?
Design Details
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Markers of adiposity - body weight
Time Frame: Up to 20 years
|
Body weight
|
Up to 20 years
|
Markers of adiposity - Body Mass Index
Time Frame: Up to 20 years
|
Body Mass Index (BMI)
|
Up to 20 years
|
Markers of adiposity - body fat
Time Frame: Up to 20 years
|
Body fat
|
Up to 20 years
|
Markers of adiposity - waist circumference
Time Frame: Up to 20 years
|
Waist circumference
|
Up to 20 years
|
Glycemic control - HbA1c
Time Frame: Up to 20 years
|
HbA1c
|
Up to 20 years
|
Glycemic control - fasting glucose
Time Frame: Up to 20 years
|
fasting glucose
|
Up to 20 years
|
Glycemic control - fasting insulin
Time Frame: Up to 20 years
|
fasting insulin
|
Up to 20 years
|
Established therapeutic lipid targets - LDL-cholesterol
Time Frame: Up to 20 years
|
LDL-cholesterol (LDL-C)
|
Up to 20 years
|
Established therapeutic lipid targets - apolipoprotein B
Time Frame: Up to 20 years
|
Apolipoprotein B (apo B)
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Up to 20 years
|
Established therapeutic lipid targets - non-HDL-cholesterol
Time Frame: Up to 20 years
|
non-HDL-cholesterol (non-HDL-C)
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Up to 20 years
|
Established therapeutic lipid targets - HDL-cholesterol
Time Frame: Up to 20 years
|
HDL-cholesterol (HDL-C)
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Up to 20 years
|
Established therapeutic lipid targets - triglycerides
Time Frame: Up to 20 years
|
Triglycerides
|
Up to 20 years
|
Blood pressure - systolic blood pressure
Time Frame: Up to 20 years
|
Systolic blood pressure
|
Up to 20 years
|
Blood pressure - diastolic blood pressure
Time Frame: Up to 20 years
|
Diastolic blood pressure
|
Up to 20 years
|
Collaborators and Investigators
Sponsor
Collaborators
Investigators
- Principal Investigator: John Sievenpiper, MD, PhD, FRCPC, University of Toronto
Publications and helpful links
Study record dates
Study Major Dates
Study Start
Primary Completion (Anticipated)
Study Completion (Anticipated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Estimate)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
- HbA1c
- Body Weight
- LDL-C
- Evidence-Based Medicine
- Triglycerides
- Total Cholesterol
- HDL-C
- Clinical Practice Guidelines
- Systolic Blood Pressure
- Fasting Blood Glucose
- Diastolic Blood Pressure
- Systematic Review and Meta-Analysis
- Evidence-Based Nutrition
- Liquid Meal Replacements
- Fasting Blood Insulin
- Controlled Feeding Trials
Additional Relevant MeSH Terms
Other Study ID Numbers
- CIHR-LMRs 2016
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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