Weight losses with low-energy formula diets in obese patients with and without type 2 diabetes: systematic review and meta-analysis

W S Leslie, R Taylor, L Harris, M E J Lean, W S Leslie, R Taylor, L Harris, M E J Lean

Abstract

Aim: To provide a systematic review, of published data, to compare weight losses following very low calorie (<800 kcal per day VLCD) or low-energy liquid-formula (>800 kcal per day LELD) diets, in people with and without type 2 diabetes mellitus (T2DM).

Methods: Systematic electronic searches of Medline (1946-2015) and Embase (1947-2015) to identify published studies using formula total diet replacement diets (VLCD/LELD). Random effects meta-analysis using weighted mean difference (WMD) in body weight between groups (with and without diabetes) as the summary estimate.

Results: Final weight loss, in the five included studies, weighted for study sizes, (n=569, mean BMI=35.5-42.6 kg/m2), was not significantly different between participants with and without T2DM: -1.2 kg; 95% CI: -4.1 to 1.6 kg). Rates of weight loss were also similar in the two groups -0.6 kg per week (T2DM) and 0.5 kg per week (no diabetes), and for VLCD (<800 kcal per day) and LELD (>800 kcal per day).

Conclusions: Weight losses with liquid-formula diets are very similar for VLCD and LELD and for obese subjects with or without T2DM. They can potentially achieve new weight loss/ maintenance targets of >15-20% for people with severe and medically complicated obesity.

Conflict of interest statement

WSL, MEJL and RT are currently engaged on the Diabetes Remission Clinical Trial (DiRECT) funded by Diabetes UK with additional support in kind from Cambridge Weight Plan. MEJL and RT have received support related to the use of formula diet products from Cambridge Weight Plan and from Nestle.

Figures

Figure 1
Figure 1
Flowchart of progress of papers through the review.
Figure 2
Figure 2
Meta-analysis (WMD) of studies comparing weight losses in those with type 2 diabetes and non-diabetic subjects.

References

    1. Walker A. The Cost of Doing Nothing: The Economics of Obesity in Scotland. Robertson Centre for Biostatistics, University of Glasgow: Glasgow, 2003.
    1. Chan JM, Rimm EB, Colditz GA, Stampfer MJ, Willett WC. Obesity, fat distribution and weight gain as risk factors for clinical diabetes in men. Diabetes Care 1994; 17: 961–969.
    1. UKPDS UK. Prospective Diabetes Study (UKPDS) VIII. Study, design, progress and performance. Diabetology 1991; 34: 877–890.
    1. Lean ME, Powrie JK, Anderson AS, Garthwaite PH. Obesity, weight loss and prognosis in type 2 diabetes. Diabet Med 1990; 7: 228–233.
    1. Scottish Health Survey. Available from: , 2008.
    1. Knowler WC, Barrett-Connor E, Fowler SE, Hamman RF, Lachin JM, Walkder EA et al. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med 2002; 346: 393–403.
    1. Rowe R, Cowx M, Poole C, McEwan P, Morgan C, Walker M. The effects of orlistat in patients with diabetes: improvement in glycaemic control and weight loss. Curr Med Res Opin 2005; 21: 1885–1890.
    1. Redmon JB, Bertoni AG, Connelly S, Feeney PA, Glasser SP, Glick H et al. Effect of the look AHEAD study intervention on medication use and related cost to treat cardiovascular disease risk factors in individuals with type 2 diabetes. Diabetes Care 2010; 33: 1153–1158.
    1. SIGN. Management of obesity no. 115. Available from: .
    1. NICE. Obesity: identification, assessment and management. Available from: , 2014.
    1. Guidone C, Manco M, Valera-Mora E, Iaconelli A, Gniuli D, Mari A et al. Mechanisms of recovery from type 2 diabetes after malabsorptive bariatric surgery. Diabetes 2006; 55: 2025–2031.
    1. Lim EL, Hollingsworth KG, Aribisala BS, Chen MJ, Mathers JC, Taylor R. Reversal of type 2 diabetes: normalisation of beta cell function in association with decreased pancreas and liver triacylglycerol. Diabetology 2011; 54: 2506–2514.
    1. Anderson JW, Cyril WC, Kendall CWC, David JA, Jenkins DJA. Importance of weight management in type 2 diabetes. J Am Coll Nutr 2003; 22: 331–339.
    1. Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Brit Med J 2009; 339: 332–336.
    1. Cochrane A. Risk of bias assessment tool for non-randomised studies of interventions (ACROBAT-NRS). Availbale from: .
    1. Henry RR, Wiest-Kent TA, Scheaffer L, Kolterman OG, Olefsky JM. Metabolic Consequences of very-low-calorie diet therapy in obese non-insulin-dependent diabetic and nondiabetic subjects. Diabetes 1986; 35: 155–164.
    1. Li Z, Tseng C-h, Deng ML, Wang M, Heber D. Clinical efficacy of a medically supervised outpatient high-protein, low-calorie diet program is equivalent in prediabetic, diabetic and normoglycaemic obese patients. Nutr Diabetes 2014; 4: e105.
    1. Baker ST, Jerumsa G, Prendergast LA, Panagiotopoulos S, Strauss BJ, Proietto J. Less fat reduction per unit weight loss in type 2 diabetic compared with nondiabetic obese individuals completing a very-low-calorie diet program. Metab Clin Exp 2012; 61: 873–882.
    1. Paisey RB, Harvey P, Rice S, Belka I, Bower L, Dunn M et al. An intensive weight loss programme in established type 2 diabetes and controls: effects on weight and atherosclerosis risk factors at 1 year. Diabet Med 1998; 15: 73–79.
    1. Noren E, Forsell H. Very low calorie diet without aspartame in obese subjects: improved metabolic control after 4 weeks treatment. Nutr J 2014; 13: 77.
    1. Christensen P, Bliddal H, Riecke BF, Leeds AR, Astrup A, Christensen R. Comparison of a low-energy diet and a very low-energy diet in sedentary obese individuals:a pragmatic randomized controlled trial. Clin Obes 2011; 1: 31–40.
    1. Lin WY, Wu CH, Chu NF, Chang CJ. Efficacy and safety of very-low-calorie diet in Taiwanese: a multicenter randomized, controlled trial. Nutrition 2009; 25: 1129–1136.
    1. Wikstrand I, Torgerson J, Bengtsson Boström K. Very low calorie diet (VLCD) followed by a randomized trial of corset treatment for obesity in primary care. Scand J Primary Health Care 2010; 28: 89–94.
    1. Rolland C, Hession M, Murray S, Wise A, Broom I. Randomized clinical trial of standard dietary treatment versus a low-carbohydrate/high-protein diet or the LighterLife Programme in the management of obesity. J Diabetes 2009; 1: 207–217.
    1. The Royal Australian College of General Practitioners and Diabetes Australia. General practice management of type 2 diabetes: 2014–2015. Available from: .
    1. American Diabetes Association. Standards of medical care in diabetes-2016. J Clin Appl Res Educ 2016; 39. Available from: .
    1. Isner JM, Sours HE, Paris AL, Ferrans VJ, Roberts WC. Sudden, unexpected death in avid dieters using the liquid-protein-modified-fast diet. Observations in 17 patients and the role of the prolonged QT interval. Circulation 1979; 60: 1401–1412.
    1. Purcell K, Sumithrab P, Prendergast LA, Bouniu CJ, Delbridge E, Proietta J. The effect of rate of weight loss on long-term weight management: randomised controlled trial. Lancet Diabetes Endocrinol 2014; 12: 954–962.
    1. Lean M, Brosnahan N, McLoone P, McCombie L, Bell Higgs A, Ross H et al. Feasibility and indicative results from a 12-month low-energy liquid diet treatment and maintenance programme for sever obesity. Br J Gen Pract 63: e115–e1242013.
    1. Christensen R, Henriksen M, Leeds AR, Gudbergson H, Christensen P, Sorensen TJ et al. The effect of weight maintenance on symptoms of knee osteoarthritis in obese patients: 12 month randomized controlled trial. Arthritis Care Res 2014; 67: 640–650.

Source: PubMed

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