Efficacy of a meal replacement diet plan compared to a food-based diet plan after a period of weight loss and weight maintenance: a randomized controlled trial

Lisa M Davis, Christopher Coleman, Jessica Kiel, Joni Rampolla, Tammy Hutchisen, Laura Ford, Wayne S Andersen, Andrea Hanlon-Mitola, Lisa M Davis, Christopher Coleman, Jessica Kiel, Joni Rampolla, Tammy Hutchisen, Laura Ford, Wayne S Andersen, Andrea Hanlon-Mitola

Abstract

Background: Obesity has reached epidemic proportions in the United States. It is implicated in the development of a variety of chronic disease states and is associated with increased levels of inflammation and oxidative stress. The objective of this study is to examine the effect of Medifast's meal replacement program (MD) on body weight, body composition, and biomarkers of inflammation and oxidative stress among obese individuals following a period of weight loss and weight maintenance compared to a an isocaloric, food-based diet (FB).

Methods: This 40-week randomized, controlled clinical trial included 90 obese adults with a body mass index (BMI) between 30 and 50 kg/m2, randomly assigned to one of two weight loss programs for 16 weeks and then followed for a 24-week period of weight maintenance. The dietary interventions consisted of Medifast's meal replacement program for weight loss and weight maintenance, or a self-selected, isocaloric, food-based meal plan.

Results: Weight loss at 16 weeks was significantly better in the Medifast group (MD) versus the food-based group (FB) (12.3% vs. 6.9%), and while significantly more weight was regained during weight maintenance on MD versus FB, overall greater weight loss was achieved on MD versus FB. Significantly more of the MD participants lost >or= 5% of their initial weight at week 16 (93% vs. 55%) and week 40 (62% vs. 30%). There was no difference in satiety observed between the two groups during the weight loss phase. Significant improvements in body composition were also observed in MD participants compared to FB at week 16 and week 40. At week 40, both groups experienced improvements in biochemical outcomes and other clinical indicators.

Conclusions: Our data suggest that the meal replacement diet plan evaluated was an effective strategy for producing robust initial weight loss and for achieving improvements in a number of health-related parameters during weight maintenance, including inflammation and oxidative stress, two key factors more recently shown to underlie our most common chronic diseases.

Trial registration: ClinicalTrials.gov NCT01011491.

References

    1. Thearle M, Aronne LJ. Obesity and Pharmacologic Therapy. Endocrinol Metab Clin North Am. 2003;32:1005–24. doi: 10.1016/S0889-8529(03)00066-5.
    1. Ogden CL, Carroll MD, McDowell MA, Flegal KM. Obesity among Adults in the United States - No Statistically Significant Change since 2003-2004. United States Department of Health and Human Services - NCHS Data Brief. 2007.
    1. Gale SM, Castracane VD, Mantzoros CS. Energy homeostasis, obesity, and eating disorders: recent advances in endocrinology. J Nutr. 2004;134:295–98.
    1. de Ferranti S, Rifai N. C-reactive protein and cardiovascular disease: a review of risk prediction and interventions. Clin Chem Acta. 2002;317:1–15. doi: 10.1016/S0009-8981(01)00797-5.
    1. Keaney JF Jr, Larson MG, Vasan RS, Wilson PW, Lipinska I, Corey D, Massaro JM, Sutherland P, Vita JA, Benjamin EJ. Obesity and Systemic Oxidative Stress. Arterioscler Thromb Vasc Biol. 2003;23:434–9. doi: 10.1161/01.ATV.0000058402.34138.11.
    1. Festi D, Colecchia A, Sacco T, Bondi M, Roda E, Marchesini G. Hepatic steatosis in obese patients: clinical aspects and prognostic significance. Obes Rev. 2004;5:27–48. doi: 10.1111/j.1467-789X.2004.00126.x.
    1. Abbott RD, Ross GW, White LR, Nelson JS, Masaki KH, Tanner CM, Curb JD, Blanchette PL, Popper JS, Petrovitch H. Midlife adiposity and the future risk of Parkinson's disease. Neurology. 2002;59:1051–57.
    1. Cheskin LJ, Mitchell AM, Jhaveri AD, Mitola AH, Davis LM, Lewis RA, Yep MA, Lycan TW. Efficacy of meal replacements versus standard food-based diet for weight loss in type 2 diabetes: a controlled clinical trial. Diabetes Educ. 2008;34:118–127. doi: 10.1177/0145721707312463.
    1. Heymsfield SB, van Mierlo CAJ, Knaap HCM van der, Heo M, Frier HI. Weight management using a meal replacement strategy: meta and pooling analysis from six studies. Int J Obes Relat Metab Disord. 2003;27:537–49. doi: 10.1038/sj.ijo.0802258.
    1. Ashley JM, Herzog H, Clodfelter S, Bovee V, Schrage J, Pritsos C. Nutrient adequacy during weight-loss interventions: a randomized study in women comparing the dietary intake in a meal replacement group with a traditional food group. Nutr J. 2007;6:6–12. doi: 10.1186/1475-2891-6-12.
    1. Ditschuneit HH, Flechtner-Mors M. Value of structured meals for weight management: risk factors and long-term weight maintenance. Obes Res. 2001;9(Suppl 4):S284–S289. doi: 10.1038/oby.2001.132.
    1. Egger GJ. Are meal replacements an effective clinical tool for weight loss?--a clarification. Med J Aust. 2006;184:591.
    1. Ditschuneit HH, Flechtner-Mors M, Johnson TD, Adler G. Metabolic and weight-loss effects of a long-term dietary intervention in obese patients. Am Soc Clin Nutr. 1999;69:198–204.
    1. Ditschuneit HH, Flechtner-Mors M. Value of structured meals for weight management: risk factors and long-term weight maintenance. Obes Res. 2001;9:S284–S289. doi: 10.1038/oby.2001.132.
    1. Rothacker DQ. Five-year self-management of weight using meal replacements: comparison with matched controls in rural Wisconsin. Nutr. 2000;16:344–8. doi: 10.1016/S0899-9007(99)00280-4.
    1. Li Z, Hong K, Saltsman P, DeShields S, Bellman M, Thames G, Liu Y, Wang HJ, Elashoff R, Heber D. Long-term efficacy of soy-based meal replacements vs an individualized diet plan in obese type II DM patients: relative effects on weight loss, metabolic parameters, and C-reactive protein. Eur J Clin Nutr. 2005;59:411–18. doi: 10.1038/sj.ejcn.1602089.
    1. Clifton PM, Noakes M, Keogh J, Foster P. How effective are meal replacements for treating obesity? Asia Pac J Clin Nutr. 2003. p. S51.
    1. Selvin E, Paynter NP, Erlinger TP. The effect of weight loss on C-reactive protein: a systematic review. Arch Intern Med. 2007;167:31–9. doi: 10.1001/archinte.167.1.31.
    1. Visser M, Bouter LM, McQuillan GM, Wener MH, Harris TB. Elevated C - reactive protein Levels in Overweight and Obese Adults. JAMA. 1999;282:2131–35. doi: 10.1001/jama.282.22.2131.
    1. Yudkin J, Stehouwer C, Emeis J, Coppack S. C-reactive protein in healthy subjects: associations with obesity, insulin resistance, and endothelial dysfunction: a potential role for cytokines originating from adipose tissue? Arterioscler Thromb Vasc Biol. 1999;19:972–78.
    1. Higdon J, Frei B. Obesity and oxidative stress: a direct link to CVD? Arterioscler Thromb Vasc Biol. 2003;23:365–7. doi: 10.1161/01.ATV.0000063608.43095.E2.
    1. Tchernof A, Nolan A, Sites CK, Ades PA, Poehlman ET. Weight loss reduces C-reactive protein levels in obese postmenopausal women. Circulation. 2002;105:564–9. doi: 10.1161/hc0502.103331.
    1. Young LR, Nestle M. Expanding portion sizes in the US marketplace: implications for nutrition counseling. J Am Diet Assoc. 2003;103:231–4. doi: 10.1053/jada.2003.50027.
    1. SPSS Inc. SPSS 15.0 Statistical Software. Chicago, IL: SPSS Inc; 2005.
    1. Stata Statistical Software: release 10.0 College Station, TX. Stata Corporation: College Station, TX; 1994.
    1. Thomas PR. Weighing the options: criteria for evaluating weight-management programs. National Academy Press; 1995.
    1. Goldstein DJ. Beneficial health effects of modest weight loss. Int J Obes Relat Metab Disord. 1992;16:397–415.
    1. Rucker D, Padwal R, Li SK, Curioni C, Lau DC. Long term pharmacotherapy for obesity and overweight: updated meta-analysis. BMJ. 2007;335:1194–9. doi: 10.1136/bmj.39385.413113.25.
    1. Gordon MM, Bopp MJ, Easter L, Miller GD, Lyles MF, Houston DK, Nicklas BJ, Kritchevsky SB. Effects of dietary protein on the composition of weight loss in post-menopausal women. J Nutr Health Aging. 2008;12:500–509.
    1. Garby L, Garrow JS, Jørgensen B, Lammert O, Madsen K, Sørensen P, Webster J. Relation between energy expenditure and body composition in man: specific energy expenditure in vivo of fat and fat-free tissue. Eur J Clin Nutr. 1998;42:301–5.
    1. Nelson KM, Weinsier RL, Long CL, Schutz Y. Prediction of resting energy expenditure from fat-free mass and fat mass. Am J Clin Nutr. 1992;56:848–56.
    1. Cunningham JJ. A reanalysis of the factors influencing basal metabolic rate in normal adults. Am J Clin Nutr. 1980;33:2372–4.
    1. Shah A, Mehta N, Reilly MP. Adipose inflammation, insulin resistance, and cardiovascular disease. JPEN. 2008;32:638–44.
    1. Dhaliwal SS, Welborn TA. Central obesity and cigarette smoking are key determinants of cardiovascular disease deaths in Australia: a public health perspective. Prev Med. 2009;49:153–7. doi: 10.1016/j.ypmed.2009.07.019.
    1. Bigaard J, Tjonneland A, Thomsen BL, Overvad K, Heitmann BL, Sorensen TI. Waist circumference, BMI, smoking, and mortality in middle-aged men and women. Obes Res. 2003;11:895–903. doi: 10.1038/oby.2003.123.
    1. Janssen I, Katzmarzyk PT, Ross R. Waist circumference and not body mass index explains obesity-related health risk. Am J Clin Nutr. 2004;79:379–84.
    1. Dansinger ML, Gleason JA, Griffith JL, Selker HP, Schaefer EJ. Comparison of the Atkins, Ornish, Weight Watchers, and Zone diets for weight loss and heart disease risk reduction: a randomized trial. JAMA. 2005;293:43–53. doi: 10.1001/jama.293.1.43.

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