Effects of a Protein-Rich, Low-Glycaemic Meal Replacement on Changes in Dietary Intake and Body Weight Following a Weight-Management Intervention-The ACOORH Trial.

Martin Röhling,Aloys Berg,Dagmar Führer-Sakel,Martin Halle,Andrea Stensitzky,Isabelle Schenkenberger,Camila Oliveira,Kerstin Kempf,Hermann Toplak,David Mccarthy,Hans Predel,Andrea Beck,Klaus Braumann

doi:10.3390/nu13020376

Abstract

Although meal replacement can lead to weight reduction, there is uncertainty whether this dietary approach implemented into a lifestyle programme can improve long-term dietary intake. In this subanalysis of the Almased Concept against Overweight and Obesity and Related Health Risk (ACOORH) study (n = 463), participants with metabolic risk factors were randomly assigned to either a meal replacement-based lifestyle intervention group (INT) or a lifestyle intervention control group (CON). This subanalysis relies only on data of participants (n = 119) who returned correctly completed dietary records at baseline, and after 12 and 52 weeks. Both groups were not matched for nutrient composition at baseline. These data were further stratified by sex and also associated with weight change. INT showed a higher increase in protein intake related to the daily energy intake after 12 weeks (+6.37% [4.69; 8.04] vs. +2.48% [0.73; 4.23], p < 0.001) of intervention compared to CON. Fat and carbohydrate intake related to the daily energy intake were more strongly reduced in the INT compared to CON (both p < 0.01). After sex stratification, particularly INT-women increased their total protein intake after 12 (INT: +12.7 g vs. CON: −5.1 g, p = 0.021) and 52 weeks (INT: +5.7 g vs. CON: −16.4 g, p = 0.002) compared to CON. Protein intake was negatively associated with weight change (r = −0.421; p < 0.001) after 12 weeks. The results indicate that a protein-rich dietary strategy with a meal replacement can improve long-term nutritional intake, and was associated with weight loss.

Highlights

Lifestyle interventions comprising of exercise and healthy eating have been shown to result in clinically relevant effects regarding body composition and metabolic risk factors [1]
intake after 12 (INT) (n = 82) or control group (CON) (n = 37) completers with correctly filled out dietary records were not significantly different regarding their anthropometrical and clinical characteristics, as well as dietary intake even when stratified by sex
The INT group showed a significantly higher increase in protein intake after 12 (+6.37% [95% CI: 4.69; 8.04] vs. +2.48% [95% CI: 0.73; 4.23], p < 0.001) and 52 weeks (+2.86% [95% CI: 1.40; 4.32] vs. +1.45% [0.04; 2.86], p = 0.052) of intervention, compared to the CON group

Summary

Introduction

Lifestyle interventions comprising of exercise and healthy eating have been shown to result in clinically relevant effects regarding body composition and metabolic risk factors [1]. Meal replacement therapies with partial [3,4] or complete replacements, known as very low energy diets [5], have been shown to be effective and appropriate for patients with obesity and related comorbidities This therapy approach leads to improved markers of cardiometabolic risk factors, as recently documented by the ACOORH study group [6,7]. In regard to type 2 diabetes, there is a wealth of data showing clinically relevant effects in terms of remission rates [5] as well as weight reduction and improvement of glucose and insulin levels [1,2,4,12,13,14] Despite these findings, there remains a general controversy about weight maintenance and the long-term effectiveness of weight management programmes [15]. Recent findings from the 2-years followup of the DiRECT-study indicate that structured weight management programs with incorporated formula diets can lead to long-term benefits regarding weight maintenance and medication reduction [16,17]

Methods

Results

Conclusion