Abstract
Very low energy diets (VLEDs), commonly achieved by replacing all food with meal replacement products and which result in fast weight loss, are the most effective dietary obesity treatment available. VLEDs are also cheaper to administer than conventional, food-based diets, which result in slow weight loss. Despite being effective and affordable, these diets are underutilized by healthcare professionals, possibly due to concerns about potential adverse effects on body composition and eating disorder behaviors. This paper describes the rationale and detailed protocol for the TEMPO Diet Trial (Type of Energy Manipulation for Promoting optimal metabolic health and body composition in Obesity), in a randomized controlled trial comparing the long-term (3-year) effects of fast versus slow weight loss. One hundred and one post-menopausal women aged 45–65 years with a body mass index of 30–40 kg/m2 were randomized to either: (1) 16 weeks of fast weight loss, achieved by a total meal replacement diet, followed by slow weight loss (as for the SLOW intervention) for the remaining time up until 52 weeks (“FAST” intervention), or (2) 52 weeks of slow weight loss, achieved by a conventional, food-based diet (“SLOW” intervention). Parameters of body composition, cardiometabolic health, eating disorder behaviors and psychology, and adaptive responses to energy restriction were measured throughout the 3-year trial.
Highlights
The worldwide prevalence of obesity is increasing at an alarming rate [1]
Weight loss can usually be achieved through lifestyle interventions, the overwhelming majority of people regain the weight lost over the long-term
Energy restriction and weight loss induce adaptive responses in neuroendocrine status that may have adverse consequences on body composition, such as loss of bone mineral density (BMD) and lean mass, as well as muscle strength, and promote regain of visceral adipose tissue (VAT), in turn increasing the risk of cardiometabolic diseases such as type 2 diabetes and cardiovascular disease [15]
Summary
Obesity is associated with a number of complications including type 2 diabetes, cardiovascular disease as well as many cancers [2], and is responsible for significant health care costs [1,3]. Energy restriction and weight loss induce adaptive responses in neuroendocrine status that may have adverse consequences on body composition, such as loss of bone mineral density (BMD) and lean mass, as well as muscle strength (which together potentially increase the risk of osteoporosis, sarcopenia and frailty), and promote regain of visceral adipose tissue (VAT), in turn increasing the risk of cardiometabolic diseases such as type 2 diabetes and cardiovascular disease [15]
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