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Selected References on Meal Replacements
In general, published studies and references have concluded
that diets including meal replacements (portion-controlled,
calorie-restricted meals) produce substantially greater weight
loss and weight loss maintenance than traditional diets.
- On average, more than three times as much weight is lost
and maintained using meal replacements as compared to traditional
diets.
- Meal replacements can be used successfully in a variety
of settings and with various treatment populations - e.g.,
by individuals alone, in structured groups, with or without
professional support, and with all medical co-morbidities.
- Importantly, meal replacements also improve dietary compliance
and overall nutritional intake, and they reduce all measured
medical risk factors. Following is a sample of meal replacement
references.
General Weight Loss Success
Blackburn GL, Rothacker
DQ. Ten-year self-management of weight using
a meal replacement diet plan: comparisons with
matched controls. Obes Res 2003;11:A103.
There was a 32.6 pound difference between
individuals who used a meal replacement plan
over 10 years compared to matched controls. Those using meal replacements lost an average
of 6 pounds over the 10 years; those not using
meal replacements gained 26.6 pounds. Participants
were only given information on the use of meal
replacements to lose and maintain weight - no
other instruction was provided. |
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Heymsfield SB, van Mierlo
CAJ, van der Knaap HCM, Heo M, Frier HI. Weight
management using a meal replacement strategy;
meta and pooling analysis from six studies.
Int J Obes 2003;27:537-549.
This meta-analysis of six studies found significantly
greater weight loss in subjects using partial
meal replacement plans (PMR) vs. conventional
reduced calorie diets. The dropout rate
was equivalent at 3 months but significantly
less in the meal replacement group at one year.
The authors concluded that "our findings
demonstrate the important potential of well-developed
PMR products and plans as a means of weight
control." |
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Ditschuneit HH, Flechtner-Mors
M, Johnson TD, Adler G. Metabolic and weight
loss effects of long-term dietary intervention
in obese patients. Am J Clin Nutr 1999;69:198-204.
In a prospective randomized study, obese
patients who used four meal replacements per
day (two meals and two snacks) for three
months lost five times more weight than those
who were on a conventional low-calorie diet (15.6 pounds vs. 2.9 pounds). Both groups
then used two meal replacements (one meal
and one snack) and, on average, all continued
to lose weight long term (24-month maintenance
phase). Additionally, by the end of the study,
both groups experienced significant reductions
in blood pressure, glucose, and insulin. |
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Bray GA. Treatment and
secondary prevention of obesity (editorial).
Nutr 2000;16:384-385. Hill JO. Long-term weight
control with meal replacements (editorial).
Nutr 2000;16:385.
In these two editorials the authors supported
the effectiveness of meal replacements as a
simple and minimal intervention. As Bray noted,
the long-term results imply that "the subjects
were continuing to treat themselves, which is
the hallmark of success for primary treatment
of obesity and for secondary prevention of weight
regain". Hill concluded that, "in
this study, a minimal intervention [i.e., meal
replacements] had a significant impact on body
weight". Commenting on the practical value
of meal replacements, he stated that "we
need to evaluate more of these 'real-life' interventions
that have the potential to be translated into
other settings". |
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Wadden TA, Berkowitz
RI, Sarwer DB, Prus-Wisniewski R, Steinberg
C. Benefits of lifestyle modification in the
pharmacologic treatment of obesity. Arch Intern
Med 2001;161:218-227.
In a one-year randomized trial of 53 obese
women, those who used meal replacements for four months in conjunction with group lifestyle
modification and obesity medications lost
four times more weight than women who used medications
alone (36.5 vs. 8.4 pounds). |
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Rothacker DQ, Staniszewski
BA, Ellis PK. Liquid meal replacement vs. traditional
food: A Potential model for women who cannot
maintain eating habit change. J Am Diet Assoc
2001;101:345-347.
Seventy-five overweight women were randomized
to either a recommended 1200 calorie/day diet
of low fat foods or a similar diet with at least
one meal replacement per day for one year. There
was no other intervention. After 12 weeks, the
meal replacement group lost significantly more
weight than the diet group, and, after one year,
the meal replacement group maintained their
initial weight loss whereas the traditional
diet group regained most of their weight loss. "In this study, having food consumption
controlled at one meal was enough to keep the
weight from coming back." |
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Allison DB, Gadbury
G, Schwartz LG, Murugesan R, Kraker JL, Heshka
S, Fontaine KR, Heymsfield SB. A novel soy-based
meal replacement formula for weight loss among
obese individuals: a randomized controlled clinical
trial. Eur J Clin Nutr 2003;571514-522.
One hundred obese patients using five meal
replacement shakes a day (along with fruits
and vegetables) lost significantly more weight
after 12 weeks than those following a conventional
low calorie diet. The meal replacement group
also had a greater change in total and LDL cholesterol. |
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Ryttig KR, Rossner S.
Weight maintenance after a very low-calorie
diet (VLCD) weight reduction period and the
effects of VLCD supplementation: A prospective,
randomized, comparative, controlled long-term
trial. J Int Med 1995;238:299-306.
Fifty-two patients who had used a VLCD for
12 weeks were then randomized to a 1600-calorie
maintenance diet - one group with and one without
the inclusion of two daily liquid supplements. After one year, the group using two daily
supplements kept off more of their weight loss
than the group using no supplement. |
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Safely Used in Type 2 Diabetes
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Redmon JB, Raatz SK,
Reck KP, Swamson JE, Kwong CA, Fan Q, Thomas
W, Bantle JP. One-year outcome of a combination
of weight loss therapies for subjects with type
2 diabetes. Diabetes Care 2003;26:2505-2511.
Overweight individuals with type 2 diabetes
lost significantly more weight and improved
diabetes control with a combination therapy
that included meal replacements compared with
a standard weight loss program. |
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Yip I, Go VLW, DeShields
S, et al. Liquid meal replacements and glycemic
control in obese type 2 diabetes patients. Obes
Res 2001;9(suppl 4):341S-347S.
Fifty-seven patients with type 2 diabetes
used either meal replacements (two meal replacement
shakes and one portion-controlled dinner high
in fruits and vegetables per day) or a calorically-restricted
diet (American Diabetes Association Exchange
Diet) for 12 weeks. Both diets results in significant
weight loss demonstrating that meal replacements
can be used safely for weight loss in obese
type 2 diabetics. The meal replacement group
had greater weight and fat mass loss and reductions
in fasting glucose compared to the ADA group. |
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Li Z, Hong K, Thames
G, Minutti C, Heber D. Meal replacements but
not individualized exchange plan diets result
in reductions in C-reactive protein (hsCRP)
levels in obese patients with type 2 diabetes.
Obes Res 2003;11(suppl):A50.
Meal replacement use resulted in greater weight
loss over 24 weeks than individualized diet
plans in obese patients with type 2 diabetes.
This resulted in significant improvements in
C-reactive protein, insulin sensitivity, and
lipid levels. |
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Reynolds LR, Konz ED,
Frederich RC, Anderson JW. Rosiglitazone amplifies
the benefits of lifestyle intervention measures
in long-standing type 2 diabetes mellitus. Diabetes
Obes Metab 2002;4:270-275.
Patients with long-standing, poorly controlled
type 2 diabetes requiring insulin therapy participated
in a 6-month structured program incorporating
meal replacements (three shakes and two pre-packaged
entrees per day), fruits and vegetables, and
physical activity. The average weight loss of
20.2 pounds led to substantial reductions in
multiple cardiovascular risk factors along with
a 14.1 unit/day average decrease in insulin
dose and an average decrease in HbA1c of 1.2
percentage points. |
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Reynolds LR, Konz ED,
Frederich RC, Anderson JW. Rosiglitazone amplifies
the benefits of lifestyle intervention measures
in long-standing type 2 diabetes mellitus. Diabetes
Obes Metab 2002;4:270-275.
Patients with long-standing, poorly controlled
type 2 diabetes requiring insulin therapy participated
in a 6-month structured program incorporating
meal replacements (three shakes and two pre-packaged
entrees per day), fruits and vegetables, and
physical activity. The average weight loss of
20.2 pounds led to substantial reductions in
multiple cardiovascular risk factors along with
a 14.1 unit/day average decrease in insulin
dose and an average decrease in HbA1c of 1.2
percentage points. |
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Used Successfully in a Variety
of Settings
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Ashley JM, St. Jeor
ST, Schrage JP, Perumean-Chaney SE, Gilbertson
MC, McCall NL, Bovee V. Weight control in the
physician's office. Arch Intern Med 2001;161:1599-1604.
A primary care office intervention that included
brief physician/nurse visits and the use of
meal replacements was as effective as a traditional
group intervention without meal replacements.
Furthermore, overweight women using meal
replacements in a traditional lifestyle-based
group lost more than twice as much weight and
maintained significantly more of the weight
loss after one year than women not using meal
replacements. The average weight loss in
the meal replacement group was 9.1% of initial
body weight, with substantial improvements in
medical risk factors. |
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Winick C, Rothacker
DQ, Normal RL. Four worksite weight loss programs
with high-stress occupations using a meal replacement
product. Occup Med 2002;52:25-30.
Nearly 500 employees in four different occupational
groups who used meal replacements (shakes
and nutrition bars) on their own, lost an
average of 16 pounds in 12 weeks. The retention
of weight loss was considerable, particularly
in the airline personnel, 2/3 of whom had retained
>80% of their weight loss after one year,
and half of these weighed less than at week
12. |
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Cho S, Alberding J,
Sadler B, Johnson KJ, Clark C. Worksite weight
loss program with meal and snack replacement
system: twelve week results. Am J Clin Nutr
2002;75:383S.
Employees at a worksite were randomized to a
1200-calorie/day diet or a similar caloric meal
replacement plan. The meal replacement group
lost more weight and showed greater reductions
in systolic blood pressure and cholesterol.
The participants found the meal replacements
"made a weight loss program simple and
easy to follow." |
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Goffhelf L, Ringie L,
Jacobsen D. Coaching a weight loss group over
the telephone: a successful treatment option.
Obes Res 2003;11:A84.
Participants in a phone-based weight loss program
incorporating meal replacements (3 shakes and
2 pre-packaged entrees per day) lost an average
of 16 pounds in 6 weeks or 7.5% of initial body
weight. These results were virtually identical
to those of participants in a clinic using the
same weight loss program. |
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Improve Dietary Compliance,
Nutritional Intake, and Reduce Risk Factors
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Ashley JM, St. Jeor
ST, Perumean-Chaney SE, Schrage JP, Bovee V.
Meal replacements in weight intervention. Obes
Res 2001;9 (suppl 4):312S-320S.
In the second year (maintenance) of an earlier
study, women using meal replacements maintained
more weight loss than those not using meal replacements. Those using meal replacements within the
structure of a lifestyle group maintained significantly
more weight loss (8.5% of initial body weight)
than all the others. Furthermore, women using
meal replacements in the group showed
an increased intake of micronutrients as well
as significant increases in vegetable and fruit
servings. |
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Flechtner-Mors M, Ditschuneit
H, Johnson T, Suchard M, Adler G. Metabolic
and weight loss effects of long-term dietary
intervention in obese patients: four year results.
Obes Res 2000;8:399-402.
In a continuation of an earlier study, two
meal replacements (one meal and one snack) daily were effective in maintaining weight
loss and sustaining healthy eating (reduced
energy, fat, and cholesterol intake) for a period
of four years. "From the health point
of view, the most important observation is that
continued use of a meal replacement strategy
can improve several important biomarkers of
disease risk for an extended time" (e.g.,
glucose, insulin, lipids, and blood pressure).
Furthermore, the continued use of meal replacements
prevented weight gain in those who dropped out
and then re-entered the program. |
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Rothacker DQ, McPartlan
L. Improved intakes of calcium with reduced
fat in adults using one daily meal replacement
shake. Obes Res 1999;7 (suppl 1):96S.
Food diaries were analyzed on designated meal
replacement days (using a meal replacement shake
for the first meal of the day) and control days
for 117 adults. By simply adding one meal
replacement shake a day, a significantly
greater percent of adults (52% vs. NIH's estimate
of 19%) were able to meet the 1000 mg/day guideline
for calcium. The average daily intake of
calcium increased by almost 300 mg, while calories
and fat were consistently lower. |
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Metz JA, Stern, JS,
Kris-Etherton P, et al. A randomized trial of
improved weight loss with a prepared meal plan
in overweight and obese patients. Arch Intern
Med 2000;160:2150-2158.
This year-long, randomized, clinical trial to
test the effect of a prepared meal plan on weight
loss included 302 patients with hypertension
and dyslipidemia or type 2 diabetes. "The
results demonstrate that the prepared meal plan
is more effective in inducing weight loss in
such subjects than a macronutrient-equivalent
UCD (usual care diet). The greater weight
loss in the prepared meal plan group likely
reflects, in part, better dietary compliance
and thus, greater sustained reductions in energy
and fat intake. Furthermore, the prepared meal
plan was more effective in improving multiple
risk factors and in enhancing quality of life. |
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McCarron DA, Oparil
S, Chait A, et al. Nutritional management of
cardiovascular risk factors. Arch Intern Med
1997;157:169-177.
The purpose of this muticenter trial (see also
Metz above) was to assess the clinical effects
of a total dietary plan designed to meet the
nutritional recommendations of major U.S. health
organizations for cardiovascular risk reduction.
The use of prepackaged meals for 10 weeks was
compared to a nutritionist-guided self-selected
diet in people with hypertension, dyslipidemia,
diabetes, or a combination of these conditions. The prepackaged plan resulted in greater
clinical benefits, weight loss, nutritional
completeness, and compliance than the self-selected
diet. Most significant was the impact of
the food plans on achieving simultaneous reductions
in multiple cardiovascular risk factors. |
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Mattes RD. Ready-to-eat
cereal used as meal replacement promotes weight
loss in humans. AJ Am Coll Nutr 2002;21:570-577.
A ready-to-eat cereal, used as a portion-controlled
meal replacement twice a day for two weeks,
led to lowered calorie intake and therefore,
greater weight loss as compared to control groups.
This study lends further support that meal
replacements provide "a conceptually simply
regimen, high palatability, relatively low cost,
and wide availability." |
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Replacements Online!
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