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
ABSTRACT 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).
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.
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.
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.
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ABSTRACT: This article provides an overview of research regarding adult behavioral lifestyle intervention for obesity treatment. We first describe two trials using a behavioral lifestyle intervention to induce weight loss in adults, the Diabetes Prevention Program (DPP) and the Look AHEAD (Action for Health in Diabetes) trial. We then review the three main components of a behavioral lifestyle intervention program: behavior therapy, an energy- and fat-restricted diet, and a moderate- to vigorous-intensity physical activity prescription. Research regarding the influence of dietary prescriptions focusing on macronutrient composition, meal replacements, and more novel dietary approaches (such as reducing dietary variety and energy density) on weight loss is examined. Methods to assist with meeting physical activity goals, such as shortening exercise bouts, using a pedometer, and having access to exercise equipment within the home, are reviewed. To assist with improving weight loss outcomes, broadening activity goals to include resistance training and a reduction in sedentary behavior are considered. To increase the accessibility of behavioral lifestyle interventions to treat obesity in the broader population, translation of efficacious interventions such as the DPP, must be undertaken. Translational studies have successfully altered the DPP to reduce treatment intensity and/or used alternative modalities to implement the DPP in primary care, worksite, and church settings; several examples are provided. The use of new methodologies or technologies that provide individualized treatment and real-time feedback, and which may further enhance weight loss in behavioral lifestyle interventions, is also discussed.Health Services Insights 05/2013; 6:15-31. DOI:10.4137/HSI.S10474
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ABSTRACT: Background: The high protein (HP) breakfast reduced gastric emptying and the most satiat-ing macronutrient appears to be dietary protein. Few studies have investigated the effects of protein to energy ratio in breakfast on mood, alertness and attention. Objective: This study was designed to investigate whether the HP breakfast is more beneficial to mood, alertness and attention of the healthy undergraduate student than adequate-protein (AP) breakfast through the rising body temperature and re-maining stable blood glucose or through other physiologic processes. Methods: Thirteen healthy male undergraduate students (18 -23 y) were studied in a double-blind, randomized crossover design. Blood samples, body tem-perature, satiety, mood and Continuous Per-formance Test (CPT) were assessed after the consumption of two isocaloric breakfasts that differed in their protein and carbohydrate con-tent: an HP breakfast (50%, 30%, and 20% of energy from protein, carbohydrate, and fat, re-spectively) or an AP breakfast (10%, 70%, and 20% of energy from protein, carbohydrate, and fat, respectively). Results: Consumption of an HP breakfast resulted in more steady glucose and insulin than AP breakfast consumption (p < 0.05). Satiety scores and body temperature were higher after HP breakfast consumption (p < 0.05). And most important, the positive mood and CPT scores were higher after HP breakfast than after AP breakfast intake (p < 0.05). Conclusion: HP breakfast can effectively stabilize postprandial serum glucose concentration and elevate post-prandial temperature of healthy male under-graduate students. Our present findings dem-onstrate the relationship between HP breakfast and mood, alertness and attention. This study indicated that HP breakfast may enhance human performance probably by increasing the thermic effect of a food and elevating body temperature.Health 01/2011; 03(06). DOI:10.4236/health.2011.36065 · 0.51 Impact Factor
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ABSTRACT: Background and objectiveWhile weight loss has been shown to reduce obesity-related comorbidity, many weight loss treatments fail. Factors that enhance weight loss success are unknown, particularly in those with asthma. The aim of the study was to identify patient characteristics that predict weight loss success in adults with asthma.Methods Baseline and change in asthma characteristics and eating behaviours were investigated for relationships with weight loss and fat loss using multiple linear regression, in 38 overweight and obese adults with asthma randomized to dietary, exercise or combined interventions targeting weight loss for 10 weeks.ResultsMean ± standard deviation weight loss was 6.6 ± 5.1 kg. Greater %weight loss and %fat loss was achieved in those with poorer asthma-related quality of life at baseline ((rs = 0.398, P = 0.015) and (rs = 0.455, P = 0.005) respectively), with 1.7% greater absolute weight loss at week 10 corresponding to each one unit reduction in the asthma-related quality of life score at baseline. Furthermore, a lower baseline forced expiratory volume in 1 s/forced vital capacity correlated with greater weight loss (rs = 0.398, P = 0.015). Male sex was associated with a 3.6 kg greater weight loss (P = 0.087). Reducing emotional eating during the programme was associated with greater weight loss in women (rs = 0.576, P = 0.010).Conclusions This study demonstrates that individuals with more severe asthma at baseline are more successful in achieving weight loss, which could be a consequence of greater motivation and could be used as a motivational tool within the clinical setting. Gender tailoring of weight loss programmes may be useful to enhance weight loss success. Future studies are urgently needed to establish predictors of long-term weight loss maintenance in those with asthma.Respirology 11/2014; 20(2). DOI:10.1111/resp.12423 · 3.50 Impact Factor