title: Metabolic and weight-loss effects of a long-term dietary intervention in obese patients.
abstract: BACKGROUND
  Obesity is a chronic disease that has become one of the most serious health problems in Western society.
  
  
  OBJECTIVE
  We assessed the long-term effects of an energy-restricted diet combined with 1 or 2 daily meal replacements on body weight and biomarkers of disease risk in 100 obese patients.
  
  
  METHODS
  Phase 1 consisted of a 3-mo, prospective, randomized, parallel intervention study of 2 dietary interventions to reduce weight. The energy-restricted diet (5.2-6.3 MJ/d) consisted of conventional foods (group A) or an isoenergetic diet with 2 meals and 2 snacks replaced daily by energy-controlled, vitamin-and-mineral-supplemented prepared foods (group B). Phase 2 consisted of a 24-mo, case-control, weight-maintenance study with an energy-restricted diet and 1 meal and 1 snack replaced daily for all patients.
  
  
  RESULTS
  Total weight loss (as a percentage of initial body weight) was 5.9+/-5.0% in group A and 11.3+/-6.8% in group B (P < 0.0001). During phase 1, mean weight loss in group B (n = 50) was 7.1+/-3.5 kg, with significant reductions in plasma triacylglycerol, glucose, and insulin concentrations (P < 0.0001). Group A patients (n = 50) lost an average of 1.3+/-2.2 kg with no significant improvements in these biomarkers. During phase 2, both groups lost on average an additional 0.07% of their initial body weight every month (P < 0.01). During the 27-mo study, both groups experienced significant reductions in systolic blood pressure and plasma concentrations of triacylglycerol, glucose, and insulin (P < 0.01).
  
  
  CONCLUSIONS
  These findings support the hypothesis that defined meal replacements can be used for successful, long-term weight control and improvements in certain biomarkers of disease risk.
authors.affiliation: University Hospital, Department of Medicine, University Ulm, Germany. herwig.ditschuneit@medizin.uni-ulm.de
authors.forename: H H
authors.initials: HH
authors.lastname: Ditschuneit
authors.forename: M
authors.initials: M
authors.lastname: Flechtner-Mors
authors.forename: T D
authors.initials: TD
authors.lastname: Johnson
authors.forename: G
authors.initials: G
authors.lastname: Adler
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism; D001794:Blood Pressure / Q000502:physiology; D015930:Diet Records; D004038:Diet, Reducing; D005260:Female; D006801:Humans; D007328:Insulin / Q000097:blood; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000097:blood* / Q000178:diet therapy* / Q000503:physiopathology; D012307:Risk Factors; D014280:Triglycerides / Q000097:blood; D015431:Weight Loss