title: A randomized trial of improved weight loss with a prepared meal plan in overweight and obese patients: impact on cardiovascular risk reduction.
abstract: OBJECTIVE
  To assess the long-term effects of a prepackaged, nutritionally complete, prepared meal plan compared with a usual-care diet (UCD) on weight loss and cardiovascular risk factors in overweight and obese persons.
  
  
  METHODS
  In this randomized multicenter study, 302 persons with hypertension and dyslipidemia (n = 183) or with type 2 diabetes mellitus (n = 119) were randomized to the nutrient-fortified prepared meal plan (approximately 22% energy from fat, 58% from carbohydrate, and 20% from protein) or to a macronutrient-equivalent UCD.
  
  
  METHODS
  The primary outcome measure was weight change. Secondary measures were changes in blood pressure or plasma lipid, lipoprotein, glucose, or glycosylated hemoglobin levels; quality of life; nutrient intake; and dietary compliance.
  
  
  RESULTS
  After 1 year, weight change in the hypertension/dyslipidemia group was -5.8+/-6.8 kg with the prepared meal plan vs -1.7+/-6.5 kg with the UCD plan (P<.001); for the type 2 diabetes mellitus group, the change was -3.0+/-5.4 kg with the prepared meal plan vs -1.0+/-3.8 kg with the UCD plan (P<.001) (data given as mean +/- SD). In both groups, both interventions improved blood pressure, total and low-density lipoprotein cholesterol levels, glycosylated hemoglobin level, and quality of life (P<.02); in the diabetic group, the glucose level was reduced (P<.001). Compared with those in the UCD group, participants with hypertension/dyslipidemia in the prepared meal plan group showed greater improvements in total (P<.01) and high-density lipoprotein (P<.03) cholesterol levels, systolic blood pressure (P<.03), and glucose level (P<.03); in participants with type 2 diabetes mellitus, there were greater improvements in glucose (P =.046) and glycosylated hemoglobin (P<.02) levels. The prepared meal plan group also showed greater improvements in quality of life (P<.05) and compliance (P<.001) than the UCD group.
  
  
  CONCLUSIONS
  Long-term dietary interventions induced significant weight loss and improved cardiovascular risk in high-risk patients. The prepared meal plan simultaneously provided the simplicity and nutrient composition necessary to maintain long-term compliance and to reduce cardiovascular risk.
authors.affiliation: Division of Nephrology, Hypertension, and Clinical Pharmacology, Suite 262, Oregon Health Sciences University, 3314 SW Veterans Hospital Rd, Portland, OR 97201-2940. metzj@ohsu.edu.
authors.forename: J A
authors.initials: JA
authors.lastname: Metz
authors.forename: J S
authors.initials: JS
authors.lastname: Stern
authors.forename: P
authors.initials: P
authors.lastname: Kris-Etherton
authors.forename: M E
authors.initials: ME
authors.lastname: Reusser
authors.forename: C D
authors.initials: CD
authors.lastname: Morris
authors.forename: D C
authors.initials: DC
authors.lastname: Hatton
authors.forename: S
authors.initials: S
authors.lastname: Oparil
authors.forename: R B
authors.initials: RB
authors.lastname: Haynes
authors.forename: L M
authors.initials: LM
authors.lastname: Resnick
authors.forename: F X
authors.initials: FX
authors.lastname: Pi-Sunyer
authors.forename: S
authors.initials: S
authors.lastname: Clark
authors.forename: L
authors.initials: L
authors.lastname: Chester
authors.forename: M
authors.initials: M
authors.lastname: McMahon
authors.forename: G W
authors.initials: GW
authors.lastname: Snyder
authors.forename: D A
authors.initials: DA
authors.lastname: McCarron
mesh_terms: D000328:Adult; D000368:Aged; D002318:Cardiovascular Diseases / Q000097:blood / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control*; D004032:Diet; D005260:Female; D005518:Food Preferences; D005527:Food, Fortified; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D009753:Nutritive Value; D009765:Obesity / Q000150:complications / Q000178:diet therapy*; D010349:Patient Compliance; D011788:Quality of Life; D012307:Risk Factors; D016896:Treatment Outcome; D015431:Weight Loss
chemical_list: D008055:Lipids