title: Intermittent versus on-demand use of a very low calorie diet: a randomized 2-year clinical trial.
abstract: OBJECTIVE
  To compare two different very low calorie diet (VLCD)-based weight maintenance strategies.
  
  
  METHODS
  A randomized 2-year clinical trial performed at the Department of Body Composition and Metabolism, Sahlgrenska University Hospital, Sweden.
  
  
  METHODS
  A total of 334 patients, body mass index (BMI) >30 kg m-2, aged 18-60 years.
  
  
  METHODS
  All the patients started with 16 VLCD weeks. Subjects in the intermittent group were then scheduled to use VLCD for 2 weeks every third month, whilst patients in the on-demand group were instructed to use VLCD whenever their body weight passed an individualized cut-off level. Irrespective of the treatment group, all the subjects were recommended a hypocaloric diet during VLCD-free periods.
  
  
  METHODS
  Changes in body weight, body composition, anthropometric variables and cardiovascular risk factors.
  
  
  RESULTS
  Completers in both groups maintained highly significant weight losses after 2 years: 7.0 +/- 11.0 kg (6.2 +/- 9.5%) in the intermittent group and 9.1 +/- 9.7 kg (7.7 +/- 8.1%) in the on-demand group (P < 0.001, ns between groups). Male completers in the on-demand group lost significantly more weight than men in the intermittent group, 14.5 +/- 11.0 kg vs. 4.0 +/- 10.5 kg, respectively (P < 0.01). Most cardiovascular risk factors improved during the first year, whilst anthropometric measures, insulin, HDL- and LDL-cholesterol were also significantly improved after 2 years of treatment.
  
  
  CONCLUSIONS
  Clinically significant weight reductions were achieved after 2 years of VLCD-based treatment. The structure of VLCD treatment during the maintenance phase did not affect weight loss in the total study population, whilst male subjects might benefit from the VLCD on-demand strategy.
authors.affiliation: Department of Body Composition and Metabolism, Sahlgrenska University Hospital, Göteborg, Sweden.
authors.forename: H
authors.initials: H
authors.lastname: Lantz
authors.forename: M
authors.initials: M
authors.lastname: Peltonen
authors.forename: L
authors.initials: L
authors.lastname: Agren
authors.forename: J S
authors.initials: JS
authors.lastname: Torgerson
mesh_terms: D000293:Adolescent; D000328:Adult; D001823:Body Composition; D015992:Body Mass Index; D001835:Body Weight; D031204:Caloric Restriction / Q000379:methods; D002318:Cardiovascular Diseases / Q000209:etiology; D016001:Confidence Intervals; D004038:Diet, Reducing; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000178:diet therapy*; D010352:Patient Dropouts; D012307:Risk Factors; D055502:Secondary Prevention; D012737:Sex Factors