Efficacy of meal replacements versus a standard food-based diet for weight loss in type 2 diabetes: a controlled clinical trial.
The purpose of this study is to compare the efficacy of a portion-controlled meal replacement diet (PCD) to a standard diet (SD) based on recommendations by the American Diabetes Association in achieving and maintaining weight loss among obese participants with type 2 diabetes.



This study is a university-based, controlled clinical trial. Participants were 119 men and women with diabetes with a body mass index between 25 and 40 kg/m(2), assigned randomly to one of two 34-week, 75% of predicted energy need diets (portion controlled or standard, self-selected, food based) and then followed by 1-year maintenance.



Using intention-to-treat analyses, weight loss at 34 weeks and weight maintenance at 86 weeks was significantly better on PCD versus SD. Approximately 40% of the PCD participants lost > or =5% of their initial weight compared with 12% of those on the SD. Significant improvements in biochemical and metabolic measures were observed at 34 weeks in both groups. The retention rate and self-reported ease of adherence in the PCD group were significantly higher throughout the study.



A diet using portion-controlled meal replacements yielded significantly greater initial weight loss and less regain after 1 year of maintenance than a standard, self-selected, food-based diet. As PCDs may help obese patients with type 2 diabetes adhere to a weight control program, diabetes educators may consider recommending them as part of a comprehensive approach to weight control.
Cheskin
Lawrence J
LJ
The Johns Hopkins Bloomberg School of Public Health, Department of International Health, Center for Human Nutrition, Baltimore, Maryland
Mitchell
Amy M
AM
The Johns Hopkins Bloomberg School of Public Health, Department of International Health, Center for Human Nutrition, Baltimore, Maryland
Jhaveri
Ami D
AD
The Johns Hopkins Bloomberg School of Public Health, Department of International Health, Center for Human Nutrition, Baltimore, Maryland
Mitola
Andrea H
AH
The Johns Hopkins Bloomberg School of Public Health, Department of International Health, Center for Human Nutrition, Baltimore, Maryland
Davis
Lisa M
LM
The Johns Hopkins Bloomberg School of Public Health, Department of International Health, Center for Human Nutrition, Baltimore, Maryland
Lewis
Rebecca A
RA
The Johns Hopkins Bloomberg School of Public Health, Department of International Health, Center for Human Nutrition, Baltimore, Maryland
Yep
Mary A
MA
The Johns Hopkins Bloomberg School of Public Health, Department of International Health, Center for Human Nutrition, Baltimore, Maryland
Lycan
Thomas W
TW
The Johns Hopkins Bloomberg School of Public Health, Department of International Health, Center for Human Nutrition, Baltimore, Maryland
D000293:Adolescent; D000328:Adult; D000368:Aged; D015142:Baltimore; D003924:Diabetes Mellitus, Type 2 / Q000503:physiopathology* / Q000534:rehabilitation*; D003927:Diet, Diabetic; D002149:Energy Intake; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic; D016896:Treatment Outcome; D015431:Weight Loss