title: Efficacy of meal replacements versus a standard food-based diet for weight loss in type 2 diabetes: a controlled clinical trial.
abstract: 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.
authors.affiliation: The Johns Hopkins Bloomberg School of Public Health, Department of International Health, Center for Human Nutrition, Baltimore, Maryland
authors.forename: Lawrence J
authors.initials: LJ
authors.lastname: Cheskin
authors.affiliation: The Johns Hopkins Bloomberg School of Public Health, Department of International Health, Center for Human Nutrition, Baltimore, Maryland
authors.forename: Amy M
authors.initials: AM
authors.lastname: Mitchell
authors.affiliation: The Johns Hopkins Bloomberg School of Public Health, Department of International Health, Center for Human Nutrition, Baltimore, Maryland
authors.forename: Ami D
authors.initials: AD
authors.lastname: Jhaveri
authors.affiliation: The Johns Hopkins Bloomberg School of Public Health, Department of International Health, Center for Human Nutrition, Baltimore, Maryland
authors.forename: Andrea H
authors.initials: AH
authors.lastname: Mitola
authors.affiliation: The Johns Hopkins Bloomberg School of Public Health, Department of International Health, Center for Human Nutrition, Baltimore, Maryland
authors.forename: Lisa M
authors.initials: LM
authors.lastname: Davis
authors.affiliation: The Johns Hopkins Bloomberg School of Public Health, Department of International Health, Center for Human Nutrition, Baltimore, Maryland
authors.forename: Rebecca A
authors.initials: RA
authors.lastname: Lewis
authors.affiliation: The Johns Hopkins Bloomberg School of Public Health, Department of International Health, Center for Human Nutrition, Baltimore, Maryland
authors.forename: Mary A
authors.initials: MA
authors.lastname: Yep
authors.affiliation: The Johns Hopkins Bloomberg School of Public Health, Department of International Health, Center for Human Nutrition, Baltimore, Maryland
authors.forename: Thomas W
authors.initials: TW
authors.lastname: Lycan
mesh_terms: 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