title: Effect of meal replacement on metabolic risk factors in overweight and obese subjects.
abstract: OBJECTIVE
  Our objective was to assess alterations in metabolic risk factors, body weight, fat mass and hormonal parameters following 6 weeks of lifestyle intervention with increased physical activity and either a meal-replacement regimen or a low calorie diet.
  
  
  METHODS
  90 overweight or obese subjects (age 47 +/- 7.5 years, weight 90.6 +/- 11.3 kg, BMI 31.5 +/- 2.3) were included in this randomized controlled clinical trial. Subjects in the fat-restricted low-calorie-diet group (LCD-G; n = 30) received 2 dietary counseling sessions and instructions on how to increase physical activity. Subjects in the meal-replacement-diet group (MRD-G; n = 60) received the same lifestyle education and were instructed to replace 2 daily meals by a low-calorie high soy-protein drink.
  
  
  RESULTS
  Subjects in the MRD-G lost significantly more weight (6.4 vs. 3.1 kg, p < 0.01) and fat mass (5.1 vs. 2.8 kg, p < 0.01) than the LCD-G. Most metabolic risk parameters were reduced in both the MRD-G and the LCD-G; however, subjects in the MRD-G showed a higher reduction in waist circumference (6.1 vs. 1.8 cm, p < 0.01) and a larger decrease in triglycerides (-19.6 vs. +12.5 mg/dl, p < 0.01). The prevalence of the metabolic syndrome was reduced in subjects in the MRD-G only (-12%, p < 0.05) compared to an unchanged risk score in the LCD-G. The reductions in leptin (18.2 vs. 6.97 ng/ml) and insulin (4.92 vs. 0.58 microU/ml) were only significant in the MRD-G (p < 0.01).
  
  
  CONCLUSIONS
  Our data suggest that even over a short period of time, a meal-replacement diet is more effective in reducing metabolic risk factors, insulin, and leptin, and in improving anthropometric measures than a fat-restricted low-calorie diet.
authors.affiliation: University Hospital Freiburg, Centre for Internal Medicine, Department of Rehabilitation, Prevention and Sports Medicine, Freiburg, Germany. Daniel.Koenig@uniklinik-freiburg.de
authors.forename: Daniel
authors.initials: D
authors.lastname: König
authors.forename: Peter
authors.initials: P
authors.lastname: Deibert
authors.forename: Ingrid
authors.initials: I
authors.lastname: Frey
authors.forename: Ulrike
authors.initials: U
authors.lastname: Landmann
authors.forename: Aloys
authors.initials: A
authors.lastname: Berg
mesh_terms: D001786:Blood Glucose / Q000378:metabolism; D001823:Body Composition / Q000187:drug effects*; D015992:Body Mass Index; D004038:Diet, Reducing; D004734:Energy Metabolism; D015444:Exercise / Q000502:physiology; D005260:Female; D005526:Food, Formulated; D006801:Humans; D007328:Insulin / Q000097:blood; D020738:Leptin / Q000097:blood; D008297:Male; D024821:Metabolic Syndrome / Q000209:etiology / Q000517:prevention & control; D008875:Middle Aged; D009765:Obesity / Q000097:blood / Q000150:complications / Q000178:diet therapy*; D050177:Overweight / Q000097:blood / Q000150:complications / Q000178:diet therapy*; D030262:Soybean Proteins; D015431:Weight Loss / Q000187:drug effects*
chemical_list: D001786:Blood Glucose; D007328:Insulin; D020738:Leptin; D030262:Soybean Proteins