title: Efficacy of a meal-replacement program for promoting blood lipid changes and weight and body fat loss in US Army soldiers.
abstract: Excess weight is associated with negative health outcomes. Meal replacements are effective in promoting favorable body composition changes in civilian populations; however, their efficacy with military service members who have unique lifestyles is unknown. The objective of this randomized controlled trial was to determine the efficacy of the Army's education-based weight-management program, "Weigh to Stay," with and without meal replacements for improving blood lipids, and to promote weight and body fat loss in overweight US Army soldiers. Soldiers (n=113; 76 males/37 females) attending Weigh to Stay at Fort Bragg, NC, in 2006/2007 were randomized to Weigh to Stay only or a commercially available meal-replacement program (two meal replacements per day) in conjunction with Weigh to Stay, and followed until Army body fat standards were met or for 6 months if standards were not met. Study completers (n=46) in both treatment groups lost weight (Weigh to Stay: -2.7+/-4.3 kg; meal replacers: -3.8+/-3.5 kg) and fat mass (Weigh to Stay, -2.7+/-3.2 kg; meal replacers: -2.9+/-2.5 kg), and improved high-density lipoprotein cholesterol concentrations (Weigh to Stay: 13+/-9 mg/dL [0.34+/-0.23 mmol/L]; meal replacers: 8+/-7 mg/dL [0.21+/-0.18 mmol/L]; P<0.05); however, no between-group differences were observed. Attrition was lower (P=0.009) and success in meeting body fat standards tended to be higher (P=0.06) for the meal replacers vs Weigh to Stay participants. Intent-to-treat analysis demonstrated that meal replacers lost more weight (1.2+/-0.5 kg), percent body fat (1.0%+/-0.4%), and fat mass (0.8+/-0.4 kg) compared to Weigh to Stay volunteers (P<0.05). Our findings suggest that meal replacement use can be recommended as a potential adjunct strategy to Weigh to Stay.
authors.affiliation: Military Nutrition Division, US Army Research Institute of Environmental Medicine, Natick, MA 01760, USA. Tracey.j.smith@us.army.mil
authors.forename: Tracey J
authors.initials: TJ
authors.lastname: Smith
authors.forename: Lori D
authors.initials: LD
authors.lastname: Sigrist
authors.forename: Gaston P
authors.initials: GP
authors.lastname: Bathalon
authors.forename: Susan
authors.initials: S
authors.lastname: McGraw
authors.forename: J Philip
authors.initials: JP
authors.lastname: Karl
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Young
mesh_terms: D000273:Adipose Tissue / Q000378:metabolism*; D000328:Adult; D001823:Body Composition / Q000502:physiology; D002784:Cholesterol / Q000097:blood*; D008076:Cholesterol, HDL / Q000097:blood; D004038:Diet, Reducing; D015444:Exercise / Q000502:physiology; D005260:Female; D005526:Food, Formulated; D006801:Humans; D008297:Male; D008889:Military Personnel; D009747:Nutritional Physiological Phenomena / Q000502:physiology; D052756:Nutritional Sciences / Q000193:education; D009765:Obesity / Q000097:blood / Q000178:diet therapy; D050177:Overweight / Q000097:blood* / Q000178:diet therapy*; D010349:Patient Compliance; D016896:Treatment Outcome; D014481:United States; D015431:Weight Loss / Q000502:physiology
chemical_list: D008076:Cholesterol, HDL; D002784:Cholesterol