title: Partial Meal Replacement Plan and Quality of the Diet at 1 Year: Action for Health in Diabetes (Look AHEAD) Trial.
abstract: BACKGROUND
  Little is known about diet quality with a reduced-energy, low-fat, partial meal replacement plan, especially in individuals with type 2 diabetes. The Action for Health in Diabetes (Look AHEAD) trial implemented a partial meal replacement plan in the Intensive Lifestyle Intervention.
  
  
  OBJECTIVE
  To compare dietary intake and percent meeting fat-related and food group dietary recommendations in Intensive Lifestyle Intervention and Diabetes Support and Education groups at 12 months.
  
  
  METHODS
  A randomized controlled trial comparing Intensive Lifestyle Intervention with Diabetes Support and Education at 0 and 12 months.
  
  
  METHODS
  From 16 US sites, the first 50% of participants (aged 45 to 76 years, overweight or obese, with type 2 diabetes) were invited to complete dietary assessments. Complete 0- and 12-month dietary assessments (collected between 2001 and 2004) were available for 2,397 participants (46.6% of total participants), with 1,186 randomized to Diabetes Support and Education group and 1,211 randomized to Intensive Lifestyle Intervention group.
  
  
  METHODS
  A food frequency questionnaire assessed intake: energy; percent energy from protein, fat, carbohydrate, polyunsaturated fatty acids, and saturated fats; trans-fatty acids; cholesterol; fiber; weekly meal replacements; and daily servings from food groups from the Food Guide Pyramid.
  
  
  METHODS
  Mixed-factor analyses of covariance, using Proc MIXED with a repeated statement, with age, sex, race/ethnicity, education, and income controlled. Unadjusted χ² tests compared percent meeting fat-related and food group recommendations at 12 months.
  
  
  RESULTS
  At 12 months, Intensive Lifestyle Intervention participants had a significantly lower fat and cholesterol intake and greater fiber intake than Diabetes Support and Education participants. Intensive Lifestyle Intervention participants consumed more servings per day of fruits; vegetables; and milk, yogurt, and cheese; and fewer servings per day of fats, oils, and sweets than Diabetes Support and Education participants. A greater percentage of Intensive Lifestyle Intervention participants than Diabetes Support and Education participants met fat-related and most food group recommendations. Within Intensive Lifestyle Intervention, a greater percentage of participants consuming two or more meal replacements per day than participants consuming less than one meal replacement per day met most fat-related and food group recommendations.
  
  
  CONCLUSIONS
  The partial meal replacement plan consumed by Intensive Lifestyle Intervention participants was related to superior diet quality.
authors.forename: Hollie A
authors.initials: HA
authors.lastname: Raynor
authors.forename: Andrea M
authors.initials: AM
authors.lastname: Anderson
authors.forename: Gary D
authors.initials: GD
authors.lastname: Miller
authors.forename: Rebecca
authors.initials: R
authors.lastname: Reeves
authors.forename: Linda M
authors.initials: LM
authors.lastname: Delahanty
authors.forename: Mara Z
authors.initials: MZ
authors.lastname: Vitolins
authors.forename: Patricia
authors.initials: P
authors.lastname: Harper
authors.forename: Connie
authors.initials: C
authors.lastname: Mobley
authors.forename: Kati
authors.initials: K
authors.lastname: Konersman
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Mayer-Davis
mesh_terms: D000368:Aged; D015992:Body Mass Index; D003131:Combined Modality Therapy / Q000009:adverse effects; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000178:diet therapy* / Q000628:therapy; D003927:Diet, Diabetic / Q000009:adverse effects; D018752:Diet, Fat-Restricted / Q000009:adverse effects; D004038:Diet, Reducing / Q000009:adverse effects; D005260:Female; D019648:Foods, Specialized / Q000009:adverse effects; D006801:Humans; D008019:Life Style; D008297:Male; D062407:Meals; D008875:Middle Aged; D009043:Motor Activity; D018673:Nutrition Policy; D009765:Obesity / Q000150:complications / Q000178:diet therapy* / Q000628:therapy; D050177:Overweight / Q000150:complications / Q000178:diet therapy* / Q000628:therapy; D010349:Patient Compliance; D057285:Precision Medicine; D062410:Snacks; D014481:United States
keywords: Diet quality; Lifestyle intervention; Partial meal replacement plan; Type 2 diabetes