Weight management using a meal replacement strategy: Meta and pooling analysis from six studies

S. B. Heymsfield, C. A J Van Mierlo, H. C M Van Der Knaap, Moonseong Heo, H. I. Frier

Research output: Contribution to journalArticle

373 Citations (Scopus)

Abstract

OBJECTIVE: Although used by millions of overweight and obese consumers, there has not been a systematic assessment on the safety and effectiveness of a meal replacement strategy for weight management. The aim of this study was to review, by use of a meta- and pooling analysis, the existing literature on the safety and effectiveness of a partial meal replacement (PMR) plan using one or two vitamin/mineral fortified meal replacements as well as regular foods for long-term weight management. DESIGN: A PMR plan was defined as a program that prescribes a low calorie (> 800 ≤ 1600 kcal/day) diet whereby one or two meals are replaced by commercially available, energy-reduced product(s) that are vitamin and mineral fortified, and includes at least one meal of regular foods. Randomized, controlled PMR interventions of at least 3 months duration, with subjects 18y of age or older and a BMI ≥ 25 kg/m2, were evaluated. Studies with self-reported weight and height were excluded. Searches in Medline, Embase, and the Cochrane Clinical Trials Register from 1960 to January 2001 and from reference lists identified 30 potential studies for analysis. Of these, six met all of the inclusion criteria and used liquid meal replacement products with the associated plan. Overweight and obese subjects were randomized to the PMR plan or a conventional reduced calorie diet (RCD) plan. The prescribed calorie intake was the same for both groups. Authors of the six publications were contacted and asked to supply primary data for analysis. Primary data from the six studies were used for both meta- and pooling analyses. RESULTS: Subjects prescribed either the PMR or RCD treatment plans lost significant amounts of weight at both the 3-month and 1-year evaluation time points. All methods of analysis indicated a significantly greater weight loss in subjects receiving the PMR plan compared to the RCD group. Depending on the analysis and follow-up duration, the PMR group lost ∼7-8% body weight and the RCD group lost ∼3-7% body weight. A random effects meta-analysis estimate indicated a 2.54 kg (P<0.01) and 2.43 kg (P=0.14) greater weight loss in the PMR group for the 3-month and 1-y periods, respectively. A pooling analysis of completers showed a greater weight loss in the PMR group of 2.54kg (P<0.01) and 2.63 kg (P<0.01) during the same time period. Risk factors of disease associated with excess weight improved with weight loss in both groups at the two time points. The degree of improvement was also dependent on baseline risk factor levels. The dropout rate for PMR and RCD groups was equivalent at 3 months and significantly less in the PMR group at 1 y. No reported adverse events were attributable to either weight loss regimen. CONCLUSION: This first systematic evaluation of randomized controlled trials utilizing PMR plans for weight management suggests that these types of interventions can safely and effectively produce significant sustainable weight loss and improve weight-related risk factors of disease.

Original languageEnglish (US)
Pages (from-to)537-549
Number of pages13
JournalInternational Journal of Obesity
Volume27
Issue number5
DOIs
StatePublished - May 1 2003
Externally publishedYes

Fingerprint

weight control
Meals
Meta-Analysis
weight loss
Weights and Measures
diet
risk factors
Weight Loss
vitamins
Diet
minerals
dropouts
duration
body weight
meta-analysis
clinical trials
data analysis
energy intake
Vitamins
Minerals

Keywords

  • Dietary management
  • Meta-analysis
  • Obesity
  • Pooling analysis
  • Weight loss treatment

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Public Health, Environmental and Occupational Health
  • Endocrinology
  • Food Science
  • Endocrinology, Diabetes and Metabolism

Cite this

Heymsfield, S. B., Van Mierlo, C. A. J., Van Der Knaap, H. C. M., Heo, M., & Frier, H. I. (2003). Weight management using a meal replacement strategy: Meta and pooling analysis from six studies. International Journal of Obesity, 27(5), 537-549. https://doi.org/10.1038/sj.ijo.0802258

Weight management using a meal replacement strategy : Meta and pooling analysis from six studies. / Heymsfield, S. B.; Van Mierlo, C. A J; Van Der Knaap, H. C M; Heo, Moonseong; Frier, H. I.

In: International Journal of Obesity, Vol. 27, No. 5, 01.05.2003, p. 537-549.

Research output: Contribution to journalArticle

Heymsfield, SB, Van Mierlo, CAJ, Van Der Knaap, HCM, Heo, M & Frier, HI 2003, 'Weight management using a meal replacement strategy: Meta and pooling analysis from six studies', International Journal of Obesity, vol. 27, no. 5, pp. 537-549. https://doi.org/10.1038/sj.ijo.0802258
Heymsfield, S. B. ; Van Mierlo, C. A J ; Van Der Knaap, H. C M ; Heo, Moonseong ; Frier, H. I. / Weight management using a meal replacement strategy : Meta and pooling analysis from six studies. In: International Journal of Obesity. 2003 ; Vol. 27, No. 5. pp. 537-549.
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AU - Heymsfield, S. B.

AU - Van Mierlo, C. A J

AU - Van Der Knaap, H. C M

AU - Heo, Moonseong

AU - Frier, H. I.

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N2 - OBJECTIVE: Although used by millions of overweight and obese consumers, there has not been a systematic assessment on the safety and effectiveness of a meal replacement strategy for weight management. The aim of this study was to review, by use of a meta- and pooling analysis, the existing literature on the safety and effectiveness of a partial meal replacement (PMR) plan using one or two vitamin/mineral fortified meal replacements as well as regular foods for long-term weight management. DESIGN: A PMR plan was defined as a program that prescribes a low calorie (> 800 ≤ 1600 kcal/day) diet whereby one or two meals are replaced by commercially available, energy-reduced product(s) that are vitamin and mineral fortified, and includes at least one meal of regular foods. Randomized, controlled PMR interventions of at least 3 months duration, with subjects 18y of age or older and a BMI ≥ 25 kg/m2, were evaluated. Studies with self-reported weight and height were excluded. Searches in Medline, Embase, and the Cochrane Clinical Trials Register from 1960 to January 2001 and from reference lists identified 30 potential studies for analysis. Of these, six met all of the inclusion criteria and used liquid meal replacement products with the associated plan. Overweight and obese subjects were randomized to the PMR plan or a conventional reduced calorie diet (RCD) plan. The prescribed calorie intake was the same for both groups. Authors of the six publications were contacted and asked to supply primary data for analysis. Primary data from the six studies were used for both meta- and pooling analyses. RESULTS: Subjects prescribed either the PMR or RCD treatment plans lost significant amounts of weight at both the 3-month and 1-year evaluation time points. All methods of analysis indicated a significantly greater weight loss in subjects receiving the PMR plan compared to the RCD group. Depending on the analysis and follow-up duration, the PMR group lost ∼7-8% body weight and the RCD group lost ∼3-7% body weight. A random effects meta-analysis estimate indicated a 2.54 kg (P<0.01) and 2.43 kg (P=0.14) greater weight loss in the PMR group for the 3-month and 1-y periods, respectively. A pooling analysis of completers showed a greater weight loss in the PMR group of 2.54kg (P<0.01) and 2.63 kg (P<0.01) during the same time period. Risk factors of disease associated with excess weight improved with weight loss in both groups at the two time points. The degree of improvement was also dependent on baseline risk factor levels. The dropout rate for PMR and RCD groups was equivalent at 3 months and significantly less in the PMR group at 1 y. No reported adverse events were attributable to either weight loss regimen. CONCLUSION: This first systematic evaluation of randomized controlled trials utilizing PMR plans for weight management suggests that these types of interventions can safely and effectively produce significant sustainable weight loss and improve weight-related risk factors of disease.

AB - OBJECTIVE: Although used by millions of overweight and obese consumers, there has not been a systematic assessment on the safety and effectiveness of a meal replacement strategy for weight management. The aim of this study was to review, by use of a meta- and pooling analysis, the existing literature on the safety and effectiveness of a partial meal replacement (PMR) plan using one or two vitamin/mineral fortified meal replacements as well as regular foods for long-term weight management. DESIGN: A PMR plan was defined as a program that prescribes a low calorie (> 800 ≤ 1600 kcal/day) diet whereby one or two meals are replaced by commercially available, energy-reduced product(s) that are vitamin and mineral fortified, and includes at least one meal of regular foods. Randomized, controlled PMR interventions of at least 3 months duration, with subjects 18y of age or older and a BMI ≥ 25 kg/m2, were evaluated. Studies with self-reported weight and height were excluded. Searches in Medline, Embase, and the Cochrane Clinical Trials Register from 1960 to January 2001 and from reference lists identified 30 potential studies for analysis. Of these, six met all of the inclusion criteria and used liquid meal replacement products with the associated plan. Overweight and obese subjects were randomized to the PMR plan or a conventional reduced calorie diet (RCD) plan. The prescribed calorie intake was the same for both groups. Authors of the six publications were contacted and asked to supply primary data for analysis. Primary data from the six studies were used for both meta- and pooling analyses. RESULTS: Subjects prescribed either the PMR or RCD treatment plans lost significant amounts of weight at both the 3-month and 1-year evaluation time points. All methods of analysis indicated a significantly greater weight loss in subjects receiving the PMR plan compared to the RCD group. Depending on the analysis and follow-up duration, the PMR group lost ∼7-8% body weight and the RCD group lost ∼3-7% body weight. A random effects meta-analysis estimate indicated a 2.54 kg (P<0.01) and 2.43 kg (P=0.14) greater weight loss in the PMR group for the 3-month and 1-y periods, respectively. A pooling analysis of completers showed a greater weight loss in the PMR group of 2.54kg (P<0.01) and 2.63 kg (P<0.01) during the same time period. Risk factors of disease associated with excess weight improved with weight loss in both groups at the two time points. The degree of improvement was also dependent on baseline risk factor levels. The dropout rate for PMR and RCD groups was equivalent at 3 months and significantly less in the PMR group at 1 y. No reported adverse events were attributable to either weight loss regimen. CONCLUSION: This first systematic evaluation of randomized controlled trials utilizing PMR plans for weight management suggests that these types of interventions can safely and effectively produce significant sustainable weight loss and improve weight-related risk factors of disease.

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KW - Meta-analysis

KW - Obesity

KW - Pooling analysis

KW - Weight loss treatment

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