Overweight and Obesity, Dyslipoproteinemia
Conditions
Keywords
Weight Management Programs, Weight loss stabilization, Cardiometabolic risk
Brief summary
Aim of this prospective randomized study was to evaluate whether a diet with meal replacements can be as effective as a conventional energy-restricted modified diet on weight loss, body composition and cardiometabolic risk profile in overweight women. Moreover, the impact of these two different weight management strategies was observed on cardiometabolic risk profile after a self-directed weight stabilization phase following the weight loss phase. After that, the effect of a specific micronutrient composition with omega-3 fatty acids versus placebo on cardiometabolic risk was observed during a following phase of weight loss maintenance.
Detailed description
Abdominal obesity, atherogenic dyslipidemia and hypertension are essential risk factors for cardiovascular diseases. Several studies showed favorable effects of weight loss in overweight subjects on cardiometabolic risk profile. The study was divided into a 3-month weight loss phase (phase 1), a subsequent 3-month phase of weight stabilization (phase 2) and a 6-month phase of weight loss maintenance (phase 3). For a total of 6 months subjects were randomly assigned to the meal replacement (MR) or control (C) group at baseline I. During weight loss phase both dietary intervention groups followed an energy-restricted diet with a balanced variety of nutrient-dense food of approximately 1200 kcal/d. The MR-WL group (MR group during weight loss phase) was advised to replace two of three meals every day with meal replacements. The C-WL group (C group during weight loss phase) was advised to follow a conventional energy-restricted modified diet with 15-20% of energy intake in the form of protein, 50-55% of energy intake in the form of carbohydrates and 30% of energy intake in the form of fat. All participants attended ten group training sessions for nutrition education. During weight stabilization phase all women of MR-S and C-S group (MR and C group during weight stabilization phase) were encouraged to consume a self-directed well-balanced variety of nutrient-dense foods without meal intervention. However, the MR-S and C-S group were instructed to continue the implemented nutrition advice of weight loss phase. At the beginning of weight loss maintenance phase (baseline II) women were randomly assigned to the verum (specific micronutrient composition with omega-3 fatty acids) group or placebo group. Both groups were encouraged to consume a self-directed well-balanced variety of nutrient-dense foods. All women participated in an exercise program (fitness walking) on 1-2 days per week during all three phases of the study for a total of 12 months.
Interventions
DIETARY_SUPPLEMENTMeal replacement (MR)
MR-WL group followed an energy-restricted diet with a balanced variety of nutrient-dense food of approximately 1200 kcal/d and was advised to replace two meals, i.e. breakfast and dinner, every day with two MR shakes, soups or bars and to prepare their own lunch during 3-month weight loss phase (phase 1). During 3-month weight stabilization phase (phase 2) MR-S group (MR group during weight stabilization phase) were encouraged to consume a self-directed well-balanced variety of nutrient-dense foods without meal intervention. MR counted to food choice option. The MR-S group was instructed to continue the implemented nutrition advice of weight loss phase. Duration: 6 months (phase 1 and phase 2: baseline I - 6.month)
OTHERControl (C)
During 3-month weight loss phase (phase 1) C-WL group followed an energy-restricted diet with a balanced variety of nutrient-dense food of approximately 1200 kcal/d without MR for weight control. During 3-month weight stabilization (phase 2) phase C-S group (C group during weight stabilization phase) were encouraged to consume a self-directed well-balanced variety of nutrient-dense foods without meal intervention. MR counted to food choice option. The C-S group was instructed to continue the implemented nutrition advice of weight loss phase. Duration: 6 months (phase 1 and phase 2: baseline I - 6.month)
DIETARY_SUPPLEMENTVerum
Verum: Specific micronutrient composition with omega-3 fatty acids (capsules) Verum group followed an energy-restricted diet with a balanced variety of nutrient-dense food of approximately 1500 kcal/d and was advised to consume 3 verum-capsules twice a day (with breakfast and dinner) with 200 ml water during 6-month weight loss maintenance phase (phase 3). Duration: 6 months (6.month / baseline II - 12.month)
OTHERPlacebo
Placebo group followed an energy-restricted diet with a balanced variety of nutrient-dense food of approximately 1500 kcal/d and was advised to consume 3 placebo-capsules twice a day (with breakfast and dinner) with 200 ml water during 6-month weight loss maintenance phase. Placebo contains no micronutrients and omega-3 fatty acids. Duration: 6 months (6.month / baseline II - 12.month)
Sponsors
FomMed HealthCare AG
Bonn Education Association for Dietetics r.A., Cologne, Germany
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Intervention model description
2 parallel arms in weight loss phase and weight stabilization phase (1. randomization at baseline I); 2 parallel arms in weight maintanance phase (2. randomization at baseline II)
Eligibility
Sex/Gender
FEMALE
Age
18 Years to 60 Years
Healthy volunteers
No
Inclusion criteria
* BMI: between 27.0 and 34.9 kg/m² * One of the following blood lipids: total cholesterol ≥ 200 mg/dL, LDL-cholesterol ≥ 175 mg/dL, HDL-cholesterol ≤ 50 mg/dL, TG 150-400 mg/dL * women, 18-60 years Specific
Exclusion criteria
* lactose or protein intolerance * hypo- or hyperthyroidism * pharmacological treatment of diabetes * intake of vitamins or mineral supplements * anticoagulants * cardiac pacemaker * contraindications to exercise
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Weight loss (phase 1) | 3-month dietary intervention (from baseline I to 3rd month) | Intervention changes in body weight |
| Total antioxidant capacity (phase 3) | 6-month dietary intervention (from baseline II to 12th month) | Intervention changes in total antioxidant capacity |
| Fasting plasma cortisol concentration (phase 3) | 6-month dietary intervention (from baseline II to 12th month) | Intervention changes in fasting plasma cortisol concentration |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Waist circumference (phase 1) | 3-month dietary intervention (from baseline I to 3rd month) | Intervention changes in waist circumference |
| Total antioxidant capacity (phase 1) | 3-month dietary intervention (from baseline I to 3rd month) | Intervention changes in total antioxidant capacity |
| Fasting plasma cortisol concentration (phase 1) | 3-month dietary intervention (from baseline I to 3rd month) | Intervention changes in fasting plasma cortisol concentration |
| Relative body fat (phase 1) | 3-month dietary intervention (from baseline I to 3rd month) | Intervention changes in relative body fat |
| Relative body weight (phase 3) | 6-month dietary intervention (from baseline II to 12th month) | Intervention changes in relative body weight |
| Responder (weight loss > 5%) | 12 months (from baseline I to 12th month) | Responder rate after 12 months |
| Waist circumference (phase 3) | 6-month dietary intervention (from baseline II to 12th month) | Intervention changes in waist circumference |
| Relative body fat (phase 3) | 6-month dietary intervention (from baseline II to 12th month) | Intervention changes in relative body fat |
| Relative body weight (phase 1) | 3-month dietary intervention (from baseline I to 3rd month) | Intervention changes in relative body weight |
| Responder (weight loss > 5%) (phase 1) | 3-month dietary intervention (from baseline I to 3rd month) | Responder rate after 12 weeks |
Outcome results
None listed