Effect of a Conventional Energy-restricted Modified Diet With or Without Meal Replacement on Weight Loss and Cardiometabolic Risk Profile in Overweight Women

Christine E Metzner; Anke Folberth-Vögele; Norman Bitterlich; Martin Lemperle; Sandy Schäfer; Birgit Alteheld; Peter Stehle; Roswitha Siener


Nutr Metab. 2011;8(64) 

In This Article

Abstract and Introduction


Background: 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.
Methods: This open-label, randomized, controlled study investigated the effect of an energy-restricted modified diet with (MR) or without meal replacements for weight control (C) on weight loss, body composition and cardiometabolic risk profile in overweight women. Of 105 randomized participants, 87 were eligible for per protocol analysis. Anthropometric, clinical, blood, 24 h-urine parameters and dietary intake were assessed at baseline and after 12 weeks.
Results: Dietary intervention resulted in a significant weight loss in both groups (MR: -5.98 ± 2.82 kg; p < 0.001, C: -4.84 ± 3.54 kg; p < 0.001). However, the rate of responder (weight loss >5%) was higher in MR (77%) versus C group (50%) (p = 0.010). A significant reduction in waist circumference (WC) and body fat mass (BFM) was observed in both groups. Body cell mass (BCM) and lean body mass (LBM) decreased, while percentage of BCM of body weight increased in MR more than in C group. Systolic and diastolic blood pressure (BP) significantly decreased and to a similar extent in both groups. Total cholesterol (TC), LDL-C but also HDL-C declined significantly in both groups, while no change occurred in triglycerides.
Conclusions: Both dietary intervention strategies had a similar effect on weight loss and body fat distribution, but rate of responder was significantly higher in MR group. Systolic BP decreased to a similar extent in both groups. Cardiometabolic risk profile improved only partly in both groups.


The rising prevalence of obesity is considered a major cause for disorders such as type 2 diabetes (DM2) and cardiovascular diseases.[1,2] Type of body fat distribution seems to play a crucial role in the pathogenesis of obesity-related diseases. Due to its higher endocrine and metabolic activity compared to subcutaneous adipose tissue, visceral adipose tissue is regarded as a predictor of cardiometabolic risk factor levels.[2–6] Abdominal obesity is strongly correlated with visceral adipose tissue, clinically represented by the measurement of waist circumference (WC).[7] A population-based cohort study of diabetes revealed that a larger waist circumference is associated with a higher risk of DM2, especially in women, whereas larger hip and thigh circumferences are clearly associated with a lower risk of diabetes.[8]

The widespread lipid disorder in visceral obesity, insulin resistance and metabolic syndrome is atherogenic dyslipidemia, which is characterized by triad of elevated serum triglycerides (TG), low HDL-cholesterol (HDL-C) and small LDL-C particles.[3] Several studies showed favorable effects of visceral weight loss on serum TG in overweight subjects.[4,9,10]

The question is whether the achieved weight loss alone is responsible for the reduction in blood pressure. Besides weight loss, mental stress reduction, dietary sodium restriction, and an increased intake of dietary flavanoids are suggested to reduce blood pressure.[11–13] Weight loss can be achieved by a conventional structured energy-restricted modified diet alone or in combination with meal replacements for weight control. Recent reports indicated that such meal replacements coupled with a low-calorie diet can offer an effective option for weight reduction and improvements in metabolic risk factors in overweight patients.[14–16] Therefore, aim of this prospective randomized study was to evaluate whether a diet with meal replacements (MR) can be as effective as a conventional energy-restricted modified diet (control diet, C) on weight loss, body composition and cardiometabolic risk profile in overweight women.


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