A traditional lifestyle intervention using meal replacements can be effective for weight control and reduction in risk of chronic disease in the physician's office setting as well as in the dietitian-led group setting.

30 to 50 years old) were randomized into three interventions: group A, a dietitian-led intervention; group B, a dietitian-led intervention incorporating MRs; and group C, a clinical office-based intervention incorporating MRs. In year 1, groups A and B attended 26 group sessions, whereas group C received the same educational materials during 26 10-minute office visits with a physician-nurse team. In year 2, participants attended monthly group seminars and drop-in visits with a dietitian. Results: For the 74 subjects completing year 1, weight loss in the office-based group C was as effective as the traditional dietitian-led group A (4.3 Ϯ 6.5% vs. 4.1 Ϯ 6.4%), while group B maintained a significantly greater weight loss (9.1 Ϯ 8.9%; p Ͻ 0.02; mean Ϯ SD). For the 43 subjects completing year 2, group B showed significant differences in the percentage of weight loss (Ϫ8.5 Ϯ 7.0%) compared with group A (Ϫ1.5 Ϯ 5.0%) and group C (Ϫ3.0 Ϯ 7.0%; p Ͻ 0.001). Discussion: Study results showed that a traditional weight loss intervention incorporating MRs was effective as a weight loss tool in the medical office practice and in the dietitian-led group setting.

BackgroundSafe and effective weight control strategies are needed to stem the current obesity epidemic. The objective of this one-year study was to document and compare the macronutrient and micronutrient levels in the foods chosen by women following two different weight reduction interventions.MethodsNinety-six generally healthy overweight or obese women (ages 25–50 years; BMI 25–35 kg/m2) were randomized into a Traditional Food group (TFG) or a Meal Replacement Group (MRG) incorporating 1–2 meal replacement drinks or bars per day. Both groups had an energy-restricted goal of 5400 kJ/day. Dietary intake data was obtained using 3-Day Food records kept by the subjects at baseline, 6 months and one-year. For more uniform comparisons between groups, each diet intervention consisted of 18 small group sessions led by the same Registered Dietitian.ResultsWeight loss for the 73% (n = 70) completing this one-year study was not significantly different between the groups, but was significantly different (p ≤ .05) within each group with a mean (± standard deviation) weight loss of -6.1 ± 6.7 kg (TFG, n = 35) vs -5.0 ± 4.9 kg (MRG, n = 35). Both groups had macronutrient (Carbohydrate:Protein:Fat) ratios that were within the ranges recommended (50:19:31, TFG vs 55:16:29, MRG). Their reported reduced energy intake was similar (5729 ± 1424 kJ, TFG vs 5993 ± 2016 kJ, MRG). There was an improved dietary intake pattern in both groups as indicated by decreased intake of saturated fat (≤ 10%), cholesterol (<200 mg/day), and sodium (< 2400 mg/day), with increased total servings/day of fruits and vegetables (4.0 ± 2.2, TFG vs 4.6 ± 3.2, MRG). However, the TFG had a significantly lower dietary intake of several vitamins and minerals compared to the MRG and was at greater risk for inadequate intake.ConclusionIn this one-year university-based intervention, both dietitian-led groups successfully lost weight while improving overall dietary adequacy. The group incorporating fortified meal replacements tended to have a more adequate essential nutrient intake compared to the group following a more traditional food group diet. This study supports the need to incorporate fortified foods and/or dietary supplements while following an energy-restricted diet for weight loss.

This study presents a new rationale and hypothesis for the successful treatment of chronic painful diabetic peripheral neuropathy. It uniquely bases the treatment algorithm on the types and sources of the pain.