Beneficial Effects of a Specially Designed Home Meal Replacement on Cardiometabolic Parameters in Individuals with Obesity: Preliminary Results of a Randomized Controlled Clinical Trial

Abstract

We aimed to investigate if a home meal replacement (HMR), designed with a low ω-6/ω-3 fatty acid ratio, improves cardiometabolic parameters, including metabolic syndrome (MetS) in obese individuals. We conducted a monocentric, controlled, randomized crossover trial. The HMR contains higher protein and fat content, lower carbohydrate content, and a lower ω6FA/ω3FA ratio than the regular diet. Sixty-four participants were randomized into two groups and switched to the other group following a 4-week intervention. While subjects in the HMR group were provided three HMRs daily, those in the control group were requested to maintain their regular dietary pattern. We conducted paired t-tests, repeated measures analysis of variance, and McNemar tests before and after the intervention. Body mass index (BMI) and weight were lower in the HMR group after adjusting for age, sex, and total energy intake and significantly changed in the between-group differences. The waist circumference, systolic blood pressure, triglycerides, triglyceride–glucose index, and triglyceride to high-density lipoprotein cholesterol ratio were reduced in the HMR group (all p < 0.05). The percentage of subjects with MetS significantly decreased from 39.1% at baseline to 28.1% post-intervention (p = 0.035). Using the HMR for 4 weeks reduced the BMI, weight, and MetS prevalence in individuals with obesity. This trial was registered at clinicaltrials.gov (NCT04552574).

The Effect of Dietary Interventions on Hypertriglyceridemia: From Public Health to Molecular Nutrition Evidence

“…After a dietary intervention period in obese and cardiometabolically ill subjects, TG concentrations decreased from baseline ( p < 0.01) and the proportion of subjects meeting criteria for HTG decreased from 34.4% to 20.3% ( p = 0.020). However, the authors caution that the results of this study should be interpreted with care because the diet was also high in protein and fat and low in carbohydrates [ 96 ].…”

“…The mechanisms of action of omega-3 in TG involve downregulation of monoacylglycerol and diacylglycerol acyltransferase activities, ApoB-48 mRNA expression, TG synthesis, VLDL production and secretion, expression and maturation of the sterol regulatory element-binding proteins-1c (SREBP-1c), as well as an increase in post-translational degradation of newly synthesized ApoB-48, plasma LPL activity, transcription of genes involved in the β oxidation pathway by binding to PPARα and PPARγ, conversion of VLDL to LDL, mitochondrial beta-oxidation of fatty acids, TG clearance with increasing of plasma lipolytic activity, and the removal of TG from chylomicrons ( Figure 1 ) [ 92 , 96 , 97 , 98 ].…”

“…Plant sterols can decrease TG concentration through the interference of the absorption of fatty acids in the intestinal lumen, reducing the circulating medium and large VLDL particles, as well as modulating hepatic de novo lipogenesis ( Figure 1 ) [ 106 ].

Figure 1 Modulation of lipid metabolism by food and bioactive compounds, adapted from [ 9 , 16 , 18 , 62 , 64 , 66 , 68 , 90 , 92 , 96 , 97 , 98 , 100 , 106 , 108 , 109 , 110 , 111 , 112 , 113 , 114 , 115 , 116 , 117 ]. 1.

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“…Flaxseed and hesperidin activate the expression of genes encoding PPAR, which stimulate β-oxidation and the inhibition of fatty acid synthesis [ 66 ]. Omega-3 reduces TG synthesis [ 90 ], VLDL production and secretion [ 97 , 98 ], and the expression and maturation of the SREBP-1c, and increases the transcription of genes involved in the β-oxidation pathway by binding to PPARα and PPARγ [ 92 ], the rate of conversion of VLDL to LDL [ 98 ], β-oxidation of fatty acids [ 90 ], TG clearance with increasing of plasma lipolytic activity [ 97 ], and the removal of TG from chylomicrons [ 96 ]. Plant sterols modulate de novo hepatic lipogenesis and reduce circulating medium and large VLDL particles [ 106 ].…”

“… Modulation of lipid metabolism by food and bioactive compounds, adapted from [ 9 , 16 , 18 , 62 , 64 , 66 , 68 , 90 , 92 , 96 , 97 , 98 , 100 , 106 , 108 , 109 , 110 , 111 , 112 , 113 , 114 , 115 , 116 , 117 ]. 1.…”