Nutrient adequacy during weight loss interventions: a randomized study in women comparing the dietary intake in a meal replacement group with a traditional food group

Abstract

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.

Weight Management Using a Meal Replacement Strategy in Type 2 Diabetes

“…An acknowledged limitation of the study is that it was for relatively short duration and the dietary intakes were self-reported; however, a comparison between predietary versus post-dietary intake indicated significant diet compliance and caloric reduction. This proposition that a commercial MR can enhance nutrient adequacy is also supported by another recent randomized clinical trial [21]. The study compared the nutrient adequacy between a diet plan using MRs versus another that used traditional food.…”

“…Across several studies that evaluated micronutrient adequacy, many of the micronutrients that consistently fell short of the recommended daily intake are essential for metabolism, energy, and bone health (B vitamins, iron, calcium, and magnesium) [20][21][22]. The caveats of these studies are that food records were often self-reported and the studies included selected groups (ie, overweight, obese) who usually tend to inaccurately report their true food intakes.…”

Predictors for Reporting of Dietary Assessment Methods in Food-based Randomized Controlled Trials over a Ten-year Period

“…Time points calculated as a proportion of the overall study length indicated that the commencement of the study was the most commonly used time point (57.5%, n D 61) for dietary assessment. The second assessment was more likely to be at the midpoint of the study (32.3%, n D 32) , Donaghue et al, 2000, Riddell et al, 2000, Smith-Warner et al, 2000, Davidson et al, 2001, McGavin et al, 2001, Leslie et al, 2002, Shah et al, 2002, Chee et al, 2003, Drummond et al, 2003, Hendriks et al, 2003, Moeller et al, 2003, Sondergaard et al, 2003, Mori et al, 2004, Dyerberg et al, 2004, He et al, 2004, Bhargava et al, 2004, Maskarinec et al, 2004a, Maskarinec et al, 2004b, Shah et al, 2004, Sloth et al, 2004, Tapsell et al, 2004, Waller et al, 2004, Hermansen et al, 2005, Barnard et al, 2006, Chen et al, 2006, Iyer et al, 2006, Marfella et al, 2006, Ashley et al, 2007, Murphy et al, 2007, TurnerMcGrievy et al, 2008, Barnard et al, 2009, Davis et al, 2009) with 25 studies completing their dietary assessments in only two periods of assessment of which only 11 included the endpoint of the study as the final time point. (Barr et al, 2000, Conceicao de Oliveira et al, 2003, Erlund et al, 2003…”

Efficacy of High Carbohydrate versus High Protein Meal Replacements on Weight Reduction - A Randomized Controlled Trial

“…The individuals may have some difficulties in selecting or cooking the complicated low-calorie menus, in which various factors such as energy, carbohydrates, proteins or fat are involved. Hence, deficiency of macro-and micronutrients can occur [24,25]. Therefore, we aimed to determine the effect on weight loss using a HC meal replacement compared to a HP meal replacement.…”