Meal Replacement By Formula Diet Reduces Weight More Than a Lifestyle Intervention Alone In Patients With Overweight Or Obesity And Accompanied Cardiovascular Risk Factors—The ACOORH Trial
There is past evidence to show that lifestyle intervention helps in achieving clinical benefits, but adherence to this approach is low. One of the alternative treatment strategies such as liquid meal replacements have been shown to provide positive clinical outcomes, but there is still uncertainty about weight maintenance and long-term effectiveness of formula diets. The author Halle and colleagues (2020) conducted a study titled “Meal replacement by formula diet reduces weight more than a lifestyle intervention alone in patients with overweight or obesity and accompanied cardiovascular risk factors—the ACOORH trial” published in “The European Journal of Clinical Nutrition”. The summary of this trial can be studied below:
Objectives:
To investigate the result of a liquid meal replacement along with a low-intensity lifestyle intervention compared to low-intensity lifestyle intervention alone on weight loss in patients with overweight/obesity along with cardiovascular risk factors.
Method:
463 participants with overweight or obesity were randomly assigned to either a control group (CON, lifestyle intervention alone) or a lifestyle intervention group (INT, liquid meal replacement included). Telemonitoring devices were used by both groups and they acquired information about healthy diet and instruction about increasing physical activity.
During the first week, liquid meal replacement substituting three meals/day (~1200 kcal) is obtained by INT group followed by two meals/day and one meal/day during 2-4 weeks and 5–26 weeks respectively (1300–1500 kcal/day).
Participants were investigated after 52 weeks. Intention-to-treat analyses were performed. The primary outcome included weight change. Secondary outcomes included changes in cardiometabolic risk factors involving body composition and laboratory parameters.
Findings:
This trial showed that a low-intensity lifestyle intervention along with a liquid formula diet results in an increased reduction in body weight as compared to low-intensity lifestyle intervention alone in patients with overweight or obesity and accompanied cardiovascular risk factors. Additionally, further improvements were observed in cardiometabolic parameters in the INT group. The trial also suggests that moderate and constant weight loss decreases the risk of adverse outcomes in the long run as compared to fast and severe weight loss.
In consideration of all benefits observed, this therapy approach can be considered as a rationale for the management of overweight and obesity in clinical, community, and health care settings.
Limitations:
Authors report that although 4-day diet diaries were used for counselling, they have purposely not guided participants on decreasing their energy intake. But the instruction to participants for the collection of empty containers in the INT group helped investigators to evaluate the amount of liquid meal replacement consumed. There was the imputation of missing values by the Last observation-carried-forward (LOCF) approach. Authors acknowledge that more sophisticated imputation methods could have been used.
Image Credit: Food photo created by bublikhaus – www.freepik.com
