Original Communication
European Journal of Clinical Nutrition (2005) 59, 411–418. doi:10.1038/sj.ejcn.1602089 Published online 22 December 2004
Long-term efficacy of soy-based meal replacements vs an individualized diet plan in obese type II DM patients: relative effects on weight loss, metabolic parameters, and C-reactive protein
Guarantor: Z Li.
Contributors: ZL and KH—manuscript preparation and data analysis. PS, MB and GT—data collection and patient evaluation. SD, H-JW and RE—statistical analysis. YL—data collection and processing. DH—principle investigator, manuscript preparation and data analysis.
Z Li1, K Hong1, P Saltsman1, S DeShields1, M Bellman1, G Thames1, Y Liu1, H-J Wang2, R Elashoff2 and D Heber1
- 1David Geffen School of Medicine, Center for Human Nutrition, University of California, Los Angeles, CA, USA
- 2Department of Biomathematics, University of California, Los Angeles, CA, USA
Correspondence: Z Li, UCLA Center for Human Nutrition, 900 Veteran Avenue Room 12-217, Los Angeles, CA 90095-1742, USA. E-mail: zli@mednet.ucla.edu
Received 22 January 2004; Revised 4 October 2004; Accepted 8 October 2004; Published online 22 December 2004.
Abstract
Background:
Achieving significant weight loss and glycemic control in diabetic patients remains a challenging task.
Objective:
This study compared the effects of a soy-based meal replacement (MR) plan vs an individualized diet plan (IDP; as recommended by the American Diabetes Association) on weight loss and metabolic profile.
Design/Subjects:
A total of 104 subjects were randomized prospectively to the two treatments for a total of 12 months.
Results:
In all, 77 of the 104 subjects completed the study. Percentage weight loss in MR group (4.57
0.81%) was significantly greater (P<0.05) than in IDP group (2.250.72%). Fasting plasma glucose was significantly reduced in MR group (126.44.9 mg/dl) compared with IDP group (152.56.6 mg/dl, P<0.0001) at 6 months but not at 12 months. Controlling for baseline levels, hemoglobin Alc level improved by 0.490.22% for those receiving MR when compared to IDP group (P<0.05). A greater number of subjects in MR group reduced their use of sulfonylureas (P<0.0001) and metformin (P<0.05) as compared to IDP group. High-sensitivity C-reactive protein (hs-CRP) decreased -26.3% (P=0.019) in MR group compared to -7.06% (P=0.338) in IDP group at 6 months. Similar changes were observed at 12 months with MR groups, with hs-CRP decreasing by -25.0% (P=0.019) compared to -18.7% (P=0.179) in IDP group.
Conclusion:
This study demonstrates that MR is a viable strategy for weight reduction in diabetic patients, resulting in beneficial changes in measures of glycemic control and reduction of medications.
Keywords:
meal replacement, obesity, DM, weight loss, C-reactive protein
