Effect of Two Meal Replacement strategies on Cardiovascular Risk Parameters in Advanced Age Patients with Obesity and Osteoarthritis

Abstract

Background and aims: Meal replacement diets consist of replacing one or more meals with an artificial nutritional supplement. The objective of this study was to compare the effect of one against two meal replacement strategies on body composition and cardiovascular risk parameters in patients with obesity. Methods: A randomized clinical trial was designed with a modified hypocaloric diet with an artificial nutritional preparation replacing one or two meals for three months in patients with obesity and osteoarthritis pending orthopedic surgery. An anthropometric evaluation and a measurement of the body composition were done with bioelectrical impedance measurement at the beginning and at three months. Results: A total of 112 patients were recruited. Fifty-two patients (46.4%) were randomized to one replacement and 60 patients (53.6%) to two meal replacements. Eighty-one patients (72.3%) were women, and the average age was 61 (11.03) years. The percentage of weight loss at three months was 8.27 (4.79)% (one meal replacement: 7.98 (5.97)%; two meal replacements: 8.50 (3.48)%; p = 0.56). A decrease in fat mass measured by the fat mass index (FMI) was detected (one meal replacement: −2.15 (1.45) kg/m2 vs. two meal replacements: −2.78 (2.55) kg/m2; p > 0.05), and a relative increase in fat-free mass was observed (one meal replacement: +3.57 (4.61)% vs. two meal replacements: +2.14 (4.45)%; p > 0.05). A decrease in HOMA-IR, systolic blood pressure (SBP), and total cholesterol was observed in both groups without differences between them. Conclusions: The substitution strategies of one or two meal replacements were effective in weight loss and fat mass decrease without differences between the two groups. An improvement in lipid parameters, glycemic control, and systolic blood pressure was observed without differences between strategies.

Relative Efficacy of Weight Management, Exercise, and Combined Treatment for Muscle Mass and Physical Sarcopenia Indices in Adults with Overweight or Obesity and Osteoarthritis: A Network Meta-Analysis of Randomized Controlled Trials

“…A total of 3563 participants were recruited, with a mean age of 64.7 (range: 41.4-71.6) years; the mean BMI was 33.1 (range: 26.4-41.4) kg/m 2 , and the average proportion of female participants was 71.0% (range: 39.1-95.0%), which was estimated by excluding eight sex-specific (women or men alone) RCTs [68,69,71,77,80,81,88,89]. All included RCTs enrolled participants who had received a diagnosis of symptomatic or radiographic knee OA, whereas four RCTs recruited individuals with a diagnosis of hip OA [64,67,72,85].…”

“…The protocols for diet therapy are summarized in Table 1. Dietary interventions employed intermittent meal replacement (MR) in one RCT [60] and regular MR in 14 RCTs [58][59][60][61][62][63]67,[74][75][76]78,88,89,91]. The MR prescribed was one meal daily (uni-MR) in four RCTs [59,60,62,67] and two or more meals daily (multi-MR) in 12 RCTs [58,60,61,63,67,[74][75][76]78,88,89,91].…”

“…Dietary interventions employed intermittent meal replacement (MR) in one RCT [60] and regular MR in 14 RCTs [58][59][60][61][62][63]67,[74][75][76]78,88,89,91]. The MR prescribed was one meal daily (uni-MR) in four RCTs [59,60,62,67] and two or more meals daily (multi-MR) in 12 RCTs [58,60,61,63,67,[74][75][76]78,88,89,91]. In addition, diet instruction and advisement (DIA), which had been conducted through nutrition classes and cognitive behavior therapy, was employed in five RCTs [68,72,73,82,83] or applied in combination with MR in nine RCTs [58][59][60][61][62][74][75][76]91].…”

“…this study, 23 of the included RCTs had a two-arm design[61,[64][65][66][67][68][69]73,[75][76][77][78][80][81][82][83][84][85][86][87][89][90][91] and the remaining 11 RCTs were multiarm studies, with a total of 21 treatment arms. Among all participants, 711 (19.9%) received diet therapy alone, 1235(34.7%) received exercise alone, 858 (24.1%) received combined treatment, and 759 (21.3%) received UC.…”

Le abitudini al tempo del Coronavirus

“…Grandi studi scientifici (11)(12)(13) hanno anche dimostrato che il consumo abbondante di carne incrementa molto il rischio di contrarre malattie infettive e che un eccesso proteico di derivazione animale stressa eccessivamente il nostro organismo.…”