Effects of a Protein-Rich, Low-Glycaemic Meal Replacement on Changes in Dietary Intake and Body Weight Following a Weight-Management Intervention—The ACOORH Trial

Abstract

Although meal replacement can lead to weight reduction, there is uncertainty whether this dietary approach implemented into a lifestyle programme can improve long-term dietary intake. In this subanalysis of the Almased Concept against Overweight and Obesity and Related Health Risk (ACOORH) study (n = 463), participants with metabolic risk factors were randomly assigned to either a meal replacement-based lifestyle intervention group (INT) or a lifestyle intervention control group (CON). This subanalysis relies only on data of participants (n = 119) who returned correctly completed dietary records at baseline, and after 12 and 52 weeks. Both groups were not matched for nutrient composition at baseline. These data were further stratified by sex and also associated with weight change. INT showed a higher increase in protein intake related to the daily energy intake after 12 weeks (+6.37% [4.69; 8.04] vs. +2.48% [0.73; 4.23], p < 0.001) of intervention compared to CON. Fat and carbohydrate intake related to the daily energy intake were more strongly reduced in the INT compared to CON (both p < 0.01). After sex stratification, particularly INT-women increased their total protein intake after 12 (INT: +12.7 g vs. CON: −5.1 g, p = 0.021) and 52 weeks (INT: +5.7 g vs. CON: −16.4 g, p = 0.002) compared to CON. Protein intake was negatively associated with weight change (r = −0.421; p < 0.001) after 12 weeks. The results indicate that a protein-rich dietary strategy with a meal replacement can improve long-term nutritional intake, and was associated with weight loss.

Early and Strong Leptin Reduction Is Predictive for Long-Term Weight Loss during High-Protein, Low-Glycaemic Meal Replacement—A Subanalysis of the Randomised-Controlled ACOORH Trial

“…The ACOORH study is an international, multicentre randomised-controlled trial analysing the effect of a meal-replacement based lifestyle intervention in overweight or obese persons with components of the metabolic syndrome. Details had been published before [15][16][17][18][19]. In brief, individuals aged 21-65 years, with a body mass index (BMI) of 27-35 kg/m 2 and/or a waist circumference of ≥88 (females) or ≥102 cm (males) and fulfilling at least one of the following criteria of the metabolic syndrome: (a) fasting blood glucose (FBG) 100-125 mg/dL, (b) triglycerides 150-400 mg/dL, (c) high-density lipoprotein (HDL)-cholesterol < 40 mg/dL, or (d) untreated systolic blood pressure of 140-160 mmHg or diastolic blood pressure of 90-100 mmHg or anti-hypertensive medication were eligible for participation.…”

“…During all study visits, anthropometrical data (BMI, body weight, fat mass, lean body mass) were measured and blood was collected as described before [15][16][17][18][19]. Leptin, fasting insulin, interleukin (IL)-6, and C-reactive protein (CRP) were analysed in an accredited medical laboratory (Synlab, Leinfelden, Germany) according to previous reports [20,21] and ratios for leptin/body weight, leptin/fat mass, insulin/body weight, and insulin/fat mass were calculated.…”

“…This might be caused by leptin resistance, which inhibits appropriate appetite control [14]. The international, multicentre ALMASED-Conceptagainst-Overweight-and-Obesity-and-Related-Health-Risk (ACOORH) study [15][16][17][18][19] is a randomised-controlled trial designed to compare the effects of a meal replacement-based lifestyle intervention vs. lifestyle intervention alone in overweight or obese adults with risk factors of the metabolic syndrome. With an estimated treatment difference (ETD) of −3.2 kg [−4.0; −2.5] (p < 0.001), previously published data demonstrated significantly higher weight reduction in the meal replacement intervention group compared to the control group after 3 months [15] accompanied by significantly stronger reductions of insulin and inflammation markers [18].…”

Weight Loss Strategies and the Risk of Skeletal Muscle Mass Loss

“…It should be noted this was a small-scale study and caution should be exercised when interpreting these findings. However, further research on VLCD and meal replacement products is warranted, especially as an increasing number of meal replacement products are available and some have been evaluated in depth in weight loss studies focusing upon body composition, metabolic, and inflammatory measures [ 88 , 89 , 90 , 91 , 92 ].…”

A High-Protein and Low-Glycemic Formula Diet Improves Blood Pressure and Other Hemodynamic Parameters in High-Risk Individuals

“…The multicenter, international and randomized controlled ‘Almased Concept against Overweight and Obesity and Related Health Risk’ (ACOORH)-trial was initiated to investigate the additional effect of a low-carbohydrate formula diet on top of a low-intensity lifestyle intervention in comparison to a lifestyle intervention alone in a larger cohort of high-risk individuals with overweight or obesity and at least one further co-morbidity of the metabolic syndrome. Previously published works of the ACOORH trial have already shown a beneficial effect on the prediabetes conversion rate to normoglycemia [ 12 ], weight loss [ 13 ] and nutritional behavior [ 14 ], as well as glucometabolic and inflammatory markers [ 15 ]. The present study analyzed the changes in hemodynamic parameters after 6 and 12 months.…”