Intermittent versus on‐demand use of a very low calorie diet: a randomized 2‐year clinical trial

Abstract

Interventions. All the patients started with 16 VLCD weeks. Subjects in the intermittent group were then scheduled to use VLCD for 2 weeks every third month, whilst patients in the on-demand group were instructed to use VLCD whenever their body weight passed an individualized cut-off level.Irrespective of the treatment group, all the subjects were recommended a hypocaloric diet during VLCDfree periods.Main outcome measures. Changes in body weight, body composition, anthropometric variables and cardiovascular risk factors.Results. Completers in both groups maintained highly significant weight losses after 2 years: 7.0 ± 11.0 kg (6.2 ± 9.5%) in the intermittent group and 9.1 ± 9.7 kg (7.7 ± 8.1%) in the on-demand group (P < 0.001, ns between groups). Male completers in the on-demand group lost significantly more weight than men in the intermittent group, 14.5 ± 11.0 kg vs. 4.0 ± 10.5 kg, respectively (P < 0.01). Most cardiovascular risk factors improved during the first year, whilst anthropometric measures, insulin, HDL-and LDL-cholesterol were also significantly improved after 2 years of treatment. Conclusion. Clinically significant weight reductions were achieved after 2 years of VLCD-based treatment. The structure of VLCD treatment during the maintenance phase did not affect weight loss in the total study population, whilst male subjects might benefit from the VLCD on-demand strategy.

Men and women respond differently to rapid weight loss: Metabolic outcomes of a multi‐centre intervention study after a low‐energy diet in 2500 overweight, individuals with pre‐diabetes (PREVIEW)

“…Changes in FFM of this magnitude are considered normal during LED weight loss 28, 29. Interestingly, however, women lost twice as much FFM as men (31.4% vs 16.1%, respectively), which is striking, as men had a larger energy deficit during the LED phase.…”

Should weight loss and maintenance programmes be designed differently for men? A systematic review of long-term randomised controlled trials presenting data for men and women: The ROMEO project

“…Men comprised 36% of participants in 18 of the trials (4771 from a total of 13,305 participants); in four trials numbers of men recruited were unclear [23][24][25][26]. Eleven trials [23,[26][27][28][29][30][31][32][33][34][35] were conducted in the USA; six [24,25,[36][37][38][39] in Finland and one trial from each of the following locations: Canada [40], Israel [41], Scandinavia [42], Sweden [43,43]and the UK [44].…”

“…Three trials considered weight loss maintenance: lifestyle counselling including a 600kcal/day deficit low fat diet and orlistat or placebo [42], intermittent versus on demand very low calorie diets [43], and monetary contracts [29].…”

“…Nine trials [27,29,34,[36][37][38]40,43,44] provided data that could be included in the analysis comparing the number of men and women who completed the trials. The total analysis included 3943 participants, with 1255 men (31.8%) and 2688 women (68.2%) ( Tables 1 and 2).…”

“…Lantz and colleagues [43] randomised participants to receive either an on-demand very low calorie diet (VLCD) (450kcal/day), after 16 weeks of the VLCD, or a regularly repeated VLCD. After the initial 16 weeks, participants in the intermittent on demand group followed a 500 kcal/day deficit diet but changed to the 450kcal/day diet when their individual body weight reached predetermined cut-off levels throughout the trial period.…”