Very Low-Energy Diets With Meal Replacements Effective for T2DM Weight Management

Low-carbohydrate no better for weight loss than higher-carbohydrate, low-fat diets; no difference seen for high-protein, Mediterranean diets
genetic weight-loss plateau
genetic weight-loss plateau

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MONDAY, Nov. 22, 2021 (HealthDay News) -- Very low-energy diets and formula meal replacements are associated with weight loss for individuals with type 2 diabetes, according to a review published online Nov. 17 in Diabetologia.

Chaitong Churuangsuk, M.D., from the University of Glasgow in the United Kingdom, and colleagues conducted a systematic review of published meta-analyses to assess dietary approaches to weight loss and remission in type 2 diabetes to inform practice and clinical guidelines. Nineteen meta-analyses of weight-loss diets were identified, involving two to 23 primary trials, with 100 to 1,587 participants.

The researchers found that weight loss was greatest with very low-energy diets versus low-energy diets (6.6 kg greater weight loss for 1.7 to 2.1 versus 4.2 to 6.3 MJ/day for eight to 12 weeks). Over 12 to 52 weeks, formula meal replacements achieved 2.4 kg greater weight loss. Compared with higher-carbohydrate/low-fat diets, low-carbohydrate diets were no better for weight loss. Minimal or no difference from control diets was seen for high-protein, Mediterranean, high-monounsaturated-fatty-acid, vegetarian, and low glycemic-index diets. Sixteen records met inclusion criteria for diabetes remission. At one year, remissions were reported for a median of 54 percent of participants in randomized controlled trials including initial low-energy total diet replacement; remission was 11 and 15 percent for meal replacements and Mediterranean diets, respectively.

"The evidence, albeit of variable 'quality,' is rather consistent such that no one diet type is superior over others for weight management in type 2 diabetes," the authors write.

Several authors disclosed financial ties to the pharmaceutical and weight-loss industries.

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