Diet Quality following Total Meal Replacement Compared with Food-Based Weight-Loss Diets in Postmenopausal Women with Obesity: A Secondary Analysis of the TEMPO Diet Trial. Issue 11 (13th September 2021)

• Record Type: Journal Article
• Authors: Pattinson, Andrea L; Seimon, Radhika V; Harper, Claudia; Nassar, Natasha; Grech, Amanda; Santoso, Eunike A; Franklin, Janet; Inan-Eroglu, Elif; Gibson, Alice A; Sainsbury, Amanda
• Is Part Of: Journal of nutrition. Volume 151:Issue 11(2021)
• Page Start: 3299
• Page End: 3312
• Publication Date: 2021-09-13
• Subjects: diet quality -- dietary intake -- meal replacement -- VLED -- very low energy diet -- severe energy restriction -- weight loss -- diet-reducing -- obesity -- postmenopausal; Nutrition -- Periodicals; Diet -- Periodicals; 613.205
• DOI: 10.1093/jn/nxab311
• Languages: English
• ISSNs: 0022-3166

Abstract

ABSTRACT: Background: Severely energy-restricted diets that utilize meal-replacement products are the most effective dietary treatment for obesity. However, there are concerns they may fail to educate individuals on how to adopt a healthy food-based diet after weight loss. Objectives: The aim of this research was to compare changes in diet quality following total meal replacement compared with food-based weight-loss diets. Methods: In this secondary analysis of a randomized controlled trial, 79 postmenopausal women aged 45–65 y, with a BMI (in kg/m 2 ) of 30–40, were randomly assigned to either a total meal-replacement diet (energy intake restricted by 65–75% relative to requirements) for 16 wks, followed by a food-based diet (energy intake restricted by 25–35% relative to requirements) until 52 wks, or the food-based diet for the entire 52-wk period. Diet quality was scored at baseline and 52 wks using the Healthy Eating Index for Australian Adults, with score changes compared between groups using an independent t test. Results: Diet quality improved from baseline in both groups, but less so in the total meal-replacement group, with a mean (SD) increase of 3.6 (10.8) points compared with 11.8 (13.9) points in the food-based group, resulting in a mean between-group difference of −8.2 ( P = 0.004; 95% CI: –13.8, –2.7) points. This improvement in diet quality within both groups was mostly driven by a reduction in the intake of discretionary foods. Intake remained below the recommendations at 52 wks for 4 of the 5 food groups in both dietary interventions. Conclusions: In postmenopausal women with obesity, weight-loss interventions that involve either a total meal-replacement diet or a food-based diet both improve diet quality, however, not sufficiently to meet recommendations. This highlights the importance of addressing diet quality as a part of all dietary weight-loss interventions. This trial is registered with the Australia and New Zealand Clinical Trials Registry as 12612000651886.