Weight management using meal replacements and cardiometabolic risk reduction in individuals with pre‐diabetes and features of metabolic syndrome: A systematic review and meta‐analysis of randomized controlled trials

Author:

Noronha Jarvis C.12,Nishi Stephanie K.1345,Khan Tauseef A.16,Blanco Mejia Sonia16,Kendall Cyril W. C.167,Kahleová Hana89,Rahelić Dario101112,Salas‐Salvadó Jordi345,Leiter Lawrence A.16131415,Lean Michael E. J.16,Sievenpiper John L.16131415ORCID

Affiliation:

1. Toronto 3D Knowledge Synthesis and Clinical Trials Unit, Clinical Nutrition and Risk Factor Modification Centre St. Michael's Hospital Toronto Ontario Canada

2. School of Medicine, Faculty of Medicine The University of Queensland Brisbane Queensland Australia

3. Universitat Rovira i Virgili Departament de Bioquímica i Biotecnologia, Alimentació, Nutrició, Desenvolupament i Salut Mental ANUT‐DSM Reus Spain

4. Alimentació, Nutrició, Desenvolupament i Salut Mental Institut d'Investigació Sanitària Pere Virgili (IISPV) Reus Spain

5. Centro de Investigación Biomédica en Red Fisiopatología de La Obesidad y La Nutrición (CIBEROBN) Instituto de Salud Carlos III Madrid Spain

6. Department of Nutritional Sciences, Temerty Faculty of Medicine University of Toronto Toronto Ontario Canada

7. College of Pharmacy and Nutrition University of Saskatchewan Saskatoon Saskatchewan Canada

8. Diabetes Centre Institute for Clinical and Experimental Medicine Prague Czech Republic

9. Physicians Committee for Responsible Medicine Washington DC USA

10. Vuk Vrhovac University Clinic for Diabetes, Endocrinology and Metabolic Diseases Merkur University Hospital Zagreb Croatia

11. School of Medicine Catholic University of Croatia Zagreb Croatia

12. School of Medicine Josip Juraj Strossmayer University of Osijek Osijek Croatia

13. Division of Endocrinology and Metabolism St. Michael's Hospital Toronto Ontario Canada

14. Li Ka Shing Knowledge Institute St. Michael's Hospital Toronto Ontario Canada

15. Department of Medicine, Temerty Faculty of Medicine University of Toronto Toronto Ontario Canada

16. School of Medicine, Dentistry and Nursing University of Glasgow Glasgow UK

Abstract

SummaryThis review synthesized the evidence from randomized controlled trials comparing the effect of meal replacements (MRs) as part of a weight loss intervention with conventional food‐based weight loss diets on cardiometabolic risk in individuals with pre‐diabetes and features of metabolic syndrome. MEDLINE, EMBASE, and Cochrane Library were searched through January 16, 2024. Data were pooled using the generic inverse variance method and expressed as mean difference [95% confidence intervals]. The overall certainty of the evidence was assessed using GRADE. Ten trials (n = 1254) met the eligibility criteria. MRs led to greater reductions in body weight (−1.38 kg [−1.81, −0.95]), body mass index (BMI, −0.56 kg/m2 [−0.78, −0.34]), waist circumference (−1.17 cm [−1.93, −0.41]), HbA1c (−0.11% [−0.22, 0.00]), LDL‐c (−0.18 mmol/L [−0.28, −0.08]), non‐HDL‐c (−0.17 mmol/L [−0.33, −0.01]), and systolic blood pressure (−2.22 mmHg [−4.20, −0.23]). The overall certainty of the evidence was low to moderate owing to imprecision and/or inconsistency. The available evidence suggests that incorporating MRs into a weight loss intervention leads to small important reductions in body weight, BMI, LDL‐c, non‐HDL‐c, and systolic blood pressure, and trivial reductions in waist circumference and HbA1c, beyond that seen with conventional food‐based weight loss diets.

Funder

Canadian Institutes of Health Research

Canada Foundation for Innovation

Publisher

Wiley

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