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	The Second National Conference on Diabesity in America Weight Management:State of the Science and Opportunities for Military Programs Meal Replacements  Bars and Liquid Drinks  Are they effective in producing lasting weight loss? Featured Product of the Month

Weight Management:State of the Science and Opportunities for Military Programs

The primary purpose of fitness and body composition standards in the U.S. Armed Forces has always been to select individuals best suited to the physical demands of military service, based on the assumption that proper body weight and composition supports good health, physical fitness, and appropriate military appearance. The current epidemic of overweight and obesity in the United States affects the military services. The pool of available recruits is reduced because of failure to meet body composition standards for entry into the services and a high percentage of individuals exceeding military weight-for-height standards at the time of entry into the service leave the military before completing their term of enlistment. To aid in developing strategies for prevention and remediation of overweight in military personnel, the U.S. Army Medical Research and Materiel Command requested the Committee on Military Nutrition Research to review the scientific evidence for: factors that influence body weight, optimal components of a weight loss and weight maintenance program, and the role of gender, age, and ethnicity in weight management. Key questions addressed: 1. What are the essential components of an effective weight/fat loss program, and the most effective strategies for sustaining weight loss? 2. How do age and gender influence success in weight management programs? 3. Which strategies would be most and least effective in a military setting, and should military programs be more proactive in identifying and discouraging dangerous weight-loss practices? 4. To what extent should weight/fat control programs and policies be standardized across the services versus tailored to the individual service? 5. How can diet be effectively dealt with as a weight management component in the military setting and should pharmacological treatment be considered for use in the military? 6. How should individuals at increased risk of weight gain be dealt with? 7. What are the knowledge gaps in weight management programs relative to the military? To hear a summary of key recommendations, read the full article at http://www.nap.edu Read on... »

Meal Replacements  Bars and Liquid Drinks  Are they effective in producing lasting weight loss?

A special study using a technique that looks at a large number of studies that meet certain standards was published in 2003 by Dr. Steven Heymsfield  a clinical professor at Columbia University -- and his colleagues. They used a special meta-analysis technique that allowed them to examine half a dozen published studies that met their rigorous criteria. The studys goal was to measure the effectiveness of diets that use meal replacement drinks fortified with vitamins and minerals on weight loss after one year. Although millions of people have been using meal replacement bars and drinks as a popular diet strategy, little is known about their ability to produce lasting weight loss. This study looked at the use of meal replacements as compared to a conventional diet strategy over a one year period. The calories in both types of diet groups were similarly restricted so that comparisons were valid. [Note: The meal replacement groups used only a liquid meal replacement at either one or two meals, so no conclusions can be drawn about the use of popular meal replacement bars based on this particular study.] The researchers found that both liquid meal replacements and conventional dietary restriction produced meaningful weight loss at both 3 months and at one year after starting the diet. However, it is important to note that no matter how they analyzed the data, the groups using liquid meal replacements lost at least 5 pounds more than the dieters using a conventional diet. The number of people who dropped out of the studies was similar in both groups at 3 months, and at one year, there were fewer people who dropped out in the meal replacement groups. This suggests that people using the liquid meal replacement diets found them more satisfactory. No safety concerns were identified in either of the groups. In fact, the health of the dieters in both groups improved as the studies progressed. The authors report this as the first systematic study of the effectiveness of liquid meal replacements based on a meta-analysis of randomized controlled trials selected according to rigorous criteria. The study results should be encouraging to the people who find it convenient to use meal replacements as a weight management strategy. [Citation: Heymsfield SB, et al. International Journal of Obesity and Related Metabolic Disorders vol. 27, pages 537-49.] Heymsfield SB, van Mierlo CA, van der Knaap HC, Heo M, Frier HI. 2003. Weight management using a meal replacement strategy: meta and pooling analysis from six studies. Int J Obes Relat Metab Disord 27(5):537- 49. PC#60546 (posted July 2, 2003) Notes: Meta-analysis; Adolescents & Adults; Also included on other reference lists (Prevention programs health professionals; Determinantsdietary patterns) Abstract: OBJECTIVE: Although used by millions of overweight and obese consumers, there has not been a systematic assessment on the safety and effectiveness of a meal replacement strategy for weight management. The aim of this study was to review, by use of a meta- and pooling analysis, the existing literature on the safety and effectiveness of a partial meal replacement (PMR) plan using one or two vitamin/mineral fortified meal replacements as well as regular foods for long-term weight management. DESIGN: A PMR plan was defined as a program that prescribes a low calorie (>800or=25 kg/m(2), were evaluated. Studies with self- reported weight and height were excluded. Searches in Medline, EMBASE, and the Cochrane Clinical Trials Register from 1960 to January 2001 and from reference lists identified 30 potential studies for analysis. Of these, six met all of the inclusion criteria and used liquid meal replacement products with the associated plan. Overweight and obese subjects were randomized to the PMR plan or a conventional reduced calorie diet (RCD) plan. The prescribed calorie intake was the same for both groups. Authors of the six publications were contacted and asked to supply primary data for analysis. Primary data from the six studies were used for both meta- and pooling analyses. RESULTS: Subjects prescribed either the PMR or RCD treatment plans lost significant amounts of weight at both the 3-month and 1-year evaluation time points. All methods of analysis indicated a significantly greater weight loss in subjects receiving the PMR plan compared to the RCD group. Depending on the analysis and follow-up duration, the PMR group lost approximately 7-8% body weight and the RCD group lost approximately 3-7% body weight. A random effects meta-analysis estimate indicated a 2.54 kg (P<0.01) and 2.43 kg (P=0.14) greater weight loss in the PMR group for the 3-month and 1-y periods, respectively. A pooling analysis of completers showed a greater weight loss in the PMR group of 2.54 kg (P<0.01) and 2.63 kg (P<0.01) during the same time period. Risk factors of disease associated with excess weight improved with weight loss in both groups at the two time points. The degree of improvement was also dependent on baseline risk factor levels. The dropout rate for PMR and RCD groups was equivalent at 3 months and significantly less in the PMR group at 1 y. No reported adverse events were attributable to either weight loss regimen. CONCLUSION: This first systematic evaluation of randomized controlled trials utilizing PMR plans for weight management suggests that these types of interventions can safely and effectively produce significant sustainable weight loss and improve weight-related risk factors of disease. ShapeUp America »

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