Jarvis C Noronha1,2, Stephanie K Nishi1,2, Catherine R Braunstein1,2, Tauseef A Khan1,2, Sonia Blanco Mejia1,2, Cyril W C Kendall1,2,3, Hana Kahleová4,5, Dario Rahelić6,7, Jordi Salas-Salvadó8,9, Lawrence A Leiter1,2,10,11,12, John L Sievenpiper13,2,10,11. 1. Toronto 3D (Diet, Digestive Tract and Disease) Knowledge Synthesis and Clinical Trials Unit, Clinical Nutrition and Risk Factor Modification Centre, St. Michael's Hospital, Toronto, Canada. 2. Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Canada. 3. College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, Canada. 4. Diabetes Centre, Institute for Clinical and Experimental Medicine, Prague, Czech Republic. 5. Physicians Committee for Responsible Medicine, Washington, DC. 6. Department of Endocrinology, Diabetes and Clinical Pharmacology, Dubrava University Hospital, Zagreb, Croatia. 7. School of Medicine, University of Zagreb, Zagreb, Croatia. 8. CIBER Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain. 9. Human Nutrition Unit, Institut d'Investigació Sanitària Pere i Virgili, Universitat Rovira i Virgili, Reus, Spain. 10. Division of Endocrinology and Metabolism, St. Michael's Hospital, Toronto, Canada. 11. Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada. 12. Department of Medicine, University of Toronto, Toronto, Canada. 13. Toronto 3D (Diet, Digestive Tract and Disease) Knowledge Synthesis and Clinical Trials Unit, Clinical Nutrition and Risk Factor Modification Centre, St. Michael's Hospital, Toronto, Canada john.sievenpiper@utoronto.ca.
Abstract
OBJECTIVE: The evidence for liquid meal replacements in diabetes has not been summarized. Our objective was to synthesize the evidence of the effect of liquid meal replacements on cardiometabolic risk factors in overweight/obese individuals with type 2 diabetes. RESEARCH DESIGN AND METHODS: Data sources included MEDLINE, EMBASE, and the Cochrane Library through 10 December 2018. We included randomized trials of ≥2 weeks assessing the effect of liquid meal replacements in weight loss diets compared with traditional weight loss diets on cardiometabolic risk factors in overweight/obese subjects with type 2 diabetes. Two independent reviewers extracted relevant data and assessed risk of bias. Data were pooled using the inverse variance method. The overall certainty of the evidence was evaluated using GRADE (Grading of Recommendations Assessment, Development and Evaluation). RESULTS: Nine trial comparisons (N = 961 [median follow-up 24 weeks]) met eligibility criteria. Mean differences were for body weight -2.37 kg (95% CI -3.30 to -1.44), BMI -0.87 kg/m2 (-1.31 to -0.42), body fat -1.66% (-2.17 to -1.15), waist circumference -2.24 cm (-3.72 to -0.77), HbA1c -0.43% (-0.66 to -0.19) (-4.7 mmol/mol [-7.2 to -2.1]), fasting glucose -0.63 mmol/L (-0.99 to -0.27), fasting insulin -11.83 pmol/L (-23.11 to -0.54), systolic blood pressure -4.97mmHg (-7.32 to -2.62), and diastolic blood pressure -1.98 mmHg (-3.05 to -0.91). There was no effect on blood lipids. The overall certainty of the evidence was low to moderate owing to imprecision and/or inconsistency. CONCLUSIONS: Liquid meal replacements in weight loss diets lead to modest reductions in body weight, BMI, and systolic blood pressure, and reductions of marginal clinical significance in body fat, waist circumference, HbA1c, fasting glucose, fasting insulin, and diastolic blood pressure. More high-quality trials are needed to improve the certainty in our estimates.
OBJECTIVE: The evidence for liquid meal replacements in diabetes has not been summarized. Our objective was to synthesize the evidence of the effect of liquid meal replacements on cardiometabolic risk factors in overweight/obese individuals with type 2 diabetes. RESEARCH DESIGN AND METHODS: Data sources included MEDLINE, EMBASE, and the Cochrane Library through 10 December 2018. We included randomized trials of ≥2 weeks assessing the effect of liquid meal replacements in weight loss diets compared with traditional weight loss diets on cardiometabolic risk factors in overweight/obese subjects with type 2 diabetes. Two independent reviewers extracted relevant data and assessed risk of bias. Data were pooled using the inverse variance method. The overall certainty of the evidence was evaluated using GRADE (Grading of Recommendations Assessment, Development and Evaluation). RESULTS: Nine trial comparisons (N = 961 [median follow-up 24 weeks]) met eligibility criteria. Mean differences were for body weight -2.37 kg (95% CI -3.30 to -1.44), BMI -0.87 kg/m2 (-1.31 to -0.42), body fat -1.66% (-2.17 to -1.15), waist circumference -2.24 cm (-3.72 to -0.77), HbA1c -0.43% (-0.66 to -0.19) (-4.7 mmol/mol [-7.2 to -2.1]), fasting glucose -0.63 mmol/L (-0.99 to -0.27), fasting insulin -11.83 pmol/L (-23.11 to -0.54), systolic blood pressure -4.97mmHg (-7.32 to -2.62), and diastolic blood pressure -1.98 mmHg (-3.05 to -0.91). There was no effect on blood lipids. The overall certainty of the evidence was low to moderate owing to imprecision and/or inconsistency. CONCLUSIONS: Liquid meal replacements in weight loss diets lead to modest reductions in body weight, BMI, and systolic blood pressure, and reductions of marginal clinical significance in body fat, waist circumference, HbA1c, fasting glucose, fasting insulin, and diastolic blood pressure. More high-quality trials are needed to improve the certainty in our estimates.
Authors: Mohammed Faraz Rafey; Razk Abdalgwad; Paula Mary O'Shea; Siobhan Foy; Brid Claffey; Colin Davenport; Derek Timothy O'Keeffe; Francis Martin Finucane Journal: Front Nutr Date: 2022-05-18
Authors: Vikkie A Mustad; Refaat A Hegazi; Deborah S Hustead; Erwin S Budiman; Ricardo Rueda; Kevin Maki; Margaret Powers; Jeffrey I Mechanick; Richard M Bergenstal; Osama Hamdy Journal: BMJ Open Diabetes Res Care Date: 2020-07