Intermittent versus on-demand use of a very low calorie diet: a randomized 2-year clinical trial

J Intern Med. 2003 Apr;253(4):463-71. doi: 10.1046/j.1365-2796.2003.01131.x.

Abstract

Objectives: To compare two different very low calorie diet (VLCD)-based weight maintenance strategies.

Design and setting: A randomized 2-year clinical trial performed at the Department of Body Composition and Metabolism, Sahlgrenska University Hospital, Sweden.

Subjects: A total of 334 patients, body mass index (BMI) >30 kg m-2, aged 18-60 years.

Interventions: All the patients started with 16 VLCD weeks. Subjects in the intermittent group were then scheduled to use VLCD for 2 weeks every third month, whilst patients in the on-demand group were instructed to use VLCD whenever their body weight passed an individualized cut-off level. Irrespective of the treatment group, all the subjects were recommended a hypocaloric diet during VLCD-free periods.

Main outcome measures: Changes in body weight, body composition, anthropometric variables and cardiovascular risk factors.

Results: Completers in both groups maintained highly significant weight losses after 2 years: 7.0 +/- 11.0 kg (6.2 +/- 9.5%) in the intermittent group and 9.1 +/- 9.7 kg (7.7 +/- 8.1%) in the on-demand group (P < 0.001, ns between groups). Male completers in the on-demand group lost significantly more weight than men in the intermittent group, 14.5 +/- 11.0 kg vs. 4.0 +/- 10.5 kg, respectively (P < 0.01). Most cardiovascular risk factors improved during the first year, whilst anthropometric measures, insulin, HDL- and LDL-cholesterol were also significantly improved after 2 years of treatment.

Conclusion: Clinically significant weight reductions were achieved after 2 years of VLCD-based treatment. The structure of VLCD treatment during the maintenance phase did not affect weight loss in the total study population, whilst male subjects might benefit from the VLCD on-demand strategy.

Publication types

  • Clinical Trial
  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Body Composition
  • Body Mass Index
  • Body Weight
  • Caloric Restriction / methods
  • Cardiovascular Diseases / etiology
  • Confidence Intervals
  • Diet, Reducing*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Obesity / diet therapy*
  • Patient Dropouts
  • Risk Factors
  • Secondary Prevention
  • Sex Factors