Advertisement

European Journal of Nutrition

, Volume 53, Issue 3, pp 939–950 | Cite as

Meal replacement based on Human Ration modulates metabolic risk factors during body weight loss: a randomized controlled trial

  • Natalia Elizabeth Galdino AlvesEmail author
  • Bárbara Nery Enes
  • Hércia Stampini Duarte Martino
  • Rita de Cássia Gonçalves Alfenas
  • Sônia Machado Rocha Ribeiro
Original Contribution

Abstract

Purpose

A meal replacement may be an effective strategy in the management of obesity to increase antioxidant intake, attenuating oxidative stress and inflammation. In the present study, we investigated the efficacy of a new nutritional supplement to reduce metabolic risk parameters in obese women.

Methods

In a randomized controlled crossover study (2 × 2), 22 women (percentage body fat 40.52 ± 3.75 %; body mass index—BMI 28.72 ± 2.87 kg/m2; 35.04 ± 5.6 years old) were allocated into two treatments: hypocaloric diet and drink containing “Human Ration” (HR) consumption (CRHR), and hypocaloric diet and control drink consumption (CR). The study consisted of 2 periods of 5 weeks with 1 week of washout in two orders (CR → CRHR and CRHR → CR). Caloric restriction was 15 %, based on estimated energy requirement. Anthropometric, clinical and metabolic risk parameters were assessed at baseline and at the end of each period.

Results

Some metabolic risk factors were favorably modulated in both interventions: reduction in body weight (CR −0.74 ± 1.27 kg; p = 0.01; CRHR −0.77 ± 1.3 kg; p = 0.02), body mass index (BMI) (CR −0.27 ± 0.51 kg/m2; p = 0.02; CRHR −0.30 ± 0.52 kg/m2; p = 0.01) and HOMA-IR (CR −0.35 ± 0.82; p = 0.02, CRHR −0.41 ± 0.83; p = 0.03). However, CRHR reduced waist circumference (−2.54 ± 2.74 cm; p < 0.01) and gynoid fat (−0.264 ± 0.28 g; p < 0.01), and increased HDL-c levels (0.08 ± 0.15 mmol/l; p = 0.04).

Conclusion

Associated with hypocaloric diet, the intake of a nutritional supplement rich in phytochemicals as a breakfast substitute for 5 weeks had no additional effect on weight reduction than caloric restriction alone, but increased central lipolysis and improved the lipoprotein profile.

Keywords

Obesity management Meal replacements Phytochemicals Oxidative stress Low-grade inflammation Metabolic risk 

Notes

Acknowledgments

The authors would like to thank Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) for financial support.

Conflict of interest

The authors declared no conflict of interest.

References

  1. 1.
    Aballay LR, Osella AR, Celi A, Díaz MP (2009) Overweight and obesity: prevalence and their association with some social characteristics in a random sample population-based study in Córdoba city, Argentina. Obes Res Clin Pract 3:75–83CrossRefGoogle Scholar
  2. 2.
    Shoelson SE, Herrero L, Naaz A (2007) Obesity, inflammation, and insulin resistance. Gastroenterology 132:2169–2180CrossRefGoogle Scholar
  3. 3.
    Lahoza C, Mostazaa J (2007) Atherosclerosis as a systemic disease. Rev Esp Cardiol 60:184–195 CrossRefGoogle Scholar
  4. 4.
    Matsuzawa-Nagata N, Takamura T, Ando H, Nakamura S, Kurita S, Misu H, Ota T, Yokoyama M, Honda M, Miyamoto K-i, Kaneko S (2008) Increased oxidative stress precedes the onset of high-fat diet-induced insulin resistance and obesity. Metabolism 57:1071–1077CrossRefGoogle Scholar
  5. 5.
    Dambal SS, Indumati V, Kumari S (2011) Role of oxidative stress in obesity with an insight into type II diabetes mellitus. JCDR 5:52–54Google Scholar
  6. 6.
    Vassalle C, Sciarrino R, Bianchi S, Battaglia D, Mercuri A, Maffei S (2012) Sex-related differences in association of oxidative stress status with coronary artery disease. Fertil Steril 97:414–419CrossRefGoogle Scholar
  7. 7.
    Tomiyama AJ, Mann T, Vinas D, Hunger JM, DeJager J, Taylor SE (2010) Low calorie dieting increases cortisol. Psychosom Med 72:357–364CrossRefGoogle Scholar
  8. 8.
    Choudhary M, Grover K (2012) Development of functional food products in relation to obesity. Funct Foods Health Dis 2:188–197Google Scholar
  9. 9.
    Babio N, Balanza R, Basulto J, Bulló M, Salas-Salvadó J (2010) Dietary fibre: influence on body weight, glycemic control and plasma cholesterol profile. Nutr Hosp 25:327–340 Google Scholar
  10. 10.
    Moraes EA, Carraro JCC, Dantas MIS, Costa NMB, Ribeiro SMR, Martino HSD (2010) Protein and food qualities of brown faxseed whole four from the raw and heat-treated seeds. Rev Inst Adolfo Lutz 69:531–536Google Scholar
  11. 10.
    Schinella G, Mosca S, Cienfuegos-Jovellanos E, Pasamar MÁ, Muguerza B, Ramón D, Ríos JL (2010) Antioxidant properties of polyphenol-rich cocoa products industrially processed. Food Res Int 43:1614–1623CrossRefGoogle Scholar
  12. 11.
    Maki KC, Beiseigel JM, Jonnalagadda SS, Gugger CK, Reeves MS, Farmer MV, Kaden VN, Rains TM (2010) Whole-grain ready-to-eat oat cereal, as part of a dietary program for weight loss, reduces low-density lipoprotein cholesterol in adults with overweight and obesity more than a dietary program including low-fiber control foods. J Am Diet Assoc 110:205–214CrossRefGoogle Scholar
  13. 12.
    IOM (2005) Dietary reference intakes: energy, carbohydrate, fiber, fat, fatty acids, cholesterol, protein, and amino acids, vol 1357. Institute of Medicine. Food and Nutrition Board, National Academy, Washington Google Scholar
  14. 13.
    Pardini R, Matsudo S, Araújo T, Matsudo V, Andrade E, Braggion G, Andrade D, Oliveira L, Júnior AF, Raso V (2001) Validation of the International Physical Activity Questionaire (IPAQ version 6): pilot study in Brazilian young adults. RBCM 9:45–51Google Scholar
  15. 14.
    Jellife DB (1966) The assessment of the nutritional status of the community (with special reference to field surveys in developing regions of the world). Monogr Ser World Health Organ 3:256–271Google Scholar
  16. 15.
    Lohman TG, Roche AF, Martorell R (1998) Anthropometric standardization reference manual. Champaign Hum Kinet Pub 24:952Google Scholar
  17. 16.
    Alberti KGMM, Eckel RH, Grundy SM, Zimmet PZ, Cleeman JI, Donato KA, Fruchart J-C, James WPT, Loria CM, Smith SC (2009) Harmonizing the metabolic syndrome. Circulation 120:1640–1645CrossRefGoogle Scholar
  18. 17.
    Bray G, Bouchard C, James W (1998) Definitions and proposed current classification of obesity. In: Bray G, Bouchard C, James W (eds) Handbook of obesity. Marcel Dekker, New York, pp 31–40Google Scholar
  19. 18.
    WHO (2000) Obesity: preventing and managing the global epidemic. Report of a WHO consultation. World Health Organ Tech Rep Ser 894:1–253Google Scholar
  20. 19.
    Pickering TG, Hall JE, Lawrence JA, Falkner BE, Graves J, Hill MN (2005) Recommendation for blood pressure measurement in humans and experimental animals. Part 1: blood pressure measurement in humans. A statement for professionals from the subcommittee of professional and public education of the American Heart Association Council on High Blood Pressure Research. Circulation 45:142–161Google Scholar
  21. 20.
    Matthews D, Hosker J, Rudenski A, Naylor B, Treacher D, Turner R (1985) Homeostasis model assessment: insulin resistance and β-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia 28:412–419CrossRefGoogle Scholar
  22. 21.
    NCEP (2007) Adult Treatment Panel III. Lipid management of CAD. National Cholesterol Education Program, Available at: http://wwwconnecticarecom/Provider/Lipid-ManagementCADpdf
  23. 22.
    Mosca L, Benjamin EJ, Berra K, Bezanson JL, Dolor RJ, Lloyd-Jones DM, Newby LK, Piña IL, Roger VL, Shaw LJ, Zhao D, Beckie TM, Bushnell C, D’Armiento J, Kris-Etherton PM, Fang J, Ganiats TG, Gomes AS, Gracia CR, Haan CK, Jackson EA, Judelson DR, Kelepouris E, Lavie CJ, Moore A, Nussmeier NA, Ofili E, Oparil S, Ouyang P, Pinn VW, Sherif K, Smith SC, Sopko G, Chandra-Strobos N, Urbina EM, Vaccarino V, Wenger NK (2011) Effectiveness-based guidelines for the prevention of cardiovascular disease in women—2011 update. Circulation 123:1243–1262CrossRefGoogle Scholar
  24. 23.
    Pearson TA, Mensah GA, Alexander RW, Anderson JL, Cannon RO, Criqui M, Fadl YY, Fortmann SP, Hong Y, Myers GL, Rifai N, Smith SC, Taubert K, Tracy RP, Vinicor F (2003) Markers of inflammation and cardiovascular disease. Circulation 107:499–511CrossRefGoogle Scholar
  25. 24.
    Diaz J, Serrano E, Acosta F, Carbonell LF (1998) Reference intervals for four biochemistry analytes in plasma for evaluating oxidative stress and lipid peroxidation in human plasma. Clin Chem 44:2215–2217Google Scholar
  26. 25.
    Visser M, Bouter LM, McQuillan GM, Wener MH, Harris TB (1999) Elevated C-reactive protein levels in overweight and obese adults. JAMA 282:2131–2135CrossRefGoogle Scholar
  27. 26.
    Mera R, Thompson H, Prasad C (1998) How to calculate sample size for an experiment: a case-based description. Nutr Neurosci 1:87–91Google Scholar
  28. 27.
    Lombard C, Deeks A, Jolley D, Teede H (2009) Preventing weight gain: the baseline weight related behaviors and delivery of a randomized controlled intervention in community based women. BMC Public Health 9:2CrossRefGoogle Scholar
  29. 28.
    Dutra ES, Baiocchi de Carvalho KM, Miyazaki E, Merchan-Hamann E, Kiyomi Ito M (2012) Metabolic syndrome in central Brazil: prevalence and correlates in the adult population. Diabetol Metab Syndr 4:20CrossRefGoogle Scholar
  30. 29.
    Maddah M, Nikooyeh B (2009) Weight retention from early pregnancy to three years postpartum: a study in Iranian women. Midwifery 25:731–737CrossRefGoogle Scholar
  31. 30.
    Ball K, Crawford D (2006) Socio-economic factors in obesity: a case of slim chance in a fat world? Asia Pac J Clin Nutr 15:15–20Google Scholar
  32. 31.
    Romero-Corral A, Somers VK, Sierra-Johnson J, Thomas RJ, Collazo-Clavell ML, Korinek J, Allison TG, Batsis JA, Sert-Kuniyoshi FH, Lopez-Jimenez F (2008) Accuracy of body mass index in diagnosing obesity in the adult general population. Int J Obes 32:959–966CrossRefGoogle Scholar
  33. 32.
    Lorenzo AD, Bianchi A, Maroni P, Iannarelli A, Daniele ND, Iacopin L, Renzo LD (2013) Adiposity rather than BMI determines metabolic risk. Int J Cardiol 166:111–117CrossRefGoogle Scholar
  34. 33.
    Raymond NC, Peterson RE, Bartholome LT, Raatz SK, Jensen MD, Levine JA (2012) Comparisons of energy intake and energy expenditure in overweight and obese women with and without binge eating disorder. Obesity 20:765–772CrossRefGoogle Scholar
  35. 34.
    Tankó LB, Bagger YZ, Qin G, Alexandersen P, Larsen PJ, Christiansen C (2005) Enlarged waist combined with elevated triglycerides is a strong predictor of accelerated atherogenesis and related cardiovascular mortality in postmenopausal women. Circulation 111:1883–1890CrossRefGoogle Scholar
  36. 35.
    Ackermann D, Jones J, Barona J, Calle MC, Kim JE, LaPia B, Volek JS, McIntosh M, Kalynych C, Najm W, Lerman RH, Fernandez ML (2011) Waist circumference is positively correlated with markers of inflammation and negatively with adiponectin in women with metabolic syndrome. Nutr Res 31:197–204CrossRefGoogle Scholar
  37. 36.
    Manolopoulos KN, Karpe F, Frayn KN (2010) Gluteofemoral body fat as a determinant of metabolic health. Int J Obes 34:949–959CrossRefGoogle Scholar
  38. 37.
    Wiklund P, Toss F, Weinehall L, Hallmans G, Franks PW, Nordström A, Nordström P (2008) Abdominal and gynoid fat mass are associated with cardiovascular risk factors in men and women. JCEM 93:4360–4366. doi: 10.1210/jc.2008-0804 Google Scholar
  39. 38.
    Zamboni M, Rossi AP, Zoico E (2012) Sarcopenic obesity. In: Cruz-Jentoft AJ, Morley JE (eds) Sarcopenia. Wiley, Chichester, UKGoogle Scholar
  40. 39.
    Katcher HI, Legro RS, Kunselman AR, Gillies PJ, Demers LM, Bagshaw DM, Kris-Etherton PM (2008) The effects of a whole grain–enriched hypocaloric diet on cardiovascular disease risk factors in men and women with metabolic syndrome. Am J Clin Nutr 87:79–90Google Scholar
  41. 40.
    Mietus-Snyder ML, Shigenaga MK, Suh JH, Shenvi SV, Lal A, McHugh T, Olson D, Lilienstein J, Krauss RM, Gildengoren G, McCann JC, Ames BN (2012) A nutrient-dense, high-fiber, fruit-based supplement bar increases HDL cholesterol, particularly large HDL, lowers homocysteine, and raises glutathione in a 2-wk trial. FASEB J 26:3515–3527CrossRefGoogle Scholar
  42. 41.
    Khera AV, Cuchel M, de la Llera-Moya M, Rodrigues A, Burke MF, Jafri K, French BC, Phillips JA, Mucksavage ML, Wilensky RL, Mohler ER, Rothblat GH, Rader DJ (2011) Cholesterol efflux capacity, high-density lipoprotein function, and atherosclerosis. N Engl J Med 364:127–135CrossRefGoogle Scholar
  43. 42.
    Baba S, Osakabe N, Kato Y, Natsume M, Yasuda A, Kido T, Fukuda K, Muto Y, Kondo K (2007) Continuous intake of polyphenolic compounds containing cocoa powder reduces LDL oxidative susceptibility and has beneficial effects on plasma HDL-cholesterol concentrations in humans. Am J Clin Nutr 85:709–717Google Scholar
  44. 43.
    Rocha JLM, Anunciação PC, Tostes MGV, Valdés ST, Carraro JCC, Alves NEG, Bressan J (2012) Human Ration does not alter weight and body composition, but improves the lipidic profile of overweight woman. Nutr Hosp 27:1460–1468Google Scholar
  45. 44.
    Galisteo M, Duarte J, Zarzuelo A (2008) Effects of dietary fibers on disturbances clustered in the metabolic syndrome. J Nutr Biochem 19:71–84CrossRefGoogle Scholar
  46. 45.
    Chaput JP, Doucet É, Tremblay A (2012) Obesity: a disease or a biological adaptation? An update. Obes Rev 13:681–691CrossRefGoogle Scholar
  47. 46.
    Halliwell B (2012) The antioxidant paradox: less paradoxical now? Br J Clin Pharmacol. doi: 10.1111/j.1365-2125.2012.04272.x Google Scholar
  48. 47.
    Amirkhizi F, Siassi F, Djalali M, Foroushani AR (2010) Evaluation of oxidative stress and total antioxidant capacity in women with general and abdominal adiposity. Obes Res Clin Pract 4:209–216CrossRefGoogle Scholar
  49. 48.
    Pou KM, Massaro JM, Hoffmann U, Vasan RS, Maurovich-Horvat P, Larson MG, Keaney JF, Meigs JB, Lipinska I, Kathiresan S, Murabito JM, O’Donnell CJ, Benjamin EJ, Fox CS (2007) Visceral and subcutaneous adipose tissue volumes are cross-sectionally related to markers of inflammation and oxidative stress. Circulation 116:1234–1241CrossRefGoogle Scholar
  50. 49.
    Thompson HJ, Heimendinger J, Gillette C, Sedlacek SM, Haegele A, O’Neill C, Wolfe P (2005) In vivo investigation of changes in biomarkers of oxidative stress induced by plant food rich diets. J Agric Food Chem 53:6126–6132CrossRefGoogle Scholar
  51. 50.
    Evans DA, Hirsch JB, Dushenkov S (2006) Phenolics, inflammation and nutrigenomics. J Sci Food Agric 86:2503–2509CrossRefGoogle Scholar
  52. 51.
    Oliveira VB, Yamada LT, Fagg CW, Brandão MGL (2012) Native foods from Brazilian biodiversity as a source of bioactive compounds. Food Res Int 48:170–179CrossRefGoogle Scholar
  53. 52.
    Puchau B, Zulet MA, de Echávarri AG, Hermsdorff HHM, Martínez JA (2010) Dietary total antioxidant capacity is negatively associated with some metabolic syndrome features in healthy young adults. Nutrition 26:534–541CrossRefGoogle Scholar
  54. 53.
    Heneman KM, Chang HC, Prior RL, Steinberg FM (2007) Soy protein with and without isoflavones fails to substantially increase postprandial antioxidant capacity. J Nutr Biochem 18:46–53CrossRefGoogle Scholar
  55. 54.
    Poljsak B (2011) Strategies for reducing or preventing the generation of oxidative stress. Oxid Med Cell Longev 2011:15. doi: 10.1155/2011/194586 Google Scholar
  56. 55.
    Gowri V, Rizvi SG, Squib S, Al Futaisi A (2010) High-sensitivity C-reactive protein is a marker of obesity and not of polycystic ovary syndrome per se. Fertil Steril 94:2832–2834CrossRefGoogle Scholar
  57. 56.
    Gonzalez AS, Guerrero DB, Soto MB, Diaz SP, Martinez-Olmos M, Vidal O (2006) Metabolic syndrome, insulin resistance and the inflammation markers C-reactive protein and ferritin. Eur J Clin Nutr 60:802–809CrossRefGoogle Scholar
  58. 57.
    Shastri N, Paunikar VM, Baig MNH (2012) Association of obesity with total leucocyte count in patients of metabolic syndrome. Int J Biol Med Res 3:1399–1401Google Scholar
  59. 58.
    Fardet A, Rock E, Rémésy C (2008) Is the in vitro antioxidant potential of whole-grain cereals and cereal products well reflected in vivo? J Cereal Sci 48:258–276CrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • Natalia Elizabeth Galdino Alves
    • 1
    Email author
  • Bárbara Nery Enes
    • 1
  • Hércia Stampini Duarte Martino
    • 1
  • Rita de Cássia Gonçalves Alfenas
    • 1
  • Sônia Machado Rocha Ribeiro
    • 1
  1. 1.Department of Nutrition and HealthUniversity Federal of ViçosaViçosaBrazil

Personalised recommendations