Skip to main content
  • More from ADA
    • Diabetes
    • Clinical Diabetes
    • Diabetes Spectrum
    • ADA Standards of Medical Care
    • ADA Scientific Sessions Abstracts
    • BMJ Open Diabetes Research & Care
  • Subscribe
  • Log in
  • My Cart
  • Follow ada on Twitter
  • RSS
  • Visit ada on Facebook
Diabetes Care

Advanced Search

Main menu

  • Home
  • Current
    • Current Issue
    • Online Ahead of Print
    • Special Article Collections
    • ADA Standards of Medical Care
  • Browse
    • By Topic
    • Issue Archive
    • Saved Searches
    • Special Article Collections
    • ADA Standards of Medical Care
  • Info
    • About the Journal
    • About the Editors
    • ADA Journal Policies
    • Instructions for Authors
    • Guidance for Reviewers
  • Reprints/Reuse
  • Advertising
  • Subscriptions
    • Individual Subscriptions
    • Institutional Subscriptions and Site Licenses
    • Access Institutional Usage Reports
    • Purchase Single Issues
  • Alerts
    • E­mail Alerts
    • RSS Feeds
  • Podcasts
    • Diabetes Core Update
    • Special Podcast Series: Therapeutic Inertia
    • Special Podcast Series: Influenza Podcasts
    • Special Podcast Series: SGLT2 Inhibitors
    • Special Podcast Series: COVID-19
  • Submit
    • Submit a Manuscript
    • Journal Policies
    • Instructions for Authors
    • ADA Peer Review
  • More from ADA
    • Diabetes
    • Clinical Diabetes
    • Diabetes Spectrum
    • ADA Standards of Medical Care
    • ADA Scientific Sessions Abstracts
    • BMJ Open Diabetes Research & Care

User menu

  • Subscribe
  • Log in
  • My Cart

Search

  • Advanced search
Diabetes Care
  • Home
  • Current
    • Current Issue
    • Online Ahead of Print
    • Special Article Collections
    • ADA Standards of Medical Care
  • Browse
    • By Topic
    • Issue Archive
    • Saved Searches
    • Special Article Collections
    • ADA Standards of Medical Care
  • Info
    • About the Journal
    • About the Editors
    • ADA Journal Policies
    • Instructions for Authors
    • Guidance for Reviewers
  • Reprints/Reuse
  • Advertising
  • Subscriptions
    • Individual Subscriptions
    • Institutional Subscriptions and Site Licenses
    • Access Institutional Usage Reports
    • Purchase Single Issues
  • Alerts
    • E­mail Alerts
    • RSS Feeds
  • Podcasts
    • Diabetes Core Update
    • Special Podcast Series: Therapeutic Inertia
    • Special Podcast Series: Influenza Podcasts
    • Special Podcast Series: SGLT2 Inhibitors
    • Special Podcast Series: COVID-19
  • Submit
    • Submit a Manuscript
    • Journal Policies
    • Instructions for Authors
    • ADA Peer Review
Continuing Evolution of Nutritional Therapy for Diabetes

The Effect of Liquid Meal Replacements on Cardiometabolic Risk Factors in Overweight/Obese Individuals With Type 2 Diabetes: A Systematic Review and Meta-analysis of Randomized Controlled Trials

  1. Jarvis C. Noronha1,2,
  2. Stephanie K. Nishi1,2,
  3. Catherine R. Braunstein1,2,
  4. Tauseef A. Khan1,2,
  5. Sonia Blanco Mejia1,2,
  6. Cyril W.C. Kendall1,2,3,
  7. Hana Kahleová4,5,
  8. Dario Rahelić6,7,
  9. Jordi Salas-Salvadó8,9,
  10. Lawrence A. Leiter1,2,10,11,12 and
  11. John L. Sievenpiper1,2,10,11⇑
  1. 1Toronto 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. 2Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Canada
  3. 3College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, Canada
  4. 4Diabetes Centre, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
  5. 5Physicians Committee for Responsible Medicine, Washington, DC
  6. 6Department of Endocrinology, Diabetes and Clinical Pharmacology, Dubrava University Hospital, Zagreb, Croatia
  7. 7School of Medicine, University of Zagreb, Zagreb, Croatia
  8. 8CIBER Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain
  9. 9Human Nutrition Unit, Institut d'Investigació Sanitària Pere i Virgili, Universitat Rovira i Virgili, Reus, Spain
  10. 10Division of Endocrinology and Metabolism, St. Michael’s Hospital, Toronto, Canada
  11. 11Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, Canada
  12. 12Department of Medicine, University of Toronto, Toronto, Canada
  1. Corresponding author: John L. Sievenpiper, john.sievenpiper{at}utoronto.ca
Diabetes Care 2019 May; 42(5): 767-776. https://doi.org/10.2337/dc18-2270
PreviousNext
  • Article
  • Figures & Tables
  • Suppl Material
  • Info & Metrics
  • PDF
Loading

Article Figures & Tables

Figures

  • Tables
  • Figure 1
    • Download figure
    • Open in new tab
    • Download powerpoint
    Figure 1

    Search summary.

  • Figure 2
    • Download figure
    • Open in new tab
    • Download powerpoint
    Figure 2

    Summary of pooled effect estimates from RCTs investigating the effect of liquid meal replacements as part of a weight loss diet (intervention) compared with traditional low-calorie weight loss diets (comparator) on cardiometabolic risk factors. Pooled effect estimates are expressed as MDs with 95% CIs and, for visualization purposes, as SMDs with 95% CIs. SMDs are represented by the diamonds and 95% CIs by the line through the diamonds. Analyses were conducted using the generic inverse variance method with random effects models (at least 5 trials available) or fixed effects models (<5 trials available). Interstudy heterogeneity was tested by the Cochran Q statistic (χ2) at a significance level of PQ < 0.10. The GRADE approach was used to evaluate the certainty of the evidence. Evidence was graded as high, moderate, low, or very low quality. RCTs were graded as high-quality evidence by default and downgraded on the basis of risk of bias, inconsistency, indirectness, imprecision, and publication bias.

Tables

  • Figures
  • Table 1

    Summary of trial characteristics

    Number of trials9
    Number of participants961
    Follow-up duration, weeks24 (12–52)
    Design, number of trials
     Parallel8
     Crossover1
    Setting, number of trials
     Asia4
     North America3
     Europe1
     Australia1
    Participant characteristics at baseline
    Age, years55 (51–62)
    Male: female (%)†48: 52
    BMI, kg/m230.5 (26.8–35.5)
    HbA1c, %7.6 (6.5–8.8)
    HbA1c, mmol/mol60 (48–73)
    Intervention characteristics
     Liquid meal replacement type, number of trials
      Glucerna SR4
      SlimFast2
      Medifast1
      Probiotec Formula WL1
      Microdiet1
     Liquid meal replacement dose, % E‡20 (13–47)
     Estimated total caloric intake, kcal/day§1,500 (1,195–1,659)
     Macronutrient composition, C: F: P (median)¶48: 30: 20
    Comparator characteristics
     Comparator type, number of trials
      Food exchange system4
      Self-selected low-calorie foods4
      Diet book1
     Estimated total caloric intake, kcal/day§1,500 (1,350–1,737)
     Macronutrient composition, C: F: P (median)¶55: 25: 17
    Dropout rate
     Intervention, % dropout18 (1–43)
     Comparator, % dropout20 (2–71)
    Funding source, number of trials**
     Agency1
     Industry6
     Agency and industry1
     Not reported1
    • Data are median (range) unless otherwise indicated. % E, % energy; C, carbohydrate; F, fat; P, protein.

    • ↵†Eight of nine trials provided data on sex.

    • ↵‡If data were not provided, calculations were made under the assumption that an average individual consumes 2,000 kcal/day. For example, if participants consumed one serving of a 200-kcal liquid meal replacement per day and were recommended a caloric target by achievement of a 500-kcal deficit per day, then the dose was calculated as follows: ([200] / [2,000–500]) × 100% = ∼13% E.

    • ↵§If data were not provided, calculations were made under the assumption that an average individual consumes 2,000 kcal/day. For example, if participants were recommended a caloric target by achieving a 500-kcal deficit per day, then the daily caloric intake was calculated as follows: 2,000 – 500 = 1,500 kcal/day.

    • ↵¶Four of nine trials provided data for the intervention group and six of nine trials provided data for the comparator group from which macronutrient composition could be estimated. End-of-study values measuring energy from carbohydrates, fat, and protein were reported only if the study did not report or design diets to have a planned macronutrient composition.

    • ↵**Agency funding is that from government, university, or not-for-profit sources. Industry funding is that from trade organizations that obtain revenue from the sale of products.

PreviousNext
Back to top
Diabetes Care: 42 (5)

In this Issue

May 2019, 42(5)
  • Table of Contents
  • Table of Contents (PDF)
  • About the Cover
  • Index by Author
  • Masthead (PDF)
Sign up to receive current issue alerts
View Selected Citations (0)
Print
Download PDF
Article Alerts
Sign In to Email Alerts with your Email Address
Email Article

Thank you for your interest in spreading the word about Diabetes Care.

NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
The Effect of Liquid Meal Replacements on Cardiometabolic Risk Factors in Overweight/Obese Individuals With Type 2 Diabetes: A Systematic Review and Meta-analysis of Randomized Controlled Trials
(Your Name) has forwarded a page to you from Diabetes Care
(Your Name) thought you would like to see this page from the Diabetes Care web site.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
Citation Tools
The Effect of Liquid Meal Replacements on Cardiometabolic Risk Factors in Overweight/Obese Individuals With Type 2 Diabetes: A Systematic Review and Meta-analysis of Randomized Controlled Trials
Jarvis C. Noronha, Stephanie K. Nishi, Catherine R. Braunstein, Tauseef A. Khan, Sonia Blanco Mejia, Cyril W.C. Kendall, Hana Kahleová, Dario Rahelić, Jordi Salas-Salvadó, Lawrence A. Leiter, John L. Sievenpiper
Diabetes Care May 2019, 42 (5) 767-776; DOI: 10.2337/dc18-2270

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
Add to Selected Citations
Share

The Effect of Liquid Meal Replacements on Cardiometabolic Risk Factors in Overweight/Obese Individuals With Type 2 Diabetes: A Systematic Review and Meta-analysis of Randomized Controlled Trials
Jarvis C. Noronha, Stephanie K. Nishi, Catherine R. Braunstein, Tauseef A. Khan, Sonia Blanco Mejia, Cyril W.C. Kendall, Hana Kahleová, Dario Rahelić, Jordi Salas-Salvadó, Lawrence A. Leiter, John L. Sievenpiper
Diabetes Care May 2019, 42 (5) 767-776; DOI: 10.2337/dc18-2270
del.icio.us logo Digg logo Reddit logo Twitter logo CiteULike logo Facebook logo Google logo Mendeley logo
  • Tweet Widget
  • Facebook Like
  • Google Plus One

Jump to section

  • Article
    • Abstract
    • Introduction
    • Research Design and Methods
    • Results
    • Risk of Bias
    • Conclusions
    • Article Information
    • Footnotes
    • References
  • Figures & Tables
  • Suppl Material
  • Info & Metrics
  • PDF

Related Articles

Cited By...

More in this TOC Section

  • Gluten Intake and Risk of Islet Autoimmunity and Progression to Type 1 Diabetes in Children at Increased Risk of the Disease: The Diabetes Autoimmunity Study in the Young (DAISY)
  • Nutritional Strategies for Prevention and Management of Diabetes: Consensus and Uncertainties
  • Nutrition Therapy for Adults With Diabetes or Prediabetes: A Consensus Report
Show more Continuing Evolution of Nutritional Therapy for Diabetes

Similar Articles

Navigate

  • Current Issue
  • Standards of Care Guidelines
  • Online Ahead of Print
  • Archives
  • Submit
  • Subscribe
  • Email Alerts
  • RSS Feeds

More Information

  • About the Journal
  • Instructions for Authors
  • Journal Policies
  • Reprints and Permissions
  • Advertising
  • Privacy Policy: ADA Journals
  • Copyright Notice/Public Access Policy
  • Contact Us

Other ADA Resources

  • Diabetes
  • Clinical Diabetes
  • Diabetes Spectrum
  • Scientific Sessions Abstracts
  • Standards of Medical Care in Diabetes
  • BMJ Open - Diabetes Research & Care
  • Professional Books
  • Diabetes Forecast

 

  • DiabetesJournals.org
  • Diabetes Core Update
  • ADA's DiabetesPro
  • ADA Member Directory
  • Diabetes.org

© 2021 by the American Diabetes Association. Diabetes Care Print ISSN: 0149-5992, Online ISSN: 1935-5548.