Weight Management

By: David Heber, M.D., Ph.D., F.A.C.P., F.A.S.N., Chairman, Herbalife Nutrition Institute

Losing weight is not always easy. Given the hectic pace of modern life, people have turned to diets or dubious weight loss schemes. Meal replacements, along with diet and exercise, offer an alternative, effective solution to weight loss and weight management.

In my last post, we discussed the difference between meal replacements and protein shakes, and how these products cater to specific goals and needs.

Today, I would like to dig deeper into why meal replacements work better than typical diets, according to science and research.

The Science Behind Meal Replacement Products

There’s nothing magical about meal replacements, and they’re not as bland or boring as food replacements in science fiction may suggest.

When we talk about the science of meal replacements, I primarily want to discuss three aspects that relate to their efficacy for weight management:

1. Glycemic Index
2. Nutrient Density
3. Behavioral Change

Glycemic Index

The glycemic index (GI) is a measure of how quickly a food causes blood sugar levels to rise. When you consume foods with a high GI, your blood sugar will spike and then fall sharply, promoting lethargy and hunger.

By contrast, when you consume low glycemic foods, your body digests and absorbs them at a slower rate, thus promoting satiety. Meal replacements that have a low glycemic index can curb appetite despite the lower calorie intake.

For comparison, an Herbalife Nutrition Formula 1 meal replacement shake, before mixed with milk, has a low GI, whereas orange juice has a moderate to high GI.

It’s important to note, however, that a low GI doesn't necessarily mean a food is high in nutrients. This is why the next concept is so important.

Nutrient Density

Nutrient density refers to the ratio of the nutrient composition of a food to the nutrient requirements of the person. In other words, nutrient density is a measure of how much nutrition you get per serving or per calorie eaten.

For example, an Herbalife Nutrition Formula 1 meal replacement shake is 170 calories when mixed with 8 oz. nonfat milk, while also providing protein, fiber, healthy fats, vitamins, and minerals. On the other hand, a croissant is around 200-300 calories, but will only provide empty calories from saturated fat and sugar, with no other significant nutrients.

Most meal replacement products may deliver vitamins and minerals to make them nutrient dense.

Meal replacements promote a high quality diet by being nutrient-dense and having a low GI. When combined with resistance exercise, meal replacements can also help promote lean body mass to maintain or build lean muscle and support fat loss.

In fact, a recent trial was conducted to investigate the effect of a high protein partial meal replacement (HPMR) diet on nutrient intake in overweight and obese people. Based on the results, the HPMR diet led to an overall improvement in diet quality over the course of the study. Significant decreases in fat and cholesterol intake and substantial increases in protein and fiber intake were observed at all time points.

Dietary intake of all micronutrients tested, including nutrients of U.S. public health concern (vitamin D, calcium, and potassium) increased significantly at all time points from baseline, and sodium intake significantly decreased.

Considering that those who are overweight or obese are likely struggling to consume a nutrient-balanced diet, the HPMR diet may be an effective strategy to enhance overall nutrition quality of their diet. The HPMR diet could be incorporated into a healthy lifestyle program that includes healthy eating and exercise for those at risk for macronutrient and micronutrient deficiencies.

Nutrient Density

Aside from the nutritional considerations, we should also look at how behavioral patterns formed by taking meal replacements influence weight management.

The Medicine Department of the University of Ulm, Germany, carried out a four-year study of obese patients (who were not taking Herbalife Nutrition products). Researchers identified six specific reasons why the meal replacement diets worked so effectively for weight loss.

These reasons include:

Convenience

Lack of time to prepare healthy meals is one of the biggest barriers to losing weight. Meal replacements make it easier to plan meals.

Increased compliance

Meal replacements reduce barriers to dietary adherence, such as the temptation to indulge in unhealthy foods.

Regular eating pattern

Repetition and routine are key in a weight loss or weight maintenance journey. Eating at regular times throughout the day and avoiding long periods of time between each meal positively affect your energy level and hunger feeling.

Accuracy of calorie estimation

Dietitians typically advise consuming a certain number of calories throughout the day, depending on your health goals. Meal replacements – when prepared as suggested – are an easy, precise way to keep track of how many calories you are consuming.

Quality of food consumed

Cutting back on calories can make it difficult to obtain the required nutrients. Meal replacements are often fortified vitamins, minerals, protein and fiber, which help avoid a nutrient gap.

Positively affects self-monitoring

Recording dietary intake helps people become aware of their current food-related behaviors. Tracking meal replacements is easy, making self-awareness of target behaviors and outcomes easier.

 

Evidence Why Meal Replacements Are Effective

In 2018, researchers from the University of Oxford published a systematic review and meta-analysis of meal replacements for weight management, not including studies of Herbalife Nutrition programs. They reviewed 14 studies that compared the effect of weight loss interventions that incorporated meal replacements to those of alternative interventions.

They concluded that meal replacements are superior to usual diet and calorie restriction.

New Findings from the Meta-Analysis

According to the study, participants assigned to a meal replacement diet lost an additional 1.44 kg (3.17 pounds) at one year, compared to a diet-only approach.

The researchers also observed that participants of the meal replacement group who joined behavioral weight loss programs to enhance their effect had a 6.13 kg greater weight loss within the group.*

This finding underlines the value of social support, as these types of programs make it easier for people to adhere to a reduced energy diet. The structure and external control associated with these programs may also promote adherence.

According to our recent survey of dietitians, adherence was the biggest obstacle in their patient’s weight loss journey. Someone simply purchasing meal replacements from a grocery store can easily grow tired of the same flavor and give up; whereas a behavioral program or supportive community will lead to greater adherence.

Meal Replacements for Clinical Use

In many countries today, the clinical recommendations for the treatment of obesity advise that individuals attempting weight loss should aim for an energy deficit of 500-1000 kcal. Unfortunately, these recommendations do not encourage meal replacements as tools to help patients achieve this deficit.

The meta-analysis provides new evidence to inform clinical guidelines, especially when it comes to obesity. The use of meal replacements should be promoted as an effective dietary strategy for weight loss since meal replacements are proven to be effective and easily available without a prescription. However, it's important to note that, as with any changes in your diet and physical activity levels, individuals should always consult their physician before engaging in any weight-loss journey.

Meal replacements for weight control have also been reviewed by the European Food Safety Authority (EFSA). The Panel on Dietetic Products, Nutrition and Allergies was commissioned to provide a scientific opinion regarding the weight loss claims related to meal replacements.

In their paper, they recognized the following:

1. Weight loss achieved with meal replacement products was significantly greater than with conventional energy-restricted diets prescribed with the same calorie content.
2. When weight loss strategies were equally effective, the intensity of intervention required was three times higher for the conventional energy-restricted diets than for meal replacements.

In summary, these studies show that meal replacements work better than self-directed weight loss attempts. While popular diets might work for short-term weight loss, in the long run, adherence will be an issue.

If you’re looking to achieve a healthy weight long term, it’s always best to find a community to support your goals.

 

*Studies still have to be conducted to determine the expected results of weight-loss or maintenance programs that use exclusively Herbalife Nutrition products.