Weight-loss programs that include a very-low-calorie diet or meal replacement formulas may be the most effective dietary strategy for weight loss — and diabetes remission — in people with type 2 diabetes, according to new research published in the journal Diabetologia.
Remission of type 2 diabetes is usually defined as having no signs of the disease, without having to take any medications to lower blood glucose levels. Recent studies point to evidence that diabetes remission may be more common than was previously suspected, occurring in about one in 20 people with type 2. Research points to several different ways that people with type 2 may experience remission, such as losing at least 10% of their body weight within a few years following a diabetes diagnosis, following a low-carbohydrate diet, or undergoing bariatric (weight-loss) surgery.
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Very-low-calorie diets, formula meal replacements linked to greatest weight loss
For the latest analysis, researchers looked at previously published meta-analyses (research looking at multiple studies) on dietary strategies for weight loss. They identified 19 meta-analyses that fit their criteria, each of which included between two and 23 studies. Overall, they found that the greatest weight loss in these studies was seen in participants who were assigned to follow very-low-calorie diets — containing about 400 to 500 calories — for 8 to 12 weeks, resulting in an average of 6.6 kilograms (14.6 pounds) greater weight loss compared with participants assigned to consume about 1,000 to 1,500 calories each day. Compared with participants who consumed 1,000 to 1,500 calories daily as part of their study, those who were assigned to instead consume formula meal replacements experienced an average of 2.4 kilograms (5.3 pounds) greater weight loss over 12 to 52 weeks.
Overall, the researchers found that low-carbohydrate diets were no better for weight loss than high-carbohydrate diets. Diets high in protein or monounsaturated fats, the Mediterranean diet, and vegetarian or low-glycemic diets led to minimal greater weight loss than standard (control) diets across the studies, leading to 0.3-2.0 kilograms (0.7-4.4 pounds) greater weight loss.
When it came to diabetes remission, this outcome was seen in a median of 54% of participants in studies involving low-calorie diets, 11% of participants in studies involving meal replacements, and 15% of participants in studies involving the Mediterranean diet. Remission was also seen in 22% of participants who followed very low-carbohydrate diets and 20% of those who followed a very-low-carbohydrate diet, but the researchers found that these studies involved a “serious and critical risk of bias” due to their design and implementation.
“Very low energy diets and formula meal replacement appear the most effective approaches” for weight loss and potential remission in type 2 diabetes, the researchers concluded, based on studies that mostly lasted less than a year. “Well-conducted research is needed to assess longer-term impacts on weight, glycemic control, clinical outcomes and diabetes complications,” they added.
Want to learn more about weight management? Read “Tried and True Weight-Loss Techniques,” “Losing Weight Without Feeling Hungry: Eight Tips,” and “Seven Ways to Lose Weight.”