Efficacy of a meal-replacement program for promoting blood lipid changes and weight and body fat loss in US Army soldiers.

Excess weight is associated with negative health outcomes. Meal replacements are effective in promoting favorable body composition changes in civilian populations; however, their efficacy with military service members who have unique lifestyles is unknown. The objective of this randomized controlled trial was to determine the efficacy of the Army's education-based weight-management program, "Weigh to Stay," with and without meal replacements for improving blood lipids, and to promote weight and body fat loss in overweight US Army soldiers. Soldiers (n=113; 76 males/37 females) attending Weigh to Stay at Fort Bragg, NC, in 2006/2007 were randomized to Weigh to Stay only or a commercially available meal-replacement program (two meal replacements per day) in conjunction with Weigh to Stay, and followed until Army body fat standards were met or for 6 months if standards were not met. Study completers (n=46) in both treatment groups lost weight (Weigh to Stay: -2.7+/-4.3 kg; meal replacers: -3.8+/-3.5 kg) and fat mass (Weigh to Stay, -2.7+/-3.2 kg; meal replacers: -2.9+/-2.5 kg), and improved high-density lipoprotein cholesterol concentrations (Weigh to Stay: 13+/-9 mg/dL [0.34+/-0.23 mmol/L]; meal replacers: 8+/-7 mg/dL [0.21+/-0.18 mmol/L]; P<0.05); however, no between-group differences were observed. Attrition was lower (P=0.009) and success in meeting body fat standards tended to be higher (P=0.06) for the meal replacers vs Weigh to Stay participants. Intent-to-treat analysis demonstrated that meal replacers lost more weight (1.2+/-0.5 kg), percent body fat (1.0%+/-0.4%), and fat mass (0.8+/-0.4 kg) compared to Weigh to Stay volunteers (P<0.05). Our findings suggest that meal replacement use can be recommended as a potential adjunct strategy to Weigh to Stay.