Subjects
A random sample of 1167 overweight participants (female = 979, male = 188; body mass index (BMI) ≥ 25 kg/m2) has been included in the weight loss program in 250 Austrian primary care settings.
Data of men and women who attended the program at least 12 months without interruption have been analyzed, and their results were compared with their baseline data. Exclusion criteria were BMI < 25 kg/m
2, diabetes mellitus, being pregnant or lactating, cardiovascular disease, other medical conditions prohibiting weight loss, substance abuse, severe psychiatric illness, and eating disorders (anorexia nervosa, bulimia nervosa, binge eating disorder). The corresponding descriptive statistic is presented in Table
1.
Table 1
Descriptive characteristic at baseline
Number | 188 | 979 | | 1167 |
Age (years) | 49.2 ± 13.8 | 46.5 ± 13.3 | n.s.b
| 46.9 ± 13.4 |
Weight (kg) | 107.5 ± 16.3 | 89.5 ± 17.7 |
p < 0.001 | 92.3 ± 18.7 |
BMI (kg/m2) | 34.1 ± 5.0 | 33.0 ± 6.3 |
p = 0.004 | 33.1 ± 6.1 |
Fat mass (kg) | 32.4 ± 9.9 | 35.9 ± 11.7 |
p < 0.001 | 35.7 ± 11.5 |
BCM (kg) | 39.1 ± 5.9 | 26.3 ± 3.9 |
p < 0.001 | 28.5 ± 6.5 |
The procedures used in this evaluation were in accordance with the Declaration of Helsinki (1964) and its later amendments. The study is approved and registered under No 2107/2013 of the ethics committee of the Medical University of Vienna. All participants gave their written informed consent prior to their inclusion into the program.
Program design
The myLINE
®-program (
www.myline.at, AENGUS, Austria) is a standardized, meal replacement-based weight loss program for at least 24 weeks. The diet is in accordance with the latest nutritional recommendations of the German Nutrition Society (DGE), the Austrian Nutrition Society (ÖGE), the Swiss Nutrition Society (SGE), and the Swiss Association for Nutrition (SVE), which are called DACH-recommendations.
The program consists of four phases:
Total energy intake: 835 kcal/day, 60.0 g/day of protein, 15.5 g/day of fat, and 100.0 g/day of carbohydrates.
Participants are trained in creating their meal according to an exchange schema. The total fat content is ≤ 30 % of the daily energy intake. The reduction phase should be undertaken until the participant achieves two-thirds of the intended weight reduction, but at least for 10 weeks.
Total energy intake: 1000–1300 kcal/day, 50–65 g/day of protein (~ 20 energy percent (E%)), 34–44 g/day of fat (~ 30 E%), and 125–160 g/d of carbohydrates (~ 50 E%). For persons with a high body cell mass (BCM), the content of proteins would be individually adjusted.
Total energy intake: 1300–1600 kcal/day, 50–65 g/day of protein (~ 20 E%), 34–44 g/day of fat (~ 30 E%), and 160–200 g/day of carbohydrates (~ 50 E%). For persons with a high BCM, the content of proteins would be individually adjusted.
During the whole program, at regular intervals (start, reduction, and transition phase: every 14 days; stabilization phase: once a month; afterward four times a year), the participants were measured by bioelectrical impedance analysis (BIA) and conventional anthropometry and received individual nutritional advice from a registered dietician. In the context of individual face-to-face consultations, aims and treatment plans, also including improvement of the activity level in accordance with the actual recommendations, are defined. A nutrition and activity diary for self-reflection and a participant handbook for support and exercises at home are used as instruments of behavior therapy.
After the weight reduction, there is the possibility to participate in a follow-up program. Regular controls should improve long-term weight loss and weight maintenance.