Replacing meals with Almased is also beneficial for diabetics
Overweight type 2 diabetics with a high level of insulin resistance can reduce their insulin requirement and their blood glucose (HbA1c), and lose weight, using Almased’s meal replacement product Vitalkost, which is low in calories and rich in protein. That is the result of a preclinical trial carried out by the West-German Centre of Diabetes and Health (WGDZ) of the Association of Catholic Hospitals Dusseldorf (VKKD).
The current guidelines for treating type 2 diabetes recommend as a first step a change of diet and exercise. If this does not result in the HbA1c in the blood being reduced to below 6.5 per cent within three to six months, the next step is to use an oral antidiabetic. If this then also fails to reduce the blood glucose to a satisfactory level, the last option is insulin therapy. About half of type 2 diabetics are being treated with insulin ten years after the disease was first diagnosed. Insulin therapy often leads, however, to a further weight increase, which in turn causes the insulin requirement to increase, so that patients end up in a vicious circle.
In its trial, the WGDZ wanted to find out whether it is possible to break this vicious circle using a meal replacement that is low in calories and rich in protein. Twenty-two type 2 diabetics aged between 35 and 75 took part in the trial; they all had a body mass index over 27 and injected more than 100 units of insulin a day. Almased Vitalkost diet powder from Almased Wellness GmbH was used as the meal replacement – enriched with linseed, olive and rapeseed oil and with vegetable juice. Almased Vitalkost consists essentially of three ingredients: soy protein (50 per cent), honey (25 per cent) and skimmed milk yoghurt powder (23 per cent).
During the first week of the trial, the participants had to replace breakfast, lunch and evening meal with 150 grams (g) of Almased powder in total dissolved in water. This represents an energy content of 2,223 kilojoules (kJ). In addition, the trial participants consumed 45 g of vegetable oil (1,717 kJ) and 750 millilitres (ml) of vegetable juice (544 kJ). Additional food intake was forbidden, and the energy input was thus limited to 4,903 kJ a day.
During the second to fourth weeks, the participants in the trial only had to replace their breakfast and their evening meal with Almased, consuming 50 g each time, and could eat a normal lunch. Lunch could comprise 150 to 200 g of fish or meat, 500 g of vegetables and not more than 50 g of carbohydrates in the form of whole-grain bread or brown rice (total 2,093 kJ). In addition, the trial participants were expected to take 45 g of vegetable oil a day. The daily energy intake was thus 4,600-5,300 kJ. In the fifth to twelfth weeks, the trial participants then only had to substitute their evening meal with 50 g of Almased.
The participants in the trial had to measure their blood glucose level eight times a day and to record this together with their food intake and their insulin requirement. Insulin intake was regularly adjusted by a diabetologist. Of the 22 participants in the trial, seven dropped out prematurely because they did not consider themselves capable of fulfilling the tasks.
With the other trial participants, a significant reduction in their daily insulin requirement was already apparent after the first week: from 147 to 91 units. This was reduced further and was 65 units a day after twelve weeks. Blood glucose improved from 8.8 per cent at the beginning of the trial to 8.0 per cent after four weeks and 7.7 per cent after eight weeks. Although it had increased again to 8.1 per cent after twelve weeks, this figure was still significantly lower than the figure at the start.
The participants also managed to reduce their weight considerably: from an average of 117.0 kg at the start to 115.4 kg after four weeks and 112.2 kg after eight weeks (based on the data of the participants still participating). After completion of the twelve weeks, the participants who had completed the trial weighed on average 107.4 kg and had lost on average 7.9 kg. The scatter was between 2.5 and 16.5 kg.
A telephone survey conducted a year and a half after completion of the trial showed that the 15 trial participants who were still participating at the end of the trial had on average still maintained their good values to a large extent. Their average daily insulin requirement was 94 units and their bodyweight 108.2 kg. At that time, four of the 15 participants were still taking Almased regularly. This had enabled them to reduce their insulin requirement, blood glucose and weight still further. Two of them had even been able to terminate their insulin therapy completely. Four of the trial participants were still taking Almased occasionally and seven had stopped taking the meal replacement. Insulin requirement, blood glucose and weight had increased again in the latter two groups.
The research paper ‘Meal replacement reduces insulin requirement, HbA1c and weight long-term in type 2 diabetes patients with >100 U insulin per day’ by Professor Stephan Martin and Dr Kerstin Kempf, which was published in the Journal of Human Nutrition and Dietetics can be downloaded here free of charge.