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Kempf, Kerstin, Röhling, Martin, Banzer, Winfried, Braumann, Klaus-Michael, Halle, Martin, Schaller, Nina, McCarthy, H. David, Predel, Hans Georg, Schenkenberger, Isabelle, Tan, Susanne, Toplak, Hermann, Martin, Stephan and Berg, Aloys (2022) Early and strong leptin reduction is predictive for long-term weight loss during high-protein, low-glycaemic meal replacement: a subanalysis of the randomised-controlled ACOORH trial. Nutrients, 14 (12). pp. 1-14. ISSN 2072-6643
Lifestyle interventions including meal replacement are suitable for prevention and treatment of obesity and type-2-diabetes. Since leptin is involved in weight regulation, we hypothesised that a meal replacement-based lifestyle intervention would reduce leptin levels more effectively than lifestyle intervention alone. In the international, multicentre, randomised-controlled ACOORH-trial (Almased-Concept-against-Overweight-and-Obesity-and-Related- Health-Risk), overweight or obese participants with metabolic syndrome criteria ( = 463) were randomised into two groups and received telemonitoring devices and nutritional advice. The intervention group additionally used a protein-rich, low-glycaemic meal replacement. Data were collected at baseline, after 1, 3, 6, and 12 months. All datasets providing leptin data ( = 427) were included in this predefined subanalysis. Serum leptin levels significantly correlated with sex, body mass index, weight, and fat mass at baseline ( < 0.0001). Stronger leptin reduction has been observed in the intervention compared to the control group with the lowest levels after 1 month of intervention (estimated treatment difference -3.4 µg/L [1.4; 5.4] for females; -2.2 µg/L [1.2; 3.3] for males; < 0.001 each) and was predictive for stronger reduction of body weight and fat mass ( < 0.001 each) over 12 months. Strongest weight loss was observed after 6 months (-5.9 ± 5.1 kg in females of the intervention group vs. -2.9 ± 4.9 kg in the control group ( < 0.0001); -6.8 ± 5.3 kg vs. -4.1 ± 4.4 kg ( = 0.003) in males) and in those participants with combined leptin and insulin decrease. A meal replacement-based lifestyle intervention effectively reduces leptin which is predictive for long-term weight loss.
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