For
the record, a meal replacement is not a ‘protein shake’ – a meal replacement is
a scientifically formulated product that contains similar macronutrients to
that of a meal (20-30g total carbohydrate) as well as a full micronutrient
profile with far fewer calories than that of a meal. Meal replacements were originally
formulated and used with patients who were in need of rapid weight loss prior
to surgery, when completely replacing all meals controlled calorie and
carbohydrate intake to such an extent that the patient was put into ketosis and
were able to lose weight rapidly.
While
still used for this purpose, meal replacements are also commonly used on many ‘diet’
programs with the same goal, helping individuals to control calorie intake as
well as being used as a meal option for meals which are commonly missed, such
as breakfast.
Being
trained as a dietitian, I was of course taught by academic types that as a
nutritionist the focus should always be on fresh, healthy, natural food and
using such products was really only a good option for those who were in
desperate need of weight reduction under medical supervision ie as a dietitian
always promote ‘real food’.
It
was not until I began working at The Children’s Hospital almost 10 years ago
solely with overweight and obese children and teens that I began experimenting
with these products. In client cases in which I had an overweight teen that
generally skipped breakfast, I began using these products as a breakfast
alternative. The teens were often happy to ‘drink’ their high protein breakfast
and almost to my disbelief we started to get positive weight loss results with
these teens, even better than we got when we used standard breakfast options of
cereal or eggs on toast.
It
is was this observation that lead me to approach a supplier of meal replacement
products in Australia to look at supplying product for a research trial and
ultimately an endorsement of these products as I do get positive results using
them in clinical practice for weight loss.
This
is not to say that I recommend meal replacements for all of my clients but I do
find that for breakfast skippers, busy executives who often miss meals and for
those who need a weight loss kick-start after finding themselves on a tough
weight loss plateau that meal replacement products can support weight loss.
To
this day I still do not really know why these products work so well, but I do
know that if I nutritionally model breakfast with a similar macronutrient ratio
to than of a meal replacement that I do not get the same weight loss results
and all I can put this down to is the calorie restriction even if it is only a
100 calorie difference between the standard breakfast option and a meal replacement
product.
Then
of course there is the ongoing aggression that arises whenever sugar is spied
on a nutrition label. Meal replacements tend to be relatively high in sugars as
a high protein drink will taste pretty ordinary without some sort of sweetener
or sugar base to sweeten it up. This appears to have no negative outcome on
insulin release or weight loss in these products simply as the high protein
load of these products is likely to be buffering the sugar load, particularly as
part of a tight calorie control.
Of
course it would be amazing to have a randomized controlled trial that really
investigates why and if these products really do work but I unfortunately do
not have the 3 to 5 years an RCT takes to justify using these products, I need
to get results with my weight loss clients now.
As
is the case with every option in nutrition and life in general people can
ultimately make their own decisions when it comes to the way they choose to go
about weight control. It is not my job to tell everyone what they should do for
weight loss. Nor is it to constantly defend why I choose different options
working with clients towards sustainable weight loss – this is the art of my
own clinical practice but if asked I can give my best scientifically informed opinion
on what I find works well in practice and that is what I have done in the case
of meal replacements. Whether or not you agree is up to you but there really is
no need to get so nasty about it.
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