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Meal replacements are foods of a fixed calorie and nutrient content that are designed to take the place of a usual meal. Commercially available meal replacements usually come in the form of ‘shakes’, soups, bars or portion control meals. The normal recommendation is to replace at least two main meals, generally breakfast and lunch, and to consume a carefully calorie-controlled evening meal. The meals can be supplemented with fruit and vegetables. Meal replacement programmes are generally based on a daily intake of 1200–1500 kcal. In theory the plan can be adjusted to any calorie goal depending on the patient’s preference and current energy intake. The role of meal replacements in weight management has been evaluated in several studies.28–31
In a study by Ditschuneit and colleagues (2001), patients randomised to a 1200–1500 kcal meal replacement diet versus a 1200–1500 kcal ‘normal’ foods diet lost on average 6.4 kg more (1 stone) over a 12-week period.32 Long-term weight loss maintenance was achieved over a further two years by the inclusion of one shake per day in the volunteers’ diets.
Advantages of meal replacements
- Takes the guesswork out of portion control and estimating calories
- Easy for patients to grasp
- Nutritionally adequate
- Encourages a regular eating pattern
- Patient can still have ‘normal’ foods in their diet
- Widely available
Disadvantages of meal replacements
- Boredom and taste fatigue
- Do not fit in with family meals
- Can be expensive for some
Patients should be asked to consider carefully the pros and cons of a meal replacement plan for them and should be provided with support both during and after a meal replacement programmes.
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