People with Health Issues

Along with being health concerns, overweight and obesity are risk factors for additional diseases such as:

1. raised blood pressure / hypertension,
2. glucose intolerance, insulin resistance and type 2 diabetes mellitus, or
3. impaired blood lipids, atherosclerosis and cardiovascular disease.

For individuals with health issues who are aiming for energy reduction and low calorie diets, meal replacement products or “slimming foods” can be a tool to support weight loss or weight maintenance strategies. This is particularly useful where dietary interventions pose a challenge, or have not been successful before. These products are designed to replace all or a part of the total daily diet, and are specifically formulated to provide the calories and nutrient needs of people on a weight-loss or weight maintenance diet. As an interim way, it is used to help people lose and regain control of their weight, often with support from healthcare professionals.

First and foremost, a negative energy balance is necessary to achieve weight loss. The type of carbohydrate can also further support this strategy. Most meal replacement products contain readily digestible carbohydrates such as maltodextrin, white sugar, or glucose, inducing a high blood glucose response and high insulin release. Insulin is a “storage” hormone, which promotes the storage of fat and suppresses fat burning in favor of glucose utilization in energy metabolism. Therefore, the frequent consumption of carbohydrates with high glycemic properties and high insulin release promotes fat storage and prevents fat burning and “melting” of fat stores.

The slow release carbohydrate isomaltulose provides the carbohydrate energy needed, while it allows for a better metabolic profile with less suppression of fat burning. It results in higher fat utilization at the expense of carbohydrate use in energy metabolism. In other words, isomaltulose helps promote the fat burning process. The higher fat burning rate with isomaltulose has been confirmed in 14 human intervention studies in conditions with relevance to weight management (König et al 2012, van Can et al 2009, 2012, Arai et al 2007) or physical activity and sports.

Isomaltulose offers a unique value among the range of fully available nutritive carbohydrates, since most traditional sugars and carbohydrates are either readily available or induce a higher contribution of carbohydrate use in energy metabolism for other reasons, like in case of fructose.

Effects of a liquid meal replacement product with isomaltulose on blood glucose levels, insulin and fuel use have been investigated by Arai et al (2007) in their study with seven healthy men: In comparison with a conventional dextrin-based meal replacement product, consumption of the isomaltulose-containing formula lead to a significantly lower blood glucose and insulin response and less suppression of free fatty acid levels. In parallel, fat burning was significantly higher and carbohydrate utilization was lower. In a second experiment, consumption of the isomaltulose-based formula for breakfast had a lowering effect on the blood glucose and insulin responses after  lunch as well, where a standard meal was consumed, suggesting a “second meal effect”.

Over time, the fat-burning capabilities of isomaltulose can influence body weight and body fat accumulation, including both visceral fat linked with adiposity, as well as liver fat associated with insulin resistance. For instance, findings from a 12-week intervention study among 50 overweight to obese adults revealed that a calorie-restricted weight loss diet with foods containing isomaltulose in place of sucrose (40g) led to a small but significantly greater weight loss. This was attributed to the higher fat use observed after food intake. These findings from Henry et al (unpublished data) illustrate that, by providing its calories in a more gentle way, isomaltulose promotes weight loss in a low-calorie diet without compromise in the palatability of the food; findings equally relevant to meal placement products formulated with essential nutrients and limited calories.

Möller et al (2015) demonstrated the effectiveness of a carbohydrate-rich meal replacement with isomaltulose and chicory root fiber in promoting weight loss, in comparison with a protein-rich meal replacement. After 2 weeks of total meal replacement with the isomaltulose-containing formula, participants experienced significant weight loss. After 8 weeks (with replacement of 2 meals in week 3-4, and replacement of 1 meal in week 5 to 8), 2 out of 3 participants had achieved a weight loss of 5% and more, and nearly 1 out of 5 had lost more than 10% of the initial body weight.

Effects of a meal replacement product on body composition and blood glucose control were investigated by Oizumi et al (2007) in a prediabetic population group. In their 12-week intervention study, 23 adults with impaired glucose tolerance were asked not to change their lifestyle apart from consuming 250 ml of an isomaltulose-based formula per day at breakfast, or following their usual breakfast for 12 week periods. The isomaltulose-based formula was linked to long-term improvements in 2h-plasma glucose after oral glucose tolerance tests (OGTT) and in serum free fatty acid levels. Additionally, it showed a decrease in visceral fat accumulation among viscerally obese people. The authors concluded that the isomaltulose-based formula has beneficial effects on metabolic syndrome-related factors. (Oizumi et al (2007).

References:

Arai H, Mizuno A, Matsuo K, Fukaya M, Sasaki H, Arima H, Matsuura M, Taketani Y, Doi T, Takeda E (2004) Effect of a novel palatinose-based liquid balanced formula (MHN-01) on glucose and lipid metabolism in male Sprague-Dawley rats after short- and long-term ingestion. Metabolism 53(8):977–983. http://www.ncbi.nlm.nih.gov/pubmed/15281004

König D, Theis S, Kozianowski G, Berg A (2012) Postprandial substrate use in overweight subjects with the metabolic syndrome after isomaltulose (Palatinose™) ingestion. Nutrition 28(6):651–656. http://www.ncbi.nlm.nih.gov/pubmed/22264450

Oizumi T, Daimon M, Jimbu Y, Kameda W, Arawaka N, Yamaguchi H, Ohnuma H, Sasaki H, Kato T (2007) A palatinose-based balanced formula improves glucose tolerance, serum free fatty acid levels and body fat composition. Tohoku J Exp Med 212(2):91–99. http://www.ncbi.nlm.nih.gov/pubmed/17548953

van Can JG, van Loon LJ, Brouns F, Blaak EE (2012) Reduced glycaemic and insulinaemic responses following trehalose and isomaltulose ingestion: implications for postprandial substrate use in impaired glucose-tolerant subjects. Br J Nutr 108(7):1210–1217. http://www.ncbi.nlm.nih.gov/pubmed/22172468

van Can, Judith G P, Ijzerman TH, van Loon, Luc J C, Brouns F, Blaak EE (2009) Reduced glycaemic and insulinaemic responses following isomaltulose ingestion: implications for postprandial substrate use. Br J Nutr 102(10):1408–1413. http://www.ncbi.nlm.nih.gov/pubmed/19671200

Möller K, Willers J, Hahn A (2015) Efficacy of high carbohydrate versus high protein meal replacements on weight reduction – a randomized controlled trial. J Obes Weight Loss Ther 5:266. https://www.omicsonline.org/open-access/efficacy-of-high-carbohydrate-versus-high-protein-meal-replacements-onweight-reduction–a-randomized-controlled-trial-2165-7904-1000266.php?aid=54708