Plant-Based Meal Replacement and Cardiometabolic Risk Factors in Adults with Obesity: A Randomized Controlled Trial
DOI:
https://doi.org/10.5281/zenodo.22343516Keywords:
plant-based diet, meal replacement, obesity, cardiometabolic risk, weight lossAbstract

Background: Obesity increasingly drives dyslipidaemia, hypertension, and dysglycaemia worldwide. Objective: To synthesise
evidence on plant-based meal replacements (PBMRs) as a strategy for weight and cardiometabolic risk reduction in adults with
obesity. Methods: Narrative review of published randomised trials, systematic reviews and meta-analyses, and mechanistic
studies retrieved from PubMed, Crossref, and Europe PMC. Findings: PBMRs produce clinically meaningful reductions in body
weight, LDL-cholesterol, blood pressure, and glycaemic markers, comparable to or exceeding conventional meal replacements.
Conclusions: PBMRs represent a scalable, evidence-supported adjunct to cardiometabolic risk management, though long-term
adherence data remain limited.
References
NCD Risk Factor Collaboration (NCD-RisC). Worldwide trends in underweight and obesity from 1990 to 2022: a pooled analysis of 3663 population-representative studies with 222 million children, adolescents, and adults. Lancet. 2024;403(10431):1027-1050. doi:10.1016/S0140-6736(23)02750-2
Noronha JC, Nishi SK, Khan TA, Blanco Mejia S, Kendall CWC, Kahleova H, Rahelić D, Salas-Salvadó J, Leiter LA, Lean MEJ, Sievenpiper JL. Weight management using meal replacements and cardiometabolic risk reduction in individuals with pre-diabetes and features of metabolic syndrome: A systematic review and meta-analysis of randomized controlled trials. Obes Rev. 2024;25(7):e13751. doi:10.1111/obr.13751
World Health Organization. Obesity and overweight. Fact sheet. Geneva: WHO; 2024. Available from: https://www.wh o.int/news-room/fact-sheets/detail/obesity-and-overweigh t
Astbury NM, Piernas C, Hartmann-Boyce J, Lapworth S, Aveyard P, Jebb SA. A systematic review and meta-analysis of the effectiveness of meal replacements for weight loss. Obes Rev. 2019;20(4):569-587. doi:10.1111/obr.12816
Lowe MR, Butryn ML, Zhang F. Evaluation of meal replacements and a home food environment intervention for long-term weight loss: a randomized controlled trial. Am J Clin Nutr. 2018;107(1):12-19. doi:10.1093/ajcn/nqx005
Koch CA, Kjeldsen EW, Frikke-Schmidt R. Vegetarian or vegan diets and blood lipids: a meta-analysis of randomized trials. Eur Heart J. 2023;44(28):2609-2622. doi:10.1093/eurheartj/ehad211
Gibbs J, Gaskin E, Ji C, Miller MA, Cappuccio FP. The effect of plant-based dietary patterns on blood pressure: a systematic review and meta-analysis of controlled intervention trials. J Hypertens. 2021;39(1):23-37. doi:10.1097/HJH.0000000000002604
Bassin SR, Ferreira De Carvalho J, Gulati M. A Review of Plant-Based Diets for Obesity Management. Endocr Pract. 2024;30(8):779-789. doi:10.1016/j.eprac.2024.04.020
Fontaine KR, Yang D, Gadbury GL, Heshka S, Schwartz LG, Murugesan R, Kraker JL, Heo M, Heymsfield SB, Allison DB. Results of soy-based meal replacement formula on weight, anthropometry, serum lipids & blood pressure during a 40-week clinical weight loss trial. Nutr J. 2003;2:14. doi:10.1186/1475-2891-2-14
Chen B, Hong S, Wang Y, Hu Q, Ma D. Efficacy of Meal Replacement Products on Weight and Glycolipid Metabolism Management: A 90-Day Randomized Controlled Trial in Adults with Obesity. Nutrients. 2024;16(19):3284. doi:10.3390/nu16193284
Campbell EK, Fidahusain M, Campbell TM 2nd. Evaluation of an Eight-Week Whole-Food Plant-Based Lifestyle Modification Program. Nutrients. 2019;11(9):2068. doi:10.3390/nu11092068
Wiśniewska K, Okręglicka K, Paskudzka M, Jagielska A, Bober J, Oczkowski M, Ciepiela O, Nitsch-Osuch A. The VEGPREV study: effectiveness of four plant-based diets on weight loss, metabolic syndrome components and appetitive traits in overweight and obese individuals: a randomized controlled trial. Front Nutr. 2025;12:1677496. doi:10.3389/fnut.2025.1677496
Lean MEJ, Leslie WS, Barnes AC, Brosnahan N, Thom G, McCombie L, Peters C, Zhyzhneuskaya S, Al-Mrabeh A, Hollingsworth KG, Rodrigues AM, Rehackova L, Adamson AJ, Sniehotta FF, Mathers JC, Ross HM, McIlvenna Y, Stefanetti R, Trenell M, Welsh P, Kean S, Ford I, McConnachie A, Sattar N, Taylor R. Primary care-led weight management for remission of type 2 diabetes (DiRECT): an open-label, cluster-randomised trial. Lancet. 2018;391(10120):541-551. doi:10.1016/S0140-6736(17)33102-1
Wang F, Zheng J, Yang B, Jiang J, Fu Y, Li D. Effects of Vegetarian Diets on Blood Lipids: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. J Am Heart Assoc. 2015;4(10):e002408. doi:10.1161/JAHA.115.002408
Reynolds K, Chin A, Lees KA, Nguyen A, Bujnowski D, He J. A meta-analysis of the effect of soy protein supplementation on serum lipids. Am J Cardiol. 2006;98(5):633-640. doi:10.1016/j.amjcard.2006.03.042
Tokede OA, Onabanjo TA, Yansane A, Gaziano JM, Djoussé L. Soya products and serum lipids: a meta-analysis of randomised controlled trials. Br J Nutr. 2015;114(6):831-843. doi:10.1017/S0007114515002603
Del Gobbo LC, Falk MC, Feldman R, Lewis K, Mozaffarian D. Effects of tree nuts on blood lipids, apolipoproteins, and blood pressure: systematic review, meta-analysis, and dose-response of 61 controlled intervention trials. Am J Clin Nutr. 2015;102(6):1347-1356. doi:10.3945/ajcn.115.110965
López PD, Cativo EH, Atlas SA, Rosendorff C. The Effect of Vegan Diets on Blood Pressure in Adults: A Meta-Analysis of Randomized Controlled Trials. Am J Med. 2019;132(7):875-883.e7. doi:10.1016/j.amjmed.2019.01.044
Melgar B, Diaz-Arocutipa C, Huerta-Rengifo C, Piscoya A, Barboza JJ, Hernandez AV. Vegetarian diets on anthropometric, metabolic and blood pressure outcomes in people with overweight and obesity: a systematic review and meta-analysis of randomized controlled trials. Int J Obes (Lond). 2023;47(10):903-910. doi:10.1038/s41366-023-01357-7
Noronha JC, Nishi S, Braunstein CR, Khan T, Blanco Mejía S, Kendall CWC, Kahleová H, Rahelić D, Salas-Salvadó J, Leiter LA, Sievenpiper JL. The Effect of Liquid Meal Replacements on Cardiometabolic Risk Factors in Overweight/Obese Individuals With Type 2 Diabetes: A Systematic Review and Meta-analysis of Randomized Controlled Trials. Diabetes Care. 2019;42(5):767-776. doi:10.2337/dc18-2270
Jenkins DJA, Kendall CWC, Augustin LSA, Mitchell S, Sahye-Pudaruth S, Blanco Mejia S, Chiavaroli L, Mirrahimi A, Ireland C, Bashyam B, Vidgen E, de Souza RJ, Sievenpiper JL, Coveney J, Leiter LA, Josse RG. Effect of legumes as part of a low glycemic index diet on glycemic control and cardiovascular risk factors in type 2 diabetes mellitus: a randomized controlled trial. Arch Intern Med. 2012;172(21):1653-1660. doi:10.1001/2013.jamainternmed.70
Bielefeld D, Grafenauer S, Rangan A. The Effects of Legume Consumption on Markers of Glycaemic Control in Individuals with and without Diabetes Mellitus: A Systematic Literature Review of Randomised Controlled Trials. Nutrients. 2020;12(7):2123. doi:10.3390/nu12072123
Barnard ND, Cohen J, Jenkins DJA, Turner-McGrievy G, Gloede L, Jaster B, Seidl K, Green AA, Talpers S. A low-fat vegan diet improves glycemic control and cardiovascular risk factors in a randomized clinical trial in individuals with type 2 diabetes. Diabetes Care. 2006;29(8):1777-1783. doi:10.2337/dc06-0606
Xie Y, Gou L, Peng M, Zheng J, Chen L. Effects of soluble fiber supplementation on glycemic control in adults with type 2 diabetes mellitus: A systematic review and meta-analysis of randomized controlled trials. Clin Nutr. 2021;40(4):1800-1810. doi:10.1016/j.clnu.2020.10.032
Nogal A, Valdes AM, Menni C. The role of short-chain fatty acids in the interplay between gut microbiota and diet in cardio-metabolic health. Gut Microbes. 2021;13(1):1-24. doi:10.1080/19490976.2021.1897212
Pavis GF, Revuelta Iniesta R, Roper H, Theobald H, Derbyshire E, Finnigan TJA, Stephens FB, Wall BT. A four-week dietary intervention with mycoprotein-containing food products reduces serum cholesterol concentrations in community-dwelling, overweight adults: A randomised controlled trial. Clin Nutr. 2024;43(3):649-659. doi:10.1016/j.clnu.2024.01.023
Song M, Fung TT, Hu FB, Willett WC, Longo VD, Chan AT, Giovannucci EL. Association of Animal and Plant Protein Intake With All-Cause and Cause-Specific Mortality. JAMA Intern Med. 2016;176(10):1453-1463. doi:10.1001/jamainternmed.2016.4182


