Intermittent versus on‐demand use of a very low calorie diet: a randomized 2‐year clinical trial

. Lantz H, Peltonen M, Ågren L, Torgerson JS (Sahlgrenska University Hospital, Göteborg, Sweden). Intermittent versus on‐demand use of a very low calorie diet: a randomized 2‐year clinical trial. J Intern Med 2003; 253: 463–471. Objectives. To compare two different very low calorie diet (VLCD)‐based weight maintenance strategies. Design and setting. A randomized 2‐year clinical trial performed at the Department of Body Composition and Metabolism, Sahlgrenska University Hospital, Sweden. Subjects. A total of 334 patients, body mass index (BMI) >30 kg m−2, aged 18–60 years. Interventions. All the patients started with 16 VLCD weeks. Subjects in the intermittent group were then scheduled to use VLCD for 2 weeks every third month, whilst patients in the on‐demand group were instructed to use VLCD whenever their body weight passed an individualized cut‐off level. Irrespective of the treatment group, all the subjects were recommended a hypocaloric diet during VLCD‐free periods. Main outcome measures. Changes in body weight, body composition, anthropometric variables and cardiovascular risk factors. Results. Completers in both groups maintained highly significant weight losses after 2 years: 7.0 ± 11.0 kg (6.2 ± 9.5%) in the intermittent group and 9.1 ± 9.7 kg (7.7 ± 8.1%) in the on‐demand group (P