In the last few decades, there has been an increase in the number of obese people to the
level of a global epidemic as a result of inadequate diet, sedentary lifestyle, but also
genetic predispositions. The World Health Organization (WHO) declared obesity to be the
biggest, global, chronic health problem in adults, that is increasingly becoming a more
serious problem than malnutrition.On the other hand, obesity is a risk factor for the
development of contemporary non-infectious diseases today that account for more than 80% of
mortality in developed countries, such as vascular disease, diabetes and respiratory diseases
such as asthma.
This trend is also recorded in Croatia, both in adult population and in children if the data
from 2003 and 2015 are being compared, while according to data from 2019, almost two thirds
of the adult population in Croatia were overweight or obese (42% overweight, 23% obese).
Of particular concern are the data from the European Obesity Monitoring Initiative from
2018/2019. according to which in Croatia 35% of children aged 8.0 to 8.9 were overweight or
obese. At the national level, the problem of obesity is greater in boys than in girls, and it
is 17.8% compared to 11.9% of girls. Croatia is in a high fifth place together with other
countries of the Mediterranean region of Europe due to the shift from the Mediterranean to
the Western lifestyle.
In cooperation with Podravka, Belupo has developed a standard and innovative product line.
Products are replacing one or more one or more daily meals, and thay must comply with
Regulation 2016/1413 requirements related to energy value, content and composition of fats
and proteins, the amount of vitamins and minerals in this type of products.
The standard product line contains common ingredients and this type of product already exists
on world markets, while the innovative product line differs from the standard one by
implementing raw materials that are considered better sources of potentially bioactive
components.
The study for a group of adult participants was designed in such a way that the participants
in the initial stage follow a low-calorie diet of about 1000 - 1100 kcal, whereby 5 daily
meals are replaced with meal replacements in the reduction diet (active group and active
control) (intensive phase). In subsequent stages, subjects gradually increase their energy
intake and gradually substitute meal replacement product (MRP) with regular nutritionally
profiled meals (active phase and maintenance phase). The final (stable) phase represents the
stage in which, in addition to one meal replacement per day, the usual meals designed by the
nutritionists of Belupo and the Culinary Center of Podravka are consumed, where education and
nutrition counseling is also carried out.
The study for the child population of respondents is designed in such a way that the
respondents in the initial phase implement a low-calorie diet of about 1300-1500 kcal,
whereby 3 daily meals are replaced with meal replacements in the reduction diet in addition
to 2 nutritionally balanced regular meals that include a minimum of 5 daily servings of
fruits and vegetables (active group and active control) (intensive phase).
In subsequent phases, subjects gradually increase their energy intake and gradually replace
MRP with regular nutritionally profiled meals (active phase and stable phase). The final
phase represents the phase in which subjects consume the usual meals designed by the
nutritionists of Children's hospital Srebrnjak, where education and nutrition counseling is
also carried out.
The usual meals of the later stages of the study, apart from being low in energy and highly
nutritionally dense are composed in such a way that they are either ready for consumption as
a complete meal (e.g. ready- to eat tuna salad) or can be quickly prepared. In this way, the
test respondents are directed to an adequate diet, which, by adopting proper food and
lifestyle habits, will ultimately enable them to maintain the achieved reduced body weight in
the long term.
Study entry stage (0-2 weeks): subjects are recruited respecting the inclusion and exclusion
criteria. Recruitment is carried out by a doctor. During this stage, subjects replace
standard meals with meal replacement products and reduce energy intake to a final defined
intake depending on the group of subjects.
200 participants in a ratio of 2:1:1 (adults and children)
Adult participants program:
The daily energy intake is defined at around 1000-1100 kcal per day, and counseling on
nutrition and physical activity is carried out.
Intensive phase(2-14 weeks) about 1000 - 1100 kcal/day 5 MRP (200-220 kcal per product)
- 1 salad (20 kcal per portion) + water/unsweetened tea.
Active phase(14-21 weeks) 1100-1200 kcal/day 3 MRP (200-220 kcal per meal) + 2 regular
meals (200-280 kcal) + water/unsweetened tea.
Maintenance phase (21-28 weeks): 1200-1500 kcal/day 2 MRP (200-220 kcal per meal) + 3
regular meals (260-350 kcal) + water/unsweetened tea
Stable phase (28-40 weeks): 1500-2000 kcal 1 MRP (200-220 kcal per meal) + 4 regular
meals (approx. 320-450 kcal) + water/unsweetened tea Usual meals can also contain snacks
with lower energy values, but it is important to consume approx. 1300-1800 kcal per day
with usual foods.
Children participants program:
The daily energy intake is defined at around 1300-1500 kcal per day, and counseling on
nutrition and physical activity is carried out.
Intensive phase children (weeks 2-14) around 1300-1500 kcal/day 3 MPR (200-220 kcal per
product + 2 regular meals (320-400 kcal) + 1 or more salad (20 kcal per product)+
water/unsweetened tea.
Active phase children (14-21 weeks) around 140-1600kcal/day 2 MPR (200-220 kcal per
product) + 3 regular meals (320-400 kcal) + water/unsweetened tea.
Maintenance phase (21-28 weeks): 1600-1900 kcal/day 1 MRP (200-220 kcal per meal) + 4
regular meals (350-420 kcal) + water/unsweetened tea
Stable phase children (week 28-40) 1750-2250 kcal/day. 5 regular meals (350-450 kcal) +
water/unsweetened tea.
Snacks are included in regular meals, where the total value of meals and snacks does not
exceed the total set value of regular meals.