PREVIEW diabetes prevention study reviewed by Professor Jennie Brand Miller at TDMR Europe seminar

Posted On: 2nd November 2021

Jennie Brand Miller, Professor of Human Nutrition at the University of Sydney, reviewed the benefits of Total Diet Replacement for weight loss and low GI/high protein diet for weight maintenance and  diabetes prevention in TDMR Europe’s webinar Total Diet Replacement: exploring sustainable weight loss and health benefits, including diabetes remission and prevention”  held on 27th October 2021. Presenting the results of the PREVIEW research, Prof Brand Miller showed that the combination of significant weight loss using total diet replacements and a low-glycaemic load diet facilitated diabetes prevention.

Professor Anthony Leeds, chairman of TDMR Europe said “The PREVIEW study has provided strong evidence for the use of an initial weight loss with total diet replacement as the first stage of a diabetes prevention programme. Ninety percent of participants were able to complete the eight-week diet intervention period, losing an average weight of 10.7kg, with 83.5% achieving >8% weight loss.  All diabetes prevention programmes have shown that the more weight loss achieved and maintained the smaller the proportion of participants who develop diabetes. PREVIEW has confirmed the importance of this but has shown the added benefit of using a low glycaemic index/low glycaemic load diet to help reduce weight regain and keep HbA1c as low as possible. This is hugely important evidence that ought to be considered when diabetes prevention programmes are designed.”

On 27th October, TDMR Europe’s online seminar brought together industry stakeholders, academics and others and showed the potential role of TDR in bringing down the incidence of obesity and severity of weight related comorbidities, such as type 2 diabetes, cardiovascular disease risk factors, osteoarthritis, and obstructive sleep apnoea. The recording of the webinar will be available soon on the TDMR Europe website.

More information on TDR is available here.

Prof Brand Miller is a Principal Investigator of the PREVIEW trial, a landmark three-year multicentre study conducted in eight countries that examined  the impact of TDR followed by a three year weight maintenance programme on type 2 diabetes risk.

The PREVIEW trial was funded through the EU framework programme 7 (FP7/2007–2013) grant agree-ment # 312057, National Health and Medical Research Council – EU Collaborative Grant, AUS 8, ID 1067711 and The Glycemic Index Foundation Australia. The Cambridge Weight Plan donated all products for the 8-week LED period.


Diabetes prevention with TDR and low GI/GL diet

Jennie Brand Miller, PREVIEW research team, University of Sydney, Australia


The PREVIEW randomised controlled trial was a landmark 3-year multicentre, type 2 diabetes prevention study carried out in 8 countries comparing 2 diets and 2 levels of exercise intensity [1]. In total 2326 adults aged 25-70 years, body mass intake BMI ≥25 and prediabetes were enrolled.  In the first phase, participants needed to lose ≥8% of body weight in 8 weeks using total meal replacements [2] to be eligible for the second phase (34 months) of weight loss maintenance. Eligible adults (79%) received a behavioural intervention including instructions to follow either a conventional healthy diet or the high protein-low glycemic index diet (25%E from protein, 45%E from carbohydrates, GI ≤ 50).  Results: Average weight loss was 11% (11 kg) at 8 weeks. At 12-months, 74% of participants remained and 52% at 3 years.  Among the completers, the incidence of diabetes was much lower than anticipated – only 3 in 100 participants whereas 13.5% was predicted (a relative risk reduction of 77%).  The incidence was the same in centres where the attrition rate was low versus those with high rate. There were no significant differences between the two diets or two exercise groups. In post-hoc analyses, the lowest vs highest tertile of dietary glycemic index and glycemic load re-gained less weight, fat mass and showed smaller increases in HbA1c, independently of weight loss [3]. The findings suggest that the combination of significant weight loss using meal replacements and a low glycemic load diet facilitates diabetes prevention.

Diabetes Prevention With TDR And Low GIGL Diet PPT Slides


  1. Raben, A.; Vestentoft, P.S.; Brand-Miller, J.; Jalo, E.; Drummen, M.; Simpson, L.; Martinez, J.A.; Handjieva-Darlenska, T.; Stratton, G.; Huttunen-Lenz, M., et al. The preview intervention study: Results from a 3-year randomized 2 x 2 factorial multinational trial investigating the role of protein, glycaemic index and physical activity for prevention of type 2 diabetes. Diabetes, Obesity and Metabolism 2021, 23, 324-337.
  2. Christensen P, Larsen TL, Westerterp-Plantenga M et al 2018 Men and women respond differently to rapid weight loss: Metabolic outcomes of a multi-centre intervention study after a low-energy diet in 2500 overweight, individuals with pre-diabetes (PREVIEW) Diabetes Obes Metab. 2018;20: 2840–2851
  3. Zhu, R.; Larsen, T.M.; Fogelholm, M.; Poppitt, S.D.; Vestentoft, P.S.; Silvestre, M.P.; Jalo, E.; Navas-Carretero, S.; Huttunen-Lenz, M.; Taylor, M.A., et al. Dose-dependent associations of dietary glycemic index, glycemic load, and fiber with 3-year weight loss maintenance and glycemic status in a high-risk population: A secondary analysis of the diabetes prevention study preview. Diabetes Care 2021, 44, 1672.