Pattinson AL, Seimon RV, Harper C, et al. - Weight-loss interventions using either a total meal-replacement diet or a food-based diet both improve diet quality in postmenopausal women with obesity, but not substantially to fulfil recommendations. This emphasizes the significance of improving diet quality as part of all dietary weight-loss strategies.

• It was a secondary analysis of a randomized controlled trial.

• Seventy-nine postmenopausal women aged 45–65 years with a BMI (in kg/m ²) of 30–40 were randomly assigned to a total meal-replacement diet (energy intake restricted by 65–75% relative to requirements) for 16 weeks, followed by a food-based diet (energy intake restricted by 25–35% relative to requirements) until 52 wks, or the food-based diet for the entire 52-week period.

• Diet quality increased from baseline in both groups, but less so in the entire meal-replacement group, with a mean (SD) gain of 3.6 (10.8) points compared with 11.8 (13.9) points in the food-based group, resulting in a mean between-group difference of −8.2 points.

• This increase in diet quality in both groups was primarily driven by a decrease in the consumption of discretionary items.

• In both dietary interventions, intake remained below the recommendations at 52 weeks for 4 of the 5 food groups.