**4. Meal replacements and nutritional adequace**

high GL stimulate a rapid rise in insulin levels, which on a chronic basis can result in insulin resistance [32, 33]. The GL of a food is calculated by multiplying its GI by the amount of carbohydrate it contains per serving, and then dividing by 100. GL is a function of the amount of carbohydrate intake and the GI of the food. In contrast, GI is an inherent property of a food, independent of the amount of carbohydrate ingested. The GI value of a diet can impact insulin sensitivity and glucose metabolism [34]. Blood sugar levels have also been implicated in appetite control, suggesting that. Furthermore, MR promote adherence to a restricted calorie diet due to simple preparation and convenience compared to preparing and cooking low‐calorie foods at home. The GI of a diet may impact overall food and energy intake [35]. Accordingly, low‐GI diets have been shown to be an effective approach for managing diabetes [36, 37] and obesity [38, 39]. The combination of a high‐protein, low‐GI diet in obese subjects is effective at inducing weight loss and maintenance of lean body mass [25, 36, 40]. Although it varies by formulation, MR tend to be high in protein and have a low GI (<55), making them ideal for

As with insulin sensitivity, the degree of intrabdominal and visceral fat is tightly linked to metabolic syndrome. Surrounding the body's critical organs, such as the heart and liver, visceral fat stimulates systemic inflammation and is known as an increasingly serious risk factor for chronic diseases, including cardiovascular disease and diabetes [41]. In simple terms, "sarcopenic obesity" can be defined as low skeletal muscle mass and strength combined with excess body fat, much of which is visceral fat [42, 43]. The concept has also been described as "thin outside, fat inside" or "TOFI" [44]. Related to obesity, individuals can have the same body mass index (BMI), but vastly different inflammatory states and risk levels due to

incorporation into an overall low‐GI diet plan.

262 Superfood and Functional Food - An Overview of Their Processing and Utilization

**Table 2.** Glycemic index (GI) values of select foods.

According to the *2015 Dietary Guidelines for Americans*, individuals should consume more nutrient‐dense foods to better balance meeting nutritional needs while avoiding excess calories or energy [52]. A position paper from the Academy of Nutrition & Dietetics concluded that there is a positive association between dietary energy density and increased adiposity [53]. Nutrient density is a term referring to the amount of essential nutrients in a food relative to the amount of energy (calories) that food delivers. High‐nutrient‐dense foods provide a high level of nutrients with relatively low caloric value, and low‐nutrient‐dense foods provide a high level of calories with relatively low nutrient content [54, 55]. Examples of nutrient‐dense foods include fruits, vegetables, whole grains, lean meats and dairy.

In the United States, more than half of the population fails to achieve the recommended intakes for key nutrients, including vitamins A, C, D and E, fiber, magnesium and potassium [56], all of which have been deemed "nutrients of concern" or "shortfall nutrients" by the 2015 Dietary Guidelines Advisory Committee [57]. Incorporation of more nutrient‐dense foods into the diet is an effective approach to achieve proper nutrient adequacy without adding excess calories.

Overweight and obese individuals are at even higher risk than the general population of experiencing nutrient deficiency, particularly vitamin D [58]. This is believed to be due, in part, to overconsumption of a high‐energy‐dense and low‐nutrient‐dense diet [59], a phenomenon described as "overfed but undernourished" [60]. Furthermore, weight loss regimens, particularly those involving rapid weight loss, can lead to compromised nutritional status [61].

With a modest amount of calories, added essential vitamins, minerals and fiber, MR are considered to be a nutrient‐dense food. Indeed, a variety of studies demonstrates that use of MR during a weight control regimen helps to ensure adequate intake of essential nutrients [12, 62–64].
