Lipoprotein responses to weight loss and weight maintenance in high-risk obese subjects

Abstract

and 2 Slim-Fast Foods Company, West Palm Beach, Florida, USA Objective: To examine changes in plasma lipids and lipoproteins after 51 months of reduced energy intake and sustained weight loss. Methods: One-hundred patients were randomized to one of two dietary interventions for 3 months (weight loss period). Groups A and B received an energy-restricted diet plan of 5.2 -6.3 MJ=day but group B was further instructed to replace two of three meals with a nutrient-fortified liquid meal replacement (MR). Upon completion of the weight loss period, all patients were given the same instructions regarding energy intake and were advised to use one MR daily. Body weight and 7 day food diaries were measured monthly or bimonthly and blood lipids at baseline, 3, 9 and 51 months. Results: Of the original 100 patients 75 had completed 4 y. Of those 75, 73 had complete lipid records. Baseline body weights of Groups A and B were 90.7 AE 14.0 and 91.6 AE 9.8 kg, respectively. The percentage change in total cholesterol (%DTC) decreased in a linear fashion with increasing weight loss, when all data was combined, but did not approach statistical significance (P 0.26, r ¼ 0.02). Further regression analysis found a significant negative linear relationship (P 0.0001, r ¼ 0.69) between initial total cholesterol (TC) concentrations and %DTC. Hence, data from 27 of the 73 completers who exhibited an elevated serum total cholesterol ( ! 6.2 mmol=l) were isolated and analyzed further. Baseline TC was 6.75 AE 0.64, 5.85 AE 0.63 at 9 months (P < 0.05) and 5.76 AE 0.52 mmol=l at 51 months (P < 0.05). Similar values for VLDL-cholesterol were 1.33 AE 0.80, 0.74 AE 0.24 and 0.66 AE 0.21 mmol=l by 51 months (P < 0.05). Weight decreased by 5.2 AE 5.1, 7.6 AE 4.9 and 6.7 AE 4.6% at 3, 9 and 51 months, respectively. Conclusion: Continuous energy restriction associated with a clinically meaningful weight loss significantly improved the lipid profile of high-risk patients. Similar weight and diet changes occurring in patients with normal plasma cholesterol were either increased or without affect.

Advantages of Group Treatment and Structured Exercise in Promoting Short-Term Weight Loss and Cardiovascular Risk Reduction in Adults With Central Obesity

“…Weight reductions of 5-10% have been shown to induce clinically signifi cant improvements in blood pressure, lipid levels, and HbA1c. [13][14][15][16] Each treatment intervention was associated with statistically signifi cant improvements in cardiovascular risk factors at 12 weeks. However, group treatment was associated with improvements in a greater number of risk factors as compared to individual treatment.…”

Healthy strategies for successful weight loss and weight maintenance: a systematic review

“…This also varied among studies: 12 months Foreyt et al 1993;Gold et al 2007;Krukowski et al 2008;Layman et al 2009;Matvienko and Hoehns, 2009;Morgan et al 2009Morgan et al , 2011Rock et al 2007;Rolls et al 2005 Tanumihardjo et al 2009;West et al 2011;Wing et al 2010;Yatsuya et al 2011), 24 months Teixeira et al 2010), 105 weeks ), 29 months (McLaughlin et al 2008, 36 months (Wolfson et al 2010), 2-4 years (Christiansen et al 2007), and 4 years Ditschuneit et al 1999Ditschuneit et al , 2002Flechtner-Mors et al 2000;Kuller et al 2006Kuller et al , 2007Kuller et al , 2012Yankura et al 2008). Mean weight loss that was maintained (from baseline to 1 year or more) ranged from 5.3% to 10.5%.…”

“…The lengths of the interventions were found to be variable among studies: 15 weeks ), 18 weeks (McLaughlin et al 2008, 21 weeks (Christiansen et al 2007), 3 months Ditschuneit and Flechtner-Mors 2001;Ditschuneit et al 1999Ditschuneit et al , 2002Flechtner-Mors et al 2000;Foreyt et al 1993;Itoh et al 2001;Morgan et al 2009Morgan et al , 2011Tanumihardjo et al 2009), 4 months Layman et al 2009;Thorpe et al 2008), 6 months (Gold et al 2007;Jeffery et al 2009;Krukowski et al 2008;Kuller et al 2006Kuller et al , 2007Kuller et al , 2012Leermakers et al 1999;Matvienko and Hoehns 2009;Rock et al 2007;Rolls et al 2005;West et al 2011;Wing et al 2010;Wolfson et al 2010;Yankura et al 2008;Yatsuya et al 2011), and 12 months Burke et al 2008;Teixeira et al 2010). These time periods were considered to reflect the weight-loss phase, because the intervention either ended or was reduced considerably.…”

Effect of a low-calorie high nutritional value formula on weight loss in type 2 diabetes mellitus

“…The study consisted in a first phase of 3 months of diet alone plus the structured package of interventions. At the end of this period we added a diabetes-specific meal replacement as a substitute for the main meal for those who could not lose at least >5% of their initial weight (the rationale being the data supporting that weight loss of at least 5-7% can improve metabolic parameters, even when ideal body weight is not achieved [1][2][3][4]). Subsequently, the two groups are designated as follows: G-denoting the group that continued without the meal replacement and G+ denoting the group that continued with the meal replacement.…”

“…Weight loss of as little as 5-7% is important to help improve glycaemic control and metabolic risk factors [1][2][3][4]. Unfortunately, it is extremely difficult to obtain a consistent and durable weight loss in these subjects, even with an intensive management programme [5].…”