Resistance training during a 12-week protein supplemented VLCD treatment enhances weight-loss outcomes in obese patients

Jo, Edward; Worts, Phillip R.; Elam, Marcus L.; Brown, Ann; Khamoui, Andy V.; Kim, Do‐Houn; Yeh, Ming‐Chia; Ormsbee, Michael J.; Prado, Carla M.; Cain, Angelina; Snyder, Katie; Kim, Jeong‐Su

doi:10.1016/j.clnu.2017.12.015

Cited by 17 publications

(13 citation statements)

References 30 publications

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“…Decrements in lean mass are typically observed with low calorie dieting, partially offset only when the weight loss program includes a moderate or high intensity exercise prescription. 31,32 An important goal of obesity treatment is that there should be minimal loss of lean tissues and their associated functions. Diets, exercise programs, and weight loss medications are often judged in the context of the relative loss of lean tissues they impose.…”

Section: Discussionmentioning

confidence: 99%

Effect of Bimagrumab vs Placebo on Body Fat Mass Among Adults With Type 2 Diabetes and Obesity

Heymsfield

Coleman²,

Miller³

et al. 2021

JAMA Netw Open

156

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IMPORTANCE Antibody blockade of activin type II receptor (ActRII) signaling stimulates skeletal muscle growth. Previous clinical studies suggest that ActRII inhibition with the monoclonal antibody bimagrumab also promotes excess adipose tissue loss and improves insulin resistance.OBJECTIVE To evaluate the efficacy and safety of bimagrumab on body composition and glycemic control in adults with type 2 diabetes and overweight and obesity. DESIGN, SETTING, AND PARTICIPANTSThis double-masked, placebo-controlled, 48-week, phase 2 randomized clinical trial was conducted among adults with type 2 diabetes, body mass index between 28 and 40, and glycated hemoglobin (HbA 1c ) levels between 6.5% and 10.0% at 9 US and UK sites. The trial was conducted from February 2017 to May 2019. Only participants who completed a full treatment regimen were included in analysis. INTERVENTIONSPatients were randomized to intravenous infusion of bimagrumab (10 mg/kg up to 1200 mg in 5% dextrose solution) or placebo (5% dextrose solution) treatment every 4 weeks for 48 weeks; both groups received diet and exercise counseling. MAIN OUTCOMES AND MEASURESThe primary end point was least square mean change from baseline to week 48 in total body fat mass (FM); secondary and exploratory end points were lean mass (LM), waist circumference (WC), HbA 1c level, and body weight (BW) changes from baseline to week 48. RESULTS A total of 75 patients were randomized to bimagrumab (n = 37; 23 [62.2%] women) or placebo (n = 38; 12 [31.6%] women); 58 (77.3%) completed the 48-week study. Patients at baseline had a mean (SD) age of 60.4 (7.7) years; mean (SD) BMI of 32.9 (3.4); mean (SD) BW of 93.6 (14.9) kg; mean (SD) FM of 35.4 (7.5) kg; and mean (SD) HbA 1c level of 7.8% (1.0%). Changes at week 48 for bimagrumab vs placebo were as follows: FM, −20.5% (−7.5 kg [80% CI, −8.3 to −6.6 kg]) vs −0.5% (−0.18 kg [80% CI, −0.99 to 0.63 kg]) (P < .001); LM, 3.6% (1.70 kg [80% CI, 1.1 to 2.3 kg]) vs −0.8% (−0.4 kg [80% CI, −1.0 to 0.1 kg]) (P < .001); WC, −9.0 cm (80% CI, −10.3 to −7.7 cm) vs 0.5 cm (80% CI, −0.8 to 1.7 cm) (P < .001); HbA 1c level, −0.76 percentage points (80% CI, −1.05 to −0.48 percentage points) vs −0.04 percentage points (80% CI, −0.23 to 0.31 percentage points) (P = .005); and BW, −6.5% (−5.9 kg [80% CI, −7.1 to −4.7 kg]) vs −0.8% (−0.8 kg [80% CI, −1.9 to 0.3 kg]) (P < .001). Bimagrumab's safety and tolerability profile was consistent with prior studies. CONCLUSIONS AND RELEVANCEIn this phase 2 randomized clinical trial, ActRII blockade with bimagrumab led to significant loss of FM, gain in LM, and metabolic improvements during 48 weeks (continued) Key Points Question What are the effects of bimagrumab, an antibody that blocks activin type II receptors and stimulates skeletal muscle growth, on total body fat mass and glycemic control in patients with type 2 diabetes and excess adiposity? Findings In this phase 2 randomized clinical trial of 75 patients with type 2 diabetes and body mass index between 28 and 40 who received bimagrumab or placebo du...

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Section: Discussionmentioning

confidence: 99%

Effect of Bimagrumab vs Placebo on Body Fat Mass Among Adults With Type 2 Diabetes and Obesity

Heymsfield

Coleman²,

Miller³

et al. 2021

JAMA Netw Open

156

View full text Add to dashboard Cite

show abstract

“…For instance, overweight subjects ( n = 127) who underwent a VLCD (430 kcal/day) for eight weeks lost a mean of 12.7 kg of total weight, of which 75% was fat loss and 25% was LBM loss [16]. A recent study using a popular VLCD system (Optifast ® , Nestlé HealthCare Nutrition, Bridgewater, NJ, USA) supplemented with whey protein described a total body weight loss of 17 kg, of which 4.6 kg was LBM (approximately 25% of the weight lost), after twelve weeks of following this 1120 kcal/day, high protein, low-fat diet [7]. Historically, fast and overall weight loss was focused on and valued, but more current thought is that the focus should be on body composition changes as opposed to solely judging success by total weight loss.…”

Section: Weight Loss Strategiesmentioning

confidence: 99%

“…Therefore, in order to enhance sustainability of any weight loss program, and to offset any potential negative health consequences, it is important to prevent the loss of LBM. In an effort to offset this LBM loss, several studies have incorporated exercise in conjunction with a weight loss program; however, this has only provided modest outcomes, most likely due to the modest caloric expenditure experienced with moderate exercise [7]. Various dietary supplement products have also been researched to augment weight loss or improve body composition with varying levels of success.…”

Section: Introductionmentioning

confidence: 99%

Body Composition Changes in Weight Loss: Strategies and Supplementation for Maintaining Lean Body Mass, a Brief Review

2018

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With over two-thirds (71.6%) of the US adult population either overweight or obese, many strategies have been suggested for weight loss. While many are successful, the weight loss is often accompanied by a loss in lean body mass. This loss in lean body mass has multiple negative health implications. Therefore, weight loss strategies that protect lean body mass are of value. It is challenging to consume a significant caloric deficit while maintaining lean body mass regardless of macronutrient distribution. Therefore, the efficacy of various dietary supplements on body weight and body composition have been a topic of research interest. Chromium picolinate has been shown to improve body composition by maintaining lean body mass. In this paper we review some common weight loss strategies and dietary supplements with a focus on their impact on body composition and compare them to the effect of chromium picolinate.

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“…Follow-up periods ranged from 4 weeks to 24 months. Most of the trials were from the USA (k = 11) 19 , 20 , 22 , 24 , 30 , 32 , 33 , 48 – 51 followed by Canada (k = 5) 25 , 52 – 55 and Brazil (k = 3). 18 , 21 , 26 Six studies used resistance training for their exercise training intervention 25 , 32 , 47 , 55 – 57 eight used aerobic training 12 , 23 , 33 , 48 , 51 , 58 – 60 and 17 used combined training programs.…”

Section: Resultsmentioning

confidence: 99%

Effects of physical activity and dietary supplement on fat free mass and bone mass density during weight loss – a systematic review and meta-analysis.

et al. 2022

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Background: After a diet- or surgery induced weight loss almost 1/3 of lost weight consists of fat free mass (FFM) if carried out without additional therapy. Exercise training and a sufficient supply of protein, calcium and vitamin D is recommended to reduce the loss of FFM. Objective: To investigate the effect of exercise training, protein, calcium, and vitamin D supplementation on the preservation of FFM during non-surgical and surgical weight loss and of the combination of all interventions together in adults with obesity. Methods: A systematic review was performed with a pairwise meta-analysis and an exploratory network meta-analysis according to the PRISMA statement. Results: Thirty studies were included in the quantitative analysis. The pairwise meta-analysis showed for Exercise Training + High Protein vs. High Protein a moderate and statistically significant effect size (SMD 0.45; 95% CI 0.04 to 0.86), for Exercise Training + High Protein vs. Exercise Training a high but statistically not significant effect size (SMD 0.91; 95% CI -0.59 to 2.41) and for Exercise Training alone vs. Control a moderate but statistically not significant effect size (SMD 0.67; 95% CI -0.25 to 1.60). In the exploratory network meta-analysis three interventions showed statistically significant effect sizes compared to Control and all of them included the treatment Exercise Training. Conclusions: Results underline the importance of exercise training and a sufficient protein intake to preserve FFM during weight loss in adults with obesity. The effect of calcium and vitamin D supplementation remains controversial and further research are needed.

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Resistance training during a 12-week protein supplemented VLCD treatment enhances weight-loss outcomes in obese patients

Cited by 17 publications

References 30 publications

Effect of Bimagrumab vs Placebo on Body Fat Mass Among Adults With Type 2 Diabetes and Obesity

Effect of Bimagrumab vs Placebo on Body Fat Mass Among Adults With Type 2 Diabetes and Obesity

Body Composition Changes in Weight Loss: Strategies and Supplementation for Maintaining Lean Body Mass, a Brief Review

Effects of physical activity and dietary supplement on fat free mass and bone mass density during weight loss – a systematic review and meta-analysis.

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