Results of the
 D
 iet,
 E
 xercise, and
 W
 eight Loss
 I
 ntervention
 T
 rial (DEW-IT)

Miller, Edgar R.; Erlinger, Thomas P.; Young, Deborah Rohm; Jehn, Megan; Charleston, Jeanne; Rhodes, Donna; Wasan, Sharmeel K.; Appel, Lawrence J.

doi:10.1161/01.hyp.0000037217.96002.8e

Cited by 287 publications

(194 citation statements)

References 17 publications

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“…The extent to which the risk factors, when present, were modified in our cohort was comparable to the intervention groups in previously published studies. Thus, there was sustainable weight loss in those who were overweight,36, 37 lowering of blood pressure in those with high levels,38 improvement of the lipid profile and insulin resistance in those with baseline abnormalities,33, 39 and promotion of a healthy diet and exercise habits,33, 40, 41 findings similar to observations in high‐risk populations 42, 43. Importantly, no perceptible decline among those with relatively normal values was observed, indicating that health was maintained in this cohort.…”

Section: Discussionmentioning

confidence: 99%

Effects of a Health‐Partner Intervention on Cardiovascular Risk

Mheid

Kelli

et al. 2016

JAHA

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BackgroundLifestyle modifications are first‐line measures for cardiovascular disease prevention. Whether lifestyle intervention also preserves cardiovascular health is less clear. Our study examined the role of a Health Partner–administered lifestyle intervention on metrics of ideal cardiovascular health.Methods and ResultsA total of 711 university employees (48±11 years; 66% women, 72% Caucasian/22.5% African Americans) enrolled in a program that promoted healthier lifestyles at Emory University (Atlanta, GA). Anthropometric, laboratory, and physical activity measurements were performed at baseline and at 6 months, 1 year, and 2 years of follow‐up. Results were utilized by the Health Partner to generate a personalized plan aimed at meeting ideal health metrics. Compared to baseline, at each of the 6‐month, 1‐year, and 2‐year follow‐up visits, systolic blood pressure was lower by 3.6, 4.6, and 3.3 mm Hg (P<0.001), total cholesterol decreased by 5.3, 6.5, and 6.4 mg/dL (P<0.001), body mass index declined by 0.33, 0.45, and 0.38 kg/m2 (P<0.001), and the percentage of smokers decreased by 1.3%, 3.5%, and 3.5% (P<0.01), respectively. Changes were greater in those with greater abnormalities at baseline. Finally, the American Heart Association “Life's Simple 7” ideal cardiovascular health score increased by 0.28, 0.40, and 0.33 at 6 month, 1 year, and 2 years, respectively, compared to baseline visit.ConclusionsA personalized, goal‐directed Health Partner intervention significantly improved the cardiometabolic risk profile and metrics of cardiovascular health. These effects were evident at 6 months following enrollment and were sustained for 2 years. Whether the Health Partner intervention improves long‐term morbidity and mortality and is cost‐effective needs further investigation.

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Section: Discussionmentioning

confidence: 99%

Effects of a Health‐Partner Intervention on Cardiovascular Risk

Mheid

Kelli

et al. 2016

JAHA

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“…10 Weight loss associated with lifestyle modifications such as diet and regular exercise are important and remain the first-line treatment for obesity and obesity-related hypertension. [11][12][13][14][15] Whelton et al 16 reported in a meta-analysis of 54 randomized, controlled trials comprising 2419 participants that aerobic exercise was associated with a significant reduction in mean systolic and diastolic blood pressure (BP) in both overweight and normal-weight participants regardless of whether they were hypertensive or normotensive on admission to the investigation. A number of studies, including a series of the Dietary Approaches to Stop Hypertension (DASH) diet studies, [17][18][19] showed that not only the dietary pattern, but also aerobic exercise and calorie restriction were necessary for weight loss, weight loss-induced BP reduction and improvement of insulin sensitivity.…”

Section: Introductionmentioning

confidence: 99%

“…Weight loss with life-style modifications can result in significantly better BP control among hypertensive patients with pharmacological treatments. 15,20 Although both life-style modifications (that is, calorie-restricted diet and exercise) are recommended for weight loss, it has not been fully clarified which is more effective with regards to weight loss-induced BP reduction in obese hypertensive patients. Therefore, in the present study, we sought to clarify the differences in neurohormonal mechanisms in weight loss-induced BP reduction between mild caloric restrictive diet and exercise over a 24-week period.…”

Section: Introductionmentioning

confidence: 99%

Different mechanisms in weight loss-induced blood pressure reduction between a calorie-restricted diet and exercise

et al. 2011

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The present study compared the effectiveness of a mild calorie-restricted diet (D) alone, exercise (EX) alone and a combination of D+EX on weight loss-induced blood pressure (BP) reduction over 24 weeks. We focussed especially on the relationship between sympathetic nervous activity, as indicated from measures of plasma norepinephrine (NE), and insulin resistance (homeostasis model of insulin resistance, HOMA-IR). The three groups each comprised 30 obese, hypertensive men. Body mass index (BMI), fat mass, waist-to-hip ratio, BP, plasma NE and HOMA-IR were measured every 2 weeks during the first 4 weeks and subsequently every 4 weeks for the next 20 weeks. All basal parameters were similar among the three groups. At 24 weeks, the combination group with D+EX comprised a significantly higher prevalence of normotensive subjects than the D alone or EX alone group (Po0.05). In the D alone group, plasma NE was decreased significantly at 2 weeks, reductions in BMI, fat mass and BP were observed at 8 weeks, and waist-to-hip ratios and HOMA-IR were decreased at 12 weeks. In comparison, in the EX alone group, significant reductions of fat mass and HOMA-IR were observed at 4 weeks. Plasma NE and HOMA-IR were reduced at 8 weeks while decreases in BP were detected at 12 weeks. In the D+EX group, significant reductions in plasma NE were observed at 2 weeks followed by significant decreases in BMI, fat mass, waist-to-hip ratio, BP levels and HOMA-IR at 4 weeks. The magnitudes of reductions of all parameters were greatest in the D+EX group. These results demonstrate that D+EX exerts a stronger ameliorative effect on weight loss, weight loss-induced BP reduction, normalization of BP, sympathetic activation and insulin resistance compared with D or EX alone. D and EX might, perhaps, exert different mechanisms on weight loss and weight loss-induced BP reduction; however, a combination of caloric restriction and exercise is preferred to control BP levels in obese hypertensive patients.

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“…In the end, sixteen randomized controlled trails "RCTs" were identified that fulfilled the criteria described above, three of which were identical and therefore eliminated. Thus the meta-analysis includes a total of thirteen studies [27][28][29][30][31][32][33][34][35][36][37][38][39] (Fig. 1). …”

Section: Methodsmentioning

confidence: 99%

Effects of Exercise, Diet, and a Combination of Exercise and Diet in Overweight and Obese Adults - A Meta-Analysis of the Data~!2009-06-21~!2010-01-05~!2010-03-11~!

Schaar¹,

Moos-Thiele²,

Platen³

2010

TOSMJ

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Abstract:The objective of the following meta-analysis was to determine what kind of treatment, or combination of treatments, has the greatest effect on weight loss in overweight and obese adults.A systematic search was conducted of the available literature published between 1993 and 2006 that covered randomized controlled trials on overweight and obese subjects who underwent treatment consisting of physical exercise and/ or changes in diet. The scope of the search thus incorporated seven relevant databases.Using 6,545 key word combinations, the electronic search yielded a total of 36,869 abstracts. 13 relevant studies with a total of 826 subjects (BMI > 25; 17 -68 years of age) met the meta-analysis criteria. The courses of treatment included "diet (d)", "physical exercise (pe)", "diet and physical exercise (dpe)", and "no intervention (ni)". The results confirmed the hypothesis that the combined intervention "dpe" had the greatest effect with regard to weight loss. The single treatments "pe" and "d" also led to weight loss, with "d" having a significantly greater effect than "pe".The main reason for the small sample size of thirteen studies out of 36,819 was that the experimental design and/or procedures of most studies were inadequate. A common error was a failure to assign subjects randomly to the different treatment groups. The results of our meta-analysis indicate that a combination of diet and physical exercise is the best form of treatment to induce weight loss in overweight individuals in the first weeks, followed by physical exercise to maintain weight loss.

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Results of the D iet, E xercise, and W eight Loss I ntervention T rial (DEW-IT)

Cited by 287 publications

References 17 publications

Effects of a Health‐Partner Intervention on Cardiovascular Risk

Effects of a Health‐Partner Intervention on Cardiovascular Risk

Different mechanisms in weight loss-induced blood pressure reduction between a calorie-restricted diet and exercise

Effects of Exercise, Diet, and a Combination of Exercise and Diet in Overweight and Obese Adults - A Meta-Analysis of the Data~!2009-06-21~!2010-01-05~!2010-03-11~!

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