scholarly journals Association of Weight Loss Maintenance and Weight Regain on 4-Year Changes in CVD Risk Factors: the Action for Health in Diabetes (Look AHEAD) Clinical Trial

Diabetes Care ◽  
2016 ◽  
Vol 39 (8) ◽  
pp. 1345-1355 ◽  
Author(s):  
Rena R. Wing ◽  
Mark A. Espeland ◽  
Jeanne M. Clark ◽  
Helen P. Hazuda ◽  
William C. Knowler ◽  
...  
Keyword(s):  
Risk Factors ◽  
Clinical Trial ◽  
Weight Loss ◽  
Weight Regain ◽  
Weight Loss Maintenance ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Look Ahead

scholarly journals Effects of visceral adipose tissue reduction on CVD risk factors independent of weight loss: The Look AHEAD study

2016 ◽  
Vol 42 (2) ◽  
pp. 86-95 ◽  
Author(s):  
Anawin Sanguankeo ◽  
Mariana Lazo ◽  
Sikarin Upala ◽  
Frederick L. Brancati ◽  
Susanne Bonekamp ◽  
...  
Keyword(s):  
Risk Factors ◽  
Weight Loss ◽  
Adipose Tissue ◽  
Visceral Adipose Tissue ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Look Ahead ◽  
The Look ◽  
Visceral Adipose ◽  
Tissue Reduction

Abstract 44: Cardiometabolic Responses to Weight Change are Different between Obese and Normal Weight Adults Who are Metabolically Healthy: The Atherosclerosis Risk in Communities Study

Circulation ◽  
2015 ◽  
Vol 131 (suppl_1) ◽  
Author(s):  
Zhaohui Cui ◽  
Kimberly P Truesdale ◽  
Patrick T Bradshaw ◽  
Jianwen Cai ◽  
June Stevens
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Weight Loss ◽  
Weight Gain ◽  
Weight Change ◽  
Weight Maintenance ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Obese Adults ◽  
Metabolically Healthy

Introduction: The 2013 AHA/ACC/TOS Guideline for the Management of Overweight and Obesity in Adults recommended weight loss for obese adults in order to reduce their cardiovascular disease (CVD) risk. However, not all obese adults develop CVD and approximately 17% of obese Americans in the 1999-2004 NHANES were metabolically healthy. The absence of abnormal CVD risk factors in this subgroup of obese adults indicates that some individuals are resistant to excess adiposity and positive energy balance, and raises the question of whether all obese adults should be recommended for weight loss treatment. We know of no study that has examined whether metabolically healthy obese (MHO) adults respond to weight changes the same way as metabolically healthy normal weight adults (MHNW). Also, no study has compared the effects of weight loss, weight maintenance and weight gain on CVD risk factors in MHO adults. Hypothesis: We hypothesized that the effects of weight change would be different in MHNW and MHO adults, with MHO adults having less stable risk factors, and that weight loss has a protective effect on CVD risk factors in the MHO compared to weight maintenance and weight gain. Methods: Data were from 2,710 MHO and MHNW participants in the Atherosclerosis Risk in Communities (ARIC) study. Four examinations yielded 4,541 observations over sequential 3-year intervals. Metabolically healthy was defined as absence of all components of metabolic syndrome, excluding waist circumference, at the beginning of a 3-year interval. Mixed effect models were applied to individually compare changes in five CVD risk factors (systolic blood pressure, diastolic blood pressure, triglycerides, high-density lipoprotein cholesterol and glucose) in MHO and MHNW adults within 3 weight change categories (<3% weight loss, weight maintenance (±3%) and >3% weight gain). Results: Weight loss was associated with small or no changes in the five CVD risk factors in both MHO and MHNW adults. Weight maintenance was associated with larger increases in MHO compared to MHNW adults in triglycerides (mean ± standard error: 10.0±1.7 vs. 6.5±1.0 mg/dL) and glucose (1.7±0.4 vs. 0.9±0.2 mg/dL). Weight gain was associated with larger increases in systolic (8.6±0.6 vs. 6.2±0.4 mmHg) and diastolic (3.9±0.4 vs. 2.5±0.3 mmHg) blood pressure, triglycerides (22.0±1.8 vs. 16.0±1.1 mg/dL) and glucose (4.9±0.4 vs. 1.9±0.3 mg/dL) among the MHO compared to the MHNW. MHO weight losers experienced more favorable changes in the five CVD risk factors compared to MHO weight maintainers (p<0.04) or gainers (p<0.0001). Conclusions: We showed that compared to MHNW, MHO adults experienced similar changes in CVD risk factors with weight loss and larger increases with weight maintenance and gain. Our study supports the 2013 Guideline that primary health care providers should recommend weight loss treatment for MHO patients.

scholarly journals Efficacy Study of Folic Acid Supplementation on Homocysteine Levels in Adolescent Epileptics Taking Antiepileptic Drugs: A Single Blind Randomized Controlled Clinical Trial

2019 ◽  
Vol 26 (3-4) ◽  
pp. 50-54
Author(s):  
Uma A. Bhosale ◽  
Radha Yegnanarayan ◽  
Akhil Agrawal ◽  
Ashwini Patil
Keyword(s):  
Risk Factors ◽  
Clinical Trial ◽  
Folic Acid ◽  
Antiepileptic Drugs ◽  
Chronic Medical Condition ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Study Results ◽  
Epileptic Patients

Background: Epilepsy is a chronic medical condition that requires long-term therapy with antiepileptic drugs (AEDs). However, long-term employment of AEDs may lead to the onset of hyperhomocysteinemia, which has been found to modulate imperative metabolic mechanisms and induce cardiovascular disorders (CVDs). Therefore, adolescent population that have been diagnosed with epilepsy and utilize AEDs are among the most vulnerable, exhibiting higher risks of developing CVDs. Purpose: The present study was designed to explore the effects of folic acid (FA) supplementation on AED-induced hyperhomocysteinemia and CVD risk factors in adolescent epileptics. Methods: The randomized clinical trial included adolescent epileptics (i.e., 10–19 years of age) of either sex, on antiepileptic therapy for > 6 months with high homocysteine levels (i.e., >10.9 µmol/L). At the time of enrolment, their baseline BP, lipid and homocysteine levels were recorded. Participants were randomly assigned to either treatment or placebo groups and received the respective treatments. At the end of the first month, BP, lipid and homocysteine levels were recorded and compared to determine the effect of FA on these parameters. Results and conclusion: A significant fall in homocysteine levels was observed with FA supplementation ( P < 0.05). However, this fall was significantly high in valproic acid treated epileptic patients. In addition, we observed an improvement in high-density lipoprotein levels, a risk factor for CVDs, but the change was statistically insignificant ( P > 0.05). The study results suggest that FA supplementation in epileptic patients receiving AED therapy may minimize AED-induced hyperhomocysteinemia and other CVD risk factors.

scholarly journals Once-Weekly Exenatide Enhances Weight Loss Maintenance in Adolescents with Severe Obesity: A Randomized, Placebo-Controlled Trial

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A63-A63
Author(s):  
Claudia K Fox ◽  
Kyle Rudser ◽  
Justin Clark ◽  
Justin R Ryder ◽  
Amy C Gross ◽  
...  
Keyword(s):  
Risk Factors ◽  
Weight Loss ◽  
Placebo Group ◽  
Body Fat ◽  
Treatment Effect ◽  
Weight Regain ◽  
Cardiometabolic Risk ◽  
Severe Obesity ◽  
Weight Loss Maintenance ◽  
Short Term

Abstract Background: In adolescents with severe obesity, long-term weight loss maintenance using lifestyle therapy alone is hampered by numerous biological adaptations favoring weight regain such as increased appetite and sense of food palatability and decreased satiety and resting energy expenditure. Anti-obesity pharmacotherapy may have a role in mitigating some of these physiological adaptations, thereby enhancing weight loss maintenance. We conducted a randomized, double-blind, placebo-controlled clinical trial to evaluate the effect of the glucagon-like peptide-1 receptor agonist (GLP-1RA) exenatide extended release (XR) on the maintenance of BMI reduction and improvements in cardiometabolic risk factors induced by short-term meal replacement therapy (MRT) among adolescents with severe obesity. Methods: One-hundred adolescents ages 12 to &lt;18 years with BMI ≥120% of the 95th percentile engaged in an MRT intervention consisting of pre-portioned meals averaging 1,400 kcals/day with a goal of reducing BMI by ≥5% within eight weeks. Participants achieving this goal were randomized 1:1 to either exenatide XR (2 mg/week subcutaneously) + lifestyle therapy or matching placebo + lifestyle therapy for a subsequent 52 weeks. The primary outcome was mean percent change in BMI from randomization (post-MRT) to 52 weeks. Secondary outcomes included changes in body fat (DXA) and cardiometabolic risk factors. Results: Sixty-six participants (mean age 16±1.5 years; 47% female; mean BMI 36.9±4.4 kg/m2) achieved ≥5% BMI reduction with MRT and were randomized; 56 (85%) completed the 52-week visit. From randomization (post-MRT) to 52-weeks, the exenatide and placebo group mean BMI increased 4.6% and 10.1%, respectively. The prespecified intention-to-treat, last observation carried forward primary analysis demonstrated a placebo-subtracted exenatide treatment effect of -4.1% (95% CI -8.6 to 0.5, p=0.078). The per-protocol analysis (excluding participants with major protocol deviations) demonstrated a placebo-subtracted exenatide treatment effect of -5.7% (95% CI -10.9 to -0.6, p=0.030). The placebo-subtracted exenatide treatment effect on total body fat was -3.0 kg (95% CI -6.7 to 0.7, p=0.108), systolic blood pressure -3.2 mmHg (95% CI -7.0 to 0.7, p=0.107), and triglycerides to HDL ratio -0.6 (95% CI -1.2 to 0.0, p=0.050). Exenatide was generally well-tolerated and the adverse event profile was similar to previous reports of GLP-1RAs. Conclusion: The steep trajectory of weight regain following short-term MRT, particularly in the placebo group, underscores the challenge many adolescents encounter in maintaining weight loss over time. GLP-1RA treatment with once-weekly exenatide appears to partly mitigate the propensity toward weight regain after initial dietary-induced weight loss among adolescents with severe obesity.

scholarly journals Effect of a High Protein Weight Loss Diet on Weight, High-Sensitivity C-Reactive Protein, and Cardiovascular Risk among Overweight and Obese Women: A Parallel Clinical Trial

2013 ◽  
Vol 2013 ◽  
pp. 1-8 ◽  
Author(s):  
Leila Azadbakht ◽  
Vajihe Izadi ◽  
Pamela J. Surkan ◽  
Ahmad Esmaillzadeh
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Weight Loss ◽  
Control Diet ◽  
High Sensitivity ◽  
High Protein ◽  
Obese Women ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Hs Crp

Studies regarding the effects of high protein (HP) diets on cardiovascular (CVD) risk factors have reported contradictory results. We aimed to determine the effects of an HP diet on CVD risk factors and high-sensitivity C-reactive protein (hs-CRP) among overweight and obese women. In this randomized controlled trial, we recruited 60 overweight and obese women, aged 20–65, into an HP or energy-restricted control diet for three months (protein, carbohydrate, and fat: 25%, 45%, and 30% versus 15%, 55%, and 30%, resp.). Total protein was divided between animal and plant sources in a 1 : 1 ratio, and animal sources were distributed equally between meats and dairy products. Fasting blood samples, hs-CRP, lipid profile, systolic and diastolic blood pressure, and anthropometric measurements were assessed using standard guidelines. Percent change was significantly different between the two diet groups for weight (standard protein (SP): −3.90 ± 0.26 versus HP: −6.10 ± 0.34%; , resp.) and waist circumference (SP: −3.03 ± 0.21 versus HP: −5.06 ± 0.28%; , resp.). Percent change of fasting blood glucose (FBG) substantially decreased in the control group compared to the HP group (−9.13 ± 0.67 versus −4.93 ± 1.4%;P= 0.01, resp.). Total cholesterol, systolic blood pressure (SBP), and diastolic blood pressure (DBP) decreased both in the HP and in the control diet groups (P= 0.06,P= 0.07, andP= 0.09, resp.); however, the results were marginally significant. Serum levels of hs-CRP were reduced both in the control (−0.08 ± 0.11%,P= 0.06) and in the high protein groups (−0.04 ± 0.09%,P= 0.06). The energy-restricted HP diet resulted in more beneficial effects on weight loss and reduction of waist circumference. CVD risk factors may improve with HP diets among overweight and obese women. When using isoenergetic weight loss diets, total cholesterol, hs-CRP, and SBP were marginally significantly reduced, independent of dietary protein content. This trial is registered with ClinicalTrials.govNCT01763528.

scholarly journals Changes in Body Composition, Cardiovascular Disease Risk Factors, and Eating Behavior after an Intensive Lifestyle Intervention with High Volume of Physical Activity in Severely Obese Subjects: A Prospective Clinical Controlled Trial

2013 ◽  
Vol 2013 ◽  
pp. 1-12 ◽  
Author(s):  
Kjersti Karoline Danielsen ◽  
Mette Svendsen ◽  
Sverre Mæhlum ◽  
Jorunn Sundgot-Borgen
Keyword(s):  
Physical Activity ◽  
Risk Factors ◽  
Weight Loss ◽  
Eating Behavior ◽  
High Volume ◽  
Fat Free Mass ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Intensive Lifestyle Intervention ◽  
Obese Subjects

We examined the effects of a 10–14-weeks inpatient lifestyle modification program, including minimum 90 min of physical activity (PA) five days/week, on body composition, CVD risk factors, and eating behavior in 139 obese subjects (BMI42.6±5.2 kg/m2). Completion rate was 71%(n=71)in the intensive lifestyle intervention (ILI) group and 85%(n=33)among waiting list controls. Compared to controls body weight (-17.0(95% CI: -18.7,-15.3) kg,P<0.0001), fat mass (-15.2(95% CI: -17.4,-13.1) kg,P<0.0001), fat free mass (-1.2(95% CI: -2.2,-0.2) kg,P=0.016) and visceral fat (-86.6(95% CI: -97.4,-75.7) cm2,P<0.0001) were reduced in the ILI-group after 10–14 weeks. Within the ILI-group weight loss was-23.8(95% CI: -25.9,-21.7) kg,P<0.0001and-20.3(95% CI: -23.3,-17.3) kg,P<0.0001, after six and 12 months, respectively. Systolic BP, glucose, triglycerides, and LDL-C were reduced, and HDL-C was increased (allP≤0.006) after 10–14 weeks within the ILI group. The reduction in glucose and increase in HDL-C were sustained after 12 months (allP<0.0001). After one year, weight loss was related to increased cognitive restraint and decreased uncontrolled eating (allP<0.05). Thus, ILI including high volume of PA resulted in weight loss with almost maintenance of fat-free mass, favorable changes in CVD risk factors, and eating behavior in subjects with severe obesity.

scholarly journals Skipping breakfast leads to weight loss but also elevated cholesterol compared with consuming daily breakfasts of oat porridge or frosted cornflakes in overweight individuals: a randomised controlled trial

2014 ◽  
Vol 3 ◽  
Author(s):  
Allan Geliebter ◽  
Nerys M. Astbury ◽  
Roni Aviram-Friedman ◽  
Eric Yahav ◽  
Sami Hashim
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Weight Loss ◽  
Body Weight ◽  
Total Cholesterol ◽  
Controlled Trial ◽  
Control Group ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Skipping Breakfast

AbstractEating breakfast may reduce appetite, body weight and CVD risk factors, but the breakfast type that produces the greatest health benefits remains unclear. We compared the effects of consuming a high-fibre breakfast, a non-fibre breakfast, or no-breakfast control on body weight, CVD risk factors and appetite. A total of thirty-six overweight participants (eighteen men and eighteen women) (mean age 33·9 (sd7·5) years, mean BMI 32·8 (sd4·7) kg/m2) were randomly assigned to consume oat porridge (n = 12), frosted cornflakes (n = 12) or a water control (n = 12) breakfast daily for 4 weeks. Appetite ratings were collected on the first day and weekly thereafter. Before and after the intervention, body weight, composition, blood pressure and resting energy expenditure (REE) were measured and a fasting blood sample was collected. Across the 4 weeks, fullness was higher and hunger was lower in the oat porridge group compared with the control group (P < 0·05). Mean weight change over the intervention was significantly different in the control group (−1·18 (sd1·16) kg) compared with both the cornflakes (−0·12 (sd1·34) kg) and oat porridge (+0·26 (sd0·91) kg) groups (P < 0·05). However, the control group also showed elevated total cholesterol concentrations relative to the cornflakes and oat porridge groups (P < 0·05). There were no differences between groups in changes in body composition, blood pressure, REE or other CVD risk factors. In conclusion, although skipping breakfast led to weight loss, it also resulted in increased total cholesterol concentrations compared with eating either oat porridge or frosted cornflakes for breakfast.

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