scholarly journals Effects of Intermittent Energy Restriction Combined with a Mediterranean Diet on Reducing Visceral Adiposity: A Randomized Active Comparator Pilot Study

Nutrients ◽  
2019 ◽  
Vol 11 (6) ◽  
pp. 1386 ◽  
Author(s):  
Chloe E. Panizza ◽  
Unhee Lim ◽  
Kim M. Yonemori ◽  
Kevin D. Cassel ◽  
Lynne R. Wilkens ◽  
...  

Intermittent energy restriction combined with a Mediterranean diet (IER+MED) has shown promise to reduce body fat and insulin resistance. In the Multiethnic Cohort Adiposity Phenotype Study, Japanese Americans had the highest visceral adipose tissue (VAT) when adjusting for total adiposity. We conducted this pilot study to demonstrate feasibility and explore efficacy of following IER+MED for 12 weeks to reduce VAT among East Asians in Hawaii. Sixty volunteers (aged 35–55, BMI 25–40 kg/m2, VAT ≥ 90 cm2 for men and ≥ 80 cm2 for women) were randomized to IER+MED (two consecutive days with 70% energy restriction and 5 days euenergetic MED) or an active comparator (euenergetic Dietary Approaches to Stop Hypertension (DASH) diet). Participants and clinic staff (except dietitians) were blinded to group assignments. IER+MED had significantly larger reductions in DXA-measured VAT and total fat mass (−22.6 ± 3.6 cm2 and −3.3 ± 0.4 kg, respectively) vs. DASH (−10.7 ± 3.5 cm2 and −1.6 ± 0.4 kg) (p = 0.02 and p = 0.005). However, after adjusting for total fat mass, change in VAT was not statistically different between groups; whereas, improvement in alanine transaminase remained significantly greater for IER+MED vs. DASH (−16.2 ± 3.8 U/L vs. −4.0 ± 3.6 U/L, respectively, p = 0.02). Attrition rate was 10%, and participants adhered well to study prescriptions with no reported major adverse effect. Results demonstrate IER+MED is acceptable, lowers visceral and total adiposity among East Asian Americans, and may improve liver function more effectively than a healthful diet pattern. ClinicalTrials.gov Identifier: NCT03639350.

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Chloe Panizza ◽  
Unhee Lim ◽  
Kim Yonemori ◽  
Kevin Cassel ◽  
Lynne Wilkens ◽  
...  

Abstract Objectives Test if an intermittent energy restriction with a Mediterranean diet (IER + MED) preferentially promotes loss of visceral adipose tissue (VAT) over subcutaneous adipose tissue (SAT), with minimal changes to resting energy expenditure (REE) and physical activity level (PAL), compared to an active control, the Dietary Approaches to Stop Hypertension (DASH) diet, in an East Asian adult population. Methods Men and women in Hawai'i (n = 60, aged 35–55, BMI 25–40, VAT ≥ 90cm2 for men and ≥ 80cm2 for women) of East Asian origin, were randomized equally to IER + MED (2 days with 70% energy restriction and 5 days euenergetic MED) or a 7 day euenergetic DASH diet for 12 weeks. Dual energy X-ray absorptiometry (DXA) for estimation of VAT and abdominal SAT, REE through indirect calorimetry, and physical activity questionnaires were collected at baseline and week 12. Four-days mobile food records were completed at baseline, weeks 5–6 and 11. Results At week 12, participants in the IER + MED group lost greater amounts of VAT (−22.6 ± 3.6 cm2 vs. −10.7 ± 3.5 cm2 in DASH, P = 0.022) and SAT (−48.2 ± 6.4 cm2 vs. −15.0 ± 6.1 cm2 in DASH, P < 0.001). The IER + MED diet did not preferentially promote loss of VAT over SAT compared to DASH. Changes in VAT: SAT were 0.01 ± 0.01 for both groups (IER + MED vs. DASH, P = 0.825). Mean daily energy intake reductions at week 11 were larger in IER + MED (27%) than DASH (16%); and mean loss of weight at week 12 was higher in the IER + MED group (−5.9 ± 0.7 kg vs. −3.3 ± 0.6 kg in DASH, P = 0.007). Despite the significant drop in energy and weight for IER + MED, there was a non-significant change in REE of −105 ± 56 kcal/day for IER + MED (P = 0.068) and −25 ± 57 kcal/day for DASH (P = 0.663). Hours of moderate-to-vigorous physical activity per day were 1.6 ± 0.2 for IER + MED and 1.4 ± 0.3 for DASH at baseline and did not change significantly over 12 weeks. Conclusions In this short-term pilot study, the IER + MED diet was more effective at reducing VAT, SAT and weight; however, it did not preferentially promote loss of VAT over SAT, as compared to the active control DASH group. Loss of VAT, SAT and weight from the IER + MED diet may be sustainable long term as REE and PAL, which commonly decrease with large energy restriction, did not significantly change over 12 weeks. Funding Sources The William & Ellen Melohn Endowed Research Fund, University of Hawaii; National Institutes of Health, National Cancer Institute.


Nutrients ◽  
2018 ◽  
Vol 10 (12) ◽  
pp. 1897 ◽  
Author(s):  
David Rogerson ◽  
Diana Maçãs ◽  
Marianne Milner ◽  
Yingshan Liu ◽  
Markos Klonizakis

The Mediterranean diet has been shown to improve cardiovascular health. Vegan diets have demonstrated similar benefits, albeit in fewer studies. In a comparative pilot study, we compared the effects of a short-term Mediterranean Diet (MD) and Vegan Diet (VD) on microvascular function and cholesterol levels in a healthy population. Twenty-four young (aged 18 to 35 years) healthy volunteers followed a four-week intervention (MD = 12; VD = 12) ad libitum. Pre and post-intervention anthropometrics, microvascular function (assessed via LDF and expressed as raw CVC and %CVC MAX), dietary-analysis data (Calories, Protein, Carbohydrates, Total Fat, Saturated Fat, Fibre), Mean Arterial Pressure (MAP), Blood Pressure, Total Cholesterol (TC), High Density Lipoprotein (HDL-C) and TC:HDL-C were compared. MD participants reduced Total Fat intake (p = 0.05). Saturated Fat decreased (MD: p = < 0.001; VD: p = 0.004) and Fibre increased (MD: p = 0.02; VD: p = < 0.001) in both groups. Dietary changes reflected improvements in plateau raw CVC in the MD group (p = 0.005), and a reduction in TC (p = 0.045) and weight loss (p = 0.047) in the VD group. The MD led to improvements in microvascular function; the VD led to reduced TC and weight loss. Although both diets might offer CVD risk-reduction benefits, evidence for the MD appeared to be stronger due to changes in vasodilatory ability and NO bioavailability.


2020 ◽  
Vol 8 (1) ◽  
Author(s):  
Mona Abdo ◽  
Ryan P Coyle ◽  
Sharon M Seifert ◽  
Jose R Castillo-Mancilla ◽  
Catherine M Jankowski ◽  
...  

Abstract Background In this study, we evaluate associations between cumulative antiretroviral adherence/exposure, quantified using tenofovir diphosphate (TFV-DP) in dried blood spots (DBS), and human immunodeficiency virus (HIV)-related aging factors. Methods This is a cross-sectional analysis of younger (ages 18–35) and older (ages ≥60) persons with HIV (PWH) taking TFV disoproxil fumarate. Tenofovir diphosphate concentrations were quantified in DBS. Linear and logistic regression models were used to evaluate associations between TFV-DP and bone mineral density (BMD), physical function, frailty, and falls. Results Forty-five PWH were enrolled (23 younger, 22 older). Every 500 fmol/punch (equivalent to an increase in ~2 doses/week) increase in TFV-DP was associated with decreased hip BMD (−0.021 g/cm2; 95% confidence interval [CI], −0.040 to −0.002; P = .03). Adjusting for total fat mass, every 500 fmol/punch increase in TFV-DP was associated with higher odds of Short Physical Performance Battery impairment (score ≤10; adjusted odds ratio [OR], 1.6; 95% CI, 1.0–2.5; P = .04). Every 500 fmol/punch increase in TFV-DP was associated with slower 400-meter walk time (14.8 seconds; 95% CI, 3.8–25.8; P = .01) and remained significant after adjusting for age, lean body mass, body mass index (BMI), and fat mass (all P ≤ .01). Every 500 fmol/punch increase in TFV-DP was associated with higher odds of reporting a fall in the prior 6 months (OR, 1.8; 95% CI, 1.1–2.8; P = .02); this remained significant after adjusting for age, lean body mass, BMI, and total fat mass (all P &lt; .05). Conclusions Higher TFV-DP levels were associated with lower hip BMD, poorer physical function, and greater risk for falls, a concerning combination for increased fracture risk.


1999 ◽  
Vol 82 (11) ◽  
pp. 1490-1496 ◽  
Author(s):  
M. Kockx ◽  
R. Leenen ◽  
J. Seidell ◽  
H. M. G. Princen ◽  
T. Kooistra

SummaryThis study was aimed at evaluating the relationship between visceral fat accumulation and plasma plasminogen activator inhibitor-1 (PAI-1) levels in healthy, obese men and women undergoing weight loss therapy. The subjects, 25 men and 25 premenopausal women, aged between 26 and 49 years, with an initial body mass index between 28 and 38 kg/m2, received a controlled diet for 13 weeks providing a 4.2 MJ/day energy deficit. Magnetic resonance imaging was used to measure visceral and subcutaneous abdominal fat. Our results show that before weight loss visceral fat was significantly correlated with PAI-1 in men (r = 0.45; p <0.05), but not in women (r = -0.15; ns). The association between visceral fat and PAI-1 in men remained significant after adjustment for age and total fat mass, and multiple linear regression analysis showed a significant independent contribution of visceral fat to plasma PAI-1 levels. Both visceral fat areas and PAI-1 levels decreased significantly with weight loss in both men and women. Changes in visceral fat area were related to changes in PAI-1 in women (r = -0.43; p = 0.05) but not in men (r = -0.01; ns); however, this association in women disappeared after adjustment for total fat mass. We conclude that there is a relationship between visceral fat and PAI-1 in obese men but not in obese women, and that PAI-1 levels decrease substantially (52%) by weight loss, but this change is not related to changes in visceral fat mass per se.


Nutrients ◽  
2020 ◽  
Vol 12 (8) ◽  
pp. 2349
Author(s):  
Stephen Keenan ◽  
Matthew B. Cooke ◽  
Regina Belski

Diets utilising intermittent fasting (IF) as a strategic method to manipulate body composition have recently grown in popularity, however, dietary practices involving fasting have also been followed for centuries for religious reasons (i.e., Ramadan). Regardless of the reasons for engaging in IF, the impacts on lean body mass (LBM) may be detrimental. Previous research has demonstrated that resistance training promotes LBM accrual, however, whether this still occurs during IF is unclear. Therefore, the objective of this review is to systematically analyse human studies investigating the effects of variations of IF combined with resistance training on changes in LBM in previously sedentary or trained (non-elite) individuals. Changes in body weight and fat mass, and protocol adherence were assessed as a secondary objective. This review followed the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. MEDLINE, CINAHL, PubMed and SportDiscus databases were searched for articles investigating IF, combined with resistance training that reported measures of body composition. Eight studies met the eligibility criteria. LBM was generally maintained, while one study reported a significant increase in LBM. Body fat mass or percentage was significantly reduced in five of eight studies. Results suggest that IF paired with resistance training generally maintains LBM, and can also promote fat loss. Future research should examine longer-term effects of various forms of IF combined with resistance training compared to traditional forms of energy restriction. Prospero registration CRD42018103867.


2012 ◽  
Vol 166 (3) ◽  
pp. 469-476 ◽  
Author(s):  
L Frederiksen ◽  
K Højlund ◽  
D M Hougaard ◽  
T H Mosbech ◽  
R Larsen ◽  
...  

ObjectiveTestosterone therapy increases lean body mass and decreases total fat mass in aging men with low normal testosterone levels. The major challenge is, however, to determine whether the metabolic consequences of testosterone therapy are overall positive. We have previously reported that 6-month testosterone therapy did not improve insulin sensitivity. We investigated the effect of testosterone therapy on regional body fat distribution and on the levels of the insulin-sensitizing adipokine, adiponectin, in aging men with low normal bioavailable testosterone levels.DesignA randomized, double-blinded, placebo-controlled study on 6-month testosterone treatment (gel) in 38 men, aged 60–78 years, with bioavailable testosterone <7.3 nmol/l, and a waist circumference >94 cm.MethodsCentral fat mass (CFM) and lower extremity fat mass (LEFM) were measured by dual X-ray absorptiometry. Subcutaneous abdominal adipose tissue (SAT), visceral adipose tissue (VAT), and thigh subcutaneous fat area (TFA) were measured by magnetic resonance imaging. Adiponectin levels were measured using an in-house immunofluorometric assay. Coefficients (b) represent the placebo-controlled mean effect of intervention.ResultsLEFM was decreased (b=−0.47 kg, P=0.07) while CFM did not change significantly (b=−0.66 kg, P=0.10) during testosterone therapy. SAT (b=−3.0%, P=0.018) and TFA (b=−3.0%, P<0.001) decreased, while VAT (b=1.0%, P=0.54) remained unchanged. Adiponectin levels decreased during testosterone therapy (b=−1.3 mg/l, P=0.001).ConclusionTestosterone therapy decreased subcutaneous fat on the abdomen and lower extremities, but visceral fat was unchanged. Moreover, adiponectin levels were significantly decreased during testosterone therapy.


2000 ◽  
Vol 8 (2) ◽  
pp. 151-159 ◽  
Author(s):  
Yuling Hong ◽  
Jean-Pierre Després ◽  
Treva Rice ◽  
André Nadeau ◽  
Michael A. Province ◽  
...  

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Marie K. Lagerquist ◽  
Karin L. Gustafsson ◽  
Petra Henning ◽  
Helen Farman ◽  
Jianyao Wu ◽  
...  

AbstractObesity has previously been thought to protect bone since high body weight and body mass index are associated with high bone mass. However, some more recent studies suggest that increased adiposity negatively impacts bone mass. Here, we aimed to test whether acute loss of adipose tissue, via adipocyte apoptosis, alters bone mass in age-related obese mice. Adipocyte apoptosis was induced in obese male FAT-ATTAC mice through AP20187 dimerizer-mediated activation of caspase 8 selectively in adipocytes. In a short-term experiment, dimerizer was administered to 5.5 month-old mice that were terminated 2 weeks later. At termination, the total fat mass weighed 58% less in dimerizer-treated mice compared with vehicle-treated controls, but bone mass did not differ. To allow for the detection of long-term effects, we used 9-month-old mice that were terminated six weeks after dimerizer administration. In this experiment, the total fat mass weighed less (− 68%) in the dimerizer-treated mice than in the controls, yet neither bone mass nor biomechanical properties differed between groups. Our findings show that adipose tissue loss, despite the reduced mechanical loading, does not affect bone in age-related obese mice. Future studies are needed to test whether adipose tissue loss is beneficial during more severe obesity.


Circulation ◽  
2013 ◽  
Vol 127 (suppl_12) ◽  
Author(s):  
Benjamin M Leon ◽  
Bernard V Miller ◽  
Gloria Zalos ◽  
Kong Y Chen ◽  
Anne E Sumner ◽  
...  

Background: As the epidemic of obesity in the United States steadily worsens, black women are disproportionately affected. Diminished insulin sensitivity has been linked with obesity and heightened risk of subsequent type 2 diabetes (T2D) and cardiovascular disease (CVD). Hypothesis: We propose that a decrease in fat mass achievable by weight loss intervention at the worksite improves insulin sensitivity in overweight black women. Methods: Fifty-four overweight black women [age 45±10 years (mean±SD), BMI range 25.9 to 54.7 kg/m 2 ] completed a 6-month program that included web-based nutrition information and/or dietitian counseling and access to exercise rooms near their work areas. All participants were advised to reduce daily caloric intake by 500 kcal and instructed to increase daily activity by 5,000 steps, measured by pedometer, above baseline readings. The following measurements were performed: weight, total fat mass by dual-energy X-ray absorptiometry, and insulin sensitivity index (S I ) calculated from the minimal model. Repeat of all measurements was performed at 6 months. Results: Baseline S I (median 3.0 liter/mU -1 •min -1 , range 0.74 to 7.58 liter/mU -1 •min -1 , with lower values signifying insulin resistance) was negatively associated with fat mass (r= -0.584, P<0.001) independent of age. Significant reductions in weight (92.6±18.1 to 91.1±18.9 kg, P<0.01) and fat mass (40.8±12.4 to 39.4±12.6 kg, P<0.01) were determined for subjects completing the program. Reduction in fat mass following completion of the program was associated with an increase in S I (r= -0.293, P=0.032). When analyzed by tertiles of fat mass change (Figure), compared to the tertile with net fat mass gain (far left bar), the two tertiles with net fat mass loss had significantly improved insulin sensitivity (higher S I ). Conclusions: Even modest fat mass reduction in overweight non-diabetic black women with a combination of diet and exercise can improve insulin sensitivity, which has the potential to reduce or delay the onset of T2D and CVD.


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