Obesity management during the rise of NAFLD: real world outcomes of the medical weight loss approach using a very low energy diet

Obesity is associated with elevated levels of inflammation and metabolic abnormalities which are linked to CVD. The aim of the present study was to investigate whether long-chain n-3 PUFA (LCn-3PUFA), combined with a very-low-energy diet (VLED), facilitated weight loss and weight maintenance, and improvements in blood lipids and inflammatory mediators. This was a double-blind, randomised, controlled trial with two parallel groups. For 14 weeks, one group consumed 6 × 1 g capsules/d of monounsaturated oil (placebo group, PB), and the other group consumed 6 × 1 g capsules/d of LCn-3PUFA (fish oil group, FO), each comprising 70 mg EPA and 270 mg DHA. Both groups were on VLED for 4 weeks (n 14 PB, n 18 FO), which was then followed by 10 weeks of weight maintenance (n 12 PB, n 17 FO). Fasting blood samples, anthropometric measurements and 3 d food diaries were collected at baseline, at 4 and 14 weeks. A greater-than-2-fold increase occurred in plasma levels of EPA and DHA in the FO group (P < 0·001). At 4 weeks, the mean weight loss was − 6·54 (sd 2·08) kg ( − 6·9 %) for PB and − 6·87 (sd 1·83) kg ( − 7·7 %) for FO. At week 14, after the maintenance phase, there was a further mean decrease in weight, − 1·57 (sd 3·7) kg (1·85 %) for PB and − 1·69 (sd 2·32) kg ( − 1·9 %) for FO. Both groups experienced improved metabolic profiles and there was a significant reduction in fat mass for the FO group at week 14 but not for PB. However, it would appear that supplementation with LCn-3PUFA had no significant effect on weight loss or weight maintenance over the 14 weeks.

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Additional protein intake limits weight regain after weight loss in humans

British Journal Of Nutrition ◽

10.1079/bjn20041305 ◽

2005 ◽

Vol 93 (2) ◽

pp. 281-289 ◽

Cited By ~ 142

Author(s):

Manuela P. G. M. Lejeune ◽

Eva M. R. Kovacs ◽

Margriet S. Westerterp-Plantenga

Keyword(s):

Weight Loss ◽

Protein Intake ◽

Weight Regain ◽

Low Energy ◽

Control Group ◽

Significant Group ◽

Very Low Energy Diet ◽

Protein Group ◽

Overweight Subjects ◽

Low Energy Diet

Since long-term weight maintenance (WM) is a major problem, interventions to improve WM are needed. The aim of the study was to investigate whether the addition of protein to the diet might limit weight regain after a weight loss of 5–10 % in overweight subjects. In a randomised parallel study design, 113 overweight subjects (BMI 29·3 (SD 2·5) kg/m2); age 45·1 (SD 10·4) years) followed a very-low-energy diet for 4 weeks, after which there was a 6-month period of WM. During WM, subjects were randomised into either a protein group or a control group. The protein group received 30 g/d protein in addition to their own usual diet. During the very-low-energy diet, no differences were observed between the groups. During WM, the protein group showed a higher protein intake (18 %v.15 %;P<0·05), a lower weight regain (0·8v.3·0 kg;P<0·05), a decreased waist circumference (−1·2 (SD 0·7)v.0·5 (SD 0·5 ) cm;P<0·05) and a smaller increase in respiratory quotient (0·03 (SD 0·01)v.0·07 0·01; (SD/)P<0·05) compared with the control group. Weight regain in the protein group consisted of only fat-free mass, whereas the control group gained fat mass as well. Satiety in the fasted state before breakfast increased significantly more in the protein group than in the control group. After 6 months follow-up, body weight showed a significant group × time interaction. A protein intake of 18 % compared with 15 % resulted in improved WM in overweight subjects after a weight loss of 7·5 %. This improved WM implied several factors, i.e. improved body composition, fat distribution, substrate oxidation and satiety.

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Association Between Ketosis and Changes in Appetite Markers with Weight Loss Following a Very Low‐Energy Diet

Obesity ◽

10.1002/oby.23011 ◽

2020 ◽

Vol 28 (12) ◽

pp. 2331-2338

Author(s):

Catia Martins ◽

Siren Nymo ◽

Helen Truby ◽

Jens F. Rehfeld ◽

Gary R. Hunter ◽

...

Keyword(s):

Weight Loss ◽

Low Energy ◽

Very Low Energy Diet ◽

Low Energy Diet

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Accuracy of aggregate 2- and 3-component models of body composition relative to 4-component for the measurement of changes in fat mass during weight loss in overweight and obese subjects

Applied Physiology Nutrition and Metabolism ◽

10.1139/apnm-2013-0424 ◽

2014 ◽

Vol 39 (8) ◽

pp. 871-879 ◽

Cited By ~ 1

Author(s):

Jose Lara ◽

Alexandra M. Johnstone ◽

Jonathan Wells ◽

Susan Jebb ◽

Mario Siervo

Keyword(s):

Weight Loss ◽

Fat Mass ◽

Reference Method ◽

Low Energy ◽

Aggregate Model ◽

Men And Women ◽

Very Low Energy Diet ◽

The Individual ◽

Component Models ◽

Low Energy Diet

The 4-component (4-C) model is the reference method to measure fat mass (FM). Simpler 2-component (2-C) models are widely used to assess FM. We hypothesised that an aggregate 2-C model may improve accuracy of FM assessment during weight loss (WL). One hundred and six overweight and obese men and women were enrolled in different WL programs (fasting, very low energy diet, low energy diet). Body density, bone mineral content, and total body water were measured. FM was calculated using 2-C, 3-C, and 4-C models. Aggregate equations for 2-C, 3-C, and 4-C models were calculated, with the aggregate 4-C model assumed as the reference method. The aggregate approach postulates that the average of the individual estimates obtained from each model is more accurate than the best single measurement. The average WL was −7.5 kg. The agreement between 3-C and 4-C models for FM change was excellent (R2= 0.99). The aggregate 2-C equation was more accurate than individual 2-C estimates in measuring changes in FM. The aggregate model was characterised by a lower measurement error at baseline and post-WL. The relationship between the aggregate 3-C and 4-C component models was highly linear (R2= 0.99), whereas a lower linearity was found for the aggregate 2-C and 4-C model (R2= 0.72). The aggregate 2-C model is characterised by a greater accuracy than commonly applied 2-C equations for the measurement of FM during WL in overweight and obese men and women.

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Efficacy of very low‐energy diet programs for weight loss: A systematic review with meta‐analysis of intervention studies in children and adolescents with obesity

Obesity Reviews ◽

10.1111/obr.12830 ◽

2019 ◽

Vol 20 (6) ◽

pp. 871-882 ◽

Cited By ~ 11

Author(s):

Sarah Andela ◽

Tracy L. Burrows ◽

Louise A. Baur ◽

Daisy H. Coyle ◽

Clare E. Collins ◽

...

Keyword(s):

Systematic Review ◽

Weight Loss ◽

Children And Adolescents ◽

Intervention Studies ◽

Meta Analysis ◽

Low Energy ◽

Very Low Energy Diet ◽

Low Energy Diet

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Diet-Induced Weight Loss and Exercise Alone and in Combination Enhance the Expression of Adiponectin Receptors in Adipose Tissue and Skeletal Muscle, but Only Diet-Induced Weight Loss Enhanced Circulating Adiponectin

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/jc.2008-2505 ◽

2010 ◽

Vol 95 (2) ◽

pp. 911-919 ◽

Cited By ~ 58

Author(s):

Tore Christiansen ◽

Søren K. Paulsen ◽

Jens M. Bruun ◽

Thorkil Ploug ◽

Steen B. Pedersen ◽

...

Keyword(s):

Skeletal Muscle ◽

Molecular Weight ◽

Weight Loss ◽

Mrna Expression ◽

Weight Maintenance ◽

Low Energy ◽

Hypocaloric Diet ◽

Adiponectin Receptors ◽

Very Low Energy Diet ◽

Low Energy Diet

Abstract Objective: The aim of the study was to investigate the effect of weight loss and exercise independently and in combination on circulating levels of adiponectin including low molecular weight, medium molecular weight, and high molecular weight adiponectin and expression of adiponectin and adiponectin receptors (AdipoR) in adipose tissue (AT) and skeletal muscle (SM). Design and Methods: Seventy-nine obese males and females were randomized into the following: 1) exercise only (12 wk of exercise without diet restriction); 2) hypocaloric diet [8 wk of very low energy diet (600 kcal/d) followed by 4 wk with a weight maintenance diet]; and 3) hypocaloric diet and exercise (DEX; 8 wk very low energy diet 800 kcal/d followed by 4 wk weight maintenance diet combined with exercise throughout the 12 wk). Blood samples and biopsies from sc abdominal AT and SM were collected at baseline and after 12 wk. The molecular subforms of adiponectin in serum were determined by Western blot. Results: The mRNA expression of AdipoR1 and -2 in SM was increased significantly in the exercise-only and DEX groups (both P < 0.05). The mRNA expression of adiponectin and AdipoRs in AT was increased significantly in all three groups (all P < 0.01), whereas serum total circulating adiponectin was significantly increased only in the DEX and hypocaloric diet groups (both P < 0.01). All the adiponectin subforms changed in a similar manner as total adiponectin, indicating no specific regulation of any of the subforms by the intervention. Conclusion: Exercise alone and in combination with a diet-induced weight loss enhance the mRNA expression of adiponectin receptors in AT and in SM but only a pronounced hypocaloric-induced weight-loss increases circulating adiponectin in obese subjects.

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