Inclusion of fish or fish oil in weight-loss diets for young adults: effects on blood lipids

Background: Elevated aldosterone promotes inflammation, insulin resistance, and hypertension. These effects are particularly important in obesity because adipocytes secrete factors that increase aldosterone production. Weight loss is thought to lower aldosterone levels, but little longitudinal data is available. We aimed to determine if, independent of changes in sodium intake, reductions in circulating aldosterone are associated with weight loss and improvements in inflammation, adipokines, insulin resistance, and blood pressure in normotensive overweight and obese young adults undergoing lifestyle modification. Methods: Participants were overweight/obese adults aged 20–45 years (20% male, 15% black) from the Slow Adverse Vascular Effects of excess weight trial, a study evaluating the relationships between weight loss, dietary sodium, and vascular health. Subjects were randomly assigned to a regular or reduced sodium diet, and all received a one-year nutrition and physical activity intervention. For this study, individuals providing valid baseline 24hr urine collections were included (n=281). Linear mixed models were used to evaluate associations between changes in aldosterone and changes in weight, blood pressure, and obesity-related factors. Results: Weight loss was significant at 6 months (∼7%), 12 months (∼6%), and 24 months (∼4%) (p<0.0001 for all). Within-subject decreases in aldosterone were associated with decreases in C-reactive protein, leptin, and homeostasis assessment of insulin resistance (HOMA-IR) and with increases in adiponectin (p<0.01 for all) in models including baseline age, sex, race, intervention arm, time since baseline, and baseline and concurrent changes in BMI, urinary sodium and potassium, and the obesity-related factor of interest. Decreases in aldosterone were associated with weight loss only in the subgroup (n=98) with metabolic syndrome (MetS) at baseline (MetS x percent weight loss p=0.02); a 10% weight reduction in this subgroup was associated with a 9% (95% CI 1–16) reduction in aldosterone. Though no association was detected between changes in aldosterone and mean arterial pressure (MAP), a significant association was found between reductions in MAP and 24hr urinary sodium in those with MetS (MetS x urinary sodium reduction p=0.02). Independent of weight loss, a 30% reduction in urinary sodium was associated with a 0.9 mm Hg (95% CI 0.2–1.6) decrease in MAP in those with MetS. Conclusions: Changes in aldosterone are associated with changes in obesity-related factors in overweight/obese normotensive young adults. In persons with MetS, weight loss and dietary sodium restriction are particularly useful to reduce aldosterone and MAP respectively. Given the adverse effects of excess aldosterone on cardiac and vascular remodeling, future studies should investigate the benefits of aldosterone antagonists in individuals with MetS.

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Abstract P249: A Behavioral Weight Loss Intervention is Effective for Change in CVD Risk Factors in Young Adults: The IDEA Study

Circulation ◽

10.1161/circ.131.suppl_1.p249 ◽

2015 ◽

Vol 131 (suppl_1) ◽

Author(s):

John M Jakicic ◽

Kelliann K Davis ◽

Bethany Barone Gibbs ◽

Diane Helsel ◽

Wendy C King ◽

...

Keyword(s):

Risk Factors ◽

Cardiovascular Disease ◽

Weight Loss ◽

Young Adults ◽

Disease Risk ◽

Cardiovascular Disease Risk ◽

Cardiovascular Disease Risk Factors ◽

Weight Loss Intervention ◽

Behavioral Weight Loss ◽

Behavioral Weight Loss Intervention

Introduction: Few studies have examined behavioral weight loss interventions with respect to change in cardiovascular disease risk factors in young adults (aged 18 to 35 years). Hypothesis: We tested the hypothesis that a 6 month behavioral weight loss intervention resulted in significant improvements in selective cardiovascular disease risk factors in young adults. Methods: Data are presented as median [25 th , 75 th percentiles]. 470 participants (age: 30.9 [27.8, 33.7] years); BMI: 31.2 [28.4, 34.3] kg/m 2 ) were enrolled in a 6 month behavioral weight loss intervention that included weekly group sessions and prescribed an energy restricted diet and moderate-to-vigorous physical activity. Assessments included weight using a standardized protocol, resting blood pressure, and fasting lipids, glucose, and insulin. Statistical significance of change was according to tests of symmetry or the Wilcoxon matched pairs signed ranks test. Results: The primary outcome (weight) was available for 424 of the 470 participants (90.2%). Weight significantly decreased (-7.8 kg [-12.2, -3.7]) (p<0.0001). Systolic (-4.0 mmHg [-8.5, 0.5] and diastolic blood pressure (-3.0 mmHg [-6.5, 1.0]) decreased (p<0.0001). Total cholesterol (-13 mg/dl [-28.0, 2.0]), LDL cholesterol (-9.5 mg/dl [-21.7, 2.0]), triglycerides (-8.5 mg/dl [-44.0, 9.0]), glucose (-4.0 mg/dl [-8.0, 1.0]), and insulin (-2.6 mIU/L [-5.9, 0.7]) decreased (p<0.0001, n=416). There was not a significant change in HDL cholesterol (p=0.72). Conclusions: In conclusion, after 6 months, weight loss was observed in young adults assigned to this behavioral intervention that focused on physical activity and diet modification. They tended to also have improved cardiovascular disease risk factors. This may demonstrate an approach to reducing cardiovascular disease risk in young adults. Supported by NIH (U01HL096770) and AHA (12BGIA9410032)

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Fat, fish oil and the cancer anorexia/weight loss syndrome

Evidence-Based Integrative Medicine ◽

10.2165/01197065-200301010-00009 ◽

2003 ◽

Vol 1 (1) ◽

pp. 51-55

Author(s):

Aminah Jatoi

Keyword(s):

Weight Loss ◽

Fish Oil ◽

Cancer Anorexia

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Abstract MP27: Cellphone Intervention for You (CITY): A Randomized, Controlled Trial of Behavioral Weight Loss Intervention by Cellphone or Personal Coaching for Young Adults

Circulation ◽

10.1161/circ.131.suppl_1.mp27 ◽

2015 ◽

Vol 131 (suppl_1) ◽

Author(s):

Laura P Svetkey ◽

Stephen S Intille ◽

Bryan C Batch ◽

Leonor Corsino ◽

Crystal C Tyson ◽

...

Keyword(s):

Weight Loss ◽

Young Adults ◽

Controlled Trial ◽

Personal Contact ◽

Control Group ◽

Weight Loss Intervention ◽

Behavioral Weight Loss ◽

National Guidelines ◽

Personal Coaching ◽

Behavioral Weight Loss Intervention

Background: Obesity affects young adults, leading to future morbidity and mortality. Early behavioral intervention may promote long-term weight control. Mobile technology-based (mHealth) interventions may be particularly effective in young adults. We compared both an mHealth behavioral weight loss intervention and a personal coaching weight loss intervention to no intervention (and to each other) in overweight/obese young adults. Methods: We randomized 365 generally healthy adults age 18-35 years with BMI > 25 kg/m2 (overweight or obese) to 24-months of intervention delivered primarily via investigator-designed cell phone (CP) or intervention delivered primarily via in-person (6 weekly) and by phone (23 monthly) coaching (PC), compared to usual care control group (Control). Primary outcome was weight change from baseline to 24 months. This study was conducted as part of the Early Adult Reduction of weight through LifestYle (EARLY) cooperative trials. Results: Randomized participants (N=365) had mean BMI 35 kg/m2, mean age 29yrs, were 70% women, 36% African American, 6% Latino. Final weight was obtained in 86%; missing weight was multiply imputed. At 24 months, weight loss was not different in either PC or CP vs Control (see Figure). Weight loss in PC was significantly greater than Control at 6 months. From baseline to 24 months, clinically significant weight loss (> 3% per national guidelines) occurred in 40% of PC, 34% of CP, and 30% of Control. Conclusions: mHealth alone may not be sufficient for weight loss in young adults but mHealth-enhanced contact with an interventionist has a modest short-term effect. Future interventions should maximize the complementarity of mHealth and personal contact to achieve larger and more sustained effect.

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Abstract P055: Six-Month Changes in Ideal Health and Cardiovascular Risk Scores Among Young Adults Enrolled in a Weight Loss Intervention

Circulation ◽

10.1161/circ.131.suppl_1.p055 ◽

2015 ◽

Vol 131 (suppl_1) ◽

Author(s):

Bethany Barone Gibbs ◽

Wendy C King ◽

John M Jakicic

Keyword(s):

Physical Activity ◽

Weight Loss ◽

Young Adults ◽

Cardiovascular Health ◽

Lifestyle Changes ◽

Risk Scores ◽

Rank Test ◽

Weight Loss Intervention ◽

Spearman's Rho ◽

Spearman’S Rho

The Framingham 10-year (FRS-10) and lifetime (FRS-LIFE) risk scores use clinical CVD risk factors to predict coronary heart disease (CHD) and CVD outcomes, respectively. In contrast, the AHA’s Ideal Cardiovascular Health (IDEAL) paradigm encourages a 7-component, healthy phenotype that additionally includes healthy diet, body mass index (BMI), and physical activity behaviors that are also associated with the avoidance of developing cardiovascular disease (CVD). Objective: To compare changes in IDEAL, FRS-10, and FRS-LIFE over 6 months in young adults enrolled in a behavioral weight loss intervention Methods: FRS-10 and FRS-LIFE were calculated using published equations at baseline and 6 months in young adults who were overweight or obese at study entry but otherwise healthy. IDEAL was calculated on a 14-point scale where, for each component, 0, 1, or 2 points were given for ‘poor’, ‘moderate’, or ‘ideal’ classification, respectively. Descriptive statistics are reported as % or median [IQR]. McNemar’s test, test of symmetry, and Wilcoxon signed rank test were employed to evaluate pre- to post-intervention changes. Spearman’s correlations evaluate associations. Results: In 335 young adults, age 31 [27, 34] yrs, BMI 31 [28, 34] kg/m 2 , and 32% male, the intervention achieved significant 6-month decreases in BMI: -3.0 [-4.3, -1.5] kg/m 2 . Out of a possible 14 points (higher is better), IDEAL was 9 [8, 10] at baseline and 11 [10, 12] at 6 months, with 73% improving and 9% worsening (net improvement 64%) (p<.0001). Though<1% ever had IDEAL diet, a net improvement in diet was observed in 19%, with specific improvements in sugar-sweetened beverage and sodium components (p<0.001). Significant net improvements were also observed in IDEAL classification for BMI (49%), physical activity (39%), total cholesterol (14%), blood pressure (14%) and glucose (11%) components (all p<.0001). FRS-10 was negligible (<1%) for 88% of the cohort at baseline and 94% at 6 months. Across predicted FRS-10 scores, 7% improved and 2% worsened (net improvement 5%) over the 6 months (p<.0001). Improved FRS-10 and IDEAL were correlated (Spearman’s rho = -0.49, p<0.001). IDEAL had a stronger correlation with change in weight compared to FRS-10 (Spearman’s rho = -0.49 vs. 0.30; both p<0.001). FRS-LIFE indicated lifetime risk was high for 35% of the cohort at baseline and 22% at 6 months (p<.0001). FRS-LIFE as a 5-category scale improved in 38% and worsened in 13% (net improvement 26%) (p<.0001). Conclusions: In a cohort of overweight or obese, but otherwise healthy, young adults enrolled in a weight loss intervention, IDEAL was able to measure positive lifestyle changes in a majority of participants while the FRS-10 and FRS-LIFE did not. These results suggest that IDEAL may be particularly sensitive and appropriate to detect positive cardiovascular health changes in the growing population of overweight and obese young adults.

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