Men and women respond differently to rapid weight loss: Metabolic outcomes of a multi-centre intervention study after a low-energy diet in 2500 overweight, individuals with pre-diabetes (PREVIEW)

ObjectiveClinical guidelines recommend weight loss to manage non-alcoholic fatty liver disease (NAFLD). However, the majority of patients find weight loss a significant challenge. We identified factors associated with engagement and adherence to a low-energy diet (LED) as a treatment option for NAFLD.Design23 patients with NAFLD enrolled in a LED (~800 kcal/day) were individually interviewed. Transcripts were thematically analysed.Results14/23 patients achieved ≥10% weight loss, 18/23 achieved ≥7% weight loss and 19/23 achieved ≥5% weight loss. Six themes were generated from the data. A desire to achieve rapid weight loss to improve liver health and prevent disease progression was the most salient facilitator to engagement. Early and significant weight loss, accountability to clinicians and regular appointments with personalised feedback were facilitators to engagement and adherence. The desire to receive positive reinforcement from a consultant was a frequently reported facilitator to adherence. Practical and emotional support from friends and family members was critically important outside of the clinical setting. Irregular working patterns preventing attendance at appointments was a barrier to adherence and completion of the intervention.ConclusionsEngagement and adherence to a LED in patients with NAFLD were encouraged by early and rapid weight loss, personalised feedback and positive reinforcement in the clinical setting combined with ongoing support from friends and family members. Findings support those identified in patients who completed a LED to achieve type 2 diabetes remission and highlight the importance of behaviour change support during the early stages of a LED to promote adherence.

Download Full-text

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.

Download Full-text

Predictors of successful weight loss with relative maintenance of fat-free mass in individuals with overweight and obesity on an 8-week low-energy diet

British Journal Of Nutrition ◽

10.1017/s0007114519001296 ◽

2019 ◽

Vol 122 (04) ◽

pp. 468-479 ◽

Cited By ~ 5

Author(s):

Thea Toft Hansen ◽

Mads Fiil Hjorth ◽

Karoline Sandby ◽

Sarah Vold Andersen ◽

Arne Astrup ◽

...

Keyword(s):

Weight Loss ◽

G Protein ◽

Protein Intake ◽

Overweight And Obesity ◽

Low Energy ◽

Fat Free Mass ◽

Rapid Weight Loss ◽

Successful Weight Loss ◽

Weight Loss Success ◽

Low Energy Diet

AbstractA low-energy diet (LED) is an effective approach to induce a rapid weight loss in individuals with overweight. However, reported disproportionally large losses of fat-free mass (FFM) after an LED trigger the question of adequate protein content. Additionally, not all individuals have the same degree of weight loss success. After an 8-week LED providing 5020 kJ/d for men and 4184 kJ/d for women (84/70 g protein/d) among overweight and obese adults, we aimed to investigate the relationship between protein intake relative to initial FFM and proportion of weight lost as FFM as well as the individual characteristics associated with weight loss success. We assessed all outcomes baseline and after the LED. A total of 286 participants (sixty-four men and 222 women) initiated the LED of which 82 % completed and 70 % achieved a substantial weight loss (defined as ≥8 %). Protein intake in the range 1·0–1·6 g protein/d per kg FFM at baseline for men and 1·1–2·2 g protein/d per kg FFM at baseline for women was not associated with loss of FFM (P = 0·632). Higher Three-Factor Eating Questionnaire (TFEQ) hunger at baseline and reductions in TFEQ disinhibition and hunger during the LED were associated with larger weight loss (all P ≤ 0·020); whereas lower sleep quality at baseline predicted less successful weight loss using intention to treat analysis (P = 0·021), possibly driven by those dropping out (n 81, P = 0·067 v. completers: n 198, P = 0·659). Thus, the protein intakes relative to initial FFM were sufficient for maintenance of FFM and specific eating behaviour characteristics were associated with weight loss success.

Download Full-text

Effect of 12-week dark chocolate intake combined with low-energy diet and exercise on weight loss in obese adults: a phase II randomized controlled trial protocol

Principles and Practice of Clinical Research Journal ◽

10.21801/ppcrj.2016.22.3 ◽

2016 ◽

Vol 2 (2) ◽

Author(s):

Roberta Diaz Savoldelli ◽

◽

Catherine Yin Mok ◽

Wilson Costa Junior ◽

Andreia Sapienza ◽

...

Keyword(s):

Weight Loss ◽

Randomized Controlled Trial ◽

Phase Ii ◽

Controlled Trial ◽

Low Energy ◽

Trial Protocol ◽

Obese Adults ◽

Randomized Controlled ◽

Diet And Exercise ◽

Low Energy Diet

Download Full-text

Comparison of Very Low Energy Diet Products Available in Australia and How to Tailor Them to Optimise Protein Content for Younger and Older Adult Men and Women

Healthcare ◽

10.3390/healthcare4030071 ◽

2016 ◽

Vol 4 (3) ◽

pp. 71 ◽

Cited By ~ 8

Author(s):

Alice Gibson ◽

Janet Franklin ◽

Andrea Pattinson ◽

Zilvia Cheng ◽

Samir Samman ◽

...

Keyword(s):

Protein Content ◽

Older Adult ◽

Low Energy ◽

Men And Women ◽

Very Low Energy Diet ◽

Adult Men ◽

Low Energy Diet

Download Full-text

Preoperative weight loss with a very-low-energy diet: quantitation of changes in liver and abdominal fat by serial imaging

American Journal of Clinical Nutrition ◽

10.1093/ajcn/84.2.304 ◽

2006 ◽

Vol 84 (2) ◽

pp. 304-311 ◽

Cited By ~ 216

Author(s):

Susan L Colles ◽

John B Dixon ◽

Paul Marks ◽

Boyd J Strauss ◽

Paul E O’Brien

Keyword(s):

Weight Loss ◽

Abdominal Fat ◽

Low Energy ◽

Preoperative Weight Loss ◽

Very Low Energy Diet ◽

Serial Imaging ◽

Preoperative Weight ◽

Low Energy Diet

Download Full-text

Low Energy Diet-induced and Bariatric Surgery-induced Weight Loss Decreases Branched-chain and Aromatic Amino Acids in Plasma and Tissue (P21-078-19)

Current Developments in Nutrition ◽

10.1093/cdn/nzz041.p21-078-19 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

Cited By ~ 1

Author(s):

Zhanxuan Wu ◽

Karl Fraser ◽

Marlena Kruger ◽

Garth Cooper ◽

Anne-Thea McGill ◽

...

Keyword(s):

Bariatric Surgery ◽

Amino Acids ◽

Weight Loss ◽

Aromatic Amino Acids ◽

Fold Change ◽

Low Energy ◽

Post Surgery ◽

T1 And T2 ◽

Branched Chain ◽

Low Energy Diet

Abstract Objectives Plasma levels of branched-chain amino acids (BCAA) and aromatic amino acids (AAA) phenylalanine (phe) and tyrosine (tyr) have been associated with obesity, insulin resistance and risk of type 2 diabetes. This study aimed to investigate the response of circulating plasma and tissue levels of BCAA and AAA to weight loss, and to correlate the level of these metabolites in plasma and tissue in obese women. Methods 28 obese (mean BMI 46.2 kg/m2) women underwent low energy diet (LED)-induced weight loss (−9.2 ± 4.2 kg) followed by bariatric surgery-induced weight loss (−23.6 ± 2.5 kg). Plasma at baseline (t0), post-LED/pre-surgery (t1) and 6-month post-surgery (t2) as well as biopsies of subcutaneous abdomen adipose tissue (SAfat), superficial thigh adipose tissue (Tfat) and vastus lateralis thigh muscle (Tmuscle) at both t1 and t2 were collected, and profiled using mass spectrometry-based metabolomics approach. Paired t-tests were applied to assess between-timepoint differences, and Pearson correlation used to calculate correlation coefficient of metabolite levels between plasma and tissue. Results Plasma BCAA and AAA were all significantly reduced post-LED at t1 (fold-change of 0.76–0.85 for val, leu, ile, tyr and phe, P < 0.05) and 6-month post-surgery at t2 (fold-change of 0.74–0.85 for val, leu, ile, tyr and phe, P < 0.05) as compared to baseline t0; but not significant between t1 and t2, although trends of decrease were observed. Among the 3 tissue biopsies, only SAfat showed significantly decreased levels of tyr, leu and ile at t2 compared to t1 (fold-change for tyr 0.63, leu 0.66, ile 0.68, P < 0.05). In addition, plasma levels of val and ile were correlated with Tfat levels at both t1 and t2 (r2 = 0.47–0.57), and that of val, ile and leu were correlated with Tmuscle at t1 only (r2 = 0.64–0.67). Conclusions Circulating levels of BCAA and AAA were decreased by weight loss interventions. The decrease following an LED program was sustained after bariatric surgery without further significant decrease. Bariatric surgery also decreased BCAA levels in SAfat; moreover, our data suggested that plasma BCAA levels correlated well with peripheral tissue Tfat and Tmuscle. Funding Sources The New Zealand National Science Challenge High-Value Nutrition program.

Download Full-text