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Lipoprotein responses to weight loss and weight maintenance in high-risk obese subjects

European Journal of Clinical Nutrition volume 56, pages 264–270 (2002)Cite this article

Abstract

Objective: To examine changes in plasma lipids and lipoproteins after 51 months of reduced energy intake and sustained weight loss.

Methods: One-hundred patients were randomized to one of two dietary interventions for 3 months (weight loss period). Groups A and B received an energy-restricted diet plan of 5.2–6.3 MJ/day but group B was further instructed to replace two of three meals with a nutrient-fortified liquid meal replacement (MR). Upon completion of the weight loss period, all patients were given the same instructions regarding energy intake and were advised to use one MR daily. Body weight and 7 day food diaries were measured monthly or bimonthly and blood lipids at baseline, 3, 9 and 51 months.

Results: Of the original 100 patients 75 had completed 4 y. Of those 75, 73 had complete lipid records. Baseline body weights of Groups A and B were 90.7±14.0 and 91.6±9.8 kg, respectively. The percentage change in total cholesterol (%ΔTC) decreased in a linear fashion with increasing weight loss, when all data was combined, but did not approach statistical significance (P≤0.26, r=0.02). Further regression analysis found a significant negative linear relationship (P≤0.0001, r=0.69) between initial total cholesterol (TC) concentrations and %ΔTC. Hence, data from 27 of the 73 completers who exhibited an elevated serum total cholesterol (≥6.2 mmol/l) were isolated and analyzed further. Baseline TC was 6.75±0.64, 5.85±0.63 at 9 months (P<0.05) and 5.76±0.52 mmol/l at 51 months (P<0.05). Similar values for VLDL-cholesterol were 1.33±0.80, 0.74±0.24 and 0.66±0.21 mmol/l by 51 months (P<0.05). Weight decreased by 5.2±5.1, 7.6±4.9 and 6.7±4.6% at 3, 9 and 51 months, respectively.

Conclusion: Continuous energy restriction associated with a clinically meaningful weight loss significantly improved the lipid profile of high-risk patients. Similar weight and diet changes occurring in patients with normal plasma cholesterol were either increased or without affect.

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References

  • Blackburn GL . 1995 Effect of degree of weight loss on health benefits Obes. Res. 3: 211S–216S

    Article  Google Scholar 

  • Dattilo AM, Kris-Etherton PM . 1992 Effects of weight reduction on blood lipids and lipoproteins: a meta-analysis Am. J. Clin. Nutr. 56: 320–328

    Article  CAS  Google Scholar 

  • Denke MA, Sempos CT, Grundy SM . 1993 Excess body weight. An underrecognized contributor to high blood cholesterol levels in white American men Arch. Intern. Med. 153: 1093–1103

    Article  CAS  Google Scholar 

  • Eckel RH . 1999 The importance of timing and accurate interpretation of the benefits of weight reduction on plasma lipids Obes. Res. 7: 227–228

    Article  CAS  Google Scholar 

  • Elashoff RM, Johnson TD, Winters BL, Yun C . 1999 Modern statistical regression methods for a longitudinal dietary intervention feasibility study In Nutritional Oncology, eds. D Heber, GL Blackburn, VLW Go, Chap 45. San Diego, CA: Academic Press

    Google Scholar 

  • Flechtner-Mors M, Ditschuneit HH, Johnson TD, Suchard MA, Adler G . 2000 Metabolic and weight-loss effects of a long-term dietary intervention in obese patients. Four-year results Obes. Res. 8: 399–402

    Article  CAS  Google Scholar 

  • Flynn MM, Zmuda JM, Milosavljevic D, Caldwell MJ, Herbert PN . 1999 Lipoprotein response to a National Cholesterol Education Program Step II diet with and without energy restriction Metabolism 48: 822–826

    Article  CAS  Google Scholar 

  • Friedewald WT, Levy RI, Fredrickson DS . 1972 Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without the use of the preparative ultracentrifuge Clin. Chem. 18: 449–502

    Google Scholar 

  • Lichtenstein AH, Ausman LM, Carrasco W, Jenner JL, Ordovas JM, Schaefer EJ . 1994 Short-term consumption of a low-fat diet beneficially affects plasma lipid concentrations only when accompanied by weight loss Arterioscler. Thromb. 14: 1751–1760

    Article  CAS  Google Scholar 

  • National Heart, Lung, and Blood Institute NIH . 1998 Clinical Guidelines on the identification, evaluation, and treatment of overweight and obesity in adults Obes. Res. 6 Suppl 2: 51S–180S

    Google Scholar 

  • NCEP . 1993 Summary of the Second Report of the National Cholesterol, Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Cholesterol in Adults (Adult Treatment Panel II) J.A.M.A. 269: 3015–3023

    Article  Google Scholar 

  • Pi-Sunyer FX . 1993 Short-term medical benefits and adverse effects of weight loss Am. Coll. Phys. 119: 722–726

    CAS  Google Scholar 

  • Pi-Sunyer FX . 1996 A review of long-term studies evaluating the efficacy of weight loss in ameliorating disorders associated with obesity Clin. Ther. 18: 1006–1035

    Article  CAS  Google Scholar 

  • Sjöström DC, Lissner L, Wedel H, Sjöström L . 1999 Reduction in incidence of diabetes, hypertension and lipid disturbances after intentional weight loss induced by bariatric surgery: the SOS Intervention Study Obes. Res. 7: 477–484

    Article  Google Scholar 

  • Snedecor GW, Cochran WG . 1967 Statistical Methods, 6th ed, Chapter 6. Iowa: Iowa State University Press

    Google Scholar 

  • Van Gaal LF, Wauters MA, De Leeuw IH . 1997 The beneficial effects of modest weight loss on cardiovascular risk factors Int. J. Obes. Relat. Metab. Disord. 21: S5–S9

    Google Scholar 

  • Wadden TA, Anderson DA, Foster GD . 1999 Two-year changes in lipids and lipoproteins associated with the maintenance of a 5% to 10% reduction in initial weight: some findings and some questions Obes. Res. 7: 170–178

    Article  CAS  Google Scholar 

  • Weinsier RL, James LD, Darnell BE, Wooldridge NH, Birch R, Hunter GR, Bartolucci AA . 1992 Lipid and insulin concentrations in obese postmenopausal women: separate effects of energy restriction and weight loss Am. J. Clin. Nutr. 56: 44–49

    Article  CAS  Google Scholar 

  • Yu-Poth S, Zhoa G, Etherton T, Naglak M, Jonnalagadda S, Kris-Etherton PM . 1999 Effects of the National Cholesterol Education Program's Step I and Step II dietary intervention programs on cardiovascular disease risk factors: a meta-analysis Am. J. Clin. Nutr. 69: 632–646

    Article  CAS  Google Scholar 

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Acknowledgements

We thank Katja Huber (research laboratory of the Department of Medicine, University of Ulm, Ulm, Germany) for her technical assistance. We thank Richard Deckelbaum, MD, PhD (Columbia University, College of Physicians and Surgeons, New York, NY, USA) for assistance with the data analysis and fruitful discussions. We thank the Slim-Fast Foods Company (West Palm Beach, FL, USA) for providing the diet shakes and nutrition bars for use in this study.

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Author notes

  1. HH Ditschuneit: Guarantor: H Ditschuneit.

  2. HH Ditschuneit, HI Frier and M Flechtner-Mors: Contributors: HHD and MF-M initiated and performed the study. HLF prepared the draft of the manuscript. All investigators contributed to the draft of the paper.

Authors and Affiliations

  1. Department of Medicine, University, Ulm, Germany

    HH Ditschuneit & M Flechtner-Mors

  2. Slim-Fast Foods Company, West Palm Beach, Florida, USA

    HI Frier

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  1. HH Ditschuneit
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Correspondence to HH Ditschuneit.

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Ditschuneit, H., Frier, H. & Flechtner-Mors, M. Lipoprotein responses to weight loss and weight maintenance in high-risk obese subjects. Eur J Clin Nutr 56, 264–270 (2002). https://doi.org/10.1038/sj.ejcn.1601375

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