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Effects of an intensive behavioral weight loss intervention consisting of caloric restriction with or without physical activity on common carotid artery remodeling in severely obese adults.


ABSTRACT:

Objective

Obesity increases cardiovascular disease risk and adversely affects vascular structure and function. Few studies have evaluated the vascular effects of non-surgical weight reduction in the severely obese. We hypothesized that weight loss and improvements in cardiometabolic factors would reduce common carotid artery intima-media thickness (CIMT) and inter-adventitial diameter (AD) in severely obese adults.

Methods

We performed carotid ultrasound and measured cardiometabolic factors in 90 severely obese participants (body mass index (BMI)?35 kg/m(2), age 30-55) at baseline and 6 months in a randomized clinical trial of dietary intervention with (n=45) or without (n=45) physical activity.

Results

The achieved weight loss (mean=8%) did not differ significantly by intervention group (P=0.10) and resulted in a 0.07 mm mean decrease in AD (P=0.001). AD change was positively correlated with changes in BMI, waist circumference, abdominal visceral and subcutaneous fat, and body fat mass, and AD decreased more in men (P<0.05 for all). After multivariable adjustment, changes in BMI (P=0.03) and abdominal subcutaneous fat (P=0.04) were significant determinants of AD change. Although CIMT did not decrease significantly overall (-0.008 mm, P=0.16), individuals who lost at least 5% of their body weight experienced a significant mean reduction in CIMT of 0.02 mm (P=0.002). CIMT change was positively correlated with changes in BMI, waist circumference, fat-free mass, leptin, and insulin (P<0.05 for all). After multivariable adjustment, insulin reduction remained a significant determinant of CIMT decrease (P=0.03).

Conclusion

A 6 month intensive behavioral intervention can significantly reverse metabolic and vascular abnormalities in severely obese adults.

SUBMITTER: Cooper JN 

PROVIDER: S-EPMC3419808 | biostudies-literature | 2012 Nov

REPOSITORIES: biostudies-literature

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Publications

Effects of an intensive behavioral weight loss intervention consisting of caloric restriction with or without physical activity on common carotid artery remodeling in severely obese adults.

Cooper Jennifer N JN   Columbus Mindy L ML   Shields Kelly J KJ   Asubonteng Julius J   Meyer Michelle L ML   Sutton-Tyrrell Kim K   Goodpaster Bret H BH   DeLany James P JP   Jakicic John M JM   Barinas-Mitchell Emma E  

Metabolism: clinical and experimental 20120509 11


<h4>Objective</h4>Obesity increases cardiovascular disease risk and adversely affects vascular structure and function. Few studies have evaluated the vascular effects of non-surgical weight reduction in the severely obese. We hypothesized that weight loss and improvements in cardiometabolic factors would reduce common carotid artery intima-media thickness (CIMT) and inter-adventitial diameter (AD) in severely obese adults.<h4>Methods</h4>We performed carotid ultrasound and measured cardiometabol  ...[more]

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