Dataset Information

Impact of weight loss on waist circumference and the components of the metabolic syndrome.

ABSTRACT: OBJECTIVE:Central adiposity is a component of the metabolic syndrome (MetS). Little is known about the impact of medical weight loss and decreased waist circumference (WC) on the MetS. Our objective was to assess the impact of changes in WC on blood pressure, lipids and glycemia. RESEARCH DESIGN AND METHODS:We studied 430 obese patients enrolled in a 2-year, intensive, behavioral, weight management program. We report results for participants who completed 6-month and 2-year follow-up. RESULTS:Participants were 49±9?years of age (mean±SD), 56% were women and 85% were white. Baseline body mass index (BMI) was 41±6?kg/m2 and baseline WC was 120±14?cm. At 6?months, BMI decreased by 6±3?kg/m2 and WC by 14±9?cm. Relative change in WC was defined as the 6-month or 2-year WC minus the baseline WC divided by the baseline WC. Systolic blood pressure decreased by 8?mm?Hg for the tertile of participants with the largest relative decrease in WC and by 2?mm?Hg for those with the smallest relative decrease in WC (p=0.025). Similar patterns of improvement were observed in total cholesterol (-29 vs -12?mg/dL, p=0.017), low-density lipoprotein-cholesterol (-19 vs -4?mg/dL, p=0.033), and glycated hemoglobin (-1.2 vs -0.3%, p=0.006). At 2?years, BMI decreased by 5±4?kg/m2 and WC by 11±11?cm and similar patterns of improvements were seen in components of the MetS. At both 6?months and 2?years, larger relative decreases in WC were associated with greater improvements in lipids and glycemia independent of sex. CONCLUSIONS:In obese people, greater relative decreases in WC with medical weight loss are associated with greater improvements in components of the MetS independent of sex.

SUBMITTER: Rothberg AE

PROVIDER: S-EPMC5337678 | biostudies-literature | 2017

REPOSITORIES: biostudies-literature

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Impact of weight loss on waist circumference and the components of the metabolic syndrome.

Rothberg Amy E AE McEwen Laura N LN Kraftson Andrew T AT Ajluni Nevin N Fowler Christine E CE Nay Catherine K CK Miller Nicole M NM Burant Charles F CF Herman William H WH

BMJ open diabetes research & care 20170220 1

<h4>Objective</h4>Central adiposity is a component of the metabolic syndrome (MetS). Little is known about the impact of medical weight loss and decreased waist circumference (WC) on the MetS. Our objective was to assess the impact of changes in WC on blood pressure, lipids and glycemia.<h4>Research design and methods</h4>We studied 430 obese patients enrolled in a 2-year, intensive, behavioral, weight management program. We report results for participants who completed 6-month and 2-year follow ...[more]

PMID: 28316795

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Project description:BackgroundHigher whole-grain (WG) intake is associated with a lower prevalence of metabolic syndrome (MetS); however, there is inconsistent clinical evidence with regard to the benefit of WGs compared with refined grains (RGs) on MetS.ObjectiveWe hypothesized that consuming WGs in the place of RGs would improve MetS criteria in individuals with or at risk of MetS.DesignA randomized, controlled, open-label parallel study was conducted in 50 overweight and obese individuals with increased waist circumference and one or more other MetS criteria. Participants consumed a controlled weight-loss diet containing either WG or RG (control) products for 12 wk. Body composition, MetS criteria and related markers, and plasma alkylresorcinols (compliance marker of WG intake) were measured at baseline and at 6 and 12 wk. A subgroup (n = 28) underwent magnetic resonance imaging to quantify subcutaneous and visceral adipose tissue (AT).ResultsBaseline variables were not significantly different between groups; however, the RG group tended to have higher triglycerides and lower high-density lipoprotein (HDL) cholesterol (P = 0.06). Alkylresorcinols increased with consumption of the WG diet and did not change with consumption of the RG diet (time × treatment, P < 0.0001), which showed dietary compliance. There were no differences in anthropometric changes between groups; however, weight, body mass index, and percentage of body AT decreased at both 6 and 12 wk (P < 0.05), and reductions in percentage of abdominal AT occurred by 6 wk and did not change between 6 and 12 wk (P = 0.09). Both glucose (P = 0.02) and HDL cholesterol (P = 0.04) were lower with the consumption of the WG compared with the RG diet. However, when noncompliant individuals (n = 3) were removed, the glucose effect was stronger (P = 0.01) and the HDL-cholesterol effect was no longer significant (P = 0.14).ConclusionsReplacing RGs with WGs within a weight-loss diet does not beneficially affect abdominal AT loss and has modest effects on markers of MetS. WGs appear to be effective at normalizing blood glucose concentrations, especially in those individuals with prediabetes.

Project description:OBJECTIVES:To apply spinal cord injury (SCI) specific waist circumference (WC) cutoff point to identify risks of 1) obesity, 2) metabolic syndrome (MetS), 3) cardiovascular disease (CVD). METHODS:Thirty-six men with chronic SCI underwent anthropometric measurements, dual-energy x-ray absorptiometry (DXA), and magnetic resonance imaging (MRI) to measure total and regional adiposity. An SCI specific WC cutoff point of 86.5 cm was applied to the existing general population criteria. Pearson chi-square (?2) analyses tested the difference in the number of participants classified as obese using the SCI specific cutoff point compared to the general population criteria. Sensitivity and specificity analyses relative to percentage body fat mass and visceral adipose tissue was used to assess classification performance of this cutoff point. The interrater reliability for three definitions of MetS was assessed using Cohen's Kappa (?) values. Linear regression analyses were utilized to propose SCI specific Framingham Coronary Heart Disease Risk Score (FRS) cutoff value. RESULTS:Using SCI specific WC cutoff point of 86.5 cm, 36% of participants were classified as obese compared to only 3% when using WC of 102 cm (P < 0.001). Relative to percentage body fat mass, the general population WC cutoff point of 102 cm had a sensitivity of 6.3% and specificity of 100% both which changed to 68.8% and 90%, respectively, with a SCI specific cutoff point of 86.5 cm. Similar results were obtained when using visceral adipose tissue as a reference. The Kappa (?) values improved substantially after using SCI specific criteria (0.95 ± 0.05) compared to the general population criteria (0.47 ± 0.28) for three definitions of MetS. The SCI specific FRS cutoff value of 6 was predicted after applying a WC cutoff of 86.5 cm. CONCLUSIONS:Using the existing general population criteria underestimated persons with SCI who are at risk of developing obesity, MetS, and CVD. The recommended SCI specific criteria are likely to distinguish those at risks of developing comorbidities and allow healthcare providers to intervene in a timely manner.

Dataset Information

Impact of weight loss on waist circumference and the components of the metabolic syndrome.

Publications

Impact of weight loss on waist circumference and the components of the metabolic syndrome.

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