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Associations between cardiorespiratory fitness and weight loss in patients with severe obesity undergoing an intensive lifestyle intervention program: retrospective cohort study.

ABSTRACT: BACKGROUND:To assess the association between cardiorespiratory fitness (CRF) and weight changes in treatment seeking patients with severe obesity who underwent a 1-year intensive lifestyle intervention (ILI) program. METHODS:Retrospective cohort study conducted at a tertiary care outpatient rehabilitation center from November 1, 2013 through January 1, 2017. CRF was measured as maximal oxygen consumption during a maximal oxygen uptake (VO2max) test on a treadmill or bicycle at baseline and after 3?months. RESULTS:A total of 180 patients had a baseline mean (SD) BMI 41.1 (4.8) kg/m2 and CRF of 79.4 (14.9) mL·kg-0.75·min-?1. Patients with a baseline CRF above median achieved a greater 3-month and 1-year weight loss compared with patients with CRF below median; mean (95% CI) 2.5?kg (1.3, 3.8) and 4.0?kg (0.8, 7.2), respectively. In addition, patients with 3-month changes of CRF above median had 4.0?kg (0.9, 7.1) greater weight loss at 1-year follow-up than those below median. CONCLUSIONS:Among patients with severe obesity who underwent a 1-year ILI program, higher baseline CRF was associated with significantly larger weight loss after 3?months and 1?year. In addition, those with higher initial 3-month CRF changes had greater weight loss at 1?year. TRIAL REGISTRATION:Retrospectively registered in Regional Committees for Medical and Health Research Ethics (REC) south east September 22, 2016 (2016/1414) and clinicaltials.gov August 13, 2018 (identifier: NCT03593798 ).

SUBMITTER: Berge J

PROVIDER: S-EPMC6604389 | biostudies-literature | 2019 Jul

REPOSITORIES: biostudies-literature

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Associations between cardiorespiratory fitness and weight loss in patients with severe obesity undergoing an intensive lifestyle intervention program: retrospective cohort study.

Berge Jarle J Støren Øyvind Ø Hertel Jens K JK Gjevestad Espen E Småstuen Milada Cvancarova MC Hjelmesæth Jøran J

BMC endocrine disorders 20190701 1

<h4>Background</h4>To assess the association between cardiorespiratory fitness (CRF) and weight changes in treatment seeking patients with severe obesity who underwent a 1-year intensive lifestyle intervention (ILI) program.<h4>Methods</h4>Retrospective cohort study conducted at a tertiary care outpatient rehabilitation center from November 1, 2013 through January 1, 2017. CRF was measured as maximal oxygen consumption during a maximal oxygen uptake (VO<sub>2max</sub>) test on a treadmill or bic ...[more]

PMID: 31262301

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Project description:BackgroundThe impact of cardiorespiratory fitness (CRF) and other lifestyle-related factors on severe COVID-19 risk is understudied. The present study aims to investigate lifestyle-related and socioeconomic factors as possible predictors of COVID-19, with special focus on CRF, and to further study whether these factors may attenuate obesity- and hypertension-related risks, as well as mediate associations between socioeconomic factors and severe COVID-19 risk.MethodsOut of initially 407,131 participants who participated in nationwide occupational health service screening between 1992 and 2020, n = 857 cases (70% men, mean age 49.9 years) of severe COVID-19 were identified. CRF was estimated using a sub-maximum cycle test, and other lifestyle variables were self-reported. Analyses were performed including both unmatched, n = 278,598, and sex-and age-matched, n = 3426, controls. Severe COVID-19 included hospitalization, intensive care or death due to COVID-19.ResultsPatients with more severe COVID-19 had significantly lower CRF, higher BMI, a greater presence of comorbidities and were more often daily smokers. In matched analyses, there was a graded decrease in odds for severe COVID-19 with each ml in CRF (OR = 0.98, 95% CI 0.970 to 0.998), and a two-fold increase in odds between the lowest and highest (< 32 vs. ≥ 46 ml·min-1·kg-1) CRF group. Higher BMI (per unit increase, OR = 1.09, 1.06 to 1.12), larger waist circumference (per cm, OR = 1.04, 1.02 to 1.06), daily smoking (OR = 0.60, 0.41 to 0.89) and high overall stress (OR = 1.36, 1.001 to 1.84) also remained significantly associated with severe COVID-19 risk. Obesity- and blood pressure-related risks were attenuated by adjustment for CRF and lifestyle variables. Mediation through CRF, BMI and smoking accounted for 9% to 54% of the associations between low education, low income and blue collar/low skilled occupations and severe COVID-19 risk. The results were consistent using either matched or unmatched controls.ConclusionsBoth lifestyle-related and socioeconomic factors were associated with risk of severe COVID-19. However, higher CRF attenuated the risk associated with obesity and high blood pressure, and mediated the risk associated with various socioeconomic factors. This emphasises the importance of interventions to maintain or increase CRF in the general population to strengthen the resilience to severe COVID-19, especially in high-risk individuals.

Project description:ObjectiveWe aimed to assess the potential association of dietary (DIS) and lifestyle inflammation score (LIS) and their joint association (DLIS) with cardiorespiratory fitness (CRF) in Tehranian adults.DesignThe present study was designed cross-sectional.ParticipantsA total of 265 males and females aged 18-70 years (mean ± SD: 36.9 ± 13.3) were entered in the present cross-sectional study. Eligible participants were healthy men and women who were free of medications and had no acute or chronic infection or inflammatory disease.MeasuresThe DIS was calculated by the use of data from 18 anti- and pro-inflammatory dietary components, and the LIS by three non-dietary components including physical activity, smoking status, and general adiposity, with higher scores indicating a more pro-inflammatory diet and lifestyle, respectively. The DLIS was calculated by summing the DIS and LIS. CRF was assessed by the Bruce protocol and VO2 max was measuredas the main variable of CRF. The odds ratio (OR) and 95% confidence interval (CI) of CRF across tertiles of the DIS, LIS, and DLIS were estimated by logistic regression analysis with considering age, gender, energy intake, marital and education status, and occupation as confounders.ResultsThe DLIS ranged from -2.10 to 0.38 (mean ± SD: -1.25 ± 0.64). In the model that controlled for all variables, the ORs of CRF for the second and third tertiles of the DLIS as compared to the first tertile were 0.42 (95%CI: 0.20, 0.90) and 0.12 (95%CI: 0.05, 0.32), respectively (P-trend < 0.001). There was a strong inverse association between the LIS and CRF (ORthirdvs.firsttertile: 0.12, 95%CI: 0.05, 0.32). There was no association between DIS and CRF.ConclusionThe present study examined the joint association of inflammation-related lifestyle behaviors with CRF and found a strong inverse association between a pro-inflammatory lifestyle with CRF. We did not find any association between dietary inflammatory properties with CRF. Future studies should address the relationship between the inflammatory potential of the diet and CRF.

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Associations between cardiorespiratory fitness and weight loss in patients with severe obesity undergoing an intensive lifestyle intervention program: retrospective cohort study.

Publications

Associations between cardiorespiratory fitness and weight loss in patients with severe obesity undergoing an intensive lifestyle intervention program: retrospective cohort study.

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