Effects of walking or resistance training on weight loss maintenance in obese, middle-aged men: a randomized trial

OBJECTIVE: To investigate whether walking or resistance training improves weight maintenance after weight loss when added to dietary counselling. DESIGN: Two months' weight reduction with very-low-energy-diet (VLED) followed by randomization into three groups (control, walking, resistance training) for 6 months' weight maintenance (WM) program and 23 months' unsupervised follow-up. During VLED and WM all groups received similar dietary counselling. SUBJECTS: The main inclusion criteria were BMI >30 kg/m(2), waist>100 cm and physical inactivity (exercise < or = once a week). Ninety healthy, obese (mean BMI 32.9 kg/m(2) and waist 112.5 cm), 35-50 y-old men started the study and 68 were measured at the end of the study. MEASUREMENTS: Weight and body composition assessed by underwater weighing. Exercise diaries and dietary records to assess energy balance. RESULTS: During VLED the mean body weight decreased from 106.0 (s.d. 9.9) kg to 91.7 (9.4) kg. Weight was regained mostly during follow-up and in the end of the study the mean weight in groups was 99.9-102.0 kg. Exercise training did not improve short or long-term weight maintenance when compared to the control group. However, resistance training attenuated the regain of body fat mass during WM (P=0.0l), but not during follow-up. In the combined groups the estimated total energy expenditure (EE) of reported physical activity was associated with less weight regain during WM. EE of 10.1 MJ/week was associated with maintaining weight after weight loss. EE of physical activity tended to decrease after WM in exercise groups due to poor long-term adherence to prescribed exercise. Energy intake seemed to increase during follow-up. CONCLUSION: Exercise training of moderate dose did not seem to improve long-term weight maintenance because of poor adherence to prescribed exercise.     

Eating control and physical activity as determinants of short-term weight maintenance after a very-low-calorie diet among obese women

OBJECTIVE: To test the hypothesis that eating control and physical activity help maintain weight and waist circumference after a very-low-calorie diet. DESIGN: A 12 week weight reduction (WR) phase, followed by a 40 week weight maintenance (WM) phase. For the latter, the subjects were randomised into a no-exercise group and one of two groups with a walking program. SUBJECTS: Eighty-five obese (body mass index 29-46, mean 34), clinically healthy, premenopausal women. MEASUREMENTS: Body weight, waist circumference, body composition, the measuring restrained eating, disinhibition and hunger, measured by Three Factor Eating Questionnaire (TFEQ), binge eating measured by the Bulimic Investigatory Test of Edinburgh (BITE), and number of daily steps measured by a pedometer. RESULTS: The change (delta) in weight during WM was predicted by the following regression: deltaweight (kg)=5.23+0.45 deltaweight during WR+0.66 disinhibition during WM0.00039 daily steps during WM, r2=0.46, SEE 3.3 kg. The change in waist circumference during WM was predicted as deltawaist (cm)=0.76+0.75 deltaweight during WM0.00021 daily steps during WM, r2=0.67, SEE 2.6 cm. Exercise group assignment did not affect the changes in weight, waist circumference, or indicators of eating control during the maintenance program. CONCLUSIONS: Control of overeating, as indicated by a lower disinhibition factor of the TFEQ, and daily physical activity, as indicated by a higher number of daily steps, were positive and independent predictors of weight maintenance after a very-low-calorie diet. The number of daily steps showed an independent association with change in waist circumference during weight maintenance, even after adjustment for weight change.     

High protein intake sustains weight maintenance after body weight loss in humans

BACKGROUND: A relatively high percentage of energy intake as protein has been shown to increase satiety and decrease energy efficiency during overfeeding. AIM: To investigate whether addition of protein may improve weight maintenance by preventing or limiting weight regain after weight loss of 5-10% in moderately obese subjects. DESIGN OF THE STUDY: In a randomized parallel design, 148 male and female subjects (age 44.2 +/- 10.1 y; body mass index (BMI) 29.5 +/- 2.5 kg/m2; body fat 37.2 +/- 5.0%) followed a very low-energy diet (2.1 MJ/day) during 4 weeks. For subsequent 3 months weight-maintenance assessment, they were stratified according to age, BMI, body weight, restrained eating, and resting energy expenditure (REE), and randomized over two groups. Both groups visited the University with the same frequency, receiving the same counseling on demand by the dietitian. One group (n=73) received 48.2 g/day additional protein to their diet. Measurements at baseline, after weight loss, and after 3 months weight maintenance were body weight, body composition, metabolic measurements, appetite profile, eating attitude, and relevant blood parameters. RESULTS: Changes in body mass, waist circumference, REE, respiratory quotient (RQ), total energy expenditure (TEE), dietary restraint, fasting blood-glucose, insulin, triacylglycerol, leptin, beta-hydroxybutyrate, glycerol, and free fatty acids were significant during weight loss and did not differ between groups. During weight maintenance, the 'additional-protein group' showed in comparison to the nonadditional-protein group 18 vs 15 en% protein intake, a 50% lower body weight regain only consisting of fat-free mass, a 50% decreased energy efficiency, increased satiety while energy intake did not differ, and a lower increase in triacylglycerol and in leptin; REE, RQ, TEE, and increases in other blood parameters measured did not differ. CONCLUSION: A 20% higher protein intake, that is, 18% of energy vs 15% of energy during weight maintenance after weight loss, resulted in a 50% lower body weight regain, only consisting of fat-free mass, and related to increased satiety and decreased energy efficiency.     

The Effects of Resistance Training on Metabolic Health With Weight Regain

J Clin Hypertens (Greenwich). 2010;12:64–72. ^© 2009 Wiley Periodicals, Inc.
To determine whether resistance training effectively maintains improvements in cardiometabolic syndrome risk factors during weight regain, 9 individuals lost 4% to 6% of their body weight during an 8- to 12-week diet- and aerobic exercise–induced weight loss phase followed by a controlled weight regain phase (8–12 weeks), during which they regained approximately 50% of the lost weight while participating in a supervised resistance training program. Following weight loss (6.0%±0.3%), body mass index, body fat percentage, waist circumference, all abdominal adipose tissue depots, total cholesterol, low-density lipoprotein cholesterol, insulin, and homeostasis model assessment (HOMA) were significantly reduced, while quantitative insulin-sensitivity check index (QUICKI) and cardiorespiratory fitness (maximal oxygen consumption) significantly increased. During weight regain (48.3%±3.3% of lost weight), body fat percentage, waist circumference, and maximal oxygen consumption were maintained and muscular strength and lean body mass significantly increased. Abdominal adipose tissue depots, insulin, HOMA, and QUICKI did not significantly change after weight regain. Resistance training was effective in maintaining improvements in metabolic health during weight regain.     

Effect of physician-delivered nutrition counseling training and an office-support program on saturated fat intake, weight, and serum lipid measurements in a hyperlipidemic population: Worcester Area Trial for Counseling in Hyperlipidemia (WATCH)

OBJECTIVE: To evaluate the effectiveness of a training program for physician-delivered nutrition counseling, alone and in combination with an office-support program, on dietary fat intake, weight, and blood low-density lipoprotein cholesterol levels in patients with hyperlipidemia. PARTICIPANTS AND METHODS: Forty-five primary care internists at the Fallon Community Health Plan, a central Massachusetts health maintenance organization, were randomized by site into 3 groups: (1) usual care; (2) physician nutrition counseling training; and (3) physician nutrition counseling training plus an office-support program. Eleven hundred sixty-two of their patients with blood total cholesterol levels in the highest 25th percentile, having previously scheduled physician visits, were recruited. Physicians in groups 2 and 3 attended a 3-hour training program on the use of brief patient-centered interactive counseling and the use of an office-support program that included in-office prompts, algorithms, and simple dietary assessment tools. Primary outcome measures included change at 1-year of follow-up in percentage of energy intake from saturated fat; weight; and blood low-density lipoprotein cholesterol levels. RESULTS: Improvement was seen in all 3 primary outcome measures, but was limited to patients in group 3. Compared with group 1, patients in group 3 had average reductions of 1.1 percentage points in percent of energy from saturated fat (a 10.3% decrease) (P = .01); a reduction in weight of 2.3 kg (P<.001); and a decrease of 0.10 mmol/L (3.8 mg/dL) in low-density lipoprotein cholesterol level (P = .10). Average time for the initial counseling intervention in group 3 was 8.2 minutes, 5.5 minutes more than in the control group. CONCLUSION: Brief supported physician nutrition counseling can produce beneficial changes in diet, weight, and blood lipids.     

Successful weight maintenance preserves lower levels of oxidized LDL achieved by weight reduction in obese men

OBJECTIVE: We studied the association between weight maintenance, oxidized low-density lipoprotein (ox-LDL) and other lipoproteins in obese men. METHODS: A 2-month weight reduction phase (WRP) with a very-low-energy diet was followed by a 6-month weight maintenance period and an unsupervised 2-year follow-up. Ninety men entered and 68 (76%) completed the study. Subjects were analyzed as one group and after division into two subgroups: 20 most successful men in maintaining the lost weight (subgroup 1) and the remaining (n=48) men (subgroup 2). Ox-LDL was measured by quantifying the amount of conjugated dienes in LDL particles. RESULTS: The mean (+/-s.d.) weight reduction at the end of the WRP (n=68) was 14% (confidence interval (CI) 12.9-14.7%, 14.5+/-4.2 kg, P<0.001). Ox-LDL decreased by 22% (CI 16.9-28.1, 12.3+/-15.4 micromol/l, P<0.001). At the end of the 2-year follow-up, the regain in weight from the end of the WRP was 11% (CI 9.0-12.4, 9.6+/-6.2 kg, P<0.001). The regain in ox-LDL was 30% (CI 18.7-41.2, 8.2+/-15.4 micromol/l, P<0.001). In subgroup 1 vs 2, the respective regains were 3% (CI 0.9-4.2, 2.2+/-3.0 kg, P=0.006) vs 14% (CI 12.7-15.6, 12.9+/-4.0 kg, P<0.001) regarding weight and 9% (2.0+/-6.9 micromol/l, P=NS) vs 39% (CI 23.7-53.9, 11.2+/-17.2 micromol/l, P相似文献   

Long-term effects of low-intensity exercise training on fat metabolism in weight-reduced obese men

The aim of the present study was to investigate the effect of long-term continuation of low-intensity exercise training on weight maintenance, substrate metabolism, and beta-adrenergic-mediated fat oxidation in weight-reduced obese men. Preceding this part of the study, subjects lost 15 +/- 6 kg of body weight by energy restriction with or without low-intensity exercise training. Twenty-nine subjects (diet group, n = 15; diet + exercise group, n = 14) participated in the follow-up study of 40 weeks in which the former diet + exercise group continued their exercise training program. Pre- and postfollow-up, measurements of body weight, body composition, maximal aerobic capacity and substrate oxidation during rest, exercise, and recovery with or without infusion of the beta-adrenergic antagonist, propranolol (PRP), were performed. Over the follow-up period, body weight, fat mass, and fat free mass increased in both groups (P <.0001) without differences between groups. Attendance at exercise training sessions was negatively correlated with regain of body weight (r = -.6, P <.05). Relative fat oxidation, energy expenditure, and beta-adrenergic-mediated fat oxidation during rest, exercise, and recovery were maintained over the follow-up period in both groups. Continuation of low-intensity exercise training after weight reduction did not limit regain of body weight, unless exercise training was frequently performed. Relative (beta-adrenergic-mediated) fat oxidation and energy expenditure were maintained at postdiet level whether or not low-intensity exercise training was performed during follow-up.     

Categorical strategies based on subject characteristics of dietary restraint and physical activity, for weight maintenance

OBJECTIVE: The aim of this study was to investigate the effect of categorical strategies based on subject-specific characteristics of dietary restraint and physical activity, on weight maintenance (WM) in overweight and obese subjects, after a very low calorie diet (VLCD). Furthermore, find predictors of WM that can be important in the context of obesity treatment. METHODS: In all, 120 subjects (age: 49.0+/-9.8 y, BMI 31.0+/-3.8 kg/m(2)) followed a VLCD (2.1 MJ/day) for 6 weeks in a free-living situation, followed by a period of 1 y WM. Body weight (BW), body composition, leptin concentration, dietary restraint and physical activity were determined right before (t0) and after (t1) the VLCD, after 3 months (t2) and after 1 y (t3). During WM, subjects were divided into four categories of WM guidelines (dietary, activity, diet+activity, placebo), taking their capability measured during weight loss and their preference for particular guidelines into account. RESULTS: BW loss during VLCD was 7.0+/-3.1 kg. After 1 y follow-up, BW regain was 56.3+/-55.0%, without significant differences between the four groups. With respect to measured capability during weight loss, subjects with an increased dietary restraint (F1 of the Three Factor Eating Questionnaire) had less BW regain than subjects with an increased physical activity (Baecke questionnaire) (35.5+/-53.2 vs 68.5+/-46.4%, P<0.05). Moreover, activity guidelines promoted WM in dietary disciplined subjects compared to activity-related disciplined subjects (% regain: 25.2 vs 74.3%, P<0.05). Subjects receiving guidelines that were opposite to their preference showed a better WM than subjects receiving preferred guidelines. After 1 y WM, 21 subjects were successful (<10% BW regain) and 99 unsuccessful (> or =10% BW regain). At baseline, these groups were significantly different in BMI (resp. 32.7+/-4.9 vs 30.7+/-3.5 kg/m(2), P<0.05), waist circumference (106.5+/-14.0 vs 100.6+/-11.2 cm, P<0.05) and fat mass (FM) (35.2+/-10.6 vs 32.1+/-6.6%, P=0.06). Finally, successful subjects appeared to spare fat-free mass (FFM) to a greater extent than unsuccessful subjects. CONCLUSION: After weight loss, type of guidelines (dietary, activity, placebo) is not related to the magnitude of WM, whereas guidelines opposite to the subject's capability and preference are related. These only reach successful WM (>90%) in originally dietary disciplined subjects who are supported by characteristics such as a relatively high baseline BMI, waist circumference and FM, together with the ability to spare FFM.     

Effect of circuit training with low-carbohydrate diet on body composition,cardiometabolic indices,and exercise capacity in adults with mild to moderate obesity in Saudi Arabia: A randomized control trial

Background:Circuit training that combines aerobic and resisted training is reported to reduce body fat, weight, and improve exercise capacity than performing either type of exercise independently. There is no study evaluating the combined effect of circuit training exercise (CTE) and dietary intervention (low-carbohydrate [LC] diet) among young males with obesity.Methods:A randomized control trial was conducted to explore the effects of a combined program of CTE and a LC diet for adults with mild or moderate obesity. Seventy adults with obesity were allocated randomly into 2 groups. The experimental group (group 1) received circuit training with LC diet intervention, whereas the control (group 2) received only circuit training. The study variables such as exercise capacity, body composition, and cardiometabolic indices were measured at the baseline and the end of 60 days of intervention.Results:The participants of group 1 showed significant improvements in body composition (body weight, body mass index, waist circumference, waist hip circumference, and body fat percentage), exercise capacity (maximal oxygen consumption), and cardiometabolic indices (high-density lipoprotein, low-density lipoprotein, triglycerides, and total cholesterol) with a P < .05 for all the variables, when compared with group 2.Conclusions:The combined structured CTE with controlled LC diet intervention in obese adults caused significant reduction in body composition and cardiometabolic indices variables and an increase in exercise capacity.     

Topical fat reduction from the waist

OBJECTIVE: Topical fat reduction from the thigh in women using aminophylline cream has been demonstrated, but the local fat reduction in other body areas or in men by lowering the local lipolytic threshold has not been demonstrated. This study is designed to test the hypothesis that aminophylline cream application to the waist will reduce waist circumference compared with a control. RESEARCH METHODS AND PROCEDURES: Fifty men and women who are 21-65 years of age with a BMI greater than 27 kg/m(2) and a waist to hip ratio > or =average were randomized in a 1 : 1 ratio to 0.5% aminophylline cream to the waist twice a day or no treatment to the waist. All subjects were instructed to follow a 1200 kcal balanced diet, participate in a walking program and return biweekly to encourage compliance. A theophylline level was drawn monthly, and the waist, BMI and waist to hip ratio were remeasured at 12 weeks. RESULTS: At week 12, there was a significant reduction in BMI from baseline that was not different between the groups. The reduction in waist circumference was 11 +/- 1.0 cm in the aminophylline cream group and 5.0 +/- 0.6 cm in the control group (p < 0.001). The reduction in waist circumference was significant for both women and men, but the women lost significantly more waist girth. The waist to hip ratio, a measure of fat distribution, declined. Aminophylline levels were undetectable, and there were no adverse events. DISCUSSION: Aminophylline cream offers a safe and effective method for cosmetic local fat reduction from the waist.     

减体重对肥胖和超重者心血管病危险因素的影响

目的：探讨对肥胖和超重者的减肥对心血管危险因素的影响。方法：对41名肥胖和超重者采取6周封闭管理的集中减肥，控制饮食，进行运动训练，每2周测定体重、腰臀围等指标，减肥前、后进行空腹血脂、血糖、血胰岛素、血转氨酶及肝脏超声检查。结果：通过6周减肥，受试者的体重、体重指数、腰围、臀围、腰臀围比、皮褶厚度、体脂含量及百分比、静息血压、心率呈非常明显的下降（P〈0．001）：减肥后血丙氨酸氨基转移酶、甘油三酯、胰岛素及胰岛素抵抗指数明显下降（P〈0．05-〈0．001），血高密度脂蛋白-胆固醇明显升高（P〈0．001），脂肪肝显著改善（P=0．001）。结论：运动锻炼结合饮食控制可减轻肥胖和超重者的体重，有效降低心血管疾病的危险因素。     

Clinical measures of obesity and weight loss in men

OBJECTIVES: (1) To determine the relationship between waist circumference and body weight in overweight men both before and after participation in a weight loss program; and (2) to make recommendations for the appropriate use of these measures at various stages of weight loss. DESIGN: Weight and waist circumference measures were taken in two diverse groups of men both before and 1-2 y after commencing a men's 'waist loss' program. Regression analyses were used to assess the relationship between weight and waist measures. SUBJECTS: One group of 42 retired Caucasian men from New South Wales, and one group of 45 indigenous men from the Torres Strait region of Northern Australia. RESULTS: There were differences in the relationships of weight and waist circumference before the program and change in weight and change in waist circumference after weight loss. These differences were similar in both groups of men (indigenous men and retired Caucasian men), with a 1 cm waist loss being on average equivalent to about 3/4 kg, but with wide variability, suggesting inter-individual variation in fat losses from different depots. This variation suggests that neither weight nor waist alone is a sufficient measure of fat loss for men. CONCLUSIONS: Weight and waist circumference should both be used at various stages in the clinical situation to assess change in body fat in men involved in obesity reduction.     

Obesity management in liver clinics: translation of research into clinical practice

BACKGROUND AND AIMS: Despite the benefits of modest weight reduction for overweight patients with chronic liver disease, long-term maintenance of weight loss is difficult to achieve in clinical practice. The aims of this study were to determine if a nutrition research protocol could be translated into clinical practice and meet the demand for dietetic service, to evaluate the effectiveness and resource implications of intensive lifestyle intervention for weight loss, and to assess the effectiveness of standard dietetic therapy as a treatment option for patients unable to attend the program. METHOD: Using a modified research protocol, an intensive weight reduction program was introduced into standard clinical care for overweight patients attending a tertiary hospital liver outpatient clinic. An audit of weight loss and cost outcomes was conducted. RESULTS: Ninety-three patients were referred to the dietetic service for weight management. Of these, 50 enrolled in an intensive lifestyle intervention, 18 received standard dietetic therapy and 25 refused any intervention. After 6 months, 83% of patients in the intensive intervention achieved weight loss with a significant decrease in weight (P < 0.001) and waist circumference (P < 0.001). In contrast, only 24% of patients receiving standard dietetic therapy achieved weight loss with no significant change in mean weight or waist circumference. Cost per kilogram weight loss after intensive intervention was $AU31 and continuation of lifestyle intervention was calculated to be less than $AU100 per patient per year. CONCLUSIONS: A clinically based, intensive lifestyle intervention is a feasible treatment option for outpatient weight management in overweight patients with chronic liver disease. Providing patients who are unable to participate in intensive programs with standard dietetic therapy is not cost-effective.     

Predictors of programme adherence and weight loss in women in an obesity programme using meal replacements

OBJECTIVE: To explore predictors of programme adherence and weight loss in patients participating in a weight management programme using meal replacements (MR). DESIGN: One hundred and fifty healthy obese women, age 48.5 years (s.d. = 8.3); weight, 97.6 kg (13.4); body mass index (BMI) 36.5 (3.7), participated in a longitudinal study with a 16-week acute weight loss phase (Phase 1) followed by 1 year of a trial of weight-loss maintenance (Phase 2). Energy intake during Phase 1 totaled 900 kcal (3.7 MJ) a day from a diet including two MR. Energy intake during Phase 2 consisted of either MR or a low-fat diet with a calculated energy deficit of 600 kcal/day (2.5 MJ). METHODS: Weight, height and waist circumference were measured and body composition assessed by air plethysmography (Bodpod). Glucose and insulin were measured by standard immunoassays and insulin sensitivity assessed by homeostatic model assessment. RESULTS: At the end of 16 weeks, 114 subjects (76%) completed Phase 1 and achieved a mean weight loss of 8.95 kg (3.38). Adherence to Phase 1 was predicted by weight loss over the first 2 weeks (p < 0.001). Weight loss during Phase 1 was predicted by initial weight and initial systolic blood pressure. Adherence to Phase 2 was not predicted by physiological measures. Weight loss maintenance in Phase 2 (not gaining more than 3% of the weight at start of phase 2) was predicted by cholesterol and triglyceride measured at the start of Phase 2 but otherwise was not predicted by the physiological measures. Initial insulin sensitivity did not predict weight loss in either phase. CONCLUSION: Participants whose weight loss over the first 2 weeks falls in the bottom third may need additional intervention if they are to continue in this type of programme. A battery of physiological measures at entry to a MR weight loss and maintenance programme explains only a very small proportion of the variation in weight loss.     

Effect of dietary restraint during and following pegylated recombinant leptin (PEG-OB) treatment of overweight men

OBJECTIVE: To examine the effect of dietary restraint during and following pegylated recombinant leptin (PEG-OB protein) treatment in overweight men. DESIGN: A randomized double-blind placebo-controlled trial in 24 overweight men (BMI: 28.8+/-0.3 kg/m(2); age: 34.8+/-0.9 y). PEG-OB protein (80 mg) or placebo was administered subcutaneously weekly for 6 weeks, combined with a 2.1 MJ/day energy restriction program. Dietary restraint was determined by the Three-Factor Eating Questionnaire before and after treatment, and after 8 weeks follow-up. RESULTS: During treatment dietary restraint increased, and general hunger, resting energy expenditure and respiratory quotient decreased similarly in the PEG-OB and the placebo group. With PEG-OB treatment, additional weight loss (P<0.03) was observed. During 8 weeks follow-up, body weight increase was larger in the PEG-OB group compared to placebo (P<0.05), and body weight regain was faster. Body weight regain was inversely correlated with the increase in cognitive dietary restraint during treatment (PEG-OB group: r(2)=0.49, P<0.02; placebo group: r(2)=0.60, P=0.01). CONCLUSION: Although treatment with PEG-OB protein led to a greater body weight loss relative to placebo, weight maintenance thereafter was mainly supported by dietary restraint, which was more effective in the placebo-treated group, resulting in a slower regain of body weight.     

Influences of apolipoprotein E polymorphism on the response of plasma lipids to the ad libitum consumption of a high-carbohydrate diet compared with a high-monounsaturated fatty acid diet

The purpose of this study was to assess the contribution of the apolipoprotein E (apoE) polymorphism and factors, such as age and waist circumference, to variations in plasma low-density lipoprotein-cholesterol (LDL-C) response following ad libitum consumption of a diet rich in complex carbohydrates (high-CHO: 58% of energy as CHO) versus a diet rich in fat and monounsaturated fatty acids (high-MUFA: fat, 40% of energy and 22% as MUFA). Sixty-five men participated in this parallel 6- to 7-week study involving either a high-CHO or a high-MUFA diet. Fasting plasma lipid profile and anthropometry were determined at the beginning and at the end of the dietary period. The high-CHO and high-MUFA diets both induced significant (P<.01) and comparable reductions in body weight and waist circumference. These changes were associated with a significant (P<.01) and comparable decrease in LDL-C (-19% and -16%, respectively). Stepwise multiple regression analyses showed that 32% of the variation in the LDL-C response to the high-CHO diet was attributable to the apoE polymorphism (18.5%, P=.04) and waist circumference (13.5%, P=.03) indicating that men with a waist circumference greater than 100 cm and the E2 allele had the greatest reduction in plasma LDL-C after the high-CHO diet. On the other hand, in the high-MUFA group, waist circumference was the only significant contributing factor to the LDL-C response and accounted for 44.5% of its variance. In conclusion, the plasma LDL-C response to ad libitum comsumption of a high-CHO and a high-MUFA diets are not modulated to the same extent by the apoE polymorphism and waist circumference.     

Effects of the amount of exercise on body weight, body composition, and measures of central obesity: STRRIDE--a randomized controlled study

BACKGROUND: Obesity is a major health problem due, in part, to physical inactivity. The amount of activity needed to prevent weight gain is unknown. OBJECTIVE: To determine the effects of different amounts and intensities of exercise training. DESIGN: Randomized controlled trial (February 1999-July 2002).Setting and PARTICIPANTS: Sedentary, overweight men and women (aged 40-65 years) with mild to moderate dyslipidemia were recruited from Durham, NC, and surrounding communities. INTERVENTIONS: Eight-month exercise program with 3 groups: (1) high amount/vigorous intensity (calorically equivalent to approximately 20 miles [32.0 km] of jogging per week at 65%-80% peak oxygen consumption); (2) low amount/vigorous intensity (equivalent to approximately 12 miles [19.2 km] of jogging per week at 65%-80%), and (3) low amount/moderate intensity (equivalent to approximately 12 miles [19.2 km] of walking per week at 40%-55%). Subjects were counseled not to change their diet and were encouraged to maintain body weight. MAIN OUTCOME MEASURES: Body weight, body composition (via skinfolds), and waist circumference. RESULTS: Of 302 subjects screened, 182 met criteria and were randomized and 120 completed the study. There was a significant (P<.05) dose-response relationship between amount of exercise and amount of weight loss and fat mass loss. The high-amount/vigorous-intensity group lost significantly more body mass (in mean [SD] kilograms) and fat mass (in mean [SD] kilograms) (-2.9 [2.8] and -4.8 [3.0], respectively) than the low-amount/moderate-intensity group (-0.9 [1.8] and -2.0 [2.6], respectively), the low-amount/vigorous-intensity group (-0.6 [2.0] and -2.5 [3.4], respectively), and the controls (+1.0 [2.1] and +0.4 [3.0], respectively). Both low-amount groups had significantly greater improvements than controls but were not different from each other. Compared with controls, all exercise groups significantly decreased abdominal, minimal waist, and hip circumference measurements. There were no significant changes in dietary intake for any group. CONCLUSIONS: In nondieting, overweight subjects, the controls gained weight, both low-amount exercise groups lost weight and fat, and the high-amount group lost more of each in a dose-response manner. These findings strongly suggest that, absent changes in diet, a higher amount of activity is necessary for weight maintenance and that the positive caloric imbalance observed in the overweight controls is small and can be reversed by a modest amount of exercise. Most individuals can accomplish this by walking 30 minutes every day.     

Dexfenfluramine as adjuvant to a low-calorie formula diet in the treatment of obesity: a randomized clinical trial.

Dexfenfluramine (dF) was compared to placebo as adjuvant to a very energy-restricted diet (1.6-4.2 MJ/24 h). The diet was continued as long as possible or until a satisfactory weight loss had been achieved, and dietary efforts were continued throughout the study. Of the 37 females and five males included, 71 per cent could be followed up for 12 months. Initial BMI ranged from 28 to 54 kg/m2. The lowest body weight was reached 1 month earlier in the dF group (P = 0.037). Throughout the study, the reduction of excess weight (REW) was greater in dF patients (P less than 0.05 only at 4 and 6 months). At 6 months, excess weight had declined by 15 per cent more in the dF group than in the placebo group (95 per cent confidence limits of the median being 1-31 per cent). Between 6 and 12 months, both groups regained weight significantly, the rates of regain differing only insignificantly. At 12 months, excess weight showed a net decrease of only 8 per cent more in the dF group than in the placebo group (95 per cent confidence limits being -7 to +24 per cent). Therefore, REW showed no significant group difference after 12 months. Type of obesity (android or gynoid) as determined by waist to hip ratio had no significant impact on either weight loss, REW, reductions of waist and hip circumferences, or on waist to hip ratio changes. S-alkaline phosphatases and s-uric acid declined significantly in the dF group only. Side-effects were all mild and their prevalence showed no group difference.(ABSTRACT TRUNCATED AT 250 WORDS)