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Pereira V, Barreiros-Mota I, Cortez F, Castela I, Teixeira D, Calhau C, Camila Dias C, Moreira-Rosário A, Silvestre MP. A randomized controlled trial of a weight loss maintenance program in adults with obesity: the WLM3P study. Eur J Clin Nutr 2024; 78:694-702. [PMID: 38844671 DOI: 10.1038/s41430-024-01454-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Revised: 04/30/2024] [Accepted: 05/21/2024] [Indexed: 08/07/2024]
Abstract
BACKGROUND/OBJECTIVES The escalating obesity epidemic necessitates effective, sustainable weight loss (WL) and maintenance strategies. This study aimed to evaluate the effectiveness of the Weight Loss Maintenance 3 Phases Program (WLM3P) in achieving a clinically significant long-term weight loss (WL) (≥5% initial WL at 18 months) in adults with obesity compared to a standard low-carbohydrate diet (LCD). SUBJECTS/METHODS In this two-phase trial, 112 participants targeting initial WL (0-6 months) and subsequent maintenance (7-18 months) were randomly assigned to either WLM3P or LCD groups. Outcomes assessed included change in body weight (kg, %), improvements in body composition, and metabolic profile. RESULTS Of 112 randomized participants, 69% (n = 77) completed the study. At 18 months, WL in the WLM3P group (n = 40) was 15.5 ± 8.3% compared to 9.6 ± 8.5% in the LCD group (n = 37) (p < 0.001). The odds ratio of achieving WL ≥ 10% and ≥15% were significantly higher in the WLM3P group. Complete-case analysis revealed significantly greater improvements in BMI, body fat mass, visceral fat area, waist circumference, waist-to-hip ratio, HDL, and triglyceride/HDL ratio in WLM3P than in LCD. No serious adverse events were reported. CONCLUSION Both programs effectively promoted clinically relevant WL and its maintenance. However, the WLM3P program was more successful in helping participants achieve greater WL targets of ≥10% and ≥15%, along with other clinical benefits, after an 18-month intervention. TRIAL REGISTRATION NUMBER NCT04192357.
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Affiliation(s)
- Vanessa Pereira
- NOVA Medical School, Faculty of Medical Sciences, NMS, FMC, Nova University of Lisbon, Lisbon, Portugal
- Nutrition Department Farmodiética, Farmodiética, 2785-723, Lisbon, Portugal
| | - Inês Barreiros-Mota
- NOVA Medical School, Faculty of Medical Sciences, NMS, FMC, Nova University of Lisbon, Lisbon, Portugal
- CHRC, NOVA Medical School, Faculty of Medical Sciences, NMS, FMC, Nova University of Lisbon, Lisbon, Portugal
| | - Filipa Cortez
- Nutrition Department Farmodiética, Farmodiética, 2785-723, Lisbon, Portugal
- Faculty of Nutrition and Food Sciences, University of Porto, Porto, Portugal
| | - Inês Castela
- NOVA Medical School, Faculty of Medical Sciences, NMS, FMC, Nova University of Lisbon, Lisbon, Portugal
- CHRC, NOVA Medical School, Faculty of Medical Sciences, NMS, FMC, Nova University of Lisbon, Lisbon, Portugal
| | - Diana Teixeira
- NOVA Medical School, Faculty of Medical Sciences, NMS, FMC, Nova University of Lisbon, Lisbon, Portugal
- CHRC, NOVA Medical School, Faculty of Medical Sciences, NMS, FMC, Nova University of Lisbon, Lisbon, Portugal
- CINTESIS@RISE, NOVA Medical School, Faculty of Medical Sciences, NMS, FMC, Nova University of Lisbon, Lisbon, Portugal
| | - Conceição Calhau
- NOVA Medical School, Faculty of Medical Sciences, NMS, FMC, Nova University of Lisbon, Lisbon, Portugal
- CHRC, NOVA Medical School, Faculty of Medical Sciences, NMS, FMC, Nova University of Lisbon, Lisbon, Portugal
| | - Cláudia Camila Dias
- Knowledge Management Unit, Faculty of Medicine of the University of Porto (FMUP), Porto, Portugal
- CINTESIS@RISE, Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS), Faculty of Medicine of the University of Porto, Porto, Portugal
| | - André Moreira-Rosário
- NOVA Medical School, Faculty of Medical Sciences, NMS, FMC, Nova University of Lisbon, Lisbon, Portugal.
- CINTESIS@RISE, NOVA Medical School, Faculty of Medical Sciences, NMS, FMC, Nova University of Lisbon, Lisbon, Portugal.
| | - Marta P Silvestre
- NOVA Medical School, Faculty of Medical Sciences, NMS, FMC, Nova University of Lisbon, Lisbon, Portugal.
- CINTESIS@RISE, NOVA Medical School, Faculty of Medical Sciences, NMS, FMC, Nova University of Lisbon, Lisbon, Portugal.
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Zhang Y, Zhang K, Huang S, Li W, He P. A review on associated factors and management measures for sarcopenia in type 2 diabetes mellitus. Medicine (Baltimore) 2024; 103:e37666. [PMID: 38640276 PMCID: PMC11029968 DOI: 10.1097/md.0000000000037666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2024] [Revised: 01/28/2024] [Accepted: 02/29/2024] [Indexed: 04/21/2024] Open
Abstract
Type 2 diabetes mellitus (T2DM) is a chronic metabolic disease characterized by hyperglycemia, insulin resistance, and insufficient insulin secretion. Sarcopenia, as a new complication of diabetes, is characterized by the loss of muscle mass and the progressive decline of muscle strength and function in T2DM patients, which has a serious impact on the physical and mental health of patients. Insulin resistance, mitochondrial dysfunction, and chronic inflammation are common mechanisms of diabetes and sarcopenia. Reasonable exercise training, nutrition supplement, and drug intervention may improve the quality of life of patients with diabetes combined with sarcopenia. This article reviews the relevant factors and management measures of sarcopenia in T2DM patients, in order to achieve early detection, diagnosis, and intervention.
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Affiliation(s)
- Yi Zhang
- Department of Geriatrics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Kemeng Zhang
- Department of Geriatrics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Sui Huang
- Department of Geriatrics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Wenhan Li
- Department of Geriatrics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Ping He
- Department of Geriatrics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Scafoglieri A, Van den Broeck J, Cattrysse E, Bautmans I, Heymsfield SB. Non-linear Associations Between Visceral Adipose Tissue Distribution and Anthropometry-Based Estimates of Visceral Adiposity. Front Nutr 2022; 9:825630. [PMID: 35399665 PMCID: PMC8987197 DOI: 10.3389/fnut.2022.825630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 02/28/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundRecent evidence suggests that excess visceral adipose tissue (VAT) is associated with future loss of subcutaneous adipose tissue (SAT) and skeletal muscle (SM) with aging. In clinical settings (abdominal) circumferences are commonly used to estimate body composition (BC). We aimed to study the linearity of VAT distribution ratios (i.e., VAT/SAT ratio and VAT/SM ratio), waist-to-hip ratio (WHR) and waist circumference (WC) with age and the relationship of VAT distribution ratios with anthropometry (i.e., WHR and WC).Materials and MethodsBC was determined using whole body magnetic resonance imaging in a large multi-ethnic group of 419 adults (42% white, 30% black, 15% Hispanic, 13% Asian, 1% other) with a BMI ranging from 15.9 to 40.8kg/m2. Linear and non-linear regression analysis was used to examine the linearity of VAT distribution ratios and anthropometry from 18 to 88 years. The relation between VAT distribution ratios and anthropometry was assessed separately.ResultsIn both sexes non-linear relationships were found between BC estimates and age, and between BC measures mutually. The ratios of VAT/SAT and VAT/SM showed quadratic relationships with age. VAT distribution ratios showed exponential or quadratic relationships with anthropometry with coefficients of determination ranging between 18 and 55%.ConclusionIn both sexes, VAT distribution ratios showed curvilinear relationships with age and with anthropometry. Given the sex differences in VAT distribution ratios, WHR and WC represent different BC proportions in men and women. These results emphasize the challenge when interpreting changes in BC based upon linear extrapolations in clinical practice.
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Affiliation(s)
- Aldo Scafoglieri
- Experimental Anatomy Research Department, Vrije Universiteit Brussel, Brussels, Belgium
- Frailty in Aging Research Department, Vrije Universiteit Brussel, Brussels, Belgium
- *Correspondence: Aldo Scafoglieri,
| | - Jona Van den Broeck
- Experimental Anatomy Research Department, Vrije Universiteit Brussel, Brussels, Belgium
| | - Erik Cattrysse
- Experimental Anatomy Research Department, Vrije Universiteit Brussel, Brussels, Belgium
| | - Ivan Bautmans
- Frailty in Aging Research Department, Vrije Universiteit Brussel, Brussels, Belgium
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Cai X, Li N, Hu J, Wen W, Yao X, Zhu Q, Heizhati M, Hong J, Sun L, Tuerxun G, Zhang D, Luo Q. Nonlinear Relationship Between Chinese Visceral Adiposity Index and New-Onset Myocardial Infarction in Patients with Hypertension and Obstructive Sleep Apnoea: Insights from a Cohort Study. J Inflamm Res 2022; 15:687-700. [PMID: 35140499 PMCID: PMC8819537 DOI: 10.2147/jir.s351238] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 01/15/2022] [Indexed: 12/13/2022] Open
Abstract
Purpose We aimed to investigate the relationship between the Chinese visceral adiposity index (CVAI) and the risk of new-onset myocardial infarction (MI) in patients with hypertension and obstructive sleep apnoea (OSA) and to inspect possible modifiers of the effect. Methods The Cox regression model was used to evaluate the relationship between baseline CVAI and risk of new-onset MI. A generalized additive model was used to identify the nonlinear relationship. Besides, we conducted subgroup analyses and interaction tests. Results A total of 2177 patients with hypertension and OSA undergoing polysomnography were enrolled in this study. During a median follow-up period of 87 months, 82 participants developed new-onset MI. Overall, CVAI was positively related to the risk of new-onset MI (per 1 SD increase; HR = 1.54, 95% CI: 1.28–1.85). In multivariable-adjusted models, the risk of new-onset MI increased with quartiles of CVAI, with an HR of 3.64 (95% CI: 1.94–6.83) for quartile 4 compared with quartile 1. The generalized additive model and smoothed curve fit revealed a nonlinear relationship between CVAI and risk of new-onset MI with an inflection point of approximately 112. None of the stratification variables had a significant effect on the relationship between CVAI and new-onset MI. Similar outcomes were observed in the sensitivity analysis. The addition of CVAI significantly improved reclassification and discrimination over the conventional model, with a category-free NRI of 0.132 (95% CI 0.021 to 0.236, P = 0.021) and an IDI of 0.012 (95% CI 0.005 to 0.023, P < 0.001). Conclusion This study demonstrated a nonlinear relationship between CVAI and the risk of new-onset MI in patients with hypertension and OSA. Higher CVAI was significantly associated with the risk of new-onset MI when CVAI was ≥112.
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Affiliation(s)
- Xintian Cai
- Hypertension Center of People’s Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, National Health Committee Key Laboratory of Hypertension Clinical Research, Key Laboratory of Xinjiang Uygur Autonomous Region, Xinjiang Clinical Medical Research Center for Hypertension Diseases, Urumqi, Xinjiang, People’s Republic of China
- Graduate School, Xinjiang Medical University, Urumqi, Xinjiang, People’s Republic of China
| | - Nanfang Li
- Hypertension Center of People’s Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, National Health Committee Key Laboratory of Hypertension Clinical Research, Key Laboratory of Xinjiang Uygur Autonomous Region, Xinjiang Clinical Medical Research Center for Hypertension Diseases, Urumqi, Xinjiang, People’s Republic of China
- Correspondence: Nanfang Li, Hypertension Center of People’s Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, National Health Committee Key Laboratory of Hypertension Clinical Research, Key Laboratory of Xinjiang Uygur Autonomous Region, Xinjiang Clinical Medical Research Center for Hypertension Diseases, Urumqi, Xinjiang, People’s Republic of China, Email
| | - Junli Hu
- Hypertension Center of People’s Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, National Health Committee Key Laboratory of Hypertension Clinical Research, Key Laboratory of Xinjiang Uygur Autonomous Region, Xinjiang Clinical Medical Research Center for Hypertension Diseases, Urumqi, Xinjiang, People’s Republic of China
| | - Wen Wen
- Hypertension Center of People’s Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, National Health Committee Key Laboratory of Hypertension Clinical Research, Key Laboratory of Xinjiang Uygur Autonomous Region, Xinjiang Clinical Medical Research Center for Hypertension Diseases, Urumqi, Xinjiang, People’s Republic of China
- Graduate School, Xinjiang Medical University, Urumqi, Xinjiang, People’s Republic of China
| | - Xiaoguang Yao
- Hypertension Center of People’s Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, National Health Committee Key Laboratory of Hypertension Clinical Research, Key Laboratory of Xinjiang Uygur Autonomous Region, Xinjiang Clinical Medical Research Center for Hypertension Diseases, Urumqi, Xinjiang, People’s Republic of China
| | - Qing Zhu
- Hypertension Center of People’s Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, National Health Committee Key Laboratory of Hypertension Clinical Research, Key Laboratory of Xinjiang Uygur Autonomous Region, Xinjiang Clinical Medical Research Center for Hypertension Diseases, Urumqi, Xinjiang, People’s Republic of China
- Graduate School, Xinjiang Medical University, Urumqi, Xinjiang, People’s Republic of China
| | - Mulalibieke Heizhati
- Hypertension Center of People’s Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, National Health Committee Key Laboratory of Hypertension Clinical Research, Key Laboratory of Xinjiang Uygur Autonomous Region, Xinjiang Clinical Medical Research Center for Hypertension Diseases, Urumqi, Xinjiang, People’s Republic of China
| | - Jing Hong
- Hypertension Center of People’s Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, National Health Committee Key Laboratory of Hypertension Clinical Research, Key Laboratory of Xinjiang Uygur Autonomous Region, Xinjiang Clinical Medical Research Center for Hypertension Diseases, Urumqi, Xinjiang, People’s Republic of China
| | - Le Sun
- Hypertension Center of People’s Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, National Health Committee Key Laboratory of Hypertension Clinical Research, Key Laboratory of Xinjiang Uygur Autonomous Region, Xinjiang Clinical Medical Research Center for Hypertension Diseases, Urumqi, Xinjiang, People’s Republic of China
| | - Guzailinuer Tuerxun
- Hypertension Center of People’s Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, National Health Committee Key Laboratory of Hypertension Clinical Research, Key Laboratory of Xinjiang Uygur Autonomous Region, Xinjiang Clinical Medical Research Center for Hypertension Diseases, Urumqi, Xinjiang, People’s Republic of China
| | - Delian Zhang
- Hypertension Center of People’s Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, National Health Committee Key Laboratory of Hypertension Clinical Research, Key Laboratory of Xinjiang Uygur Autonomous Region, Xinjiang Clinical Medical Research Center for Hypertension Diseases, Urumqi, Xinjiang, People’s Republic of China
| | - Qin Luo
- Hypertension Center of People’s Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, National Health Committee Key Laboratory of Hypertension Clinical Research, Key Laboratory of Xinjiang Uygur Autonomous Region, Xinjiang Clinical Medical Research Center for Hypertension Diseases, Urumqi, Xinjiang, People’s Republic of China
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