Effects of alternate fasting or very low calorie diet and low calorie diet on metabolic syndrome in severely obese patients (original) (raw)
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Physiological Research, 2013
Obesity in T1DM patients is associated with the components of metabolic syndrome. The influence of controlled fasting and low calorie diet (LCD) on insulin sensitivity and glucose metabolism was studied in 14 obese patients with type 1 diabetes mellitus (T1DM) (42.6±9.4 years, BMI 32.4±2.1 kg m−2). Insulin sensitivity in obese T1DM patients was measured using a hyperinsulinemic-euglycemic clamp before fasting, immediately after 7 days of fasting, and after 21 days of LCD. Glucose oxidation and non-oxidative glucose disposal were measured before and during the clamp by indirect calorimetry. In the control group of 13 of non-obese T1DM patients (36.9±13.9 years, BMI 22.6±2.1 kg m−2), only one hyperinsulinemic-euglycemic clamp was performed. Obese T1DM patients lost 6.1±1.1 kg after fasting and maintained reduction in body weight after 21 days of LCD. Fasting transiently reduced insulin-mediated glucose disposal in the clamp (from 9.69±1.48 to 6.78±1.21 mg min−1 kg−1, P<0.001). This...
MCAST Journal of Applied Research & Practice
The main objective of this study was to determine whether an intermittent fasting diet in combination with a CR diet results in better outcomes on risk factors associated with metabolic syndrome (such as lowering of triglycerides, fasting blood glucose, and blood pressure decrease in abdominal obesity and an increase in HDL-cholesterol and related weight loss for both male and female patients) than with a conventional CR diet alone. A 12-week retrospective case-control study was carried out and involved 78 females and 22 males who exhibited or were receiving medications for three or more conditions related to metabolic syndrome and who completed the study out of 120 participants at baseline. These were randomly assigned to either a conventional calorie-restriction diet or to an intermittent-fasting diet. Relevant baseline parameters were measured during the first encounter and were then repeated after twelve weeks. Professional contact was maintained on a fortnightly basis for both ...
Srpski arhiv za celokupno lekarstvo, 2007
Introduction Obesity is often accompanied by a number of complications including diabetes mellitus and cardiovascular diseases. Elevated blood pressure and lipids, as well as deterioration of glucoregulation are attributed, as the most significant factors, to development of diabetes mellitus and cardiovascular complications in obese patients. Objective The aim of our study was to evaluate the effects of a fasting diet on blood pressure, lipid profile and glucoregulatory parameters. Method We included 110 patients (33 male and 77 female; mean age 35?1 years, body weight 131.7?2.6 kg, body mass index 45.4?0.8 kg/m2) who were hospitalized for three weeks for the treatment of extreme obesity with the fasting diet. At the beginning, during, and at the end of this period, we evaluated changes in blood pressure, lipid profile, as well as parameters of glucoregulation including glycaemia, insulinaemia, and insulin sensitivity by HOMA. Oral glucose tolerance test (OGTT) was performed in all ...
Effects of a 3-Week Hospital-Controlled Very-Low-Calorie Diet in Severely Obese Patients
Nutrients, 2021
Although a very-low-calorie diet (VLCD) is considered safe and has demonstrated benefits among other types of diets, data are scarce concerning its effects on improving health and weight loss in severely obese patients. As part of the personalized weight loss program developed at the Duga Resa Special Hospital for Extended Treatment, Croatia, we evaluated anthropometric, biochemical, and permanent DNA damage parameters (assessed with the cytochalasin B-blocked micronucleus cytome assay—CBMN) in severely obese patients (BMI ≥ 35 kg m−2) after 3-weeks on a 567 kcal, hospital-controlled VLCD. This is the first study on the permanent genomic (in)stability in such VLCD patients. VLCDs caused significant decreases in weight (loss), parameters of the lipid profile, urea, insulin resistance, and reduced glutathione (GSH). Genomic instability parameters were lowered by half, reaching reference values usually found in the healthy population. A correlation was found between GSH decrease and re...
Menopause
Objective: To compare the effects of a caloric restriction (CR) on body composition, lipid profile, and glucose homeostasis in obese postmenopausal women with and without metabolic syndrome (MetS). Methods: Secondary analyses were performed on 73 inactive obese postmenopausal women (age 57.7 AE 4.8 years; body mass index 32.4 AE 4.6 kg/m 2) who participated in the 6-month CR arm of a study of the Montreal-Ottawa New Emerging Team. The harmonized MetS definition was used to categorize participants with MetS (n ¼ 20, 27.39%) and without MetS (n ¼ 53, 72.61%). Variables of interest were: body composition (dual-energy X-ray absorptiometry), body fat distribution (computed tomography scan), glucose homeostasis at fasting state and during a euglycemic/hyperinsulinemic clamp, fasting lipids, and resting blood pressure. Results: By design, the MetS group had a worse cardiometabolic profile, whereas both groups were comparable for age. Fifty-five participants out of 73 displayed no change in MetS status after the intervention. Twelve participants out of 20 (or 60.0%) in the MetS group had no more MetS after weight loss (P ¼ NS), whereas 6 participants out of 53 (or 11.3%) in the other group developed the MetS after the intervention (P ¼ NS). Overall, indices of body composition and body fat distribution improved significantly and similarly in both groups (P between 0.03 and 0.0001). Furthermore, with the exception of triglyceride levels and triglycerides/high-density lipoprotein cholesterol ratio, which decrease significantly more in the MetS group (P 0.05), no difference was observed between groups for the other variables of the cardiometabolic profile. Conclusions: Despite no overall significant effects on MetS, heteregeneous results were obtained in response to weight loss in the present study, with some improving the MetS, whereas other displaying deteriorations. Further studies are needed to identify factors and phenotypes associated with positive and negative cardiometabolic responses to CR intervention.
Menopause, 2017
Objective: To compare the effects of a caloric restriction (CR) on body composition, lipid profile, and glucose homeostasis in obese postmenopausal women with and without metabolic syndrome (MetS). Methods: Secondary analyses were performed on 73 inactive obese postmenopausal women (age 57.7 AE 4.8 years; body mass index 32.4 AE 4.6 kg/m 2) who participated in the 6-month CR arm of a study of the Montreal-Ottawa New Emerging Team. The harmonized MetS definition was used to categorize participants with MetS (n ¼ 20, 27.39%) and without MetS (n ¼ 53, 72.61%). Variables of interest were: body composition (dual-energy X-ray absorptiometry), body fat distribution (computed tomography scan), glucose homeostasis at fasting state and during a euglycemic/hyperinsulinemic clamp, fasting lipids, and resting blood pressure. Results: By design, the MetS group had a worse cardiometabolic profile, whereas both groups were comparable for age. Fifty-five participants out of 73 displayed no change in MetS status after the intervention. Twelve participants out of 20 (or 60.0%) in the MetS group had no more MetS after weight loss (P ¼ NS), whereas 6 participants out of 53 (or 11.3%) in the other group developed the MetS after the intervention (P ¼ NS). Overall, indices of body composition and body fat distribution improved significantly and similarly in both groups (P between 0.03 and 0.0001). Furthermore, with the exception of triglyceride levels and triglycerides/high-density lipoprotein cholesterol ratio, which decrease significantly more in the MetS group (P 0.05), no difference was observed between groups for the other variables of the cardiometabolic profile. Conclusions: Despite no overall significant effects on MetS, heteregeneous results were obtained in response to weight loss in the present study, with some improving the MetS, whereas other displaying deteriorations. Further studies are needed to identify factors and phenotypes associated with positive and negative cardiometabolic responses to CR intervention.
Background: Intermittent fasting (IF; severe restriction 1 d/week) facilitates weight loss and improves coronary heart disease (CHD) risk indicators. The degree to which weight loss can be enhanced if IF is combined with calorie restriction (CR) and liquid meals, remains unknown. Objective: This study examined the effects of IF plus CR (with or without a liquid diet) on body weight, body composition, and CHD risk. Methods: Obese women (n = 54) were randomized to either the IFCR-liquid (IFCR-L) or IFCR-food based (IFCR-F) diet. The trial had two phases: 1) 2-week weight maintenance period, and 2) 8-week weight loss period.
Advances in Therapy, 2016
Introduction: The aim of this prospective study was to assess the results of a standard low-calorie dietary intervention (7.5 MJ/day) on body weight (BW) and the metabolic profile of obese patients with type 2 diabetes mellitus (T2DM) on intensive insulin therapy (IIT: 4 insulin injections/day) versus conventional insulin therapy (CIT: 2/3 insulin injections/day). Methods: A total of 60 patients (n = 60, 23 males and 37 postmenopausal females) were recruited and categorized into two groups according to the scheme of insulin treatment. Thirty were on IIT (13 males and 17 females) and an equal number on CIT (10 males and 20 females). BW, body mass index (BMI), HbA1c, and metabolic parameters were compared at 6 and 12 months after baseline. Results: Significant reductions were observed in the BW, BMI, HbA1c (p B 0.001 for all) and cholesterol (p B 0.05) at 6 months post-intervention. At 1 year, median BW reduction was 4.5 kg (3.3, 5.8) for patients on IIT and 4.8 kg (3.6, 7.0) for those on CIT. The 12-month dietary intervention increased prevalence of normoglycemia in the IIT group and reduced the prevalence of obesity prevalence among the CIT participants (all p\0.001). CIT patients with BW reduction C5.0% demonstrated 11-fold greater chances of being normoglycemic
A Low-Carbohydrate as Compared with a Low-Fat Diet in Severe Obesity
New England Journal of Medicine, 2003
The effects of a carbohydrate-restricted diet on weight loss and risk factors for atherosclerosis have been incompletely assessed. methods We randomly assigned 132 severely obese subjects (including 77 blacks and 23 women) with a mean body-mass index of 43 and a high prevalence of diabetes (39 percent) or the metabolic syndrome (43 percent) to a carbohydrate-restricted (low-carbohydrate) diet or a calorie-and fat-restricted (low-fat) diet.
Scandinavian Journal of Clinical & Laboratory Investigation, 2012
Objective. Evaluation of the effect of an 8-week very low calorie diet (VLCD, 500 -600 kcal daily) on weight, body fat distribution, glucose, insulin and lipid metabolism, androgen levels and incretin secretion in obese women. Methods. Seventeen overweight women (BMI Ͼ 28) were recruited to the study. Glucose, insulin and lipid metabolism were evaluated by euglycemic clamp technique, indirect calorimetry and an oral glucose tolerance test (OGTT) . Insulin sensitivity was calculated as glucose disposal rate (GDR) and insulin sensitivity index (ISI), and also by HOMA-IR. Insulin secretion rate (ISR) was calculated from plasma C-peptide measurements. Secretion of glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic peptide (GIP) was measured during an oral glucose tolerance test. Abdominal fat distribution was assessed by dual x-ray absorptiometry scan and computed tomography. Results. Ten women completed the intervention. The subjects lost an average 11% of their baseline weight. There was a signifi cant loss of subcutaneous abdominal fatty tissue ( p Ͻ 0.01) and intra-abdominal fatty tissue ( p ϭ 0.05). Whole body (HOMA-IR) ( p Ͻ 0.05) insulin sensitivity increased signifi cantly, but peripheral (ISI) insulin sensitivity was unaltered after weight loss. GIP increased ( p Ͻ 0.05) and GLP-1 was unaltered after the dietary intervention. Insulin responses did not differ before and after dietary intervention, however, a signifi cant increase in insulin clearance ( p Ͻ 0.05) was observed. The weight loss resulted in a signifi cant decrease in free testosterone. Conclusion. A VLCD is an effective weight loss treatment, which results in an immediate improvement in several metabolic parameters.