Low-calorie Diet Group Research Articles

The Impact of a Very-Low-Calorie Ketogenic Diet on Monocyte Subsets of Patients with Obesity: A Pilot Study.

Background/Objectives: Obesity is closely linked to chronic low-grade inflammation and the development of cardio-metabolic comorbidities. Monocyte subsets, which are crucial in immune responses, have been reported to be altered in individuals with obesity, potentially exacerbating inflammation. Although very-low-calorie ketogenic diets (VLCKDs) are recognized for their efficacy in promoting weight loss and improving metabolic health, their impact on circulating monocyte subsets remains poorly understood. The objective of our study is to investigate the impact of VLCKDs on monocyte subset distribution in people with obesity. Methods: Thirty-six participants were divided into four groups-healthy controls, individuals with obesity and no dietary intervention, and individuals with obesity following either a low-calorie diet (LCD) or VLCKD for 28 days. Blood samples were analyzed to assess the distribution of classical monocytes (CMs), intermediate monocytes (IMs), and non-classical monocytes (NCMs) using flow cytometry. Results: Individuals with obesity exhibited significant increases in IMs and NCMs, alongside a decrease in CMs compared to healthy controls. The VLCKD led to a notable shift in monocyte distribution, with increased CMs and reduced IMs and NCMs, restoring levels closer to those observed in healthy individuals. In contrast, the LCD group showed no significant changes in monocyte subsets. Conclusions: VLCKDs may exert anti-inflammatory effects by modulating monocyte subset distribution, offering potential therapeutic benefits in mitigating obesity-related inflammation. These preliminary findings suggest that VLCKDs could be an effective strategy for improving immune function in individuals with obesity.

Comparison of the low-calorie DASH diet and a low-calorie diet on serum TMAO concentrations and gut microbiota composition of adults with overweight/obesity: a randomized control trial

This study compares two diets, Dietary Approaches to Stop Hypertension (DASH) and a Low-Calorie Diet on Trimethylamine N-oxide (TMAO) levels and gut microbiota. 120 obese adults were randomly allocated to these three groups: a low-calorie DASH diet, a Low-Calorie diet, or a control group for 12 weeks. Outcomes included plasma TMAO, lipopolysaccharides (LPS), and gut microbiota profiles. After the intervention, the low-calorie DASH diet group demonstrated a greater decrease in TMAO levels (-20 ± 8.1 vs. −10.63 ± 4.6 μM) and a significant decrease in LPS concentration (-19.76 ± 4.2 vs. −5.68 ± 2.3) compared to the low-calorie diet group. Furthermore, the low-calorie DASH diet showed a higher decrease in the Firmicutes and Bactericides (F/B) ratio, which influenced TMAO levels, compared to the Low-Calorie diet (p = 0.028). The current study found the low-calorie DASH diet improves TMAO and LPS in comparison to a Low-Calorie diet.

Effect of the Very Low Calorie Ketogenic Low-Fat Diet (VLCKLFD) Compared to a Low-Calorie Diet (LCD) on the Lipid Profile of Mexican Patients with Type I Obesity

BackgroundDyslipidemia is known as abnormalities in the concentration of lipids in the blood. The most important are hypercholesterolemia and hypertriglyceridemia, there are other alterations, such as the decrease in HDL cholesterol. In Mexico, a study of more than 1,700 patients showed that 16.4% had cholesterol levels ≥240 mg/dl, 34.1% of those studied reported values between 200 - 240 mg/dl, and 32.5% had elevated triglyceride and they had not been previously diagnosed. ObjectiveTo compare the effect of two nutritional interventions in the regulation of blood lipid levels. MethodologyA prospective, randomized, double-blind study, lasting 12 weeks. 88 patients were recruited, 56 assigned to VLCKLFD group and 32 to LCD group. We evaluated total weight, visceral body fat, cholesterol levels, HDL, LDL, VLDL and triglycerides. ResultsThe mean weight loss for the VLCKLFD reported 12.39 ± 2.8, while for the LCD it was 6.95 ± 1.9 kg. (p < 0.001).The total cholesterol in VLCKLFD group at baseline was 192.6 ± 35.7 mg/dl and at the end 170.0 ± 34.3 mg/dl., patients assigned to LCD baseline was 184.6 ± 36.1 mg/dl and at the end of the study was 166.46 ± 34.3 mg/dl.The Triglycerides in the VLCKLFD group at baseline was 161.5 ± 68.7 mg/dl and in the final determination was 94.1± 42.1 mg/dl., the LCD group at baseline reported 165.5 ± 100.74 mg/dl and the final 106.5 ± 57.22 mg/dl. ConclusionVLCKLFD is more effective at 12 weeks in reducing blood lipid levels when compared with LCD.

Very-Low-Calorie Ketogenic Diet as a Safe and Valuable Tool for Long-Term Glycemic Management in Patients with Obesity and Type 2 Diabetes.

Obesity-related type 2 diabetes represents one of the most difficult challenges for the healthcare system. This retrospective study aims to determine the efficacy, safety and durability of a very-low-calorie ketogenic diet (VLCKD), compared to a standard low-calorie diet (LCD) on weight-loss, glycemic management, eating behavior and quality of life in patients with type 2 diabetes (T2DM) and obesity. Thirty patients with obesity and T2DM, aged between 35 and 75 years, who met the inclusion criteria and accepted to adhere to a VLCKD or a LCD nutritional program, were consecutively selected from our electronic database. Fifteen patients followed a structured VLCKD protocol, fifteen followed a classical LCD. At the beginning of the nutritional protocol, all patients were asked to stop any antidiabetic medications, with the exception of metformin. Data were collected at baseline and after 3 (T1) and 12 (T2) months. At T1 and T2, BMI was significantly reduced in the VLCKD group (p < 0.001), whereas it remained substantially unchanged in the LCD group. HbA1c was significantly reduced in the VLCKD group (p = 0.002), whereas a slight, although not significant, decrease was observed in the LCD group. Quality of life and eating behavior scores were improved in the VLCKD group, whereas no significant changes were reported in the LCD group, both at T1 and T2. At the end of the study, in the VLCKD group 26.6% of patients had stopped all antidiabetic medications, and 73.3% were taking only metformin, whereas 46.6% of LCD patients had to increase antidiabetic medications. The study confirms a valuable therapeutic effect of VLCKD in the long-term management of obesity and T2DM and its potential contribution to remission of the disease.

The effect of L-Carnitine supplementation on clinical symptoms, C-reactive protein and malondialdehyde in obese women with knee osteoarthritis: a double blind randomized controlled trial

BackgroundsL-carnitine decreases oxidation and inflammation by reducing the fatty acid in plasma and using oxygen in ATP synthesis. As such, knee osteoarthritis (KOA) can be improved by reducing apoptotic chondrocytes. This study was designed to compare the effect of L-carnitine supplementation and low-calorie diet on improving KOA among obese women. We further investigated the effect of L- carnitine on improvement of KOA in obese women on low calorie diet.MethodsTo conduct the study, 76 obese women with KOA were randomly assigned into two low-calorie diet groups: the first received 1000 mg of LCG and the second took the placebo (PLG) (n = 38). Anthropometry indices, body composition, lipid profile, C-reactive Protein (CRP), Malondialdehyde (MDA), and the Western Ontario and McMaster Universities Arthritis Index (WOMAC) were assessed at the baseline condition and after 12 weeks.ResultsThe mean change of body mass index (BMI) (− 1.21 ± 0.84 vs. -0.79 ± 0.70; P = 0.02) and weight (− 2.76 ± 1.69 vs. -1.95 ± 1.73; P = 0.05) were significant in the LCG compared with the PLG. Likewise, LCG compared to the PLG showed insignificant improvement in waist circumference (WC) (− 5.65 ± 5.85 vs. -3.64 ± 3.37; P = 0.08). Total cholesterol (P = 0.02), MDA (P = 0.03), fat mass (P = 0.03) and visceral fat (P = 0.001) only showed decreased levels in LCG in comparison to the baseline condition. There was no significant difference between LCG and PLG, in the mean changes of hip circumference, visceral fat, free fat mass, fat mass, lipid profiles, CRP, MDA as well as stiffness, physical function, decrease of pain and total scores (P > 0.05).ConclusionThe 12-week L-carnitine supplementation could improve BMI, but had no significant effect on other anthropometric and body composition measures as well as clinical symptoms, CRP, MDA, and lipid profile in women with KOA. Further trials with higher doses and longer durations are required. IRCT registration number: IRCT2017011932026N2. Registration date: 2017-04-27.

A Randomized, Controlled Trial Comparing the Impact of a Low-Calorie Ketogenic vs a Standard Low-Calorie Diet on Fat-Free Mass in Patients Receiving an Elipse\u2122 Intragastric Balloon Treatment

BackgroundThe Elipse™ intragastric balloon (EIGB) is a new swallowable balloon for weight loss (WL). Preserving metabolically active fat-free mass (FFM) and resting metabolic rate (RMR) during WL are crucial to maximize fat mass (FM) loss. After EIGB placement, a standard low-calorie diet (LCD) is generally prescribed. A low-calorie ketogenic diet (LCKD) has proven to be safe and effective in reducing FM while preserving FFM and RMR.ObjectiveTo prospectively compare the effects on WL, FM, FFM, and RMR in two groups of patients who were randomized to two different diets: LCKD and a standard LCD after EIGB placement.MethodsWL, FM, FFM, and RMR were measured before EIGB and at 4 months in 48 patients who received either a LCKD (n = 24) or a standard LCD (n = 24). Compliance in following the prescribed diet was determined with food frequency questionnaires in all patients. The impact of LCKD and LCD on renal function was also evaluated.ResultsThe LCKD group showed a significantly lower decrease in FFM and RMR when compared with the LCD group (3.55 vs 14.3%, p < 0.001; 9.79 vs 11.4%, p < 0.001, respectively). FM decreased more significantly with LCKD compared to LCD (41.6 vs 33.1%, p = 0.0606). Compliance in following the prescribed diets, without negative impact on renal function, was found.ConclusionBased on our findings, despite the small sample size, we were able to support the hypothesis that LCKD is associated with an increased FM loss while reducing the FFM loss and the RMR, without interfering with renal function after EIGB.

Combined Effects of Weight Training and Aerobic Exercise Accompanied by Normal and Low-Calorie Diets on Fat Percentage of Young Women

Sports with a combination of weight training and aerobics are expected to be an alternative to increase students' desire to exercise and reduce fat more effectively. Therefore, this study aims to determine the potential of combined aerobic exercise and weight training to be an alternative to reducing body fat combined with a normal diet program with a low calorie diet program. This research is a quantitative quasi-experimental research with pre-test and post-test control group design. With a total of 60 participants, which were divided into two groups, namely the experimental group using the low calorie diet program and the control group using the normal diet program. All data obtained were searched for the mean and the differences between the two body fat reduction programs using independent sample t-test. The combination of aerobic exercise and weight training can reduce participants' body weight, body fat and waist circumference, both in the normal diet and low-calorie diet groups. However, the low calorie diet program is more effective than the normal diet. This is evidenced by the significant reduction in body fat and strengthened by the independent sample t-test which is seen from the t value which is greater than the t table and the significance value obtained is less than 0.025, namely 0.012 for weight loss, 0.011 for a decrease in the percentage of fat, and 0.010 for a decrease in waist circumference. It is concluded that there is a difference in the decrease in the percentage of fat in the normal diet and low calorie diet groups.

Effect of Fasting Therapy and Low-Calorie Diet on Anthropometric and Serum Lipids in Obese Females

Background: Preclinical and clinical studies have shown the importance of calorie restriction diet in weight reduction and cardiovascular risk factors. In this study, our objective is to compare the naturopathic-based short-term fasting therapy with low-calorie diet (LCD) on anthropometric and lipid profile among obese and overweight persons. A total number of subjects (n = 100) with body mass index (BMI) ≥25 were randomly allocated into either fasting therapy intervention (n = 48) or a LCD (n = 52). Materials and Methods: Participants underwent very LCD (288–904 kcal) in fasting therapy and a LCD (1234 kcal) in the other group respectively for 10 days. Individuals in both the groups were assessed with anthropometric parameters such as BMI, weight, waist circumference, hip circumference and waist-hip ratio, serum lipid profile, and serum leptin levels at the baseline and after 10 days. Results: The anthropometric measurements were decreased significantly in the fasting group when compared with the LCD group (P &lt; 0.05). The decrease in mean serum total cholesterol (TC) (−27.43%), triglycerides (TGs) (−13.05%), and low-density lipoprotein (LDL) (−20.9%) in the treated group were statistically significant (P &lt; 0.001), whereas serum high density lipoprotein (2.32%) was increased but insignificantly (P &gt; 0.001) when compared with the nontreated group. Conclusions: Our findings support that short-term fasting therapy is beneficial in anthropometric measures and reducing leptin level among obese or overweight person compared to LCD. However, long-term adherence of weight loss with these interventions should be tested in future studies with bigger sample size.

Impact of a preoperative low-calorie diet on liver histology in patients with fatty liver disease undergoing bariatric surgery

BackgroundA low-calorie diet (LCD) before bariatric surgery has been shown to reduce liver volume and facilitate ease of operation. It is estimated that 75%–100% of individuals undergoing bariatric surgery have nonalcoholic fatty liver disease (NAFLD). ObjectivesWe aimed to investigate how an LCD affects liver histology in the setting of NAFLD. SettingUniversity Hospital, United States. MethodsForty intraoperative liver specimens were analyzed histologically as follows: 20 with and 20 without a preoperative 2-week, 1200 kcal/d LCD. Weight was measured prediet, at surgery, and 6 months after surgery. NAFLD activity score was used to grade liver histology at surgery. The NAFLD activity score scores steatosis, lobular inflammation, hepatocellular ballooning, and fibrosis. ResultsThe non-LCD group (n = 20) had mean weight at surgery of 136.1 ± 24.1 kg. The LCD group (n = 20) had initial mean weight of 128.6 ± 25.4 kg, with presurgical weight loss of 3.43 kg (range, 0–9.3 kg), mean change in body mass index 1.24 kg/m2 (2.66% total weight loss) on an LCD. The LCD group had significantly less steatosis (P = .02), fewer foci of lobular inflammation (P = .01), and less hepatocellular ballooning (P = .04) compared with the non-LCD group; with no difference in degree of fibrosis. Fewer patients in the LCD group had nonalcoholic steatohepatitis with ballooning (P = .04). Weight loss on an LCD before bariatric surgery was predictive of weight loss 6 months after surgery (P = .026). ConclusionsA 2-week LCD before bariatric surgery is associated with significant improvement in steatosis, inflammation, and hepatocellular ballooning in NAFLD. Among LCD patients, preoperative weight loss was associated with improved 6-month weight loss and liver function.

Four Weeks of Preoperative Omega-3 Fatty Acids Reduce Liver Volume: a Randomised Controlled Trial.

Weight loss before bariatric surgery with a low-calorie diet (LCD) has several advantages, including reduction of liver volume and an improved access to the lesser sac. Disadvantages include performing surgery in a state of undernutrition, side effects, costs and patient compliance. Omega-3 fatty acids may serve as an alternative to reduce liver steatosis. A randomised controlled open-label trial was done to compare the effects of a LCD with Modifast (800kcal/day) during 2weeks with 2g of omega-3 fatty acids a day and a normal diet (2000kcal/day) during 4weeks. Total liver volume (TLV) and volume of the left liver lobe (LLL), visceral fat area (VFA) and muscle area (SMA) at the L3-L4 level were measured with MRI before and after preoperative treatment. Sixty-two morbidly obese women undergoing laparoscopic Roux-en-Y gastric bypass surgery (LRYGB) were recruited. In both groups, there was a significant decrease in LLL, TLV and VFA. For LLL and TLV reduction, the LCD had a significantly larger effect (p < 0.05). Only in the LCD group was there a significant decrease in SMA with significantly more side effects and worse compliance. Both the LCD and omega-3 diet reduced LLL, TLV and VFA. The LCD outperformed the omega-3 diet in LLL and TLV reduction, but induced significant loss of SMA and had worse compliance due to more side effects. Omega-3 fatty acids may provide a safe and more patient-friendly alternative for a LCD and further research is indicated. The study is registered at www.clinicaltrials.gov (NCT02206256).

Metformin induces weight loss associated with gut microbiota alteration in non-diabetic obese women: a randomized double-blind clinical trial.

The increasing prevalence of obesity over the past few decades constitutes a global health challenge. Pharmacological therapy is recommended to accompany life-style modification for obesity management. Here, we perform a clinical trial to investigate the effects of metformin on anthropometric indices and gut microbiota composition in non-diabetic, treatment-naive obese women with a low-calorie diet (LCD). Randomized double-blind parallel-group clinical trial. Forty-six obese women were randomly assigned to the metformin (500 mg/tab) or placebo groups using computer-generated random numbers. Subjects in both groups took two tablets per day for 2 months. Anthropometric measurements and collection of blood and fecal samples were done at the baseline and at the end of the trial. Gut microbiota composition was assessed using 16S rRNA amplicon sequencing. Twenty-four and twenty-two subjects were included in the metformin + LCD and placebo + LCD groups, respectively; at the end of trial, 20 and 16 subjects were analyzed. The metformin + LCD and placebo + LCD caused a 4.5 and 2.6% decrease in BMI from the baseline values, respectively (P < 0.01). Insulin concentration decreased in the metformin + LCD group (P = 0.046). The overall fecal microbiota composition and diversity were unaffected in the metformin + LCD group. However, a significant specific increase in Escherichia/Shigella abundance was observed after metformin + LCD intervention (P = 0.026). Fecal acetate concentration, but not producers, was significantly higher in the placebo + LCD group, adjusted for baseline values and BMI (P = 0.002). Despite the weight reduction after metformin intake, the overall fecal microbiota composition remained largely unchanged in obese women, with exception of changes in specific proteobacterial groups.

Metabolomics identifies increases in the acylcarnitine profiles in the plasma of overweight subjects in response to mild weight loss: a randomized, controlled design study.

BackgroundUsing metabolomics technique to analyze the response to a dietary intervention generates valuable information concerning the effects of the prescribed diet on metabolic regulation. To determine whether low calorie diet (LCD)-induced weight reduction causes changes in plasma metabolites and metabolic characteristics.MethodsOverweight subjects consumed a LCD (n = 47) or a weight maintenance diet (control, n = 50) in a randomized, controlled design study with a 12-week clinical intervention period. Plasma samples were analyzed using an UPLC-LTQ-Orbitrap MS.ResultsThe 12-week LCD intervention resulted in significant mild weight loss, with an 8.3% and 10.6% reduction observed in the visceral fat area (VFA) at the level of the lumbar vertebrae L1 and L4, respectively. The LCD group showed a significant increase in the mean change of serum free fatty acids compared to the control group. In the LCD group, we observed a significant increase in the acylcarnitine (AC) levels, including hexanoylcarnitine, L-octanoylcarnitine, 9-decenoylcarnitine, trans-2-dodecenoylcanitine, dodecanoylcarnitine, 3,5-tetradecadiencarnitine, cis-5-tetradecenoylcarnitine, 9,12-hexadecadienoylcarnitine, and 9-hexadecenoylcarnitne at the 12-week follow-up assessment. When the plasma metabolite changes from baseline were compared between the control and LCD groups, the LCD group showed significant increases in hexanoylcarnitine, L-octanoylcarnitine, trans-2-dodecenoylcanitine, and 3,5-tetradecadiencarnitine than the control group. Additionally, the changes in these ACs in the LCD group strongly negatively correlated with the changes in the VFA at L1 and/or L4.ConclusionMild weight loss from 12-week calorie restriction increased the plasma levels of medium- and long-chain ACs. These changes were coupled with a decrease in VFA and an increase in free fatty acids.Trial registrationNCT03135132; April 26, 2017.

Comparing the effects of short-term fasting therapy and low-calorie diet on anthropometric and leptin measures among obese or overweight persons: Randomized controlled trial

Background: Preclinical and clinical studies have shown the importance of calorie restriction diet in cardiovascular risk factors such as weight. In this study, our objective is to compare the Naturopathic short-term fasting therapy with low-calorie diet on anthropometric and leptin measures among obese and overweight persons. Materials and Methods: Obese and overweight subjects (n = 84, 59.52% females) with Body Mass Index (BMI) ≥25 were randomized into fasting therapy intervention (n = 42) and a low-calorie diet intervention (n = 42). After a written informed consent, the fasting therapy and low-calorie diet intervention group underwent a very low-calorie diet (288-904 kcal) and a low-calorie diet (1234 kcal) respectively for 10 days. Subjects in both the groups were assessed with serum leptin levels and anthropometric parameters such as BMI, weight, waist circumference (WC), hip circumference (HC) and waist-hip ratio (WHR) at the baseline and after 10 days. Results: Within-group comparison showed both the groups did better in all the parameters. However, greater changes were observed in the fasting group as compared to the low-calorie diet group. Changes in BMI, weight, HC and WC were significantly different in the two groups (P 0.05). Conclusions: The findings support that, both short-term fasting therapy and a low–calorie diet are beneficial in reducing leptin and anthropometric parameters among obese or overweight subjects. However, long-term adherence of weight loss with these interventions need to be tested with future studies.

Obesity treatment by very low-calorie-ketogenic diet at two years: reduction in visceral fat and on the burden of disease.

The long-term effect of therapeutic diets in obesity treatment is a challenge at present. The current study aimed to evaluate the long-term effect of a very low-calorie-ketogenic (VLCK) diet on excess adiposity. Especial focus was set on visceral fat mass, and the impact on the individual burden of disease. A group of obese patients (n = 45) were randomly allocated in two groups: either the very low-calorie-ketogenic diet group (n = 22), or a standard low-calorie diet group; (n = 23). Both groups received external support. Adiposity parameters and the cumulative number of months of successful weight loss (5 or 10 %) over a 24-month period were quantified. The very low-calorie-ketogenic diet induced less than 2 months of mild ketosis and significant effects on body weight at 6, 12, and 24 months. At 24 months, a trend to regress to baseline levels was observed; however, the very low-calorie-ketogenic diet induced a greater reduction in body weight (-12.5 kg), waist circumference (-11.6 cm), and body fat mass (-8.8 kg) than the low-calorie diet (-4.4 kg, -4.1 cm, and -3.8 kg, respectively; p < 0.001). Interestingly, a selective reduction in visceral fat measured by a specific software of dual-energy x-ray absorptiometry (DEXA)-scan (-600 g vs. -202 g; p < 0.001) was observed. Moreover, the very low-calorie-ketogenic diet group experienced a reduction in the individual burden of obesity because reduction in disease duration. Very low-calorie-ketogenic diet patients were 500 months with 5 % weight lost vs. the low-calorie diet group (350 months; p < 0.001). In conclusion, a very low-calorie-ketogenic diet was effective 24 months later, with a decrease in visceral adipose tissue and a reduction in the individual burden of disease.

Energy Metabolic Adaptation and Cardiometabolic Improvements One Year After Gastric Bypass, Sleeve Gastrectomy, and Gastric Band.

It is not known whether the magnitude of metabolic adaptation, a greater than expected drop in energy expenditure, depends on the type of bariatric surgery and is associated with cardiometabolic improvements. To compare changes in energy expenditure (metabolic chamber) and circulating cardiometabolic markers 8 weeks and 1 year after Roux-en-y bypass (RYGB), sleeve gastrectomy (SG), laparoscopic adjustable gastric band (LAGB), or a low-calorie diet (LCD). Design, Setting, Participants, and Intervention: This was a parallel-arm, prospective observational study of 30 individuals (27 females; mean age, 46 ± 2 years; body mass index, 47.2 ± 1.5 kg/m2) either self-selecting bariatric surgery (five RYGB, nine SG, seven LAGB) or on a LCD (n = 9) intervention (800 kcal/d for 8 weeks, followed by weight maintenance). After 1 year, the RYGB and SG groups had similar degrees of body weight loss (33-36%), whereas the LAGB and LCD groups had 16 and 4% weight loss, respectively. After adjusting for changes in body composition, 24-hour energy expenditure was significantly decreased in all treatment groups at 8 weeks (-254 to -82 kcal/d), a drop that only persisted in RYGB (-124 ± 42 kcal/d; P = .002) and SG (-155 ± 118 kcal/d; P = .02) groups at 1 year. The degree of metabolic adaptation (24-hour and sleeping energy expenditure) was not significantly different between the treatment groups at either time-point. Plasma high-density lipoprotein and total and high molecular weight adiponectin were increased, and triglycerides and high-sensitivity C-reactive protein levels were reduced 1 year after RYGB or SG. Metabolic adaptation of approximately 150 kcal/d occurs after RYGB and SG surgery. Future studies are required to examine whether these effects remain beyond 1 year.

Risk of symptomatic gallstones and cholecystectomy after a very-low-calorie diet or low-calorie diet in a commercial weight loss program: 1-year matched cohort study

Background:Concern exists regarding gallstones as an adverse event of very-low-calorie diets (VLCDs; <800 kcal per day).Objective:To assess the risk of symptomatic gallstones requiring hospital care and/or cholecystectomy in a commercial weight loss program using VLCD or low-calorie diet (LCD).Design:A 1-year matched cohort study of consecutively enrolled adults in a commercial weight loss program conducted at 28 Swedish centers between 2006 and 2009. A 3-month weight loss phase of VLCD (500 kcal per day) or LCD (1200–1500 kcal per day) was followed by a 9-month weight maintenance phase. Matching (1:1) was performed by age, sex, body mass index, waist circumference and gallstone history (n=3320:3320). Gallstone and cholecystectomy data were retrieved from the Swedish National Patient Register.Results:One-year weight loss was greater in the VLCD than in the LCD group (−11.1 versus −8.1 kg; adjusted difference, −2.8 kg, 95% CI −3.1 to −2.4; P<0.001). During 6361 person–years, 48 and 14 gallstones requiring hospital care occurred in the VLCD and LCD groups, respectively, (152 versus 44/10 000 person–years; hazard ratio, 3.4, 95% CI 1.8–6.3; P<0.001; number-needed-to-harm, 92, 95% CI 63–168; P<0.001). Of the 62 gallstone events, 38 (61%) resulted in cholecystectomy (29 versus 9; hazard ratio, 3.2, 95% CI 1.5–6.8; P=0.003; number-needed-to-harm, 151, 95% CI 94–377; P<0.001). Adjusting for 3-month weight loss attenuated the hazard ratios, but the risk remained higher with VLCD than LCD for gallstones (2.5, 95% CI 1.3–5.1; P=0.009) and became borderline for cholecystectomy (2.2, 95% CI 0.9–5.2; P=0.08).Conclusion:The risk of symptomatic gallstones requiring hospitalization or cholecystectomy, albeit low, was 3-fold greater with VLCD than LCD during the 1-year commercial weight loss program.

Arterial stiffness, lifestyle intervention and a low‐calorie diet in morbidly obese patients—A nonrandomized clinical trial

ObjectiveArterial stiffness is an independent predictor of cardiovascular morbidity and mortality. This study aimed to compare the 7-week effect of a low-calorie diet (LCD) and an intensive lifestyle intervention program (ILI) on arterial stiffness in morbidly obese individuals.Design and MethodsNonrandomized clinical trial. The LCD provided 900 kcal/day, and participants in the LCD group were instructed to maintain their habitual physical activity level. The ILI included two 90-min supervised training sessions 3 days a week at moderate to high intensity (4-8 METs) and a caloric restriction of 1000 kcal/day.ResultsA total of 179 individuals completed the study, 88 (56 women) in the ILI group and 91 (57 women) in the LCD group. High-fidelity applanation tonometry (Millar®, Sphygmocor®) was used to measure carotid-femoral pulse wave velocity (PWV). After adjustment for relevant confounders, the ILI group had a significantly greater reduction in PWV than the LCD group; −0.4 (−0.6, −0.1) m/s, P = 0.004. When compared to the LCD group, the ILI group showed a larger reduction in systolic and diastolic blood pressure −5 (−9, −1) and −5 (−7, −2) mmHg, P = 0.038 and P ≤ 0.001 respectively, whereas no difference was observed regarding pulse pressure, P = 0.661. No significant differences between groups were found regarding the loss of fat mass, P = 0.259, but the loss of muscle mass was larger in the LCD group, 0.8 (0.5, 1.1) kg, P ≤ 0.001.ConclusionDespite the limitations of a nonrandomized design, our findings indicate that for morbidly obese individuals a moderate caloric restriction combined with aerobic physical exercise is associated with a greater decline in PWV than a LCD alone.

High density lipoprotein is positively correlated with the changes in circulating total adiponectin and high molecular weight adiponectin during dietary and fenofibrate treatment

The investigation of the relationship between high density lipoprotein (HDL) and adiponectin. Thirty-seven obese or overweight [body mass index ≥27 Kg/m(2)], hypertriglyceridemic patients underwent one of the following interventions for 3 months: 1) Low-calorie diet (n=19), 2) Low-calorie diet plus fenofibrate (n=18). Circulating total adiponectin did not change significantly in the low-calorie diet group. However, in the subgroup of patients whose high density lipoprotein cholesterol (HDL-C) decreased over the first month of diet, a statistically significant reduction of the circulating total adiponectin was observed (p=0.010), while in the subgroup of patients whose HDL-C increased over the latter 2 months of the diet, an increase in circulating total adiponectin over the 2 months was found (p=0.043). The percentage change of HDL-C over the first month of diet was positively correlated with the percentage change of circulating total adiponectin (r=0.579, p=0.019). The percentage change of HDL-C over the 3 months of diet was positively correlated with the percentage changes of circulating total adiponectin (r=0.527, p=0.030) and high molecular weight (HMW) adiponectin (r=0.524, p=0.031). The change in circulating total adiponectin over the first month of diet was positively correlated with the HDL-C at 1 month (r=0.606, p=0.013). The change in HMW adiponectin over the 3 months of diet was positively correlated with the HDL-C at 3 months (r=0.602, p=0.011). The percentage change of circulating HMW adiponectin over the first month of fenofibrate treatment was positively correlated with the percentage change of HDL-C (r=0.594, p=0.012). HDL is positively correlated with the changes in circulating adiponectin during dietary and fenofibrate treatment.

The effects of weight loss by a low-calorie diet and a low-calorie plus exercise in overweight undergraduate students

Korean undergraduate students attempt to lose weight but often fail due to utilizing ineffective weight loss strategies. Some diet programs have succeeded, yet, they have not provided adequate skills for long-term weight maintenance. The aim of the study was to determine the effect of a low calorie diet and exercise with nutritional education on weight loss, serum lipid profiles, nutrient intakes, and dietary behavior modification in overweight and obese undergraduate students. The subjects in the low calorie diet group (LCD n = 12) and the low calorie diet plus exercise group (LCDE n = 13) had the same goal of losing 4 kg during a 12 week program. Nutrient intakes were assessed by the 24 hour recall method. Also, food habits and dietary behaviors were investigated by self-administered questionnaires before and after the weight control program and one month after completing the program. LCD and LCDE groups lowered body weight by 2 kg and 1 kg, respectively, although they decreased calorie intake by 355 and 287 kcal per day compared to intakes prior to the study. Body fat mass decreased in both the LCD and LCDE groups; however, the decrease was greater in the LCDE group. In addition, only the LCDE group increased muscle mass. The LCD group had a slightly better effect in reducing body weight, body fat, and waist circumference than the LCDE group. However, their decrease was reversed after the mid-study check in the LCD group; the reduction was better maintained and decreased more in the LCDE group. However, serum lipid profiles were already in borderline prior to the study; moreover, they were not modified after losing weight. The dietary behavior program helped students to develop better dietary habits. In conclusion, the combination of a low calorie diet and exercise is necessary in order to maintain longer weight loss by increasing muscle mass and decreasing body fat.

Preoperative 4-Week Low-Calorie Diet Reduces Liver Volume and Intrahepatic Fat, and Facilitates Laparoscopic Gastric Bypass in Morbidly Obese

The aim of this study was to explore changes in liver volume and intrahepatic fat in morbidly obese patients during 4weeks of low-calorie diet (LCD) before surgery and to investigate if these changes would facilitate the following laparoscopic gastric bypass. Fifteen female patients (121.3kg, BMI 42.9) were treated preoperatively in an open study with LCD (800-1,100kcal/day) during 4weeks. Liver volume and fat content were assessed by magnetic resonance imaging and spectroscopy before and after the LCD treatment. Liver appearance and the complexity of the surgery were scored at the operation. Eighteen control patients (114.4kg, BMI 40.8), without LCD were scored similarly. Average weight loss in the LCD group was 7.5kg, giving a mean weight of 113.9kg at surgery. Liver volume decreased by 12% (p < 0.001) and intrahepatic fat by 40% (p < 0.001). According to the preoperative scoring, the size of the left liver lobe, sharpness of the liver edge, and exposure of the hiatal region were improved in the LCD group compared to the controls (all p < 0.05). The overall complexity of the surgery was perceived lower in the LCD group (p < 0.05), due to improved exposure and reduced psychological stress (both p < 0.05). Four weeks of preoperative LCD resulted in a significant decrease in liver volume and intrahepatic fat content, and facilitated the subsequent laparoscopic gastric bypass as scored by the surgeon.