Reduction In Total Body Fat Research Articles

Effects of a One-Year Intensified Weight Loss Program on Body Composition Parameters in Patients with Severe Obesity and Obstructive Sleep Apnea (OSA): A Randomized Controlled Trial.

Background: Studies focusing on the effects of lifestyle strategies on patients with obstructive sleep apnea (OSA) that go beyond body weight and explore body composition are currently scarce and inconclusive. Objectives/Methods: The aim of this study was to evaluate the effects of a 12-month intensive life intervention program (ILI), based on a hypocaloric Mediterranean diet, on changes in the body composition parameters as assessed by abdominal computed tomography (CT) and the cardiorespiratory profile of patients with severe OSA and grade I-II obesity, compared to patients receiving standard care. Resultts:Thirty-four patients (30 males and four females) were randomly assigned to an intervention group (IG) (n = 18) or a control group (CG) (n = 16). We observed an improvement in OSA severity following the intervention. Patients in the IG lost 8.2% of their body weight compared to 0.1% of the patients in the CG (p < 0.001), and this loss was primarily due to reductions in total body fat, visceral adipose tissue index (VATI) [IG -19.4 (18.1) cm2/m2 versus CG 2.32 (11.6) cm2/m2, p < 0.001], and a tendency toward lower intramuscular adipose tissue index (IMATI) [IG -0.69 (0.85) cm2/m2 versus CG 0.04 (1.3) cm2/m2, p = 0.098]. These changes were associated with an improvement in patients' metabolic and inflammatory profile. Younger age and a higher degree of obesity at baseline were associated with greater weight loss. Conslusions: In conclusion, the ILI was effective in reducing 8.2% of body weight at 12 months, leading to favorable changes in patients' body composition profile that resulted in healthier metabolic and inflammatory parameters.

Meal Frequency Does Not Affect Weight Loss in Overweight/Obese Women but Affects the Body Composition: A Randomized Controlled Trial

Objectives Studies showing the relationship between meal frequency, weight loss and anthropometric measurements are contradictory. This study aims to determine the effect of meal frequency on weight loss, anthropometric measurements, and body composition. Methods This is a parallel designed randomized control trial that was conducted with 40 female volunteers between the ages of 19–64 years, with a Body Mass Index (BMI) ≥27 who applied to a private clinic. Participants were randomized in two treatment arms (3 meals + 3 snacks/day (n = 20) vs 3 meals/day (n = 20)) and same dietary energy restriction (–500kcal) was applied for 3 months. Food consumption was questioned with 3 day food records, and anthropometric measurements and body composition were measured before the study and repeated each week till the end of the study by the researcher. Results All of the participants completed the study period. Body weight (kg), BMI (kg/m2), total body fat (kg), body fat percentage (%), fat free mass (kg) and waist circumference (cm) decreased, while fat free mass percentage (%) increased significantly in both of the groups at the end of the study (p < 0.05). The rate of difference for body weight, BMI (kg/m2) and waist circumference (cm) were similar among the groups. When difference in body composition analyses was examined, the rate of reduction in total body fat (–18.82 ± 4.97% vs −14.87 ± 7.44%) and body fat percentage (%)(–10.79 ± 4.63% vs −7.68 ± 7.04%) and the rate of increase in fat free mass percentage (%)(7.65 ± 3.16% vs 5.04 ± 3.44%) were significantly higher in 3 meals + 3 snacks group (p < 0.05). Conclusion When energy restricted and balanced weight loss programs are applied, alteration in body weight, BMI and waist circumference is not affected from meal frequency, but body composition does. Clinical Trial Number NCT05581862 (Date of Trial Registration: 13/10/2022)

Body mass components affecting low-attenuation noncalcified coronary plaque burden

Abstract Funding Acknowledgements Type of funding sources: Public hospital(s). Main funding source(s): National Institute of Cardiology in Warsaw, Poland Background Weight control is a major risk modifier for coronary artery disease. However, the effect exerted by individual body mass components on coronary plaque may not be uniform. Low-attenuation noncalcified plaque (LAP) has been recently identified as an independent predictor of cardiovascular outcomes [1]. Purpose To determine the relationship between changes in body mass composition and LAP burden. Methods 89 participants of Dietary Intervention to Stop Coronary Atherosclerosis in Computed Tomography (DISCO-CT) were enrolled into the analysis (40% women, mean age 60±7.7 years). Patients with non-obstructive (stenosis&amp;lt;70%) coronary atherosclerosis confirmed in coronary computed tomography angiography (CCTA) and qualified to conservative treatment were randomized (1:1) to intensive diet and lifestyle intervention atop optimal medical therapy (OMT) versus OMT alone over 66.8±13.7 months [2]. Body mass (BM) and body mass components including total body fat (TBF), skeletal muscle mass (SMM), visceral cell mass (VCM), and extracellular mass (ECM) were measured at baseline and follow-up (InBody S10 analyser, South Korea). LAP burden was defined as the volume of coronary plaque &amp;lt;30 Hounsfield units divided by the vessel volume, and expressed in %. Changes in body components were compared with changes in LAP measured in serial CCTA scans (QAngioCT, Medis Medical Imaging Systems, the Netherlands). Results Reduction in BM was significantly higher in the experimental (∆BM=-3.6±4.9 kg) vs control arm (∆BM=-1.4±2.9 kg; p = 0.016) and so was the reduction in TBF (∆TBF=-4.2±5.3 kg vs ∆TBF=0.2±4.3 kg, respectively; p&amp;lt;0.001). SMM increased by 0.4±2.6 kg in the experimental arm and decreased by 1.0±2.1 kg in the control arm (p = 0.006). No significant interarm differences were observed for changes in VCM and ECM. Reduction in LAP was higher in the experimental vs control arm (∆LAP=-0.42±1.4% vs ∆LAP=-0.03±0.45%, respectively; p = 0.078). In the entire study population, a significant positive correlation between LAP reduction and BM reduction was revealed (r=0.45, p&amp;lt;0.001). Multivariate regression model incorporating the investigated body mass components identified TBF as the only component associated with LAP reduction (table). Conclusions Body mass reduction may decrease LAP burden due to body fat reduction.

Abstract P622: Increase From Low to Moderate Consumption of Caffeinated Coffee is Associated With Favorable Changes in Body Fat

Introduction: Higher consumption of coffee and caffeine has been linked to less weight gain and lower body mass index in prospective cohort studies, usually with exposure assessment limited to baseline values. As BMI is a proxy for adiposity but does not capture fat tissue or its metabolically relevant distribution, precise measurements of distinct adipose tissues are needed, so the cardiometabolic impact of an anti-obesity effect can be assessed. Hypothesis: We assessed the hypothesis that an increase in coffee consumption is associated with a reduction in body fat, in particular with trunk fat and visceral adipose tissue (VAT). Methods: In the setting of a large, randomized trial of Mediterranean diet and physical activity intervention, we evaluated 1483 participants with metabolic syndrome. Changes in the consumption of caffeinated and decaffeinated coffee were derived from validated food frequency questionnaires at baseline, 6 months and yearly during follow-up. Fat tissue was measured with dual x-ray absorptiometry at baseline and after 6, 12 months and three years. Linear multilevel mixed effect models were used to investigate the relationship between changes in coffee consumption and corresponding concurrent changes in fat tissue over three years. Results: After adjustment for intervention group, and other potential confounders, an increase in caffeinated coffee consumption from no or infrequent consumption (≤ 3 cups/ month) to moderate consumption (1-7 cups/week) was associated with reductions in total body fat (Δ z-score: -0.06; 95 % CI: -0.11 to -0.02), trunk fat (Δ z-score: -0.07; 95 % CI: -0.12 to -0.02), and VAT (Δ z-score: -0.07; 95 % CI: -0.13 to -0.01). However, changes to even higher levels (&gt; 1 cup/day) showed no significant association. Conclusions: Moderate consumption of caffeinated coffee, but not high consumption, was associated with reductions in total body fat, trunk fat and VAT in a Mediterranean cohort with metabolic syndrome. Decaffeinated coffee was not linked to adiposity indicators. In conclusion, moderate consumption of caffeinated coffee may be part of a weight management strategy.

Increase from low to moderate, but not high, caffeinated coffee consumption is associated with favorable changes in body fat

Higher consumption of coffee and caffeine has been linked to less weight gain and lower body mass index in prospective cohort studies. The aim of the study was to longitudinally assess the association of changes in coffee and caffeine intake with changes in fat tissue, in particular, visceral adipose tissue (VAT) using dual x-ray absorptiometry (DXA). In the setting of a large, randomized trial of Mediterranean diet and physical activity intervention, we evaluated 1483 participants with metabolic syndrome (MetS). Repeated measurements of coffee consumption from validated food frequency questionnaires (FFQ) and DXA measurements of adipose tissue were collected at baseline, 6 months, 12 months and 3 years of follow-up. DXA-derived measurements of total and regional adipose tissue expressed as % of total body weight were transformed into sex-specific z-scores. Linear multilevel mixed-effect models were used to investigate the relationship between changes in coffee consumption and corresponding concurrent changes in fat tissue during a 3-year follow-up. After adjustment for intervention group, and other potential confounders, an increase in caffeinated coffee consumption from no or infrequent consumption (≤3 cups/month) to moderate consumption (1-7 cups/week) was associated with reductions in total body fat (Δ z-score:-0.06; 95% CI:-0.11 to-0.02), trunk fat (Δ z-score:-0.07; 95% CI:-0.12 to-0.02), and VAT (Δ z-score:-0.07; 95% CI:-0.13 to-0.01). Neither changes from no or infrequent consumption to high levels of caffeinated coffee consumption (>1 cup/day) nor any changes in decaffeinated coffee consumption showed significant associations with changes in DXA measures. Moderate changes in the consumption of caffeinated coffee, but not changes to high consumption, were associated with reductions in total body fat, trunk fat and VAT in a Mediterranean cohort with MetS. Decaffeinated coffee was not linked to adiposity indicators. Moderate consumption of caffeinated coffee may be part of a weight management strategy. The trial was registered at the International Standard Randomized Controlled Trial (ISRCTN: http://www.isrctn.com/ISRCTN89898870) with number 89898870 and registration date of 24 July 2014, retrospectively registered.

OR10-2 Hormonal and Cardiometabolic Changes Associated with Diazoxide Choline Extended-Release (DCCR) Tablets in Patients with Prader-Willi Syndrome

Abstract Background Prader-Willi syndrome (PWS) is a rare genetic neurodevelopmental condition, characterized by hyperphagia, obesity, hormone deficiencies and behavioral/psychological manifestations. DCCR is under investigation as a treatment for hyperphagia in PWS through its actions on hypothalamic circuits involved in appetite regulation including NPY neurons and central inhibition of DMV neurons to improve insulin sensitivity. In addition to these effects, DCCR acts on pancreatic beta cells, to reduce glucose stimulated insulin secretion, which might have additional effects to reduce fat deposition in adipocytes, serum leptin concentrations and insulin resistance. Objectives and methods This analysis characterized changes in hormonal and cardiometabolic parameters in patients with PWS receiving oral daily DCCR. 125 participants with genetically-confirmed PWS ≥4 years old with hyperphagia were treated with DCCR in multi-center studies conducted at 29 sites in the US and the UK: a 13-week, Phase 3, double-blind, placebo-controlled study (DESTINY PWS) and its long-term, open-label extension study (analysis at 52 weeks). The target DCCR dose for these studies was ≥3.3 mg/kg with an optimal dose of 4.2 - 5.8 mg/kg. Overall, 103 patients received DCCR (100-525 mg/day) for 52 weeks. For all parameters, the baseline measurement was defined as (immediately prior to) start of DCCR treatment. Results Serum leptin, insulin, and HOMA-IR were significantly reduced following 52 weeks of DCCR administration. Results are expressed as Least square (LS) mean change from baseline [Standard Error (SE)]. There were significant decreases in: Leptin (ng/mL) = -11.08[1.26], p&amp;lt;0.001; Insulin (μIU/mL) = -2.5[0.69], p&amp;lt;0.001; and HOMA-IR = -0.5 [0.17], p=0.003. Serum adiponectin (µg/mL) was significantly increased: 1.82[0.41], p &amp;lt; 0.001. Fat mass measured by DXA was stable at 52 weeks. Conclusions The reductions in fasting leptin, insulin and HOMA-IR, and the increase in adiponectin with prolonged DCCR treatment in the absence of reductions in total body fat are consistent with improved insulin sensitivity that may also reflect improvement in leptin sensitivity and healthier body fat distribution, such as reduced visceral adiposity. This could result from both direct pancreatic and hypothalamus-to-periphery actions of DCCR. It remains to be determined if such beneficial metabolic changes also result in reduced systemic inflammation and cardiovascular health. DCCR administration was associated with significant reductions in leptin, insulin, and HOMA-IR, increases in adiponectin and stabilization of body fat. These and other changes in cardiometabolic parameters suggest that DCCR may have long term health benefit in patients with PWS. Presentation: Sunday, June 12, 2022 11:15 a.m. - 11:30 a.m.

RF24 | PSUN126 A Very-Low Calorie Diet Can Reduce Insulin Resistance and Cause Remission of Diabetes Mellitus and Hypertriglyceridemia in a Patient With Familial Partial Lipodystrophy Type 2

Abstract Background Lipodystrophy syndromes are associated with inadequate adipocyte capacity that results in an earlier threshold for ectopic deposition and metabolic dysfunction. We have previously reported that patients with familial partial lipodystrophy (FPLD) present with metabolic severity equivalent to what is observed at 8-12 BMI points higher in a population with common obesity. Currently, there is no strong evidence that any specific diet is the preferred treatment, but bariatric surgery has been reported to improve metabolic outcomes in a few patients. Here, we report the effect of an aggressive calorie-restricted diet in a patient with FPLD who showed remarkable benefit after 16 weeks of the intervention. Clinical Case This is a 38-year-old female diagnosed with FPLD type 2, with LMNA p. R482Q mutation who had a history of recurrent pancreatitis, NAFLD, impaired ovulation, and diabetes mellitus. She had a short-term goal of improving her metabolic state rapidly to achieve pregnancy by IVF. Upon presentation, body weight was 81.6kg, BMI 23.2kg/m2, HbA1c 7.7% and triglycerides 215mg/dL. She was started on very-low calorie diet (VLCD) (800 kcal/day) employing a formula total liquid diet meal replacement: 160 kcal per shake (18g total carbohydrates, 15g net carbohydrates, 3.5g fat, and 16g protein) with the goal to reduce body weight by 15% as has been described for patients in the University of Michigan Weight Management Program. After 1 week on diet, she discontinued glucose and lipid lowering therapies. After 12-weeks of VLCD followed by 4 weeks of transition to low-calorie diet (incorporating 3 meal replacements, one meal, and ad libitum non-starchy vegetables), we observed 12.3kg of body weight and a 1.4% decrease in HbA1c. Insulin resistance was reduced by 66.7 and 61.5% (HOMA-IR and ADIPO-IR, respectively). Fasting insulinemia was reduced by 64.2%. We also performed an OGTT with 75g of glucose for 180 min and observed a decrease in the area under the curve of insulin (-33.2%), triglycerides (-40.7%), and free fatty acids (-34%). DEXA scan showed a reduction in total body fat of 16%. Liver fat via the chemical shift MRI method was reduced from 10±2% to 2±1%. She did not experience any adverse events during the intervention. More importantly, her egg retrieval rate and egg quality during IVF were far superior to past attempts. Conclusion This case illustrates the strong effect and safety of a VLCD intervention in a patient with lipodystrophy. We observed rapid reduction in body weight, and in insulin resistance leading to the remission of diabetes mellitus, hypertriglyceridemia and fatty liver disease. Moreover, there was improved response to ovulation induction. Our data encourage the use of this medical approach for other patients with similar metabolic and reproductive abnormalities due to adipose tissue distribution abnormalities. Presentation: Sunday, June 12, 2022 12:30 p.m. - 2:30 p.m., Sunday, June 12, 2022 12:36 p.m. - 12:41 p.m.

Increased Consumption of Unsaturated Fatty Acids Improves Body Composition in a Hypercholesterolemic Chinese Population.

While an increase in fat intake and the resulting excess calorie intake are implicated in weight gain, different fat types exert variable effects on body composition, with unsaturated fats showing favorable effects on body composition in Western population. Whether and to what extent these associations apply to Asian population have not been established. We investigated the effects of two separate Asian-based oil blends, rich in unsaturated fats, made from refined rice bran, sesame, and flaxseed oils, in comparison with refined olive oil, on body composition using dual-energy X-ray absorptiometry (DXA), from an 8-week, parallel design, randomized trial in 66 men (58.7 ± 5.71 years old, 23.0 ± 2.38 kg/m2) and 69 postmenopausal women (59.1 ± 5.34 years old, 21.7 ± 2.52 kg/m2), with borderline hypercholesterolemia. Despite increases in mean daily intakes of total energy (approximately +400 kcal/day, female, and approximately +240 kcal/day, male), as well as increases in percentage of calories from fats and proteins and decreases in percentage of calories from carbohydrates during the dietary intervention period, there were no significant changes in total body fat mass in both genders and also in all treatment groups. While total body weight increased slightly (0.36 ± 0.12 kg, p = 0.005) in women during intervention, this was mainly due to gain in lean mass (0.38 ± 0.081 kg, p < 0.0001). Correspondingly, there were reductions in total body fat (%), android fat (%), and gynoid fat (%) in women. No significant differences between the 3 intervention oil types were found in any of the measured parameters in either gender. Increasing relative intakes of unsaturated fats may prevent fat mass gain and circumvent muscle mass loss associated with menopause in older Asian women. Long-term studies are needed to confirm findings. This study had been registered on clinicaltrials.gov (Identifier No.: NCT03964857, https://www.clinicaltrials.gov/ct2/show/NCT03964857).

Pharmacokinetic characteristics and morphometric effects of sodium-glucose contransporter-2 inhibitors in men and women with type 2 diabetes mellitus (literature review and own results)

Background. According to the latest international clinical guidelines, gliflozins— sodium-glucose cotransporter-2 inhibitors— are indicated as oral antidiabetic drugs of second-third-line therapy in type 2 diabetes mellitus. Due to insulin-independent stimulation of glucosuria, gliflozins have extraglycemic effects such as weight loss, improved adipose tissue distribution, better plasma lipid profile, and decreased uricemia that in generally reduce the risk of cardiovascular complications. The purpose of this study was to evaluate the effectiveness of dapagliflozin in the treatment of men and women with type 2 diabetes mellitus with a metabolically unhealthy phenotype. Materials and methods. The study included 17 individuals with diabetes mellitus type 2 (11 men and 6women), aged 58.0±1.7 years (95% confidence interval 53–62), whose body composition was evaluated by bioelectric impedance using a Tanita analyzer BC-545N (Japan). Patients received therapy with dapagliflozin, antihypertensive and antihyperlipidemic drugs (statins). Results. A three-month use of dapagliflozin in a dose of 10 mg once daily caused a decrease in body mass index, waist circumference, improvement of body composition, in particular a reduction in total body fat (the significance of changes was determined using a paired t-test). No significant changes in muscle and bone mass, body composition, lipid profile, and uricemia level were observed. The group of women, in contrast to men, had a decreased level of visceral fat, which was accompanied by an improvement in the body’s water supply, and a reduction in the estimated metabolic age. Conclusions. Treatment of type 2 diabetes patients with sodium-glucose cotransporter-2 inhibitors for 3 months has reduced the degree of obesity and improved some indices of body composition. Confirmation of this trend can be obtained in further observations.

Atrial Fibrillation and Obesity: Reverse Remodeling of Atrial Substrate With Weight Reduction.

This study sought to evaluate the effect of weight loss on the atrial substrate for atrial fibrillation (AF). Whether weight loss can reverse the atrial substrate of obesity is not known. Thirty sheep had sustained obesity induced by ad libitum calorie-dense diet over 72weeks. Animals were randomized to 3 groups: sustained obesity and 15% and 30% weight loss. The animals randomized to weight loss underwent weight reduction by reducing the quantity of hay over 32weeks. Eight lean animals served as controls. All were subjected to the following: dual-energy x-ray absorptiometry, echocardiogram, cardiac magnetic resonance, electrophysiological study, and histological and molecular analyses (fatty infiltration, fibrosis, transforming growth factor β1, and connexin 43). Sustained obesity was associated with increased left atrium (LA) pressure (p<0.001), inflammation (p<0.001), atrial transforming growth factor β1 protein (p<0.001), endothelin-B receptor expression (p=0.04), atrial fibrosis (p=0.01), epicardial fat infiltration (p<0.001), electrophysiological abnormalities, and AF burden (p=0.04). Connexin 43 expression was decreased in the obese group (p=0.03). In this obese ovine model, 30% weight reduction was associated with reduction in total body fat (p<0.001), LA pressure (p=0.007), inflammation (p<0.001), endothelin-B receptor expression (p=0.01), atrial fibrosis (p=0.01), increase in atrial effective refractory period (cycle length: 400 and 300ms; p<0.001), improved conduction velocity (cycle length: 400 and 300ms; p=0.01), decreased conduction heterogeneity (p<0.001), and decreased AF inducibility (p=0.03). Weight loss was associated with a nonsignificant reduction in epicardial fat infiltration in posterior LA (p=0.34). Weight loss in an obese ovine model is associated with structural and electrophysiological reverse remodeling and a reduced propensity for AF. This provides evidence for the direct role of obesity in AF substrate and the role of weight reduction in patients with AF.

Effects of Extra Virgin Olive Oil (EVOO) and the Traditional Brazilian Diet on Sarcopenia in Severe Obesity: A Randomized Clinical Trial.

Background: Nutritional interventions may have positive effects on sarcopenia and body composition. Objective: to evaluate the effectiveness of extra virgin olive oil (EVOO) consumption and a healthy traditional Brazilian diet (DieTBra) on improving sarcopenia indicators and reducing total body fat in severe obesity. Methods: A randomized controlled trial registered at ClinicalTrials.gov (NCT02463435) conducted with 111 severely obese participants randomized into three treatment groups—(1) EVOO (52 mL/day), (2) DieTBra, (3) DieTBra + EVOO (52 mL/day)—for 12 weeks. Body composition was assessed by dual-energy X-ray absorptiometry and sarcopenia by walking speed and handgrip strength. Results: Significant reductions in total body fat (p = 0.041) and body weight (p = 0.003) were observed in the DieTBra group. In the DietBra + olive oil group there was also a significant reduction in body weight (0.001) compared to the olive oil-only group. ANCOVA analyses showed reductions in total body fat in the DieTBra (p = 0.016) and DieTBra + olive oil (p = 0.004) groups. Individuals in the DieTBra group had significant improvements in their walking speed (p = 0.042) and handgrip strength (p = 0.044). Conclusions: DieTBra contributes to improvements in handgrip strength, walking speed, and total body fat in severely obese adults. The major study was registered at ClinicalTrials.gov (NCT02463435).

The Effect of an 8 Week Prescribed Exercise and Low-Carbohydrate Diet on Cardiorespiratory Fitness, Body Composition and Cardiometabolic Risk Factors in Obese Individuals: A Randomised Controlled Trial.

Background: Low-carbohydrate (LC) diets are an effective method for treating obesity and reducing cardiometabolic risk. However, exposure to LC diets is associated with reductions in muscle mass and increased osteoporosis risk in obese individuals. The combination of exercise with a LC diet appears to attenuate muscle mass loss induced by LC diets alone, and to further improve cardiometabolic profile. However, evidence to date in obese individuals is limited. We assessed the effect of LC diet in combination with supervised exercise on cardiorespiratory fitness, body composition and cardiometabolic risk factors in obese individuals. Methods: Male and female participants in the experimental (EX-LC; structured supervised exercise program + low-carbohydrate meals; n = 33; 35.3 years) and control (EX-CO; structured supervised exercise program + standard dietary advice; n = 31; 34.2 years) conditions underwent measurements of cardiorespiratory fitness (VO2peak), body fat, lean muscle mass (LMM), and cardiometabolic biomarkers before and after an 8 week intervention. Results: Participants in the EX-LC condition demonstrated greater improvements in VO2peak (p = 0.002) and fat mass index (FMI, p = 0.001) compared to the EX-CO condition. Achieving a ketogenic state (β-hydroxybutyrate, βHB ≥0.3 mmol/L) was associated with greater reductions in total body fat (p = 0.011), visceral adipose tissue (p = 0.025), FMI (p = 0.002) and C-reactive protein (CRP, p = 0.041) but also with greater reductions in LMM (p = 0.042). Conclusion: Short-term LC diet combined with prescribed exercise enhanced cardiorespiratory fitness and the cardiometabolic profile of obese individuals but was also associated with greater muscle mass loss compared to similar exercise training and standard dietary advice. The long-term effects of the LC diet should be further explored in future studies.

Conjugated Linoleic Acid (CLA) Effect on Body Weight and Body Composition in Women (Systematic Review and Meta-Analysis).

AbstractIntroduction:Conjugated linoleic acid (CLA) is a food supplement that is proposed as an anti-obesity supplement in animal and human studies. Animal studies have shown a significant anti-obesity effect of CLA, but results in humans were inconsistent, where some of the studies found an anti-obesity effect while other studies failed to find any decline in obesity markers after CLA supplementation. This meta-analysis aimed to determine if oral CLA supplementation has been shown to reduce obesity-related markers in women.Method:Pub Med, Cochrane Library, and Google Scholar were used to identify the eligible trials using two main searching strategies: the first one was to search eligible trials using keywords “Conjugated linoleic acid”, “CLA”, “Women”, and the second strategy was to extract the eligible trials from previously published systematic reviews and meta-analyses. The eligible trials were placebo control trials where women supplemented with CLA mixture in the form of oral capsules for 6 months or less. Furthermore, eligible trials reported body weight (BW), body mass index (BMI), total body fat (TBF), percentage body fat (BF%), and/ or lean body mass (LBM). The quality of each included study was assessed using both JADAD scale and an adapted CONSERT checklist.Results:Meta-analysis of 8 eligible trials showed that CLA supplementation was significantly associated with reduced BW (Mean ± SD, 1.2 ± 0.26 kg, p &lt; 0.001), BMI (0.6 ± 0.13kg/m2, p &lt; 0.001) and TBF (0.76 ± 0.26 kg, p = 0.003) in women, when supplemented over 6–16 weeks. Subgroup meta-analysis demonstrated a significant reduction in BW (1.29 ± 0.31 kg, p &lt; 0.001), BMI (0.60 ± 0.14 kg/m2, p &lt; 0.001) and TBF (0.82 ± 0.28 kg, p = 0.003) in the trials that had recruited overweight-obese women. The second subgroup meta-analysis, that considered the menopausal status of the participants, found that CLA was significantly associated with reduced BW (1.35 ± 0.37 kg, p &lt; 0.001; 1.05 ± 0.36 kg, p = 0.003) and BMI (0.50 ± 0.17 kg/m2, p = 0.003; 0.75 ± 0.2 kg/m2, p &lt; 0.001) in both pre and post-menopausal age women, respectively. A reduction in TBF (1.09 ± 0.37 kg, p = 0.003) was only significant in post-menopausal women.Discussion:This meta-analysis suggests a moderate anti-obesity effect of CLA on BW, BMI and TBF reduction in women, when supplemented over 6–16 weeks, particularly in overweight-obese women and post-menopausal women. More well-designed trials are required to confirm this meta-analysis results.

P2680Changes in body fat distribution after intensive dietary intervention in patients with stable coronary artery disease

Abstract Introduction Contradictory reports are available on the role of adipose tissue in the pathophysiology and progression of coronary artery disease (CAD). It seems accepted that local fat distribution is more relevant than the general amount of body fat. As in the case of visceral fat, pericardial adipose tissue (PEAT) has been postulated an important mediator of metabolic risk, with a special role attributed to epicardial adipose tissue (EAT). Purpose To study the effect of intensive dietary and lifestyle modification on the distribution of body fat in patients diagnosed with stable CAD qualified to conservative treatment. Methods Total body fat mass (TBF), visceral fat area (VFA), PEAT volume, and EAT volume were measured in 67 participants (43% women) of the DISCO-CT trial (Dietary Intervention to Stop COronary Atherosclerosis in Computed Tomography, NCT02571803) who completed the study by the end of 2018. All patients, randomly assigned to either experimental or control arm in a 1:1 fashion, were regularly followed-up at our site, with those in the experimental arm being strictly supervised by a dietitian to stick to Dietary Approaches to Stop Hypertension (DASH) diet and encouraged to lifestyle changes atop optimal medical therapy. Contrast-enhanced coronary computed tomography was performed at baseline and after the median time of 59 weeks (2x192-multislice scanner, temporal resolution 66 ms, Somatom Force, Siemens). PEAT and EAT volumes, expressed in mm3, were measured with a dedicated offline workstation (syngo.via Frontier, Siemens Healthcare) using a semiautomatic segmentation technique (window width range −195 to −45 Hounsfield units). TBF, expressed in kg, and VFA, expressed in cm2, were measured using the InBody S10 Body Water Analyser at baseline and completion of the study. 57% of subjects included into the analysis represented the experimental arm. Results There were no significant between-arm differences in baseline TBF, VFA, PEAT, and EAT volumes. A significant reduction by 3.7±5.0 kg in TBF (p&lt;0.001; 95% CI 2.1, 5.3) and by 19.7±30.1 cm2 in VFA (p&lt;0.001; 95% CI 9.8, 29.6) was observed in the experimental arm, while in the control group both TBF and VFA irrelevantly increased, by 0.6±4.7 kg (p=0.53; 95% CI −2.4, 1.3) and 2.2±27.0 cm2 (p=0.67; 95% CI −12.7, 8.2), respectively. A significant decrease in PEAT volume, by 19.9±43.0 mm3 (p=0.007; 95% CI 5.8, 34.1), was observed in the experimental group, compared to a non-significant PEAT volume reduction by 5.8±3.5.0 mm3 (p=0.38, 95% CI −7.5; 19.2) in the control group. Contrarily, no significant changes in EAT volumes were observed in either experimental (reduction by 3.8±15.2 mm3; p=0.13, 95% CI −1.2, 8.8) or control arm (reduction by 5.1±17.2 mm3; p=0.13, 95% CI −1.5, 11.6). Conclusion Intensive dietary intervention in patients with stable CAD can lead to a significant reduction in total body fat, visceral fat and pericardial fat, this effect, however, may not apply to epicardial fat. Acknowledgement/Funding This study was founded by a grant (2.15/III/15) from the Institute of Cardiology in Warsaw, Poland

Effectiveness of surf therapy for children with disabilities

BackgroundFew researchers have examined the effects of surf programs on children with disabilities. Due to previous research findings, surfing is being used, as the focus of physical activity intervention due to its numerous health and therapeutic benefits. Objective/hypothesisThe purpose of this study was to explore the effects of an eight-week surfing intervention on various physical fitness measures in 71 children with disabilities such as autism spectrum disorder, down syndrome, global developmental delays, and cerebral palsy. The study also sought to compare the differences in overall fitness levels between the surf therapy group and an unstructured pool playgroup. Researchers predicted significant differences in the surf therapy group. MethodsThe assessment procedure consisted of pre and post physical fitness measures selected from the Brockport Physical Fitness Test in two groups: surfing (n = 71) and an unstructured aquatic program (n = 20). ResultsThe results demonstrated significant improvements in core strength (p = 0.00), upper body strength (p = 0.00), flexibility (p = 0.01) and cardiorespiratory endurance (p = 0.00) in the surfing group. However, there were no significant differences in overall fitness levels between the surfing and unstructured pool playgroups. Body composition measurements on the surfing group demonstrated a significant reduction in total body fat % (p = 0.016) and fat free mass (p = 0.008) and a significant improvement in bone mineral density (p = 0.004) pre to post surf therapy. ConclusionsThis research demonstrated the effectiveness and physiological benefits of surf therapy for children with selected disabilities.

The Health Risks of Obesity Have Been Exaggerated.

The Health Risks of Obesity Have Been Exaggerated.

Are the metabolic benefits of resistance training in type 2 diabetes linked to improvements in adipose tissue microvascular blood flow?

The microcirculation in adipose tissue is markedly impaired in type 2 diabetes (T2D). Resistance training (RT) often increases muscle mass and promotes a favorable metabolic profile in people with T2D, even in the absence of fat loss. Whether the metabolic benefits of RT in T2D are linked to improvements in adipose tissue microvascular blood flow is unknown. Eighteen sedentary people with T2D (7 women/11 men, 52 ± 7 yr) completed 6 wk of RT. Before and after RT, overnight-fasted participants had blood sampled for clinical chemistries (glucose, insulin, lipids, HbA1c, and proinflammatory markers) and underwent an oral glucose challenge (OGC; 50 g glucose × 2 h) and a DEXA scan to assess body composition. Adipose tissue microvascular blood volume and flow were assessed at rest and 1 h post-OGC using contrast-enhanced ultrasound. RT significantly reduced fasting blood glucose ( P = 0.006), HbA1c ( P = 0.007), 2-h glucose area under the time curve post-OGC ( P = 0.014), and homeostatic model assessment of insulin resistance ( P = 0.005). This was accompanied by a small reduction in total body fat ( P = 0.002), trunk fat ( P = 0.023), and fasting triglyceride levels ( P = 0.029). Lean mass ( P = 0.003), circulating TNF-α ( P = 0.006), and soluble VCAM-1 ( P < 0.001) increased post-RT. There were no significant changes in adipose tissue microvascular blood volume or flow following RT; however those who did have a higher baseline microvascular blood flow post-RT also had lower fasting triglyceride levels ( r = -0.476, P = 0.045). The anthropometric, glycemic, and insulin-sensitizing benefits of 6 wk of RT in people with T2D are not associated with an improvement in adipose tissue microvascular responses; however, there may be an adipose tissue microvascular-linked benefit to fasting triglyceride levels.

Pleiotrophin deletion alters glucose homeostasis, energy metabolism and brown fat thermogenic function in mice.

Pleiotrophin, a developmentally regulated and highly conserved cytokine, exerts different functions including regulation of cell growth and survival. Here, we hypothesise that this cytokine can play a regulatory role in glucose and lipid homeostasis. To test this hypothesis, we performed a longitudinal study characterising the metabolic profile (circulating variables and tissue mRNA expression) of gene-targeted Ptn-deficient female mice and their corresponding wild-type counterparts at different ages from young adulthood (3months) to older age (15months). Metabolic cages were used to investigate the respiratory exchange ratio and energy expenditure, at both 24°C and 30°C. Undifferentiated immortalised mouse brown adipocytes (mBAs) were treated with 0.1μg/ml pleiotrophin until day 6 of differentiation, and markers of mBA differentiation were analysed by quantitative real-time PCR (qPCR). Ptn deletion was associated with a reduction in total body fat (20.2% in Ptn+/+ vs 13.9% in Ptn-/- mice) and an enhanced lipolytic response to isoprenaline in isolated adipocytes from 15-month-old mice (189% in Ptn+/+ vs 273% in Ptn-/- mice). We found that Ptn-/- mice exhibited a significantly lower QUICKI value and an altered lipid profile; plasma triacylglycerols and NEFA did not increase with age, as happens in Ptn+/+ mice. Furthermore, the contribution of cold-induced thermogenesis to energy expenditure was greater in Ptn-/- than Ptn+/+ mice (42.6% and 33.6%, respectively). Body temperature and the activity and expression of deiodinase, T3 and mitochondrial uncoupling protein-1 in the brown adipose tissue of Ptn-/- mice were higher than in wild-type controls. Finally, supplementing brown pre-adipocytes with pleiotrophin decreased the expression of the brown adipocyte markers Cidea (20% reduction), Prdm16 (21% reduction), and Pgc1-α (also known as Ppargc1a, 11% reduction). Our results reveal for the first time that pleiotrophin is a key player in preserving insulin sensitivity, driving the dynamics of adipose tissue lipid turnover and plasticity, and regulating energy metabolism and thermogenesis. These findings open therapeutic avenues for the treatment of metabolic disorders by targeting pleiotrophin in the crosstalk between white and brown adipose tissue.

A systematic review and meta-analysis of interval training versus moderate-intensity continuous training on body adiposity.

Interval training (including high-intensity interval training [HIIT] and sprint interval training [SIT]) is promoted in both scientific and lay media as being a superior and time-efficient method for fat loss compared with traditional moderate-intensity continuous training (MICT). We evaluated the efficacy of HIIT/SIT when directly compared with MICT for the modulation of body adiposity. Databases were searched to 31 August 2016 for studies with exercise training interventions with minimum 4-week duration. Meta-analyses were conducted for within-group and between-group comparisons for total body fat percentage (%) and fat mass (kg). To investigate heterogeneity, we conducted sensitivity and meta-regression analyses. Of the 6,074 studies netted, 31 were included. Within-group analyses demonstrated reductions in total body fat (%) (HIIT/SIT: -1.26 [95% CI: -1.80; -0.72] and MICT: -1.48 [95% CI: -1.89; -1.06]) and fat mass (kg) (HIIT/SIT: -1.38 [95% CI: -1.99; -0.77] and MICT: -0.91 [95% CI: -1.45; -0.37]). There were no differences between HIIT/SIT and MICT for any body fat outcome. Analyses comparing MICT with HIIT/SIT protocols of lower time commitment and/or energy expenditure tended to favour MICT for total body fat reduction (p=0.09). HIIT/SIT appears to provide similar benefits to MICT for body fat reduction, although not necessarily in a more time-efficient manner. However, neither short-term HIIT/SIT nor MICT produced clinically meaningful reductions in body fat.

Obesity and Metabolic Syndrome in Adults with Prader-Willi Syndrome

Body fat distribution in patients with Prader-Willi syndrome (PWS) is characterized by reduce lean body mass (LBM), increased total body fat mass (FM), and lower percentage of visceral adipose tissue (VAT). Individuals with PWS seem to have a lower risk for insulin resistance with high levels of adiponectin, an anti-atherogenic adipocytokine that is decreased in visceral fat hypertrophy subjects compared to simple obese subjects, both in children and in adults. The mechanism of the reduction in visceral adiposity in PWS is still unclear. It might be related to qualitative intrinsic characteristics of adipocyte or novel genetic influences on the control of fat distribution. However, obesity remains a critical problem, and obesity status plays a crucial role in individual metabolic risk clustering and development of metabolic syndrome (Mets) in PWS children and adults. Long-term growth hormone (GH) treatment after cessation of skeletal growth improved body composition, with an increase in lean body mass and a reduction in total body fat and subcutaneous and visceral fat in PWS adults. Thus, the role of GH is important after childhood because it might attenuate obesity and Mets in PWS adult by adipocyte modification.