Significant Reduction In BMI Research Articles

Tertiary level management of overweight and obese children and adolescents—Does intensive dietetic intervention using a moderate protein intake have a positive impact on weight control in children?

Aims: To review weight loss outcomes (change in BMI z score) in a tertiary (dietetic) clinical practice, to determine if number of appointments or time between appointments is associated with outcome, to determine gender or age differences in outcome, to determine correlation between level of obesity and attrition rate and to review clinical practice dependent upon outcome. Methods: A retrospective audit with analysis of patient data collected June 2005—September 2009. Data included: Anthropometry, biochemistry, comorbidities and referral source on 210 patients (52% females). Patients attended for assessment and education on a structured moderate-protein diet. Reviews are scheduled monthly for up to 5 visits. Results: Significant reduction in BMI z score for boys at all appointments (p < 0.001). Significant reduction in BMI z score for girls by the fifth appointment (p = 0.036). Significant reduction in pre-adolescent BMI z scores at all appointments (p < 0.001). High attrition rate (50%) after the first appointment but 20% still returning for the fifth appointment. Changes in BMI z score ranging from −0.28 to −0.13. No correlation between changes in BMI z score and duration or number of clinic appointments. Conclusions: Tertiary level dietary treatment of childhood obesity using a structured moderate protein intake and regular reviews has a positive influence on childhood obesity. These findings will assist in service improvement and development of best practice guidelines for treatment of childhood obesity in a tertiary clinic setting. Funding source: None.

Effect of 3-Month Yoga on Oxidative Stress in Type 2 Diabetes With or Without Complications

OBJECTIVETo assess the effect of yoga on anthropometry, blood pressure, glycemic control, and oxidative stress in type 2 diabetic patients on standard care in comparison with standard care alone.RESEARCH DESIGN AND METHODSThe study involved 123 patients stratified according to groups with microvascular complications, macrovascular complications, and peripheral neuropathy and without complications and assigned to receive either standard care or standard care along with additional yoga for 3 months.RESULTSIn comparison with standard care alone, yoga resulted in significant reduction in BMI, glycemic control, and malondialdehyde and increase in glutathione and vitamin C. There were no differences in waist circumference, waist-to-hip ratio, blood pressure, vitamin E, or superoxide dismutase in the yoga group at follow-up.CONCLUSIONSYoga can be used as an effective therapy in reducing oxidative stress in type 2 diabetes. Yoga in addition to standard care helps reduce BMI and improve glycemic control in type 2 diabetic patients.

Effect of a 2-Month Program of Antioxidants-Micronutrient-Rich Diet on Concentrations of Lead, Cadmium and Aluminum in Obese Egyptian Children

Background: It is conceivable that toxic metals contribute to obesity by influencing various aspects of metabolism. On the same time, antioxidant micro nutrient rich diet can be a major factor in chelating heavy metals. Objective: Evaluate the effects of a 2-month program of a balanced low-caloric diet rich in antioxidants and micronutrients on the level of lead, cadmium and aluminum in obese children. Material and Methods: 65 children (11 to 14 years) with simple obesity (BMI > the 95th percentile) were selected in this study. Children were put on a balanced diet regimen high in antioxidants and micro nutrients with low calories (1500 cal/day) for 2 months. Levels of lead, cadmium and aluminum in 24- hour urine collected were measured before and after the intervention using atomic absorption spectrometry. Results: Comparing before and after dietary intervention program, significant reduction was observed only in case of urinary lead and cadmium with P < 0.001. In addition to significant weight loss and reduction of BMI (kg/m 2 ) from 29.1 to 27 with P<0.05. Conlusion: Diet rich in antioxidants and micro nutrients could reduce the toxic effects of heavy metals in obese children and thus facilitate control of obesity.

The effectiveness of a non-pharmacological intervention for weight gain management in severe mental disorders: results from a national multicentric study

To evaluate the effectiveness of a non-pharmacological intervention for weight gain management in severe mental disorders. An open, multicentre interventional study was conducted in 93 mental health services. Patients concerned with weight gain were included in this study and received a 12-week 1-hour group intervention focused on nutrition counseling, lifestyle, physical activity and self-esteem. Weight, waist circumference and blood pressure were measured before and after the intervention. 1,071 patients were enrolled in the study, and 73.9% completed the 12-week intervention. Significant weight loss (Mean difference: 0.41, CI 95%: 0.18 to 0.64, p = 0.001) and a significant BMI reduction (Mean difference: 0.13, CI 95%: 0.04 to 0.22, p = 0.006) were observed. During the intervention 37 (4.4%) patients lost > 7% of their initial weight, 780 (92.5%) maintained their weight, and 26 (3.1%) of the patients had a meaningful weight gain (> 7%). There was a significant increase in the proportion of patients undertaking physical activity after the intervention (70.8%, p < 0.001). In this 3-month open study we found a small weight and waist reduction, and increased physical activity practice, suggesting a trend towards anthropometric profile improvement. However, further randomized-controlled trials are necessary to evaluate the efficacy and clinical relevance of this psychosocial intervention for weight gain.

Therapie der Adipositas aus sozialpädiatrischer, ernährungstherapeutischer und gesundheitswissenschaftlicher Sicht

The prevalence of obesity and associated comorbidities among children and adolescents has risen worldwide throughout the past 3 decades. To break this trend, population-based activities in health promotion/prevention and health care are necessary. Studies showed that long-term eating behavior improvement with the cooperation of the patient's family together with child-friendly organization support both individual therapeutic improvements as well as a relevant reduction of obesity prevalence. A significant BMI reduction can be achieved with a normal varied diet, whose energetic value is 300-400 kcal/day below the patient's daily energetic needs, due to the lower consumption of fat and sugar. This requires, however, that the entire family be willing to change their unhealthy eating behaviors (e.g., soft drinks and fast food) and to introduce regular meals into their daily routine. Sensibly, most therapies combine diet therapy with increased physical activity and parental training. Controlled media consumption, active leisure-time behavior, and a structured daily routine are further conditions for successful weight reduction. The high-risk groups for pediatric obesity, i.e., families with migration background and/or low socioeconomic status, have been poorly reached by established programs.

Bariatrische Chirurgie bei extremer Adipositas im Kindes- und Jugendalter

The management of childhood obesity is a clinical dilemma. Validated and evidence-based intervention programs are still missing for this age group, and pediatricians increasingly see children with morbid obesity and with obesity-related comorbidities. For those extremely obese patients who failed to respond to the classical therapeutic approaches, bariatric surgery is a therapeutic option. Although available data for bariatric surgery in childhood and adolescence is limited to date, significant postoperative reduction in BMI and an evident improvement of preoperatively existing metabolic and cardiovascular comorbidities and psychosocial well-being have been reported. The indication for bariatric surgery in adolescents follows strict criteria and should be proposed within an interdisciplinary team in specialized centers, including a clinical ethics committee. This review discusses the present guidelines for bariatric surgery in childhood and adolescence as well as available follow-up data for both adults and pediatric patients.

Effects of bariatric surgery on Type-2 Diabetes Mellitus in a Caribbean setting

Objectives To determine if there is a beneficial effect of bariatric surgery in the management of Diabetes Mellitus in obese patients in a Caribbean setting. Methods A retrospective review of charts of all obese patients with Type-2 Diabetes Mellitus (DM) who had undergone Laparoscopic Roux en Y gastric bypass (LRYGBP) over a 4 year period was undertaken and clinical data recorded. A questionnaire was prospectively administered via telephone to determine the quality of life. Results Of 146 patients who underwent LRYGBP, 40 were found to have clinically significant DM. Patients of age < 50 years and females had a higher preponderance of DM. Patient body weight decreased significantly from a pre-operative131.2 ± 21.6 [Mean ± Standard Deviation (SD)] to 99.4 ± 16.6 after surgery ( p < 0.0001). There was also a significant reduction of BMI from 47.0 ± 7.9 to 34.7 ± 5.8 ( p < 0.0001). There was complete resolution of clinically significant DM in 85% of patients, while in 15% there was a significant reduction in the dosage of anti-diabetic medications. Perioperative complications were minimal and there was no mortality. 96% of the patients reported a drastic improvement in their quality of life. Conclusions Bariatric surgery for obese diabetic patients resulted in complete resolution, improved diabetes control and overall improvement in the quality of life. Due to better outcomes, the surgery can safely be recommended in the Caribbean multiethnic setting where there is a high prevalence of obesity and Diabetes Mellitus.

A 10-month physical activity intervention improves body composition in young black boys.

Objective. To determine if a 10-month after-school physical activity (PA) intervention could prevent deleterious changes in body composition and cardiovascular (CV) fitness in young black boys. Methods. Following baseline measures, 106 boys (8–12 yrs) were randomized to either a control group or an intervention group, further divided into attenders (ATT) and nonattenders (NATT), participating in ≥60% or <60% of the intervention, respectively. The daily intervention consisted of skills development (25 min), vigorous PA (VPA, 35 min), and strengthening/stretching (20 min) components. Body composition was measured by dual-energy X-ray absorptiometry. Results. Following the intervention, the ATT exhibited an increase in moderate-to-vigorous PA and a significant reduction in BMI, fat mass, and %BF compared to the control group. A significant association among the intervention energy expenditure and changes in body composition and CV fitness was observed only in the ATT group. Conclusion. An after-school PA program of sufficient length and intensity can promote healthy changes in body composition and fitness levels in black boys who attend at least 3 days/week.

Randomised clinical trial of a family-based lifestyle intervention for childhood obesity involving parents as the exclusive agents of change

Parent-centred interventions for childhood obesity aim to improve parents’ skills and confidence in managing children’s dietary and activity patterns, and in promoting a healthy lifestyle in their family. However, few studies assess changes in parenting over the course of treatment. This study describes the evaluation of a lifestyle-specific parenting program (Group Lifestyle Triple P) on multiple child and parent outcomes. One-hundred-and-one families with overweight and obese 4- to 11-year-old children participated in an intervention or waitlist control condition. The 12-week intervention was associated with significant reductions in child BMI z score and weight-related problem behaviour. At the end of the intervention, parents reported increased confidence in managing children’s weight-related behaviour, and less frequent use of inconsistent or coercive parenting practices. All short-term intervention effects were maintained at one-year follow-up assessment, with additional improvements in child body size. The results support the efficacy of Group Lifestyle Triple P and suggest that parenting influences treatment outcomes. Further research is needed to evaluate the long-term effectiveness of the intervention and to elucidate the mechanisms of change.

Using Pedometers in an Active Scripting Program for Low-Active Older Adults: Healthy Steps Study

Participation in physical activity (PA) is an important determinant of healthy ageing. The New Zealand Green Prescription (GRx) is an efficacious and cost-effective primary care program to improve activity levels through PA prescription and follow-up telephone counselling. PURPOSE: To investigate (with an RCT) the effectiveness of a pedometer-enhanced GRx (compared to a standard GRx) in improving PA, blood pressure, BMI, health-related quality of life, and a range of functional tests in older adults. METHODS: Participants were 330 low-active older adults (mean age 74±6 yrs) recruited through primary care settings. The Auckland Heart Study Physical Activity Questionnaire and SF-36 were administered at baseline to the intervention (pedometer GRx) and control (standard GRx) groups. Blood pressure, height, and weight were also assessed. Participants in the intervention group were given a pedometer and received 3 telephone counselling sessions over 3 months based on accumulating steps to increase PA. Those in the control group also received 3 telephone counselling sessions over 3 months, however, based around increasing PA without a specific focus on accumulating steps. All outcome measures were readministered at 3 months (end of intervention) and 12 months. RESULTS: At 12 months both groups significantly increased their moderate to vigorous PA (p<0.0001), walking for leisure (p<0.0001), and total walking (p<0.0001), with no significant differences between groups. Both groups also showed significant reductions in blood pressure (p<0.0001) and BMI (p=0.004) with no group x time significant effects. Number to treat analysis indicated that to achieve an increase of 60 min of moderate to vigorous PA in 1 person, 2.5 people would need to be treated with the pedometer GRx compared with 3.0 people for the standard GRx. Similarly, to achieve a reduction of 5mmHg in systolic blood pressure, 4.2 people would need to be treated with the pedometer GRx compared with 5.6 for the standard GRx. CONCLUSIONS: Findings from this trial indicate the effectiveness of both GRx interventions in increasing PA and reducing blood pressure and BMI with some differential effects of interventions using the number needed to treat procedure. Supported by Health Research Council of New Zealand Grant 05/279 and Sport and Recreation New Zealand.

Treatment of Obese Adolescents: The Influence of Periodization Models and ACE Genotype

The aims of the present study were to compare the effects of two periodization models on metabolic syndrome risk factors in obese adolescents and verify whether the angiotensin-converting enzyme (ACE) genotype is important in establishing these effects. A total of 32 postpuberty obese adolescents were submitted to aerobic training (AT) and resistance training (RT) for 14 weeks. The subjects were divided into linear periodization (LP, n = 16) or daily undulating periodization (DUP, n = 16). Body composition, visceral and subcutaneous fat, glycemia, insulinemia, homeostasis model assessment of insulin resistance (HOMA-IR), lipid profiles, blood pressure, maximal oxygen consumption (VO(2max)), resting metabolic rate (RMR), muscular endurance were analyzed at baseline and after intervention. Both groups demonstrated a significant reduction in body mass, BMI, body fat, visceral and subcutaneous fat, total and low-density lipoprotein cholesterol, blood pressure and an increase in fat-free mass, VO(2max), and muscular endurance. However, only DUP promoted a reduction in insulin concentrations and HOMA-IR. It is important to emphasize that there was no statics difference between LP and DUP groups; however, it appears that there may be bigger changes in the DUP than LP group in some of the metabolic syndrome risk factors in obese adolescents with regard to the effect size (ES). Both periodization models presented a large effect on muscular endurance. Despite the limitation of sample size, our results suggested that the ACE genotype may influence the functional and metabolic characteristics of obese adolescents and may be considered in the future strategies for massive obesity control.

Intentional Weight Loss in Overweight and Obese Patients With Severe Mental Illness

Obesity is 2 to 3 times more common among people with severe mental illness and has adverse effects on physical and psychological health. We report the experience from the first 8 years of a self-referring weight management clinic. From 2000 to 2008, 113 patients with severe mental illness (according to ICD-10 criteria) with a mean +/- SE age of 43.8 +/- 1.7 years (range, 22-71 years) referred themselves to this clinic. The patients were seen in weekly group sessions lasting 1 hour that involved weight measurement, discussion, and education. The response to the program was assessed by the paired Student t test and linear analysis corrected for repeated measures. Mean +/- SE baseline weight was 90.1 +/- 1.6 kg (body mass index [BMI] = 32.2 +/- 0.5 kg/m(2)). Fifty subjects of the 142 total patient episodes (35%) dropped out within the first 3 months. Sixty-four subjects completed 1 year of the program, and 35 have attended for 2 years or longer. There were progressive statistically significant reductions in mean weight and BMI throughout the duration of monitoring, with no suggestion of a plateau. The mean +/- SE final weight loss was 7.2 +/- 0.6 kg. Weight loss was correlated only with the number of sessions attended (r = 0.42, P < .0001). Lifestyle advice within a group setting may be effective in long-term management of obese and overweight patients with severe mental illness.

The Consumption of Food Products from Linseed‐Fed Animals Maintains Erythrocyte Omega‐3 Fatty Acids in Obese Humans

Based on mechanistic and epidemiological data, we raise the question of the relationship between qualitative dietary polyunsaturated fatty acids (PUFA) changes and increase in obesity. In this double-blind trial, we studied the effects on 160 overweight volunteers (body mass index, BMI >30) of a 90 days experimental diet rich principally in animal fat with a low PUFA/saturated fatty acid (SFA) ratio but a low n-6/n-3 ratio, using animal products obtained from linseed-fed animals. The control diet provided less animal fat, a higher PUFA/SFA ratio and a higher n-6/n-3 ratio. Both diets excluded seafood. In the experimental group, we observed a significant increase in red blood cell (RBC) alpha-linolenic acid content and a slight increase in EPA and DHA derivatives, while in the control group we observed a significant reduction in EPA and DHA content. Between groups now, the difference in the three n-3 fatty acids changes in RBC was significant. This demonstrates that plasma EPA and DHA levels can be maintained without fish if products from linseed-fed animals are used. During the diets, we noted a significant reduction in weight, BMI and hip circumference within both groups of volunteers. However, no significant difference was observed between the control group and the experimental group. Interestingly, 150 days after the end of the trial (i.e., day 240), we noted a significant weight gain in the control group, whereas no significant weight gain was observed in the experimental group. This was also observed for the BMI and hip circumference. Moreover, significant differences in BMI (P < 0.05) and weight (P = 0.05) appeared between the two groups, showing in both cases a smaller increase in the experimental group. During the 90 days trial, we did not observe any differences between groups in terms of total cholesterol, HDL cholesterol, LDL cholesterol or triglycerides, suggesting that the saturate content and the P/S ratio are not as important as the n-6 and n-3 fatty acid composition.

Investigation of the effect of high dairy diet on body mass index and body fat in overweight and obese children

To investigate whether an increase in dairy food consumption improves the changes in BMI and adiposity in children on an energy restricted diet. Overweight and obese children (n = 120, age: 12-18 y, BMI: 27-40 kg/m2) were randomized to receive a calorie restricted diet providing a 500 kcal/d deficit from total energy expenditure and two (n = 40), three (n = 40) or four (n = 40) servings of dairy products/day. Anthropometric measurements in addition to serum hs-CRP and lipid profile were measured at baseline and after 12 weeks. Among the 96 children who completed the study, significant reductions in overall BMI, BMI z-score, weight, total body fat percentage and total body fat mass were observed (p < 0.001) but these reductions were not significantly affected by increasing dairy intake (p > 0.05). Overall waist/hip ratio, Serum vitamin D and lipid profile did not change significantly (p > 0.05) apart from a significant increase in HDL-cholesterol (p < 0.001) which was independent of dairy intake (p > 0.05). Increased intake of dairy products does not lead to an augmented change in BMI, weight and body fat in overweight and obese children beyond what is achieved by calorie restriction.

Study of the effects of transoral gastroplasty on insulin sensitivity and secretion in obese subjects

Background and aims Transoral gastroplasty (TOGA) recently emerged as a new, feasible and relatively safe technique for the surgical treatment of obesity. However, so far there are no data on the effects on insulin sensitivity in the literature. Our aim is to evaluate the effect of TOGA on insulin sensitivity and secretion. Methods and results Nine glucose normo-tolerant obese subjects (age:41 ± 6 years; BMI:42.49 ± 1.03 kg/m 2) were studied. Fat-free mass (FM) and fat mass (FM) were assessed by bioelectrical impedance; plasma glucose, insulin, and C-peptide were measured during an oral glucose tolerance test (OGTT) before and 3 months after the operation. Insulin sensitivity was calculated using the oral-glucose insulin-sensitivity index, and insulin secretion by C-peptide deconvolution. Three months after surgery, a significant ( P = 0.008) reduction of BMI to 35.65 ± 0.65 kg/m 2, with a decrease of FM and FFM from 57.22 ± 2.19 to 41.46 ± 3.02 kg ( P = 0.008) and from 59.52 ± 1.36 to 56.67 ± 1.10 kg ( P = 0.048) respectively, was observed. Insulinemia was significantly reduced at fast and at 120 min after OGTT; in contrast, no significant change in glucose concentration was observed. Insulin sensitivity significantly increased (348.45 ± 20.08 vs. 421.18 ± 20.84 ml/min/m 2, P = 0.038) and the incremental area of insulin secretion rate (total ISR) significantly decreased (from 235.05 ± 27.50 to 124.77 ± 14.50 nmol/min/m 2, P = 0.021). Total ISR correlated with weight, BMI and FM ( r = 0.522, P = 0.028; r = 0.541, P = 0.020; r = 0.463, P = 0.049, respectively). BMI represented the most powerful predictor of ISR decrease ( R 2 = 0.541, P = 0.020). Conclusion Transoral gastroplasty allows a significant weight loss 3 months after the intervention as well as an amelioration of insulin sensitivity with subsequent reduction of the insulin secretion.

Association between functional FABP2 promoter haplotypes and body mass index: Analyses of 8072 participants of the KORA cohort study

Studies in relatively small cohorts provide preliminary evidence that functional fatty acid binding protein 2 (FABP2) promoter haplotypes are associated with type 2 diabetes and BMI. Here, we studied the influence of the haplotypes on BMI by using 8072 male and female participants of the Kooperative Gesundheitsforschung in der Region Augsburg (KORA) cohort. By linear regression analysis, we found in males a reduction of -0.39 BMI units (95% CI: -0.73, -0.05, p = 0.024) in homozygous FABP2 promoter haplotype B carriers. Carriers of haplotype B showed a significant decrease in BMI of -0.19 BMI units (95% CI: -0.35, -0.02, p = 0.027). In accordance, a significant reduction in BMI of the minor haplotype carriers in the BMI point categories of 25-30 (BMI units: -0.10, 95% CI: -0.18, -0.01, p = 0.03) and < 30 (BMI units: -0.37, 95% CI: -0.67, -0.07, p = 0.02) were found. In summary, the minor FABP2 promoter haplotype B contributes to a reduced BMI in men. This provides evidence that functional FABP2 contributes to multifactorialy regulated body weight.

Effects Of Exercise And Diet On Nitric Oxide And Endothelin-1 Levels In Impaired Glucose Tolerance

Impaired glucose tolerance forms an intermediate stage in the natural history of diabetes mellitus. These individuals with impaired glucose tolerance (IGT) have a significant risk of developing diabetes and thus are an important target group for primary prevention. On the other hand, it is generally accepted that prolonged physical exercise increases insulin sensitivity and might be useful in the prevention of type 2 diabetes. PURPOSE: To determine the effects of chronic exercise and low-calorie diet on plasma NO and ET-1 levels in individuals with impaired glucose tolerance (IGT), and to elucidate the relationship between the oxidant stress markers and NO/ET-1 levels in the plasma before and following exercise episodes. METHODS: Individuals with IGT (n=14) participated in a regular exercise program starting at an intensity corresponding to 35% of the heart rate reserve of the individual and exercised for 40 minutes each day 3 days a week for 12 weeks. Physiological, anthropometric and biochemical measurements were done before, on the 6th week and at the end of the program. RESULTS: There was a significant reduction in BMI, body fat content, systolic and diastolic blood pressures as well as NO and ET-1 concentrations following 12 weeks of exercise and diet program. Exercise training significantly elevated subjects' maximum oxygen consumption whereas resting metabolic rates of the individuals did not change. Formation of TBARS in the plasma, which is an indicator of lipid peroxidation, was significantly reduced, while sulfhydryl (RSH) groups were significantly increased on the 6th weeks (p<0.05) and at the end of program (p<0.01). CONCLUSION: Our results demonstrate that exercise along with low-calorie diet, induced reductions in the plasma of both ET-1 and NO. Furthermore, upon completion of the program, beneficial effects were observed on anthropometrical measurements and plasma oxidant stress markers, indicating weight loss associated with exercise training and calorie restriction may effectively improve endothelial dysfunction in individuals with impaired glucose tolerance.

A Statewide Intervention Reduces BMI in Adults: Shape Up Rhode Island Results

Given the epidemic of obesity, approaches to weight loss that can be applied on a community, state, or national level are needed. We report results from Shape Up Rhode Island 2007 (SURI), a statewide Internet-based program involving team-based competition to increase physical activity and achieve weight loss. A total of 4,717 adults (84% women; mean BMI = 29.6 kg/m(2)) enrolled in the 16-week weight loss competition of SURI and 3,311 completed at least 12 weeks. Completers reported losing 3.2 +/- 3.4 kg, and 30% achieved a clinically significant weight loss of >or=5%. Although modest, these weight losses shifted the BMI distribution from a mean BMI of 29.4 to a mean of 28.2 kg/m(2) and reduced the population that was obese from 39 to 31%. More conservative intent-to-treat analyses and analysis of 132 participants with objective weights still showed a significant reduction in BMI of -0.8 units. These findings suggest that statewide weight loss campaigns can produce modest weight losses in large numbers of participants. These data provide a benchmark that can be used for comparisons with other statewide campaigns. Research on ways to improve such campaigns is needed.

Aerobic Exercise, Estrogens, and Breast Cancer Risk in Pre-Menopausal Women

PURPOSE: Currently known risk factors for breast cancer are difficult to control and modify and therefore, there is a need to identify alternative risk factors that are more suitable for intervention, especially among young women. The WISER study, Women in Steady Exercise Research, and the pilot study that proceded it investigate the effect of aerobic exercise on sex hormone levels in healthy premenopausal women. METHODS: The WISER study is a randomized, exercise-controlled clinical trial that is randomizing 320 sedentary, healthy (BMI 18-40kg/m2), eumenorrheic, premenopausal women aged 18 to 30 years old into an exercise or no-exercise control group. Intervention subjects exercise aerobically for 30 minutes, 5 times a week during 4 menstrual cycles in which the workout intensity increases every four weeks by 5% of their age-predicted maximal heart rate until it reaches 80%-85%. The effect of aerobic exercise on blood sex hormones, urinary estrogen metabolites, menstrual cycle characteristics, ovulation status, measures of fitness (time to 85% max heart rate, MET-h/week), and body composition are being measured at baseline and follow-up. The study design for the completed pilot study in 15 women was identical, except for the lack of a comparison group. RESULTS: In the WISER pilot study, after 15 weeks of aerobic exercise, there were significant reductions in body weight (-1.7 %, p <0.007), BMI (-2.4%, p< 0.01), and fat mass (-6.5%, p<0.04). In contrast, a significant 10.6% increase in submaximal fitnesss (p< 0.004) was attained through the intervention. No significant changes in endogenous estrogens were observed, though the pattern of changes was consistent with a reduction of cancer risk. Levels of estrone, 16-α-hydroxyestrone, estriol, 4-hydroxyestrogens, and the ratio of 2-to-4 hydroxyestrogens were reduced while that of 2-hydroxyestrogens and the ratio of 2-to-16-α-hydroxyestrone increased. CONCLUSIONS: Results from the pilot study showed that aerobic exercise training at the dose currently recommended for health promotion and disease prevention results in significant reductions in body fat in young eumennorheic women. Changes in estrogens were in the expected direction, though not significant. The larger, ongoing WISER trial was designed to further investigate the effects of aerobic exercise training on endogenous sex hormones and other breast cancer biomarkers. The WISER study will contribute to a better understanding of the effect of aerobic exercise on the hormonal and physiological profiles of healthy, sedentary, young women and help determine the efficacy of such an intervention on breast cancer risk prevention.

Effect of Advice to Increase Carbohydrate and Reduce Fat Intake on Dietary Profile and Plasma Lipid Concentrations in Healthy Postmenopausal Women

Background: The current dietary guidelines advise an increase in carbohydrate intake. However, there is concern regarding the effect this may have on coronary heart disease (CHD) risk, in particular in postmenopausal women, in light of the knowledge that raised triacylglycerol (TAG) may pose a stronger risk for CHD in this group. Aim: To evaluate the effect of advice to increase carbohydrate intake to 50% of energy intake as part of advice to follow current dietary guidelines on the dietary profile, including dietary glycaemic index (GI) and plasma lipids in healthy postmenopausal women. Methods: Twelve healthy postmenopausal women (56 ± 6.5 years) took part in the study. Habitual diet was assessed by a 7-day weighed intake. On the basis of the results, subjects were advised to increase their carbohydrate intake to comply with the current dietary guidelines. Subjects were asked to follow this diet for 4 weeks, in a free-living situation. Fasting blood samples were obtained at baseline and after 1 and 4 weeks. Results: There was a significant decrease in body mass index (BMI; p < 0.05) after 4 weeks. There was a significant increase in fasting TAG concentrations after 1 week (p < 0.05), and the high-density lipoprotein (HDL) cholesterol concentration was significantly decreased (p < 0.05) after 1 and 4 weeks. The subjects significantly increased their percentage of energy from carbohydrates and starch (p < 0.05 and p < 0.01, respectively) after 1 week, and their percentage of energy from starch after 4 weeks (p < 0.05). Dietary GI was significantly increased (p < 0.05) after 1 and 4 weeks. Fruit and vegetable intake was significantly increased after 1 week (p < 0.01), as was fruit intake alone (p < 0.05), and there was a significant increase (p < 0.05) in the ‘antioxidant power’ as measured by the ferric reducing ability of plasma assay. Conclusion: In postmenopausal women, following the UK dietary guidelines resulted in changes in the lipid profile that were more likely to favour an increased risk of CHD, as TAG concentrations were increased and HDL cholesterol concentrations were reduced. However, in addition, we found a significant reduction in BMI and a significant increase in the ‘antioxidant power’ of plasma, which should benefit health.