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9) kg, corresponding to 13. Effect of a Stepped-Care Intervention Approach on Weight Loss in Adults. Cortisol clearance and associations with insulin sensitivity, body fat and fatty liver in middle-aged men. 6% (95% CI, 30. We followed the intention-to-treat principle, ascribing the assigned diet to each measure regardless of adherence. An alternative explanation is that weight loss elicits biological adaptations—specifically a decline in energy expenditure (adaptive thermogenesis) and an increase in hunger—that promote weight regain. Low-dose leptin reverses skeletal muscle, autonomic, and neuroendocrine adaptations to maintenance of reduced weight. Effects of experimental weight perturbation on skeletal muscle work efficiency, fuel utilization, and biochemistry in human subjects. Connected lines indicate individual outcomes for each participant. Effects of Dietary Composition on Energy Expenditure During Weight-Loss Maintenance. 1%-33. Percentage body fat by dual-energy x-ray absorptiometry decreased from a mean of 33. Weight regain after a diet-induced loss is predicted by higher baseline leptin and lower ghrelin plasma levels. The institutional review boards at all participating institutions approved the study protocol, and participants provided written informed consent. Cortisol is negatively associated with insulin sensitivity in overweight Latino youth. Supplemental Content Ebbeling CB, Swain JF, Feldman HA, et al. To avoid bias, we formulated menus with healthful components inherent to typical prescriptions for respective diets. One variable with extreme skew (CRP) was rank transformed for analysis. Primary outcome was resting energy expenditure (REE), with secondary outcomes of total energy expenditure (TEE), hormone levels, and metabolic syndrome components. We assessed body composition by dual-energy x-ray absorptiometry before and after weight loss. Variables with skewed distribution were log-transformed for analysis. 3 (0. The results of our study challenge the notion that a calorie is a calorie from a metabolic perspective. Comparison of weight-loss diets with different compositions of fat, protein, and carbohydrates. We measured study outcomes during an inpatient hospital admission and under free-living conditions at baseline and the end of each test diet period. Methodological detail can be found in the eMethods. 2%) at baseline to 29. Weight management through lifestyle modification for the prevention and management of type 2 diabetes: rationale and strategies: a statement of the American Diabetes Association, the North American Association for the Study of Obesity, and the American Society for Clinical Nutrition. 5% decrease in body weight, and established energy requirements for stabilizing weight at the reduced level. Many people can lose weight for a few months, but most have difficulty maintaining clinically significant weight loss over the long term. Several recent clinical trials indicate a direct relationship between dietary adherence and weight loss, regardless of dietary treatment group assignment. Effects of weight loss and leptin on skeletal muscle in human subjects. Long-term persistence of hormonal adaptations to weight loss. Ebbeling CB, Swain JF, Feldman HA, Wong WW, Hachey DL, Garcia-Lago E, Ludwig DS. Regarding components of the metabolic syndrome, indexes of peripheral ( P. Dietary macronutrient content alters cortisol metabolism independently of body weight changes in obese men. Dr Jakicic and coauthors compared a stepped-care weight loss intervention with a standard behavioral weight loss intervention to determine which one would result in greater weight loss and cost savings. 6% of baseline body weight. 5 -. Effects of weight loss and long-term weight maintenance with diets varying in protein and glycemic index on cardiovascular risk factors: the diet, obesity, and genes (DiOGenes) study: a randomized, controlled trial. A low-glycemic index diet and exercise intervention reduces TNF(alpha) in isolated mononuclear cells of older, obese adults. Stable isotope analysis for assessing total energy expenditure (TEE) was conducted at Baylor College of Medicine, Houston, Texas. Glycemic index of foods: a physiological basis for carbohydrate exchange.
Reduced energy expenditure following weight loss is thought to contribute to weight gain. Assessments during inpatient hospital admissions and under free-living conditions occurred during the weight monitoring period and at the end of each test diet period. We enrolled 32 participants, including 17 men and 15 women. Data are shown as mean (95% CI) unless otherwise noted. The physiological basis for the differences in REE and TEE remains subject to speculation. In view of the mechanistic nature of this study, relying on a feeding protocol, we did not design the diets for long-term practicality. To examine the effects of 3 diets differing widely in macronutrient composition and glycemic load on energy expenditure following weight loss. Participants included men and women aged 18 to 40 years with a body mass index (calculated as weight in kilograms divided by height in meters squared) of 27 or higher. 1%) after weight loss. Dietary Reference Intakes for Energy, Carbohydrate, Fiber, Fat, Fatty Acids, Cholesterol, Protein, and Amino Acids. 0%-37. The study comprised run-in and test phases ( Figure 1 ). The very low-carbohydrate diet was modeled on the Atkins Diet and had a low glycemic load due to more severe restriction of carbohydrate. During the run-in phase, participants lost a mean (SD) of 14. Effects of experimental weight perturbation on skeletal muscle work efficiency in human subjects. 21 As missing values were uncommon (typically 1 per outcome), we did not perform any imputation, relying on the unbiasedness of mixed-effects regression when data are missing at random. Effect of a Stepped-Care Intervention Approach on Weight Loss in Adults. Our goal was to design test diets that (1) would encompass a broad range of macronutrient composition and glycemic load, (2) have been commonly recommended for obesity treatment, and (3) could be physiologically sustainable for long periods. Baseline characteristics for the 21 participants who completed the study are shown in Table 2. Study Design of the Run-in and Test Phases View Large Download Body composition was assessed during the weight monitoring period of the run-in phase and following weight loss. 20. During the run-in phase, we obtained baseline data for study outcomes, restricted energy intake of participants to achieve a 12. Noncompleters did not differ from completers with respect to any of these characteristics. Weight and metabolic outcomes after 2 years on a low-carbohydrate versus low-fat diet: a randomized trial. Table 1 shows the composition of the run-in and test diets. 1% (95% CI, 25. Long-term weight loss maintenance in the United States. Immediately before the 3-day inpatient hospital admission, the assessments under free-living conditions were conducted over 14 (total energy expenditure) or 7 (physical activity) days. Energy expenditure during weight-loss maintenance differed significantly among the 3 diets ( Table 3 and Figure 3 ). 22 We used SAS version 9. Composition of the Run-in and Test Diets During Weight-Loss Maintenance (per 2000 kcal) View Large Download Table 2. Phenotypic and genetic variation in leptin as determinants of weight regain. We applied an outlier-deletion algorithm with optimal properties, equivalent to robust regression. However, the effect of dietary composition on energy expenditure during weight-loss maintenance has not been studied. Obesity treatment should emphasize behavioral methods to foster and maintain decreased energy intake. Meal-induced thermogenesis and macronutrient oxidation in lean and obese women after consumption of carbohydrate-rich and fat-rich meals. 3, 4. Baseline Characteristics of the Study Participants a View Large Download Table 3. In an accompanying 7263, Dr Bray discusses diet and exercise for weight loss. Of these, 11 participants did not complete the study ( Figure 2 ). 2 (SAS Institute Inc) for all computations. Gi index diet images index video:
