Effect of Different Obesity Phenotypes on Incidence of Chronic Kidney Disease in Tehranian Adults Eating behavior in humans, characterized by cumulative food intake curves—a review Effects of aerobic exercise and obesity phenotype on abdominal fat reduction in response to weight loss The effect of the plasma n-3/n-6 polyunsaturated fatty acid ratio on the dietary LDL phenotype transformation - insights from the LIPGENE study. Daily physical activity and macronutrient distribution of low-calorie diets jointly affect body fat reduction in obese women. The effect of weight management interventions that include a diet component on weight‐related outcomes in pregnant and postpartum women: a systematic review protocol Shifting to a control diet after a high-fat, high-sucrose diet intake induces epigenetic changes in retroperitoneal adipocytes of Wistar rats Size acceptance and intuitive eating improve health for obese, female chronic dieters. Whole-body vibration training in obese subjects: A systematic review Effect of weight loss on sympatho-vagal balance in subjects with grade-3 obesity: restrictive surgery versus hypocaloric diet Substantial changes in epicardial fat thickness after weight loss in severely obese subjects. The effects of moderate energy restriction on apnoea severity and CVD risk factors in obese patients with obstructive sleep apnoea. Randomized comparison of reduced fat and reduced carbohydrate hypocaloric diets on intrahepatic fat in overweight and obese human subjects. Structured exercise training programme versus hypocaloric hyperproteic diet in obese polycystic ovary syndrome patients with anovulatory infertility: a 24-week pilot study. Five-week, low-glycemic index diet decreases total fat mass and improves plasma lipid profile in moderately overweight nondiabetic men. Obesity phenotype and incident hypertension: a prospective community-based cohort study Cold-activated brown adipose tissue in healthy men. Effects of α-lipoic acid and eicosapentaenoic acid in overweight and obese women during weight loss. A randomized trial comparing a very low carbohydrate diet and a calorie-restricted low fat diet on body weight and cardiovascular risk factors in healthy women. Liver steatosis (LS) evaluated through chemical-shift magnetic resonance imaging liver enzymes in morbid obesity; effect of weight loss obtained with intragastric balloon gastric banding Rosiglitazone decreases serum bone-specific alkaline phosphatase activity in postmenopausal diabetic women. Effects of agar (kanten) diet on obese patients with impaired glucose tolerance and type 2 diabetes. Nigella sativa oil with a calorie-restricted diet can improve biomarkers of systemic inflammation in obese women: A randomized double-blind, placebo-controlled clinical trial.
Background : The aim of this community-based study is to ascertain the effect of different obesity phenotypes on the incidence of chronic kidney disease in Iranian adults . Study Design : A prospect i ve cohort study , the Tehran Lipid Glucose Study ( TLGS ) . Setting and Participants : Adults aged ≥ 20 years with a mean age of 40.38 years ( 54.8 % female ) who were free from chronic kidney disease ( CKD ) at baseline ( phase 1 ) and were followed up at 3 time stages ( phases 2 , 3 , and 4 ) for a mean duration of 9.4 years to assess the risk for CKD . Predictor : Obesity phenotypes . Outcome : Incidence of chronic kidney disease . Measurements : Glomerular filtration rate ( GFR ) was estimated from the simplified equation developed using data from the Modification of Diet in Renal Disease ( MDRD ) Study . Results : CKD events occurred in 1162 participants . The prevalence of the 2 known obesity phenotypes ( metabolically obese normal weight [ MONW ] and metabolically healthy but obese [ MHO ] ) in the overall population was 3.5 % and 8.8 % , respectively . According to Kaplan-Meier curves , rates of freedom from CKD in the MHO and MONW obesity phenotypes were 75.3 % and 60.6 % , respectively ( p < 0.0001 ) . Age- and sex-adjusted ( model 1 ) hazard ratios for participants with MHO or MONW obesity phenotype were 1.14 ( 95 % confidence interval [ CI ] , 0.91–1.43 ) and 1.43 ( 95 % CI , 1.09–1.88 ) , respectively . After further adjustment for confounder variables ( model 2 ) , multivariate-adjusted hazard ratios for CKD for participants with MHO or MONW obesity phenotypes were 1.23 ( 95 % CI , 0.93–1.62 ) and 1.43 ( 95 % CI , 1.08–1.90 ) , respectively . Conclusion : Adults with the MONW obesity phenotype compared to those with MHO obesity phenotype have a higher risk for incidence of CKD . The results indicate that having a normal weight is not the only factor to protect against incidence of CKD Cumulative food intake curves have been obtained by monitoring eating from a plate , placed on a scale built into a table , and connected to a digital computer . They describe and integrate parameters of consumption of an ad lib single course meal , i.e. meal size , meal duration , eating rate , change in eating rate , bite size and bite frequency . It is concluded that they are an adequate tool for analyzing dietary and clinical interventions on meal size , because the cumulative food intake curve parameters : are stable and consistent within subjects ; show a clear relationship with the subject characteristics dietary restraint and obesity ; show a clear relationship with the physiological parameters satiation , diet-induced thermogenesis and body-temperature near the liver , and with the cognitive parameter : estimating forthcoming ingestion ; are sensitive to instructions , clinical and dietary interventions ( preloads , palatability , energy density , macronutrient composition ) , and to a state of negative energy balance . Because of possible compensatory post-pr and ial effects , it is suggested that assessment of meal size should be part of a 24 h appetite profile and food intake observation OBJECTIVE : To test the effects on abdominal fat reduction of adding aerobic exercise training to a diet program and obesity phenotype in response to weight loss . DESIGN : A prospect i ve clinical trial with a 14-week weight-loss intervention design . SETTING AND PARTICIPANTS : In total , 209 overweight and obese women were assigned to four subgroups depending on type of treatment and the subject 's obesity phenotype : diet alone ( DA ) with intra-abdominal  fat  ( IF ) obesity ( ≥mean IF area ) , diet plus exercise ( DE ) with IF obesity , DA with abdominal subcutaneous fat ( ASF ) obesity ( < mean IF area ) and DE with ASF obesity . Abdominal fat areas were evaluated by CT scans , with values adjusted for selected variables . RESULTS : Values were adjusted for age , menopausal status and change in body weight and total fat mass . The IF reductions were significantly ( P<0.0001 ) greater in subjects with IF obesity phenotype ( −45.1 cm2 ) compared to the ASF obesity phenotype ( −22.2 cm2 ) . The ASF reductions were significantly ( P<0.001 ) greater for subjects with ASF obesity ( −74.5 cm2 ) compared to IF obesity ( −55.5 cm2 ) . For IF obesity , the IF reduction was significantly ( P<0.01 ) greater in the DE group ( −49.3 cm2 ) than in the DA group ( −37.8 cm2 ) . CONCLUSION : These results suggest that for individuals with IF obesity , the efficacy on reducing IF of adding aerobic exercise training to a diet-alone weight-reduction program is more prominent ( −49.3 cm2/−37.8 cm2=1.3 times ) compared with DA . Moreover , abdominal fat reduction was found to be modified by obesity phenotype in response to weight loss BACKGROUND & AIMS LDL phenotype B is associated with obesity , insulin resistance , hypertriglyceridemia and oxidative stress . The effect of plasma n-3/n-6 PUFA ratio on LDL phenotype transformation was investigated . METHODS Patients with metabolic syndrome ( n=99 ) received one of four isocaloric diets : ( A ) High-fat ( 38 % energy ) SFA-rich diet ( HSFA ) ; ( B ) High-fat ( 38 % energy ) , MUFA-rich diet ( HMUFA ) ; ( C ) , low-fat ( LF ) ( 28 % energy ) , high-complex carbohydrate diet with 1.24g/d oleic sunflower oil ( LFHCC ) and ( D ) : low-fat ( 28 % energy ) , high-complex carbohydrate diet , with 1.24g/d LC n-3 PUFA ( LFHCC n-3 ) for 12 weeks . Analysis of plasma lipid profile and LDL phenotype was done pre- and post- interventions . RESULTS Post-dietary change of LDL density was a main effect observed in all groups . LFHCC n-3 and HFMUFA diets result ed in favorable alteration of LDL phenotype from B to A and decreased LDL density . In contrast , increased LDL density was observed in HSFA and LFHCC groups . The plasma pre-n3/n6 PUFA , Apo E change and pre-Apo CIII/CII ratios explained in 65 % the post-dietary change of LDL density in diet LFHCC n-3 consumers . CONCLUSIONS Study demonstrates efficacy of dietary n-3 PUFA to modify pro-atherogenic to less atherogenic LDL phenotype in patients with metabolic syndrome . Study identifier at Clinical Trials.gov was NCT00429195 Inadequate dietary patterns and sedentary lifestyles are believed to be important factors in predisposing people to obesity . This study analyzed the potential interaction between habitual physical activity and the carbohydrate (CHO)-fat distribution in 2 hypocaloric diets and the impact of such interplay on body composition changes . Forty healthy obese women , 20 - 50 years old , were r and omly assigned to a high- or low-CHO energy-restricted diet , which was low or high in fat , respectively , during 10 weeks . Baseline and final measurements were performed to assess dietary habits , resting metabolic rate , and body composition changes . Physical activity was measured with a triaxial accelerometer and with a question naire . There were no significant differences in anthropometric and metabolic variables between both dietary groups at baseline . However , there was a positive correlation between total free-living physical activity and arm muscle preservation after 10 weeks ( r = 0.371 ; p = 0.024 ) . Interestingly , an interaction between macronutrient ( CHO-fat distribution ) intake and physical activity was found , since less-active subjects with a high-CHO-low-fat diet showed a greater fat loss than those more active with a lower-CHO-high-fat diet , whereas more-active subjects with a high-CHO-low-fat diet showed a smaller fat loss than those receiving a low-CHO-high-fat diet . Physical activity and the macronutrient content of energy-restricted diets , when design ed to promote body fat mass reduction , should be considered together to better predict the outcome Review question / objective What are the effects of weight management interventions that include a diet component on weight‐related outcomes in pregnant and postpartum women ? The primary objective of this systematic review is to evaluate the effectiveness of weight management interventions which include a diet component and are aim ed at limiting gestational weight gain and postpartum weight retention in women . The second objective of this systematic review is to investigate included intervention components with respect to effect on weight‐related outcomes . This may include , but is not limited to : length of intervention , use of face‐to‐face counselling , group or individual consultations , use of other interventions components including exercise , use of goals and use of support tools like food diaries , coaching , including email or text message support . Background Around half of all women of reproductive age are either overweight or obese,1,2,3 with women aged 25‐34 years having a greater risk of substantial weight gain compared with men of all ages.1,4 Excessive gestational weight gain ( GWG ) and postpartum weight retention ( PPWR ) may play a significant role in long term obesity . Having one child doubles the five‐ and 10‐year obesity incidence for women , with many women who gain excessive weight during pregnancy remaining obese permanently.5 Excessive GWG and /or PPWR can also significantly contribute to short‐ and long‐term adverse health outcomes for mother , baby and future pregnancies.6,7 Maternal obesity increases the risk of pregnancy related complications such as pre‐eclampsia , gestational diabetes mellitus , stillbirth and the rate of caesarean section.8 Childhood obesity is a further long term complication of maternal obesity for offspring , which may persist in to adulthood.9 Excess GWG is also a risk factor for PPWR both in the short and long‐term.10,11 Nehring et al. conducted a meta‐ analysis with over 65,000 women showing that , compared to women who gained weight within recommendations during pregnancy , women with GWG above Institute of Medicine weight gain recommendations , 12 retained an additional 3.1 kg and 4.7 kg after three and greater than or equal to 15 years postpartum , respectively.13 The health risk associated with PPWR is highlighted in a study of 151,025 Swedish women followed between 1992 and 2001.The study identified the risk of adverse pregnancy outcomes for those who gained three or more units of Body Mass Index ( kg/m2 ) between consecutive pregnancies ( an average of two years ) was much higher compared with women whose BMI changed from ‐1.0 and 0.9 units.14 Long‐term chronic disease risk may also be affected by PPWR as weight retention at the end of the first year post‐partum has been found to be a predictor of maternal overweight 15 years later.15With around 14‐20 % of women retaining 5 kg or more 12 months postpartum,16,5 the risk of developing conditions like diabetes , metabolic syndrome and cardiovascular disease may be increased.17 It becomes evident that interventions which aim to support attainment of healthy weight both in the antenatal and postpartum periods are key health priorities for women during this life stage . Lifestyle factors of overweight , having poor diet quality , and not undertaking enough moderate‐to‐vigorous physical activity are amongst the top five predictors of mortality in women.18 Additionally it is noted that , for many women , pregnancy and the postpartum period are associated with a reduction in physical activity.19 It is known that a combination of poor dietary choices , an increase in sedentary time and reduction in physical activity are all contributors to the development of overweight and obesity . With this in mind , current research has focused on lifestyle interventions to limit GWG and PPWR . Thangaratinam et al. review ed 44 r and omized controlled trials ( 7278 women ) where interventions including diet , physical activity or both were evaluated for their influence on maternal weight during  pregnancy.20 Results indicate that all were significantly effective in reducing GWG compared with the control group . More specifically , dietary interventions were the most effective in reducing weight gain , with a mean weight loss of ‐3.84 kg compared with ‐0.72 kg and ‐1.06 kg for physical activity and the mixed ( diet plus physical activity ) approach , respectively.20 This finding is supported by Hill and colleagues ' recent systematic review of theory based interventions to limit GWG.21 Included studies in this review reported an underpinning theory base and were classified as adopting a dietary , physical activity or mixed approach . Hill et al. concluded that studies which included a diet intervention were significantly more effective at limiting GWG.21 In 2011 Tanentsapf et al. review ed the effect of dietary interventions alone for reducing GWG in normal weight , overweight and obese pregnant women.22 This review analysed 13 r and omized controlled trials and quasi‐r and omized controlled trials with a dietary intervention to prevent excessive GWG in women . The review concluded that dietary interventions during pregnancy were effective in reducing GWG with an effect of ‐1.92 kg ( n=1434 ) compared with the control group.22 Tanentsapf et al. identified that trials differed in the conduct of the interventions with various diet and non‐diet related components utilised . Dietary approaches were highly variable with some trials focusing only on calorie restriction and others included additional target macronutrient distribution for intake . Some trials further provided feedback based on maternal weight gain guidelines .12 Interventions also varied in delivery method with a variety of modes used , including face‐to‐face , individual or group consultations and /or written correspondence . The frequency of communication , despite the type or mix , also changed from trial to trial with additional methods via telephone , posted material s , feedback or food diaries utilised . The inclusion of physical activity in addition to diet intervention was also common . Whilst the recent review by Tanentsapf et al.22 identified that dietary interventions are effective in reducing GWG , the review did not investigate the impact that different intervention components , delivery methods or dietary counselling approaches had on gestational weight management . It remains unclear as to which intervention components optimize GWG in women . The impact of lifestyle interventions has also been investigated in the postpartum period . The recent systematic review from van der Pligt et al. reported seven of 11 studies review ed were successful in limiting PPWR.23 As with studies aim ed at limiting GWG , interventions included in van der Pligt et al. 's review differed greatly in their conduct . Six of these seven studies included both dietary and physical activity components for the intervention , with the final successful study including a diet only intervention . Five of the successful studies recruited overweight or obese women only . Intervention time varied considerably in successful studies with some running for as little at ten days , and others up to six months . Bertz et al. demonstrated that their 12‐week behavior modification intervention which targeted diet alone or diet and exercise , including two individual sessions with a dietitian and physical therapist , provision of scales for weight self‐monitoring and bi‐weekly text messages was successful in achieving significant weight loss following the intervention , and sustained at one year.24 The diet intervention and the diet and exercise intervention  yielded significant weight loss compared to the control . Following 12 weeks a reduction of ‐8.3 + /‐ 4.2 kg for diet intervention and ‐6.9 + /‐ 3.0 kg for diet and exercise was observed . Additionally after one year , the diet intervention showed ‐10.2 + /‐ 5.7 kg reduction and ‐7.3 + /‐ 6.3 kg for the diet and exercise intervention (p<0.001).24 Colleran et al. also found significant weight change results by implementing a 16‐week intervention which consisted of weekly individual sessions with a dietitian regarding calorie restriction , two additional home visits regarding exercise , weekly food diary completion and email support.25 The intervention group had greater weight loss compared to the control group ( ‐5.8 kg + /‐ 3.5 kg vs ‐1.6 kg + /‐ 5.4 kg ) . It can be seen that various methods have been utilized in investigating the impact of diet and physical activity interventions on PPWR . The review by van der Pligt et al.23 highlights the impact successful lifestyle interventions can have on postpartum weight change . However , this review did not investigate the different intervention strategies utilized . It remains unclear as to the optimal setting , delivery method , diet strategy , contact frequency or intervention length to limit PPWR . Previous systematic review s for both GWG and PPWR have focused on the effectiveness of lifestyle interventions as a whole for weight management in pregnant and postpartum women.20,23 And despite Tanentsapf et al. 's focus on dietary interventions for GWG,22 much is still unknown about the effectiveness of differing diet interventions over the antenatal and postpartum period . Specifically , the impact of differing diet intervention strategies on maternal weight gain is not known . Firstly , this systematic review will focus on whether  weight management interventions which include a dietary component  are effective in pregnant and postpartum women . In addition to this , this review will investigate the different intervention strategies utilized and their effectiveness in maternal weight management . A search of systematic review protocol data bases has shown that there is no current review underway for this topic The aim of the study was to analyze the phenotypic and epigenetic changes induced by the shift to a chow diet  after an obesogenic environment . Animals were r and omized to fed chow ( control group ) or high-fat – sucrose diet ( HFS ) . After 10 weeks , half of the rats fed with HFS diet were reassigned to a chow diet ( rest group ) while the other half continued with the obesogenic diet ( HFS group ) until week 20 . Changes in fat content , biochemical profile , and DNA methylation levels of several gene promoters from retroperitoneal adipocytes were analyzed . HFS diet intake for 10 weeks induced obese phenotype in the animals , increasing body weight and fat content . These effects were maintained until the end of the trial in HFS group , where an increase in liver fat content , a modification of lipid profile , and retroperitoneal adipose tissue hypertrophy were also observed . Changing the dietary pattern reversed these parameters . Epigenetic analysis showed that HFS diet intake for 20 weeks hypermethylated several CpG sites ( 6.7 and 29.30 ) and hypomethylated CpG site 15 from leptin gene promoter . Moreover , the obesogenic diet also hypomethylated CpG site 1 from Fasn ( fatty acid synthase ) gene promoter , without changes on Ppargc1a ( peroxisome proliferator-activated receptor gamma coactivator 1-alpha ) , Srebf1 ( sterol regulatory element-binding transcription factor 1 ) , and aquaporin 7 . Shifting to a chow diet reverted HFS-induced DNA methylation levels of some CpG sites of leptin promoter . Changing the dietary pattern hypomethylated a CpG site of Srebf1 and hypermethylated other CpGs on Ppargc1a and Fasn promoter . This study shed light on the reversibility of phenotypical and epigenetic changes induced by a HFS diet intake OBJECTIVE Examine a model that encourages health at every size as opposed to weight loss . The health at every size concept supports homeostatic regulation and eating intuitively ( ie , in response to internal cues of hunger , satiety , and appetite ) . DESIGN Six-month , r and omized clinical trial ; 2-year follow-up . SUBJECTS White , obese , female chronic dieters , aged 30 to 45 years ( N=78 ) . SETTING Free-living , general community . INTERVENTIONS Six months of weekly group intervention ( health at every size program or diet program ) , followed by 6 months of monthly aftercare group support . MAIN OUTCOME MEASURES Anthropometry ( weight , body mass index ) , metabolic fitness ( blood pressure , blood lipids ) , energy expenditure , eating behavior ( restraint , eating disorder pathology ) , and psychology ( self-esteem , depression , body image ) . Attrition , attendance , and participant evaluations of treatment helpfulness were also monitored . STATISTICAL ANALYSIS PERFORMED Analysis of variance . RESULTS Cognitive restraint decreased in the health at every size group and increased in the diet group , indicating that both groups implemented their programs . Attrition ( 6 months ) was high in the diet group ( 41 % ) , compared with 8 % in the health at every size group . Fifty percent of both groups returned for 2-year evaluation . Health at every size group members maintained weight , improved in all outcome variables , and sustained improvements . Diet group participants lost weight and showed initial improvement in many variables at 1 year ; weight was regained and little improvement was sustained . CONCLUSIONS The health at every size approach enabled participants to maintain long-term behavior change ; the diet approach did not . Encouraging size acceptance , reduction in dieting behavior , and heightened awareness and response to body signals result ed in improved health risk indicators for obese women Objective ( i ) to determine the outcomes of whole-body vibration training ( WBVT ) on obese individuals , and the intervention setting s producing such effects ; ( ii ) identify potential improper or harmful use of WBVT . Design Systematic review . Data sources Medline , Scopus , Web of Science , PEDro and Scielo until July 2018 . Eligibility criteria Full papers evaluating the effect of  WBVT on body composition , cardiovascular status and functional performance in obese adults . Papers with PEDro score<4 were excluded . Study appraisal and synthesis Risk of bias and quality of WBVT reporting were assessed with PEDro scale ( r and omized controlled trials ) or TREND checklist ( non-r and omized studies ) and a 14-items checklist , respectively . Weighted acceleration , daily exposure and Hedges ’ adjusted g were computed . Results We included 18 papers published 2010–2017 . Typical interventions consisted in three sessions/week of exercises ( squats , calf-raises ) performed on platforms vibrating at 25–40 Hz ( amplitude : 1–2 mm ) ; according to ISO 2631–1:1997 , daily exposure was “ unsafe ” in 7/18 studies . Interventions lasting ≥6 weeks improved cardiac autonomic function and reduced central /peripheral arterial stiffness in obese women ; 10 weeks of WBVT  produced significant weight/fat mass reduction , leg strength improvements as resistance training , and enhanced glucose regulation when added to hypocaloric diet . No paper evidence d losses of lean mass . Isolated cases of adverse effects were reported . Summary To date , WBVT is a promising adjuvant intervention therapy for obese women ; long-term studies involving larger cohorts and male participants are required to demonstrate the associated safety and health benefits . The therapeutic use of WBVT in the management of obese patients is still not st and ardised and should be supported by an extensive knowledge on the causality between vibration parameters and outcomes Few and mostly uncontrolled studies indicate that weight loss improves heart rate variability ( HRV ) in grade -3 obesity . The aim of this study was to compare in grade -3 obesity surgery and hypocaloric diet on clinical and metabolic variables and on autonomic indices of HRV . Twenty-four subjects ( body mass index , BMI 45.5 ± 9.13 kg/m2 ) underwent surgery ( n = 12 , gastric b and ing , LAGB ) or received hypocaloric diet ( n = 12 , 1,000–1,200 kg/day ) . Clinical [ BMI , systolic blood pressure ( SBP ) and diastolic blood pressure ( DBP ) , heart rate ] and metabolic variables [ glucose , cholesterol , HDL- and LDL-cholesterol , triglycerides , AST and ALT transaminases ] and 24-h Holter electrocardiographic-derived HRV parameters [ R – R interval , st and ard deviation of R – R intervals ( SDNN ) ; low/high-frequency ( LF/HF ) ratio , and QT interval ] were measured at baseline and after 6 months . The two groups were identical at baseline . BMI ( −7.5 ± 3.57 kg/m2 , mean ± SD ) , glucose ( −24.1 ± 26.77 mg/dL ) , SBP ( −16.7 ± 22.19 mmHg ) and DBP ( −6.2 ± 8.56 mmHg ) decreased in LAGB subjects ( p < 0.05 ) and remained unchanged in controls . At 6 months , SDNN increased in LAGB subjects ( + 25.0 ± 37.19 ms , p < 0.05 ) and LF/HF ratio diminished ( 2.9 ± 1.84 vs. 4.9 ± 2.78 ; p = 0.01 ) , with no change in controls ; LF ( daytime ) and HF ( 24 h and daytime ) increased in LAGB subjects , with no change in controls . Decrease in BMI correlated with SBP and DBP decrease ( p < 0.05 ) , and DBP decrease correlated with HR decrease ( p < 0.05 ) and QT shortening ( p < 0.05 ) . Weight loss is associated with improvement of glucose metabolism , of blood pressure , and with changes in time and frequency domain parameters of HRV ; all these changes indicate recovery of a more physiological autonomic control , with increase in parasympathetic and reduction in sympathetic indices of HRV We sought to evaluate the effect of weight loss on echocardiographic epicardial fat thickness , as index of visceral adiposity , and whether epicardial fat change after the weight loss can be proportionally different from overall body weight changes and related to cardiac parameters changes in severely obese subjects . This was an interventional study in 20 severely obese subjects ( 12 women , 8 men , BMI 45+/-5 kg/m(2 ) , 35+/-10 years ) who underwent 6-month very low calorie diet weight loss program .  Baseline and after 6-month weight loss anthropometrics , echocardiographic epicardial fat thickness , left ventricular mass ( LVM ) , and diastolic function parameters were assessed . Subjects lost 20 % of original body weight , BMI reduced by 19 % of original BMI , waist circumference decreased by 23 % of initial waist circumference . Epicardial fat thickness decreased from 12.3+/-1.8 to 8.3+/-1 mm P<0.001 after the 6-month very low calorie diet , as -32 % of baseline epicardial fat thickness . LVM and diastolic function changes were better correlated with epicardial fat changes . We showed that significant weight loss can be associated with significant reduction in the epicardial fat thickness , marker of visceral adiposity in severely obese subjects .  Epicardial fat decrease , therefore visceral fat decrease , can be proportionally higher than overall adiposity decrease . Epicardial fat changes are significantly associated with obesity-related cardiac morphological and functional changes during weight loss . Measurement of echocardiographic epicardial fat thickness may provide an additional tool in underst and ing the metabolic risk associated with variation in fat distribution Nutritional intervention for weight loss is one of the treatment options for  obstructive sleep apnoea ( OSA ) in patients with overweight or obesity . However , the effects of moderate energy restriction on OSA severity are not yet known . The present study aim ed to evaluate the effects of moderate energy restriction on OSA severity and CVD risk factors  in obese patients with OSA . In this 16-week r and omised clinical trial , twenty-one obese subjects aged 20 - 55 years and presenting an apnoea/hypopnoea index (AHI)≥5 events/h were r and omised into two groups : the energy restriction group ( ERG ) and the control group ( CG ) . The ERG was instructed to follow an energy-restricted diet -3347·2 kJ/d ( -800 kcal/d ) and the CG was advised not to change their food intake . At the beginning and at the end of the study , participants underwent evaluation of the following : OSA ( Watch-PAT200 ® ) , nutritional parameters , blood pressure , sympathetic activity , inflammatory biomarkers , metabolic profile and endothelial function . The ERG ( n 11 ) , compared with the CG ( n 10 ) , had a significantly greater reduction in body weight ( Cohen 's d=-1·19 ; P<0·001 ) , in AHI ( Cohen 's d=-0·95 ; P=0·04 ) and in plasma concentrations of adrenaline ( Cohen 's d=-1·02 ; P=0·04 ) as well as a significantly greater increase in minimum O2 saturation ( Cohen 's d=1·08 ; P=0·03 ) . Although energy restriction was not associated with significant improvements in CVD risk factors , medium-to-large effect sizes were observed , suggesting that the statistically non-significant difference between groups may be due to the small sample size . This study suggests that in obese patients with OSA , moderate energy restriction is able to reduce the parameters of OSA severity and sympathetic activity UNLABELLED Obesity-related hepatic steatosis is a major risk factor for metabolic and cardiovascular disease . Fat reduced hypocaloric diets are able to relieve the liver from ectopically stored lipids . We hypothesized that the widely used low carbohydrate hypocaloric diets are similarly effective in this regard . A total of 170 overweight and obese , otherwise healthy subjects were r and omized to either reduced carbohydrate ( n = 84 ) or reduced fat ( n = 86 ) , total energy restricted diet ( -30 % of energy intake before diet ) for 6 months . Body composition was estimated by bioimpedance analyses and abdominal fat distribution by magnetic resonance tomography . Subjects were also su bmi tted to fat spectroscopy of liver and oral glucose tolerance testing . In all , 102 subjects completed the diet intervention with measurements of intrahepatic lipid content . Both hypocaloric diets decreased body weight , total body fat , visceral fat , and intrahepatic lipid content . Subjects with high baseline intrahepatic lipids ( > 5.56 % ) lost ≈7-fold more intrahepatic lipids compared with those with low baseline values ( < 5.56 % ) irrespective of diet composition . In contrast , changes in visceral fat mass and insulin sensitivity were similar between subgroups , with low and high baseline intrahepatic lipids . CONCLUSION A prolonged hypocaloric diet low in carbohydrates and high in fat has the same beneficial effects on intrahepatic lipid accumulation as the traditional low-fat hypocaloric diet . The decrease in intrahepatic lipids appears to be independent of visceral fat loss and is not tightly coupled with changes in whole body insulin sensitivity during 6 months of an energy restricted diet BACKGROUND Lifestyle modifications are successfully employed to treat obese and overweight women with polycystic ovary syndrome ( PCOS ) . The aims of the current pilot study were ( i ) to compare the efficacy on reproductive functions of a structured exercise training ( SET ) programme with a diet programme in obese PCOS patients and ( ii ) to study their clinical , hormonal and metabolic effects to eluci date potentially different mechanisms of action . METHODS Forty obese PCOS patients with anovulatory infertility underwent a  SET programme ( SET group , n = 20 ) and a hypocaloric hyperproteic diet ( diet group , n = 20 ) . Clinical , hormonal and metabolic data were assessed at baseline , and at 12- and 24-week follow-ups . Primary endpoint was cumulative pregnancy rate . RESULTS The two groups had similar demographic , anthropometric and biochemical parameters . After intervention , a significant improvement in menstrual cycles and fertility was noted in both groups , with no differences between groups . The frequency of menses and the ovulation rate were significantly ( P < 0.05 ) higher in the SET group than in diet group but the increased cumulative pregnancy rate was not significant . Body weight , body mass index , waist circumference , insulin resistance indexes and serum levels of sex hormone-binding globulin , and rostenedione and dehydroepi and rosterone sulphate changed significantly ( P < 0.05 ) from baseline and were significantly different ( P < 0.05 ) between the two groups . CONCLUSIONS Both SET and diet interventions  improve fertility in obese PCOS patients with anovulatory infertility . We hypothesize that in both interventions an improvement in insulin sensitivity is the pivotal factor involved in the restoration of ovarian function but potentially acting through different mechanisms OBJECTIVE To evaluate whether a 5-week low-glycemic index ( LGI ) diet versus a high-glycemic index ( HGI ) diet can modify glucose and lipid metabolism as well as total fat mass in nondiabetic men . RESEARCH DESIGN AND METHODS In this study , 11 healthy men were r and omly allocated to 5 weeks of an LGI or HGI diet separated by a 5-week washout interval in a crossover design . RESULTS The LGI diet result ed in lower postpr and ial plasma glucose and insulin profiles and areas under the curve ( AUCs ) than the HGI diet . A 5-week period of the LGI diet lowered plasma triacylglycerol excursion after lunch ( AUC , P < 0.05 LGI vs. HGI ) . These modifications were associated with a decrease in the total fat mass by approximately 700 g ( P < 0.05 ) and a tendency to increase lean body mass ( P < 0.07 ) without any change in body weight . This decrease in fat mass was accompanied by a decrease in leptin , lipoprotein lipase , and hormone-sensitive lipase RNAm quantities in the subcutaneous abdominal adipose tissue ( P < 0.05 ) . CONCLUSIONS We concluded that 5 weeks of an LGI diet ameliorates some plasma lipid parameters , decreases total fat mass , and tends to increase lean body mass without changing body weight . These changes were accompanied by a decrease in the expression of some genes implicated in lipid metabolism . Such a diet could be of benefit to healthy , slightly overweight subjects and might play a role in the prevention of metabolic diseases and their cardiovascular complications Objective : The relationship betweens the healthy obese phenotype and the risk of cardiovascular events remains unclear . We prospect ively investigated the association between the obesity phenotype and the incidence of hypertension . Methods : We studied 2352 participants , aged 40–69 years at baseline , with normal blood pressure ( BP ) from the Ansan cohort and the Ansung cohort of the Korean Genome Epidemiology Study . Participants were divided into six groups based on BMI and the metabolic syndrome ( MetS ) components : healthy ( none of the five MetS components ) normal weight ( BMI < 23 kg/m2 ) , unhealthy ( one or more MetS component ) normal weight , healthy overweight ( BMI 23–24.9 kg/m2 ) , unhealthy overweight , healthy obesity ( BMI ≥25 kg/m2 ) , and unhealthy obesity .  The incidence of hypertension was identified by biennial health examinations during the 8-year follow-up . Results : After adjusting for age , sex , cohort , physical activity , smoking , alcohol consumption , and family history of hypertension and cardiovascular diseases , an increased risk for hypertension in combined cohort was observed in the healthy obesity [ hazard ratio ( HR ) : 2.20 , 95 % confidence interval (CI):1.34–3.60 ] , unhealthy overweight ( HR : 1.47 , 95 % CI : 1.00–2.14 ) , and unhealthy obesity ( HR : 2.45 , 95 % CI : 1.79–3.37 ) , compared with the healthy normal weight group . In each cohort , the healthy obesity was still associated with a higher incidence of hypertension ( HR 2.20 , 95 % CI 1.11–4.36 for the Ansan cohort and HR 2.21 , 95 % CI 1.01–4.83 for the Ansung cohort ) . Conclusion : These findings provide evidence that the metabolically healthy obese phenotype may not be a benign condition BACKGROUND Studies in animals indicate that brown adipose tissue is important in the regulation of body weight , and it is possible that individual variation in adaptive thermogenesis can be attributed to variations in the amount or activity of brown adipose tissue . Until recently , the presence of brown adipose tissue was thought to be relevant only in small mammals and infants , with negligible physiologic relevance in adult humans . We performed a systematic examination of the presence , distribution , and activity of brown adipose tissue in lean and obese men during exposure to cold temperature .  Brown-adipose-tissue activity was studied in relation to body composition and energy metabolism . METHODS We studied 24 healthy men--10 who were lean ( body-mass index [ BMI ] [ the weight in kilograms divided by the square of the height in meters ] , < 25 ) and 14 who were overweight or obese ( BMI , > or = 25)--under thermoneutral conditions ( 22 degrees C ) and during mild cold exposure ( 16 degrees C ) . Putative brown-adipose-tissue activity was determined with the use of integrated (18)F-fluorodeoxyglucose positron-emission tomography and computed tomography .  Body composition and energy expenditure were measured with the use of dual-energy x-ray absorptiometry and indirect calorimetry . RESULTS Brown-adipose-tissue activity was observed in 23 of the 24 subjects ( 96 % ) during cold exposure but not under thermoneutral conditions . The activity was significantly lower in the overweight or obese subjects than in the lean subjects ( P=0.007 ) . BMI and percentage of body fat both had significant negative correlations with brown adipose tissue , whereas resting metabolic rate had a significant positive correlation . CONCLUSIONS The percentage of young men with brown adipose tissue is high , but its activity is reduced in men who are overweight or obese . Brown adipose tissue may be metabolically important in men , and the fact that it is reduced yet present in most overweight or obese subjects may make it a target for the treatment of obesity OBJECTIVE To evaluate the potential body weight-lowering effects of dietary supplementation with eicosapentaenoic acid ( EPA ) and α-lipoic acid separately or combined in healthy overweight/obese women following a hypocaloric diet . METHODS This is a short-term double-blind placebo-controlled study with parallel design that lasted 10 weeks . Of the r and omized participants , 97 women received the allocated treatment  [ Control , EPA ( 1.3 g/d ) , α-lipoic acid ( 0.3 g/d ) , and EPA+α-lipoic acid ( 1.3 g/d+0.3 g/d ) ] , and 77 volunteers completed the study . All groups followed an energy-restricted diet of 30 % less than total energy expenditure . Body weight , anthropometric measurements , body composition , resting energy expenditure , blood pressure , serum glucose , and insulin and lipid profile , as well as leptin and ghrelin levels , were assessed at baseline and after nutritional intervention . RESULTS Body weight loss was significantly higher ( P<0.05 ) in those groups supplemented with α-lipoic acid . EPA supplementation significantly attenuated ( P<0.001 ) the decrease in leptin levels that occurs during weight loss . Body weight loss improved lipid and glucose metabolism parameters but without significant differences between groups . CONCLUSIONS The intervention suggests that α-lipoic acid supplementation alone or in combination with EPA may help to promote body weight loss in healthy overweight/obese women following energy-restricted diets Untested alternative weight loss diets , such as very low carbohydrate diets , have unsubstantiated efficacy and the potential to adversely affect cardiovascular risk factors . Therefore , we design ed a r and omized , controlled trial to determine the effects of a very low carbohydrate diet on body composition and cardiovascular risk factors . Subjects were r and omized to 6 months of either an ad libitum very low carbohydrate diet or a calorie-restricted diet with 30 % of the calories as fat . Anthropometric and metabolic measures were assessed at baseline , 3 months , and 6 months . Fifty-three healthy , obese female volunteers ( mean body mass index , 33.6 + /- 0.3 kg/m(2 ) ) were r and omized ; 42 ( 79 % ) completed the trial . Women on both diets reduced calorie consumption by comparable amounts at 3 and 6 months . The  very low carbohydrate diet group lost more weight ( 8.5 + /- 1.0 vs. 3.9 + /- 1.0 kg ; P < 0.001 ) and more body fat ( 4.8 + /- 0.67 vs. 2.0 + /- 0.75 kg ; P < 0.01 ) than the low fat diet group .  Mean levels of blood pressure , lipids , fasting glucose , and insulin were within normal ranges in both groups at baseline . Although all of these parameters improved over the course of the study , there were no differences observed between the two diet groups at 3 or 6 months . beta- Hydroxybutyrate increased significantly in the very low carbohydrate group at 3 months ( P = 0.001 ) . Based on these data , a very low carbohydrate diet is more effective than a low fat diet for short-term weight loss and , over 6 months , is not associated with deleterious effects on important cardiovascular risk factors in healthy women The aim of this study was to evaluate in morbid obesity clinical and metabolic effects related to weight loss on liver steatosis ( LS ) , measured through chemical-shift magnetic resonance imaging ( MRI ) and liver enzymes . Forty obese subjects ( 8 M/32 W ; BMI 42.8 ± 7.12 kg/m2 , mean ± SD ) were evaluated for LS through ultrasound ( US-LS ) , chemical-shift MRI ( MRI-LS  ) , liver enzymes [ aspartate aminotransferase ( AST ) , alanine aminotransferase ( ALT ) , γ-glutamyltransferase ( GGT ) , alkaline phosphatase ( ALP ) ] , anthropometric parameters [ weight , BMI , waist circumference ( WC ) ] , lipids , insulin , insulin resistance ( HOMA-IR ) , glycated hemoglobin ( HbA1c ) , oral glucose tolerance test , and body composition [ fat mass ( FM ) and fat-free mass ( FFM ) at bio-impedance analysis ( BIA ) ] . Anthropometric measures , MRI-LS , BIA , and biochemical parameters were reevaluated 6 months later in 18 subjects undergoing restrictive bariatric approach , i.e. ,  intragastric balloon ( BIB , n = 13 ) or gastric b and ing ( LAGB , n = 5 ) , and in 13 subjects receiving hypocaloric diet .  At baseline , US-LS correlates only with MRI-LS , and the latter correlates with ALT , AST , and GGT . After 6 months , subjects undergoing BIB or LAGB had significant changes of BMI , weight , WC , ALT , AST , GGT , ALP , HbA1c , insulin , HOMA-IR , FM , FFM , and MRI-LS . Diet-treated obese subjects had no significant change of any parameter under study ; change of BMI , fat mass , and fat-free mass was significantly greater in LAGB/BIB subjects than in diet-treated subjects . Change of MRI-LS showed a significant correlation with changes in weight , BMI , WC , GGT , ALP , and basal MRI-LS . Significant weight loss after BIB or LAGB is associated with decrease in chemical-shift MRI-LS and with reduction in liver enzymes ; chemical-shift MRI and liver enzymes allow monitoring of LS in follow-up studies OBJECTIVES Our objectives were to evaluate the effect of rosiglitazone on bone metabolism and to assess the association between changes in bone turnover parameters and plasma cytokine levels in postmenopausal diabetic women . DESIGN This was a 12-wk open-label r and omized-controlled trial . PATIENTS OR OTHER PARTICIPANTS A total of 56 obese postmenopausal women with newly diagnosed diabetes and 26 nondiabetic healthy controls matched for age and body mass index were included in the study . INTERVENTIONS The subjects were instructed to follow a weight-maintenance diet . Half were r and omly assigned to receive rosiglitazone 4 mg/d , and the other half remained on diet alone . MAIN OUTCOME MEASURES Before and after the interventions , metabolic bone markers and serum cytokine levels were assessed . RESULTS Serum total alkaline phosphatase ( ALP ) and bone-specific ALP levels were statistically significantly lower 12 wk after initiation of rosiglitazone treatment . There were no statistically significant changes in osteocalcin levels among the three groups or in deoxypyridinoline levels in the rosiglitazone group . At the end of 12 wk , all patients had statistically significantly decreased IL-1beta and TNF-alpha levels compared with baseline . Changes in bone-specific ALP levels showed a moderate negative correlation with the changes in the TNF-alpha levels after rosiglitazone treatment and after diet in the diabetic control group . CONCLUSIONS Rosiglitazone use is associated with reduced bone formation at earlier stages in postmenopausal diabetic women . The cytokine-lowering effects of rosiglitazone and lifestyle changes could reverse the early inhibitory effect of rosiglitazone therapy on bone formation . Further studies will clarify the long-term effects of rosiglitazone therapy on bone loss and fracture AIM The aim of this study was to evaluate the efficacy of agar diet in combination with a conventional diet ( traditional Japanese food ) for obese patients with impaired glucose tolerance and type 2 diabetes . METHODS After a 4-week run-in period on their habitual diets , 76 patients were r and omly assigned to have conventional diet or conventional diet with agar .  Both groups were on these diets for 12 weeks . Body weight , body mass index ( BMI ) , glycaemic control , blood pressure , insulin resistance , total body fat , fat distribution and lipids were assessed before and after the experimental period . RESULTS In both groups , after 12 weeks , mean body weight , BMI , fasting glucose levels , homeostasis model assessment -insulin resistance , and systolic and diastolic blood pressures had decreased significantly from their baseline values . HbA(1)c , visceral fat area , subcutaneous fat area , total body fat , insulin area under the curve after oral glucose tolerance test and total cholesterol decreased significantly in the agar-diet group . After 12 weeks , mean changes of body weight ( -2.8 + /- 2.7 kg vs. -1.3 + /- 2.3 kg , p = 0.008 ) , BMI values ( -1.1 + /- 1.1 kg/m(2 ) vs. -0.5 + /- 0.9 kg/m(2 ) , p = 0.009 ) and total cholesterol ( -7.6 + /- 27.5 mg/dl vs. + 2.4 + /- 23.4 mg/dl , p = 0.036 ) were significantly greater in the agar-diet group than in the conventional diet group . CONCLUSIONS The agar diet result ed in marked weight loss due to the maintenance of reduced calorie intake and to an improvement in metabolic parameters BACKGROUND Inflammation is one of the primary mechanisms in the development of metabolic complications . Although anti-inflammatory characteristics of Nigella sativa ( NS ) have been indicated in animal models , clinical trials related to the effects of NS on inflammatory parameters are relatively scarce . OBJECTIVE The aim of the present study was to determine the effects of NS oil combined with a calorie-restricted diet on systemic inflammatory biomarkers in obese women . METHODS In this double-blind placebo-controlled r and omized clinical trial , 90 volunteer obese ( body mass index = 30 - 34.9 kg/m(2 ) ) women aged 25 - 50 years were recruited . Participants were r and omly divided into two groups , an intervention group ( n = 45 ) and a placebo group ( n = 45 ) . Each group received either : ( 1 ) a low-calorie diet with 3 g/day of NS oil or ( 2 ) a low-calorie diet with 3 g/day placebo for 8 weeks . RESULTS A total of 84 females ( intervention group = 43 ; placebo group = 41 ) completed the trial . Subjects in the intervention group did not report any side effects with the NS oil supplementation . NS oil decreased serum levels of tumor necrosis factor-alpha ( -40.8 % vs -16.1 % , P = .04 ) and high-sensitivity C-reactive protein ( -54.5 % vs -21.4 % , P = .01 ) compared to the placebo group . However , there were no significant changes in interleukin-6 levels ( -8.6 vs -2.4 % , P = .6 ) in the NS group compared to the placebo group . CONCLUSIONS NS oil supplementation combined with a calorie-restricted diet may modulate systemic inflammatory biomarkers in obese women . However , more studies are needed to clarify the efficacy of NS oil as an adjunct therapy to improve inflammatory parameters in obese subjects
The baseline characteristics related to lipid profile were more favorable for metabolically healthy obese than for metabolically unhealthy obese .
Changes in fasting glucose , HOMA-IR and hsCRP did not show significant changes .
Sufficient evidence was not found to support the use of specific diets in metabolically healthy obese subjects .
This analysis suggests that the effect of caloric restriction exerts its effects through a reduction in BMI , blood pressure and triglycerides in metabolically healthy obese ( MHO ) patients
The aim of this systematic review was to assess the effect of diet on changes in parameters describing the body size phenotype of metabolically healthy obese subjects .