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Clinical Trial
. 2013 Apr;21(4):690-7.
doi: 10.1002/oby.20099.

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

N Nordstrand  1 , E Gjevestad, J K Hertel, L K Johnson, E Saltvedt, J Røislien, J Hjelmesaeth
Affiliations
Free PMC article
Clinical Trial

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

N Nordstrand et al. Obesity (Silver Spring). 2013 Apr.
Free PMC article

Abstract

Objective: Arterial stiffness is an independent predictor of cardiovascular morbidity and mortality. This study aimed to compare the 7-week effect of a low-calorie diet (LCD) and an intensive lifestyle intervention program (ILI) on arterial stiffness in morbidly obese individuals.

Design and methods: Nonrandomized clinical trial. The LCD provided 900 kcal/day, and participants in the LCD group were instructed to maintain their habitual physical activity level. The ILI included two 90-min supervised training sessions 3 days a week at moderate to high intensity (4-8 METs) and a caloric restriction of 1000 kcal/day.

Results: A total of 179 individuals completed the study, 88 (56 women) in the ILI group and 91 (57 women) in the LCD group. High-fidelity applanation tonometry (Millar(®) , Sphygmocor(®) ) was used to measure carotid-femoral pulse wave velocity (PWV). After adjustment for relevant confounders, the ILI group had a significantly greater reduction in PWV than the LCD group; -0.4 (-0.6, -0.1) m/s, P = 0.004. When compared to the LCD group, the ILI group showed a larger reduction in systolic and diastolic blood pressure -5 (-9, -1) and -5 (-7, -2) mmHg, P = 0.038 and P ≤ 0.001 respectively, whereas no difference was observed regarding pulse pressure, P = 0.661. No significant differences between groups were found regarding the loss of fat mass, P = 0.259, but the loss of muscle mass was larger in the LCD group, 0.8 (0.5, 1.1) kg, P ≤ 0.001.

Conclusion: Despite the limitations of a nonrandomized design, our findings indicate that for morbidly obese individuals a moderate caloric restriction combined with aerobic physical exercise is associated with a greater decline in PWV than a LCD alone.

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Figures

FIGURE 1
FIGURE 1
Flow chart.
FIGURE 2
FIGURE 2
Changes in carotid-femoral PWV after 7 weeks of follow up. Within groups (a), adjusted difference between groups (b).
FIGURE 3
FIGURE 3
The within-group changes in systolic and diastolic blood pressure after 7 weeks of follow-up.
FIGURE 4
FIGURE 4
The loss of skeletal muscle mass and fat mass after 7 weeks of follow-up.
See this image and copyright information in PMC

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