Intensive lifestyle intervention provides rapid reduction of serum fatty acid levels in women with severe obesity without lowering omega-3 to unhealthy levels

Abstract

Serum fatty acid (FA) levels were monitored in women with severe obesity during intensive lifestyle intervention. At baseline, total FA levels and most individual FAs were elevated compared to a matching cohort of normal and overweight women (healthy controls). After 3 weeks of intensive lifestyle intervention, total level was only 11-12% higher than in the healthy controls and with almost all FAs being significantly lower than at baseline, but with levels of omega-3 being similar to the healthy controls. This is contrary to observations for patients subjected to bariatric surgery where omega-3 levels dropped to levels significantly lower than in the lifestyle patients and healthy controls. During the next 3 weeks of treatment, the FA levels in lifestyle patients were unchanged, while the weight loss continued at almost the same rate as in the first 3 weeks. Multivariate analysis revealed that weight loss and change of serum FA patterns were unrelated outcomes of the intervention for lifestyle patients. For bariatric patients, these processes were associated probably due to reduced dietary input and increased input from the patients' own fat deposits, causing a higher rate of weight loss and simultaneous reduction of the ratio of serum eicosapentaenoic to arachidonic acid.

Keywords: Bariatric surgery; intensive lifestyle intervention; multivariate analysis; serum omega-3 fatty acids.

Figure 1

This figure shows the multivariate pattern of change caused by the first 3 weeks of lifestyle treatment. This selectivity ratio plot 21, 22 quantifies impact of 3 weeks of lifestyle treatment on changes in absolute levels of serum fatty acids and body mass index. Confidence bounds shown on bars correspond to two standard deviations. Negative bar implies reduction, while positive bar implies increase of variable after treatment.

Figure 2

This figure shows the changes in fatty acid profiles on the multivariate pattern displayed in Fig. 1 as positions (scores) of lifestyle patients (N = 23) at baseline (black bars) and after 3 weeks of lifestyle treatment (neighboring grey bars). The plot displays quantitatively the status for each subject at baseline (black bar), the change during 3 weeks of the treatment (difference between grey and black bar) and the status (grey) after 3 weeks.

Figure 3

This figure shows the changes in fatty acid (FA) pattern and body mass index (BMI) after surgery. This selectivity ratio plot 21, 22 quantifies impact of bariatric surgery on changes in absolute levels of serum FAs and BMI 3 months after surgery. Confidence bounds shown on bars correspond to two standard deviations. Negative bar implies reduction, while positive bar implies increase of variable after treatment.

Figure 4

This figure shows the changes for the patients in the discriminating pattern displayed in Fig. 3. as positions (scores) of bariatric patients (N = 14) just before (black bars) and 3 months after surgery (neighboring grey bars). The plot displays quantitatively the status for each subject at baseline (black bar), the change 3 months after surgery (difference between grey and black bar) and the status (grey) 3 months after surgery.