Disclosure: The authors declared no conflict of interest.
Arterial stiffness, lifestyle intervention and a low-calorie diet in morbidly obese patients—A nonrandomized clinical trial†
Version of Record online: 25 MAY 2013
Copyright © 2013 The Obesity Society
Volume 21, Issue 4, pages 690–697, April 2013
How to Cite
Nordstrand, N., Gjevestad, E., Hertel, J.K., Johnson, L.K., Saltvedt, E., Røislien, J. and Hjelmesæth, J. (2013), Arterial stiffness, lifestyle intervention and a low-calorie diet in morbidly obese patients—A nonrandomized clinical trial. Obesity, 21: 690–697. doi: 10.1002/oby.20099
- Issue online: 25 MAY 2013
- Version of Record online: 25 MAY 2013
- Accepted manuscript online: 18 OCT 2012 12:58PM EST
- Manuscript Accepted: 23 OCT 2012
- Manuscript Received: 25 MAY 2012
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.
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.
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.