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Contemporary strategies for weight loss and cardiovascular disease risk factor modification

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Abstract

Because of the overweight/obesity epidemic and attendant increase in risk of chronic disease worldwide, there is a pressing need to identify effective weight loss strategies. Current recommendations for weight loss advocate a reduced-calorie dietary pattern (lower in total fat) in conjunction with regular physical activity and behavior change. This combined approach is important for long-term adherence and weight maintenance. Several large-scale clinical trials implementing different reduced-calorie dietary patterns have shown that 4 to 10 kg of weight is typically lost. The different hypocaloric dietary patterns shown to be effective include reduced-fat diets (10%–30% of calories from fat), a Mediterranean-style diet, and diets that are reduced in energy density. The weight loss achieved is accompanied by beneficial changes in cardiovascular disease risk, including the lipid and lipoprotein profile and blood pressure. This article summarizes our current understanding of effective weight loss programs.

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References and Recommended Reading

  1. Levi J, Gadola E, Segal LM: F as in fat: how obesity policies are failing in America. Available at: http://healthyamericans.org/reports/obesity2007/Obesity2007Report.pdf. Accessed on January 20, 2008.

  2. National Heart, Lung, and Blood Institute: Clinical guidelines on the identification, evaluation, and treatment of overweight and obesity in adults: executive summary. Expert Panel on the Identification, Evaluation, and Treatment of Overweight in Adults. Am J Clin Nutr 1998, 68:899–917.

    Google Scholar 

  3. US Department of Health and Human Services and US Department of Agriculture: Dietary Guidelines for Americans, edn 6. Washington, DC: Government Printing Office; 2005.

    Google Scholar 

  4. US Department of Agriculture: MyPyramid.gov: steps to a healthier you. Available at: http://www.mypyramid.gov. Accessed on February 18, 2008.

  5. Lichtenstein AH, Appel LJ, Brands M, et al.: Diet and Lifestyle Recommendations Revision 2006: A Scientific Statement From the American Heart Association Nutrition Committee. Circulation 2006, 114:82–96.

    Article  PubMed  Google Scholar 

  6. Franz MJ, VanWormer JJ, Crain AL, et al.: Weight-loss outcomes: a systematic review and meta-analysis of weight-loss clinical trials with a minimum 1-year follow-up. J Am Diet Assoc 2007, 107:1755–1767.

    Article  PubMed  Google Scholar 

  7. The Expert Panel: Report of the National Cholesterol Education Program Expert Panel on detection, evaluation, and treatment of high blood cholesterol in adults. Arch Intern Med 1988, 148:36–69.

    Article  Google Scholar 

  8. The Expert Panel: Summary of the second report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel II). JAMA 1993, 269:3015–3023.

    Article  Google Scholar 

  9. Krebs-Smith SM, Kris-Etherton P: How does MyPyramid compare to other population-based recommendations for controlling chronic disease? J Am Diet Assoc 2007, 107:830–837.

    Article  PubMed  Google Scholar 

  10. Pate RR, Pratt M, Blair SN, et al.: Physical activity and public health. A recommendation from the Centers for Disease Control and Prevention and the American College of Sports Medicine. JAMA 1995, 273:402–407.

    Article  PubMed  CAS  Google Scholar 

  11. Haskell WL, Lee IM, Pate RR, et al.: Physical activity and public health: updated recommendation for adults from the American College of Sports Medicine and the American Heart Association. Med Sci Sports Exerc 2007, 39:1423–1434.

    Article  PubMed  Google Scholar 

  12. Van Gaal LF, Mertens IL, Ballaux D: What is the relationship between risk factor reduction and degree of weight loss? Eur Heart J Suppl 2005, 7:L21–L26.

    Article  Google Scholar 

  13. Dattilo AM, Kris-Etherton PM: Effects of weight reduction on blood lipids and lipoproteins: a meta-analysis. Am J Clin Nutr 1992, 56:320–328.

    PubMed  CAS  Google Scholar 

  14. Carroll S, Dudfield M: What is the relationship between exercise and metabolic abnormalities?: a review of the metabolic syndrome. Sports Med 2004, 34:371–418.

    Article  PubMed  Google Scholar 

  15. Kelley GA, Kelley KS, Vu Tran Z: Aerobic exercise, lipids and lipoproteins in overweight and obese adults: a meta-analysis of randomized controlled trials. Int J Obes (Lond) 2005, 29:881–893.

    Article  CAS  Google Scholar 

  16. Leon AS, Sanchez OA: Response of blood lipids to exercise training alone or combined with dietary intervention. Med Sci Sports Exerc 2001, 33:S502–S515; discussion S528–S509.

    Article  PubMed  CAS  Google Scholar 

  17. Kodama S, Tanaka S, Saito K, et al.: Effect of aerobic exercise training on serum levels of high-density lipoprotein cholesterol: a meta-analysis. Arch Intern Med 2007, 167:999–1008.

    Article  PubMed  CAS  Google Scholar 

  18. Fagard RH: Exercise is good for your blood pressure: effects of endurance training and resistance training. Clin Exp Pharmacol Physiol 2006, 33:853–856.

    Article  PubMed  CAS  Google Scholar 

  19. Knowler WC, Barrett-Connor E, Fowler SE, et al.: Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med 2002, 346:393–403.

    Article  PubMed  CAS  Google Scholar 

  20. Orchard TJ, Temprosa M, Goldberg R, et al.: the effect of metformin and intensive lifestyle intervention on the metabolic syndrome: The Diabetes Prevention Program randomized trial. Ann Intern Med 2005, 142:611–619.

    PubMed  CAS  Google Scholar 

  21. Hamman RF, Wing RR, Edelstein SL, et al.: Effect of weight loss with lifestyle intervention on risk of diabetes. Diabetes Care 2006, 29:2102–2107.

    Article  PubMed  Google Scholar 

  22. Pi-Sunyer X, Blackburn G, Brancati FL, et al.: Reduction in weight and cardiovascular disease risk factors in individuals with type 2 diabetes: one-year results of the Look AHEAD trial. Diabetes Care 2007, 30:1374–1383.

    Article  PubMed  Google Scholar 

  23. Koertge J, Weidner G, Elliott-Eller M, et al.: Improvement in medical risk factors and quality of life in women and men with coronary artery disease in the Multicenter Lifestyle Demonstration Project. Am J Cardiol 2003, 91:1316–1322.

    Article  PubMed  Google Scholar 

  24. Ornish D, Brown SE, Billings JH, et al.: Can lifestyle changes reverse coronary heart disease?: the Lifestyle Heart Trial. Lancet 1990, 336:129–133.

    Article  PubMed  CAS  Google Scholar 

  25. Pischke CR, Weidner G, Elliott-Eller M, et al.: Comparison of coronary risk factors and quality of life in coronary artery disease patients with versus without diabetes mellitus. Am J Cardiol 2006, 97:1267–1273.

    Article  PubMed  Google Scholar 

  26. Pischke CR, Weidner G, Elliott-Eller M, Ornish D: Lifestyle changes and clinical profile in coronary heart disease patients with an ejection fraction of <= 40% or > 40% in the Multicenter Lifestyle Demonstration Project. Eur J Heart Fail 2007, 9:928–934.

    Article  PubMed  Google Scholar 

  27. Daubenmier JJ, Weidner G, Sumner MD, et al.: The contribution of changes in diet, exercise, and stress management to changes in coronary risk in women and men in the multisite cardiac lifestyle intervention program. Ann Behav Med 2007, 33:57–68.

    Article  PubMed  Google Scholar 

  28. Appel LJ, Moore TJ, Obarzanek E, et al.: A clinical trial of the effects of dietary patterns on blood pressure. N Engl J Med 1997, 336:1117–1124.

    Article  PubMed  CAS  Google Scholar 

  29. Obarzanek E, Sacks FM, Vollmer WM, et al.: Effects on blood lipids of a blood pressure-lowering diet: the Dietary Approaches to Stop Hypertension (DASH) trial. Am J Clin Nutr 2001, 74:80–89.

    PubMed  CAS  Google Scholar 

  30. Sacks FM, Svetkey LP, Vollmer WM, et al.: Effects on blood pressure of reduced dietary sodium and the Dietary Approaches to Stop Hypertension (DASH) diet. N Engl J Med 2001, 344:3–10.

    Article  PubMed  CAS  Google Scholar 

  31. Appel LJ, Champagne CM, Harsha DW, et al.: Effects of comprehensive lifestyle modification on blood pressure control: main results of the PREMIER clinical trial. JAMA 2003, 289:2083–2093.

    Article  PubMed  Google Scholar 

  32. Elmer PJ, Obarzanek E, Vollmer WM, et al.: Effects of comprehensive lifestyle modification on diet, weight, physical fitness, and blood pressure control: 18-month results of a randomized trial. Ann Intern Med 2006, 144:485–495.

    PubMed  Google Scholar 

  33. Lien LF, Brown AJ, Ard JD, et al.: Effects of PREMIER lifestyle modifications on participants with and without the metabolic syndrome. Hypertension 2007, 50:609–616.

    Article  PubMed  CAS  Google Scholar 

  34. Burke V, Beilin LJ, Cutt HE, et al.: Effects of a lifestyle programme on ambulatory blood pressure and drug dosage in treated hypertensive patients: a randomized controlled trial. J Hypertens 2005, 23:1241–1249.

    Article  PubMed  CAS  Google Scholar 

  35. Ryan DH, Espeland MA, Foster GD, et al.: Look AHEAD (Action for Health in Diabetes): design and methods for a clinical trial of weight loss for the prevention of cardiovascular disease in type 2 diabetes. Control Clin Trials 2003, 24:610–628.

    Article  PubMed  Google Scholar 

  36. The Diabetes Prevention Program Research Group: The Diabetes Prevention Program (DPP): description of lifestyle intervention. Diabetes Care 2002, 25:2165–2171.

    Article  Google Scholar 

  37. Brehm BJ, D’Alessio DA: Weight loss and metabolic benefits with diets of varying fat and carbohydrate content: separating the wheat from the chaff. Nat Clin Pract End Met 2008, 4:140–146.

    Article  CAS  Google Scholar 

  38. Dansinger ML, Gleason JA, Griffith JL, et al.: Comparison of the Atkins, Ornish, Weight Watchers, and Zone Diets for weight loss and heart disease risk reduction: a randomized trial. JAMA 2005, 293:43–53.

    Article  PubMed  CAS  Google Scholar 

  39. Gardner CD, Kiazand A, Alhassan S, et al.: Comparison of the Atkins, Zone, Ornish, and LEARN Diets for change in weight and related risk factors among overweight premenopausal women: the A To Z weight loss study: a randomized trial. JAMA 2007, 297:969–977.

    Article  PubMed  CAS  Google Scholar 

  40. Malik VS, Hu FB: Popular weight-loss diets: from evidence to practice. Nat Clin Pract Cardiovasc Med 2007, 4:34–41.

    Article  PubMed  CAS  Google Scholar 

  41. Nordmann AJ, Nordmann A, Briel M, et al.: Effects of low-carbohydrate vs low-fat diets on weight loss and cardiovascular risk factors: a meta-analysis of randomized controlled trials. Arch Intern Med 2006, 166:285–293.

    Article  PubMed  CAS  Google Scholar 

  42. Alhassan S, Kim S, Bersamin A, et al.: Dietary adherence and weight loss success among overweight women: results from the A To Z weight loss study. Int J Obes 2008 (Epub ahead of print).

  43. McManus K, Antinoro L, Sacks F: A randomized controlled trial of a moderate-fat, low-energy diet compared with a low fat, low-energy diet for weight loss in overweight adults. Int J Obes Relat Metab Disord 2001, 25:1503–1511.

    Article  PubMed  CAS  Google Scholar 

  44. Giugliano D, Esposito K: Mediterranean diet and metabolic diseases. Curr Opin Lipidol 2008, 19:63–68.

    PubMed  CAS  Google Scholar 

  45. Esposito K, Marfella R, Ciotola M, et al.: Effect of a Mediterranean-style diet on endothelial dysfunction and markers of vascular inflammation in the metabolic syndrome: a randomized trial. JAMA 2004, 292:1440–1446.

    Article  PubMed  CAS  Google Scholar 

  46. van Baak MA, Larsen TM, Jebb A, et al.: Weight loss maintenance on ad libitum diets varying in protein content and glycemic index: first results of the DIOGENES highly-controlled shop-based intervention. Available at http://www.diogenes-eu.org/News/ECO2008%20Abstract%20Template.pdf. Accessed on June 2, 2008.

  47. Ello-Martin JA, Roe LS, Ledikwe JH, et al.: Dietary energy density in the treatment of obesity: a year-long trial comparing 2 weight-loss diets. Am J Clin Nutr 2007, 85:1465–1477.

    PubMed  CAS  Google Scholar 

  48. Ledikwe JH, Rolls BJ, Smiciklas-Wright H, et al.: Reductions in dietary energy density are associated with weight loss in overweight and obese participants in the PREMIER trial. Am J Clin Nutr 2007, 85:1212–1221.

    PubMed  CAS  Google Scholar 

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Correspondence to Penny M. Kris-Etherton.

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Hill, A.M., Kris-Etherton, P.M. Contemporary strategies for weight loss and cardiovascular disease risk factor modification. Curr Atheroscler Rep 10, 486–496 (2008). https://doi.org/10.1007/s11883-008-0076-1

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