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Relation between body composition, mode of wieght reduction and hypertension in obese patients with impaired glucose tolerance
AJH 1996;9:177A-178A
POSTERS: Diet, Nutrition and Metabolism
J2 RELATION BETWEEN BODY COMPOSITION, MODE OF WEIGHT REDUCTION AND HYPERTENSION IN OBESE PATIENTS WITH IMPAIRED GLUCOSE TOLERANCE. o Hamd!·. ManllOUr. FaCUlty or Medicine, MansourI, Egypt. Obesity, hypertension and impaired glucose Iolerance are frequently conCO~l~t ~s components of the metabohc syndrome together WIth dyshp"lernia, tnsulin resis~ce and hyperuncemia To Investigate the effect of the mode ~f weIght reduction on hypertenSIOn and glucose tolerance, 60 pstlents WIth unpsrred glucose tolerance increased body mass index (BMI) >30 and recently dIagnosed hypertensl~n, were randomly dIVIded tnto 3 groups group "A" was rnatntained on 1600 KcaVdny dIet, group "B" on fo~ula dIet ennched WIth ins~t protein to minunize the loss in lean body weIght ~d group "C" on ~dard 2200 KcaVdny dIet as a control group. SodIum mlake was kept similar and all the three groups were adVIsed 10 ~erclse. dnily. Body composition parameters were measured by the bIoelectrical unpednnce lest, before and atler 12 weeks Fitleen patients were non-adherent and were excluded Groups "An & "n'" showed slgOlficant reduction in fasting plasma glucose (p<0.01). postprandial plasma glucose (p<0.05) and 1!bA1' (p<0.05) on comparison WIth group "C", but no slgruficant differences were notIced between them Group "An showed 34 5% reduction m the excess body fat, while group "B" 26 2% and group "C" g I % Changes in the lean body weIght were -2. g, -2 3 and +O.6Kg in the three groups respectIvely The reduction in fatllean ratIo atler the study penod was 77 in group "A", 5.1 10 group "B" and 3.1 m group "e" Iloth dIet regunens lead to a hIghly significant reduction in Iotal body weight, BMI, percent body fat. fat body weight and blood pressure (p<0.001). WeIght reduction in the first 2 groups was associated with a reduction in mean SBP and DBP of 7.6fT and 11.3/9 g nunHg respectively, WIth no change in the third group. DespIte the reduction in total body weIght and BMI is sigruficantly less in group "A" than group "B" (p<0.05), thIS group achieved more reductIon in SBP and DBP. PrecIsely, it was noticed that the reduclJon an fatllean ratio was SIgnificantly different between those 2 groups (p<0.05). It IS concluded that nol only the extent of weIght loss is the determent of the magrutude of blood pressure control 10 obese patients WIth metabotlc syndrome but also the psttern of body composItion, specIally fatllean ratio, is much more unportanl. Conservation of lean body weight by exercising and by mcreasmg protem portion m the diet regImen must be of pnme concern in diet planmng for obese patients with hypertension as this could achieve better control of blood pressure even WIth modest decrease in total body weight and BMI On the other hand the mode of weight reduclJon has no effect on the extent of improvement in glucose Iolerance Key Words:
ATTENDANCE AT GROUP COUNSELING SESSIONS NOT PREDICTIVE OF SUCCESS WITH WEIGHT LOSS IN THE HOT WEIGHT LOSS SUBSTUDY. ME Miller,* ME Cameron, DL Willoughby, CM Adair, and DW Jones*. Univ. of MS Medical Center, Jackson, MS. Of 114 subjects enrolled in the Weight Loss Substudy of the Hypertension Optimal Treatment (HOT) International Study, 56 were randomized to a weight loss intervention consisting of traditional behavioral methods with an emphasis on dietary caloric and fatty intake reduction implemented by a registered dietitian. Much of the intervention was planned through group counseling/educational sessions. In this analysis of the 53 subjects in follow-up, the association between attendance at the group sessions and weight loss (>1 lb.) at 18 months is described. Results: Weight Loss YES NO Attendance >20% 10 13 <20% 11 19 P - 0.78 (Chi square) We conclude that there was no association between attendance at group sessions and success at weight loss in this study. This adds to the growing evidence that current behavioral methods to assist subjects in weight loss are less than optimal. Key Words:
body composition, obesity, hypel1ension, weight reduction, dIet.
Weight, Compliance, Obesity, Hypertension, Blood Pressure
J3
J4
EFFECTS OF A COMPREHENSNE NUTRITION PROGRAM IN SUBJECTS WITH GENERALIZED CARnIOVASCULAR AND METABOLIC DISEASE (GCMD) pA McCarrop", L Resnick, S Opari1, on behalf of the Vanguard Study Group, Oregon Health Sciences University, PonIand, OR DIet is a preferred initial method of treatrnelll for many cardiovascular and metabolic diseases. We report on a multicclller study comparing two therapeutIc dietary intervelllions: I) self-selection of foods and 2) a proprietary prepared meal plan. Subjects (N = 97) met criteria for two or more of the GCMD triad of hypertension, dyslipldemia, or NIDDM. As a part of. larger study, free-living adults (2S- 70 yrs) were given nutritional prescriptions based on itKIlviduai energy requiremelllS for a diet of <20" Kcal from fal, IS20" Kcal from protein. and SS-60" from cartlohydtrates. Of the nwltiple cardiovascular risk factor subjects, 47 were randomized to the self-select plan and SO to the prepared meal plan. Blood pressure, lipids, carbohydrate melabohsm, and food intake were measured throughout the 10-week trial. Both dietary plans (treatrnelll-baseline) significantly reduced all of the following variables: PValue PValue Between SelfPrepared With lliW ~ ~ EIaD I2ic1 0.18 SBP (mmHg) -S.0±8.7 -7.3±8.1 <0.001 0.04 DBP (mmHg) -3.3±S.0 -S.HS.3 <0.001 0.002 BMI females -1.0±1.1 -2.0±1.0 <0.001 0.002 BMI males -1.0±0.9 -U±1.2 <0.001 0.S7 Chol (mg/dl) -11.3±23.9 -14.1±24.2 <0.001 0.S7 Glu (mgld!) -6.4±18.2 -9.1±26 -0.001 0.81 HbA (") ~.2±O.S ~.3±0.8 <0.001 0.03 Insulin (J.lIU/ml) ~.l ±S.O ·2.7±6, I -0.02
DIET IMPROVES QUALITY OF LIFE (QOL) IN PATIENTS WITH GENERALIZED CARDIOVASCULAR METABOUC DISEASE (GCMD) Damel C HaUQP", and the Vanguard Study Group, Oregon Health Sciences University, Portland, OR
Dtfferences (treatrnelll-baseline) in outcomes between the groups were The benelicial health effects of a prepared meal program in GCMD patielllS at high risk for cardiovascular disease, and the ease or its prescription aOO practice, make it • viable option to effect dietary change.
not statistically significant,
Key Words: dietary intervention, generalized cardiovascular aOO metabolic disease, hypertension, dyslipidemia, NIDDM
Improved nutrition is • fundamental part of the therapeutic regimen for patients with hypertension and other chronic dIseases with cardiovascular sequelae. A major obstacle to improving nutrition patterns has been the diffiCUlty people have modlfylOg their diets to incorporate nutritIon reconunendalJoos. Therefore, findmg ways of reducing the difficulties associated WIth dielary change is of Cnllcal imponance to the success nutntlonal therapy. The objective of this study was to assess quality of life following two dtfferent dIetary intervelllions deSIgned to achIeve the same health outcomes; a complete prepared meal plan and an intensive nutritionist-guided, self-selected diet. Both meal plans provided as "Kcal <20% fal, IS-20%protein and SS-60% carbohydrate. Subjects (n=S60) from 10 medical centers met enlry criteria for marginally cOlllrolled hypertensIOn, dyslipidemia or NIDDM and were randomly assigned to the two diet groups. The study consisted ota 4-week-phase of usual diet followed by a 10 week diet intervention phase. Quality of Me was measured at weeks -2, 0, 4 and 10. Repealed measures ANOVA showed that both groups had significant improvement over weeks for mental health (p< .(01), general health perceptions (p< .001), dally and work activIties (P< .001), social funclJon (P< .(01), wtritional health perceptions (P< .(01), tUltritional hassles (P< .(01), affect (P< .(01) and dtet satisfaction (p < .001). lmprovemellls were greater for iOOividuais in the prepared meal plan for daily aOO work activities (p < .OS) aOO nutritional health perceptions (P< .01). We conclude that improving tUltrition palterns enhances QOL in patiellls with GCMD. Reducing the demands on the patient by providing a complete prepared meal plan results in the grealest improvement in QOL.
Key Words.
quality of Itfe, hypenension, nutrition, generalized cardiovascular metabolic disease, diet
POSTERS: Diet, Nutrition and Metabolism
J2 RELATION BETWEEN BODY COMPOSITION, MODE OF WEIGHT REDUCTION AND HYPERTENSION IN OBESE PATIENTS WITH IMPAIRED GLUCOSE TOLERANCE. o Hamd!·. ManllOUr. FaCUlty or Medicine, MansourI, Egypt. Obesity, hypertension and impaired glucose Iolerance are frequently conCO~l~t ~s components of the metabohc syndrome together WIth dyshp"lernia, tnsulin resis~ce and hyperuncemia To Investigate the effect of the mode ~f weIght reduction on hypertenSIOn and glucose tolerance, 60 pstlents WIth unpsrred glucose tolerance increased body mass index (BMI) >30 and recently dIagnosed hypertensl~n, were randomly dIVIded tnto 3 groups group "A" was rnatntained on 1600 KcaVdny dIet, group "B" on fo~ula dIet ennched WIth ins~t protein to minunize the loss in lean body weIght ~d group "C" on ~dard 2200 KcaVdny dIet as a control group. SodIum mlake was kept similar and all the three groups were adVIsed 10 ~erclse. dnily. Body composition parameters were measured by the bIoelectrical unpednnce lest, before and atler 12 weeks Fitleen patients were non-adherent and were excluded Groups "An & "n'" showed slgOlficant reduction in fasting plasma glucose (p<0.01). postprandial plasma glucose (p<0.05) and 1!bA1' (p<0.05) on comparison WIth group "C", but no slgruficant differences were notIced between them Group "An showed 34 5% reduction m the excess body fat, while group "B" 26 2% and group "C" g I % Changes in the lean body weIght were -2. g, -2 3 and +O.6Kg in the three groups respectIvely The reduction in fatllean ratIo atler the study penod was 77 in group "A", 5.1 10 group "B" and 3.1 m group "e" Iloth dIet regunens lead to a hIghly significant reduction in Iotal body weight, BMI, percent body fat. fat body weight and blood pressure (p<0.001). WeIght reduction in the first 2 groups was associated with a reduction in mean SBP and DBP of 7.6fT and 11.3/9 g nunHg respectively, WIth no change in the third group. DespIte the reduction in total body weIght and BMI is sigruficantly less in group "A" than group "B" (p<0.05), thIS group achieved more reductIon in SBP and DBP. PrecIsely, it was noticed that the reduclJon an fatllean ratio was SIgnificantly different between those 2 groups (p<0.05). It IS concluded that nol only the extent of weIght loss is the determent of the magrutude of blood pressure control 10 obese patients WIth metabotlc syndrome but also the psttern of body composItion, specIally fatllean ratio, is much more unportanl. Conservation of lean body weight by exercising and by mcreasmg protem portion m the diet regImen must be of pnme concern in diet planmng for obese patients with hypertension as this could achieve better control of blood pressure even WIth modest decrease in total body weight and BMI On the other hand the mode of weight reduclJon has no effect on the extent of improvement in glucose Iolerance Key Words:
ATTENDANCE AT GROUP COUNSELING SESSIONS NOT PREDICTIVE OF SUCCESS WITH WEIGHT LOSS IN THE HOT WEIGHT LOSS SUBSTUDY. ME Miller,* ME Cameron, DL Willoughby, CM Adair, and DW Jones*. Univ. of MS Medical Center, Jackson, MS. Of 114 subjects enrolled in the Weight Loss Substudy of the Hypertension Optimal Treatment (HOT) International Study, 56 were randomized to a weight loss intervention consisting of traditional behavioral methods with an emphasis on dietary caloric and fatty intake reduction implemented by a registered dietitian. Much of the intervention was planned through group counseling/educational sessions. In this analysis of the 53 subjects in follow-up, the association between attendance at the group sessions and weight loss (>1 lb.) at 18 months is described. Results: Weight Loss YES NO Attendance >20% 10 13 <20% 11 19 P - 0.78 (Chi square) We conclude that there was no association between attendance at group sessions and success at weight loss in this study. This adds to the growing evidence that current behavioral methods to assist subjects in weight loss are less than optimal. Key Words:
body composition, obesity, hypel1ension, weight reduction, dIet.
Weight, Compliance, Obesity, Hypertension, Blood Pressure
J3
J4
EFFECTS OF A COMPREHENSNE NUTRITION PROGRAM IN SUBJECTS WITH GENERALIZED CARnIOVASCULAR AND METABOLIC DISEASE (GCMD) pA McCarrop", L Resnick, S Opari1, on behalf of the Vanguard Study Group, Oregon Health Sciences University, PonIand, OR DIet is a preferred initial method of treatrnelll for many cardiovascular and metabolic diseases. We report on a multicclller study comparing two therapeutIc dietary intervelllions: I) self-selection of foods and 2) a proprietary prepared meal plan. Subjects (N = 97) met criteria for two or more of the GCMD triad of hypertension, dyslipldemia, or NIDDM. As a part of. larger study, free-living adults (2S- 70 yrs) were given nutritional prescriptions based on itKIlviduai energy requiremelllS for a diet of <20" Kcal from fal, IS20" Kcal from protein. and SS-60" from cartlohydtrates. Of the nwltiple cardiovascular risk factor subjects, 47 were randomized to the self-select plan and SO to the prepared meal plan. Blood pressure, lipids, carbohydrate melabohsm, and food intake were measured throughout the 10-week trial. Both dietary plans (treatrnelll-baseline) significantly reduced all of the following variables: PValue PValue Between SelfPrepared With lliW ~ ~ EIaD I2ic1 0.18 SBP (mmHg) -S.0±8.7 -7.3±8.1 <0.001 0.04 DBP (mmHg) -3.3±S.0 -S.HS.3 <0.001 0.002 BMI females -1.0±1.1 -2.0±1.0 <0.001 0.002 BMI males -1.0±0.9 -U±1.2 <0.001 0.S7 Chol (mg/dl) -11.3±23.9 -14.1±24.2 <0.001 0.S7 Glu (mgld!) -6.4±18.2 -9.1±26 -0.001 0.81 HbA (") ~.2±O.S ~.3±0.8 <0.001 0.03 Insulin (J.lIU/ml) ~.l ±S.O ·2.7±6, I -0.02
DIET IMPROVES QUALITY OF LIFE (QOL) IN PATIENTS WITH GENERALIZED CARDIOVASCULAR METABOUC DISEASE (GCMD) Damel C HaUQP", and the Vanguard Study Group, Oregon Health Sciences University, Portland, OR
Dtfferences (treatrnelll-baseline) in outcomes between the groups were The benelicial health effects of a prepared meal program in GCMD patielllS at high risk for cardiovascular disease, and the ease or its prescription aOO practice, make it • viable option to effect dietary change.
not statistically significant,
Key Words: dietary intervention, generalized cardiovascular aOO metabolic disease, hypertension, dyslipidemia, NIDDM
Improved nutrition is • fundamental part of the therapeutic regimen for patients with hypertension and other chronic dIseases with cardiovascular sequelae. A major obstacle to improving nutrition patterns has been the diffiCUlty people have modlfylOg their diets to incorporate nutritIon reconunendalJoos. Therefore, findmg ways of reducing the difficulties associated WIth dielary change is of Cnllcal imponance to the success nutntlonal therapy. The objective of this study was to assess quality of life following two dtfferent dIetary intervelllions deSIgned to achIeve the same health outcomes; a complete prepared meal plan and an intensive nutritionist-guided, self-selected diet. Both meal plans provided as "Kcal <20% fal, IS-20%protein and SS-60% carbohydrate. Subjects (n=S60) from 10 medical centers met enlry criteria for marginally cOlllrolled hypertensIOn, dyslipidemia or NIDDM and were randomly assigned to the two diet groups. The study consisted ota 4-week-phase of usual diet followed by a 10 week diet intervention phase. Quality of Me was measured at weeks -2, 0, 4 and 10. Repealed measures ANOVA showed that both groups had significant improvement over weeks for mental health (p< .(01), general health perceptions (p< .001), dally and work activIties (P< .001), social funclJon (P< .(01), wtritional health perceptions (P< .(01), tUltritional hassles (P< .(01), affect (P< .(01) and dtet satisfaction (p < .001). lmprovemellls were greater for iOOividuais in the prepared meal plan for daily aOO work activities (p < .OS) aOO nutritional health perceptions (P< .01). We conclude that improving tUltrition palterns enhances QOL in patiellls with GCMD. Reducing the demands on the patient by providing a complete prepared meal plan results in the grealest improvement in QOL.
Key Words.
quality of Itfe, hypenension, nutrition, generalized cardiovascular metabolic disease, diet