Factors Associated with Visceral Fat Loss in Response to a Multifaceted Weight Loss Intervention

Background

Visceral adipose tissue is more metabolically active than other fat depots and is more closely associated with obesity-related diseases, such as cardiovascular disease and type 2 diabetes, than indicators of obesity, such as body mass index. Across various strategies to promote weight loss, including energy-reduced diet and exercise, variable effects on VAT compared to loss of total body fat have been reported.

Methods

To examine the effect of a behavioral weight loss intervention using portion-controlled prepackaged entrées on VAT, we examined data and measurements from overweight/obese men and women (N=183) who were assigned to a weight loss intervention and prescribed a reduced-energy diet with either portion-controlled prepackaged entrées or self-selected meals in a randomized clinical trial. VAT was estimated with dual-energy X-ray absorptiometry at baseline and study end (12 weeks).

Results

VAT loss was greater for the prepackaged entrees group (p=0.02), with an average loss of 29% compared to an average loss of 19% among participants consuming self-selected meals. VAT (mean [SEM]) was 1651 (71) g and 1546 (157) g at baseline and 1234 (59) g and 1278 (118) g at study end in the prepackaged entrees and self-selected meal groups, respectively. Greater VAT loss was associated with higher baseline weight and VAT, and greater weight loss, but not associated with age or physical activity.

Conclusion

Prescribing portion-controlled prepackaged entrees in a behavioral weight loss intervention promotes a reduction in VAT, which should promote improved metabolic profile and reduced cardiovascular disease risk.

Six Month Outcomes of a Primary Care-Based Weight Loss Trial Using a Lay-Trained Counselor

BACKGROUND

Obesity remains an important problem in primary health care settings. Intensive counseling from trained nutrition professionals has proven efficacy but is resource intensive. Trials have begun to assess the effectiveness of lower cost counselors.

METHODS

This paper describes the 6-month outcomes of a high intensity counseling intervention on weight (primary outcome), as well as cardiovascular disease risk factors and health-related quality of life (secondary outcomes). We also sought to assess whether baseline characteristics were associated with 6-month weight change. Participants (n=106) had obesity and at least one co-morbid medical condition. The trial used a trained layperson counselor and provided study participants with subsidized access to an evidence-based regimen of portion-controlled foods. Weight change data were analyzed using intention-to-treat analysis. Participants who dropped out prior to 6 months were assumed to have regained weight.

RESULTS

Average weight loss after 6 months was 7.0 kg, equal to 6.5% of initial weight. Significant improvements were noted in blood pressure, waist circumference, glycemic control, mood, and overall health-related quality of life. Most baseline characteristics were not associated with weight loss after 6 months.

CONCLUSIONS

An intensive lifestyle intervention, using a trained layperson and portion-controlled foods, produced clinically significant weight loss at 6 months. Improvements were also noted in cardiovascular disease risk factors and in quality of life.