Men and women respond differently to rapid weight loss: Metabolic outcomes of a multi-centre intervention study after a low-energy diet in 2500 overweight, individuals with pre-diabetes (PREVIEW).

Abstract

AIMS:

The PREVIEW lifestyle intervention study (ClinicalTrials.gov Identifier: NCT01777893) is, to date, the largest, multinational study concerning prevention of type-2 diabetes. We hypothesized that the initial, fixed low-energy diet (LED) would induce different metabolic outcomes in men vs women.

MATERIALS AND METHODS:

All participants followed a LED (3.4 MJ/810 kcal/daily) for 8 weeks (Cambridge Weight Plan). Participants were recruited from 8 sites in Europe, Australia and New Zealand. Those eligible for inclusion were overweight (BMI ≥ 25 kg/m2 ) individuals with pre-diabetes according to ADA-criteria. Outcomes of interest included changes in insulin resistance, fat mass (FM), fat-free mass (FFM) and metabolic syndrome Z-score.

RESULTS:

In total, 2224 individuals (1504 women, 720 men) attended the baseline visit and 2020 (90.8%) completed the follow-up visit. Following the LED, weight loss was 16% greater in men than in women (11.8% vs 10.3%, respectively) but improvements in insulin resistance were similar. HOMA-IR decreased by 1.50 ± 0.15 in men and by 1.35 ± 0.15 in women (ns). After adjusting for differences in weight loss, men had larger reductions in metabolic syndrome Z-score, C-peptide, FM and heart rate, while women had larger reductions in HDL cholesterol, FFM, hip circumference and pulse pressure. Following the LED, 35% of participants of both genders had reverted to normo-glycaemia.

CONCLUSIONS:

An 8-week LED induced different effects in women than in men. These findings are clinically important and suggest gender-specific changes after weight loss. It is important to investigate whether the greater decreases in FFM, hip circumference and HDL cholesterol in women after rapid weight loss compromise weight loss maintenance and future cardiovascular health.

• Authors: Pia Christensen, Thomas Meinert Larsen, Margriet Westerterp-Plantenga, Ian Macdonald, J Alfredo Martinez, Svetoslav Handjiev, Sally Poppitt, Sylvia Hansen, Christian Ritz, Arne Astrup, Laura Pastor-Sanz, Finn Sandø-Pedersen, Kirsi H Pietiläinen, Jouko Sundvall, Mathijs Drummen, Moira A Taylor, Santiago Navas-Carretero, Teodora Handjieva-Darlenska, Shannon Brodie, Marta P Silvestre, Maija Huttunen-Lenz, Jennie Brand-Miller, Mikael Fogelholm, Anne Raben
• Journal: Diabetes, obesity & metabolism (Diabetes Obes Metab) Vol. 20 Issue 12 Pg. 2840-2851 (12 2018) ISSN: 1463-1326 [Electronic] England
• PMID: 30088336 (Publication Type: Journal Article, Multicenter Study, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
• Copyright: © 2018 The Authors. Diabetes, Obesity and Metabolism published by John Wiley & Sons Ltd.

Chemical References

• Blood Glucose
• Cholesterol, HDL

Topics

• Adult
• Aged
• Australia
• Blood Glucose
• Body Mass Index
• Caloric Restriction (methods)
• Cholesterol, HDL (blood)
• Diabetes Mellitus, Type 2 (etiology, prevention & control)
• Europe
• Female
• Humans
• Insulin Resistance
• Life Style
• Male
• Metabolic Syndrome (complications, diet therapy, physiopathology)
• Middle Aged
• New Zealand
• Overweight (complications, diet therapy, physiopathology)
• Prediabetic State (diet therapy, etiology, physiopathology)
• Sex Factors
• Time Factors
• Treatment Outcome
• Weight Loss (physiology)