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The effect of a randomized controlled physical activity trial on health related quality of life in metabolically unhealthy African-American women: FIERCE STUDY.
Taylor, TR, Dash, C, Sheppard, V, Makambi, K, Ma, X, Adams-Campbell, LL
Contemporary clinical trials. 2018;:121-128
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Abstract
PURPOSE African-American women (AAW) are more likely to be metabolically unhealthy than White women (WW). Metabolic syndrome (MetS) is associated with increased breast cancer risk and mortality from breast cancer is greater in AAW compared to WW. Data show MetS affects health-related quality of life (HRQoL). Exercise studies report improvements in MetS, however, no study to date has examined HRQoL in metabolically unhealthy AAW enrolled in an exercise trial. METHODS This report examined the effect of a 6-month, 3-arm (supervised exercise, home-based exercise, control) randomized exercise controlled trial on HRQoL among 213 obese, metabolically unhealthy, postmenopausal AAW at high risk for breast cancer. RESULTS Certain baseline participant characteristics were related to baseline HRQoL dimensions. The "exercise group" (supervised group combined with the home-based group) showed significantly greater improvement in health change scores (M = 13.6, SD = 3.1) compared to the control group (M = 0.7, SD = 4.4) (p = 0.02) over the 6-month study period. There were no significant differences in HRQoL change scores between the 3 study groups, however, although non-significant, data indicated most HRQoL change scores were more favorable in the supervised group. CONCLUSION While significant improvement occurred in health change scores in the combined supervised and home-based group compared to the control group, we did not observe any significant differences on HRQoL change scores between all three study groups. However, while non-significant, there was a trend for more favorable HRQoL change scores in the supervised group versus the home-based and control groups. Additional research is needed to further explore this topic.
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Treatment of metabolic syndrome by combination of physical activity and diet needs an optimal protein intake: a randomized controlled trial.
Dutheil, F, Lac, G, Courteix, D, Doré, E, Chapier, R, Roszyk, L, Sapin, V, Lesourd, B
Nutrition journal. 2012;:72
Abstract
BACKGROUND The recommended dietary allowance (RDA) for protein intake has been set at 1.0-1.3 g/kg/day for senior. To date, no consensus exists on the lower threshold intake (LTI = RDA/1.3) for the protein intake (PI) needed in senior patients ongoing both combined caloric restriction and physical activity treatment for metabolic syndrome. Considering that age, caloric restriction and exercise are three increasing factors of protein need, this study was dedicated to determine the minimal PI in this situation, through the determination of albuminemia that is the blood marker of protein homeostasis. METHODS Twenty eight subjects (19 M, 9 F, 61.8 ± 6.5 years, BMI 33.4 ± 4.1 kg/m²) with metabolic syndrome completed a three-week residential programme (Day 0 to Day 21) controlled for nutrition (energy balance of -500 kcal/day) and physical activity (3.5 hours/day). Patients were randomly assigned in two groups: Normal-PI (NPI: 1.0 g/kg/day) and High-PI (HPI: 1.2 g/kg/day). Then, patients returned home and were followed for six months. Albuminemia was measured at D0, D21, D90 and D180. RESULTS At baseline, PI was spontaneously 1.0 g/kg/day for both groups. Albuminemia was 40.6 g/l for NPI and 40.8 g/l for HPI. A marginal protein under-nutrition appeared in NPI with a decreased albuminemia at D90 below 35 g/l (34.3 versus 41.5 g/l for HPI, p < 0.05), whereas albuminemia remained stable in HPI. CONCLUSION During the treatment based on restricted diet and exercise in senior people with metabolic syndrome, the lower threshold intake for protein must be set at 1.2 g/kg/day to maintain blood protein homeostasis.
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A low-carbohydrate as compared with a low-fat diet in severe obesity.
Samaha, FF, Iqbal, N, Seshadri, P, Chicano, KL, Daily, DA, McGrory, J, Williams, T, Williams, M, Gracely, EJ, Stern, L
The New England journal of medicine. 2003;(21):2074-81
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Abstract
BACKGROUND The effects of a carbohydrate-restricted diet on weight loss and risk factors for atherosclerosis have been incompletely assessed. METHODS We randomly assigned 132 severely obese subjects (including 77 blacks and 23 women) with a mean body-mass index of 43 and a high prevalence of diabetes (39 percent) or the metabolic syndrome (43 percent) to a carbohydrate-restricted (low-carbohydrate) diet or a calorie- and fat-restricted (low-fat) diet. RESULTS Seventy-nine subjects completed the six-month study. An analysis including all subjects, with the last observation carried forward for those who dropped out, showed that subjects on the low-carbohydrate diet lost more weight than those on the low-fat diet (mean [+/-SD], -5.8+/-8.6 kg vs. -1.9+/-4.2 kg; P=0.002) and had greater decreases in triglyceride levels (mean, -20+/-43 percent vs. -4+/-31 percent; P=0.001), irrespective of the use or nonuse of hypoglycemic or lipid-lowering medications. Insulin sensitivity, measured only in subjects without diabetes, also improved more among subjects on the low-carbohydrate diet (6+/-9 percent vs. -3+/-8 percent, P=0.01). The amount of weight lost (P<0.001) and assignment to the low-carbohydrate diet (P=0.01) were independent predictors of improvement in triglyceride levels and insulin sensitivity. CONCLUSIONS Severely obese subjects with a high prevalence of diabetes or the metabolic syndrome lost more weight during six months on a carbohydrate-restricted diet than on a calorie- and fat-restricted diet, with a relative improvement in insulin sensitivity and triglyceride levels, even after adjustment for the amount of weight lost. This finding should be interpreted with caution, given the small magnitude of overall and between-group differences in weight loss in these markedly obese subjects and the short duration of the study. Future studies evaluating long-term cardiovascular outcomes are needed before a carbohydrate-restricted diet can be endorsed.