1.
Regaining body weight after weight reduction further increases pulse wave velocity in obese men with metabolic syndrome.
Liang, KW, Lee, WJ, Lee, IT, Lin, SY, Wang, JS, Lee, WL, Sheu, WH
Medicine. 2018;97(40):e12730
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Atherosclerosis can increase stiffness of the aorta and, therefore, increased pulse wave velocity (PWV), which is a predictor for cardiovascular disease and mortality. Metabolic syndrome (MetS), diabetes and obesity increase the risk of aortic stiffness and higher PWV. Weight loss may reduce arterial stiffness but mechanisms are not known. The aim this study was to investigate changes over time of PWV, ankle-brachial index (ABI, a marker for arterial disease of the leg), insulin resistance and inflammatory markers after weight loss and regained weight in obese non-diabetic men with MetS compared to lean controls. Obese participants followed a three months weight loss programme based on diet and exercise during which they lost an average of 8.6kg and saw statistically significant improvements in blood pressure and many biochemical markers but not in PWV or ABI. At the second follow-up visit, at 60 months, they had regained their weight, blood pressure and most biochemical markers were back to baseline whilst PWV and adiponectin were worse than before weight loss. Increases in blood pressure but not weight, hs-CRP (an inflammatory marker) or insulin resistance correlated with the increase in PWV after weight regain. Although healthy controls also gained weight over the 60 months study duration, their increase in PWV was significantly lower than in obese participants. Their PWV was also lower at baseline.
Abstract
Subjects with metabolic syndrome (MetS) or obesity have worse arterial stiffness. However, there have been no studies addressing time-sequential changes in pulse wave velocity (PWV) after weight loss and then regaining weight in obese non-diabetic men with MetS.We prospectively enrolled 40 obese, non-diabetic men with MetS undergoing a 3-month weight reduction program. Another 26 lean and healthy men were recruited for comparisons. Oral glucose tolerance test and brachial ankle (ba) PWV were assessed in study subjects. Eighteen obese non-diabetic MetS and 15 lean control subjects had follow-ups at the 60th month.The body weight of obese MetS decreased from 94.8 ± 7.6 to 86.1 ± 9.0 (N = 18, P < .001) after a 3-month weight reduction program but regained gradually thereafter to 93.6 ± 11.6 kg at the 60th month (P < .001 versus 3rd month). baPWV decreased after weight loss slightly (P = .240) while weight regain significantly increased the baPWV (from 3rd month, 1358 ± 168 to 60th month 1539 ± 264 cm/sec, P < .001). Systolic and diastolic blood pressure increments correlated with the increment of baPWV after weight regain. At the 60th month, lean controls (N = 15) had increases in body weight while their baPWV increased non-significantly. The increments of baPWV after weight regain in obese MetS were significantly higher than the increment of baPWV in lean controls after weight gain.In conclusion, regaining body weight after weight reduction worsened arterial stiffness with significant increase of baPWV in obese non-diabetic MetS.
2.
A Pecan-Rich Diet Improves Cardiometabolic Risk Factors in Overweight and Obese Adults: A Randomized Controlled Trial.
McKay, DL, Eliasziw, M, Chen, CYO, Blumberg, JB
Nutrients. 2018;10(3)
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There has been a global rise in cardiovascular disease (CVD) and type 2 diabetes mellitus (TD2M) and dietary risk factors are a known contributor. While evidence has shown that an increased intake of tree nuts is associated with a reduced risk of disease indicators, there is limited research specifically on the effects of pecans. The aim of this randomised crossover trial was to assess the impact of pecan consumption on biomarkers related to CVD and T2DM risk in 26 overweight or obese women. Participants consumed a pecan-rich diet with an iso-caloric control diet of similar fat and fibre content, but absent in nuts, for four weeks with a two-week washout period. This trial demonstrated that displacing a portion of saturated fat in the typical American diet with pecans has a protective effect for CVD and TD2M. Based on these results, the authors recommend using dietary change as a first-line approach to disease prevention and management and suggest further studies be done to better understand potential benefits and associated mechanisms.
Abstract
Evidence from observational and intervention studies has shown a high intake of tree nuts is associated with a reduced risk of cardiovascular disease (CVD), mortality from type 2 diabetes (T2DM), and all-cause mortality. However, there is limited data regarding their effects on indicators of cardiometabolic risk other than hypercholesterolemia, and little is known about the demonstrable health benefits of pecans (Carya illinoensis (Wangenh.) K.Koch). We conducted a randomized, controlled feeding trial to compare the effects of a pecan-rich diet with an isocaloric control diet similar in total fat and fiber content, but absent nuts, on biomarkers related to CVD and T2DM risk in healthy middle-aged and older adults who are overweight or obese with central adiposity. After 4 weeks on a pecan-rich diet, changes in serum insulin, insulin resistance (HOMA-IR) and beta cell function (HOMA-β) were significantly greater than after the control diet (p < 0.05). Pecan consumption also lowered the risk of cardiometabolic disease as indicated by a composite score reflecting changes in clinically relevant markers. Thus, compared to the control diet, the pecan intervention had a concurrent and clinically significant effect on several relevant markers of cardiometabolic risk.