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Abstract (Nakata Y in AFSM 2005)
Many studies have revealed that comprehensive lifestyle
therapy, involving diet, exercise, and behavioral modification, can
lead to improvements in coronary heart disease (CHD) risk factors. To
sustain the effects of lifestyle therapy, long-term maintenance of the
reduced weight and visceral fat would be required. However, many obese
persons experience weight gains after relapsing toward their pre-intervention
lifestyle. Few reports are currently available that indicate the extent
to which gains of weight and visceral fat contribute to unfavorable
effects on CHD risk factors. PURPOSE: To examine the
effect of changes in weight and visceral fat on CHD risk factors after
weight loss. METHODS: One hundred fourteen overweight
and obese women (age 46.5 ± 8.0 years, BMI 27.6 ± 2.8 kg/m2) had participated
in a 14-week weight-loss program and were retested 2 to 5 (3.6 ± 1.4)
years later. The changes of weight, visceral fat area (VFA) estimated
with computed tomography, and CHD risk factors [systolic and diastolic
blood pressure (SBP, DBP), total cholesterol (TC), triglycerides (TG),
low-density lipoprotein cholesterol (LDLC), and fasting plasma glucose
(FPG)] were assessed before and after the weight-loss program and at
follow-up. RESULTS: Body weight before and after the
program averaged 67.7 ± 7.5 kg and 59.1 ± 7.0 kg, respectively, and
the mean increased to 63.2 ± 8.0 kg at follow-up. With the moderate
rebound of weight (+4.1 ± 3.5 kg), VFA increased slightly but significantly
(+9.4 ± 25.9 cm2, P < 0.05). The weight change was significantly
correlated with changes in SBP, DBP, and VFA (P < 0.05), and the
VFA change was significantly correlated with change in DBP. Although
TC, TG, LDLC, and FPG also increased (P < 0.05), they were not significantly
associated with changes in weight and VFA. CONCLUSION:
A moderate weight rebound was accompanied by relapses of CHD risk factor
profiles. The extent of the relapses could not always be accounted for
by the changes in weight and VFA.