Morbid Obesity Center, Vestfold Hospital Trust, Tønsberg, Norway.
Obesity (Silver Spring). 2013 Apr;21(4):690-7. doi: 10.1002/oby.20099.
Arterial stiffness is an independent predictor of cardiovascular morbidity and mortality. This study aimed to compare the 7-week effect of a low-calorie diet (LCD) and an intensive lifestyle intervention program (ILI) on arterial stiffness in morbidly obese individuals.
Nonrandomized clinical trial. The LCD provided 900 kcal/day, and participants in the LCD group were instructed to maintain their habitual physical activity level. The ILI included two 90-min supervised training sessions 3 days a week at moderate to high intensity (4-8 METs) and a caloric restriction of 1000 kcal/day.
A total of 179 individuals completed the study, 88 (56 women) in the ILI group and 91 (57 women) in the LCD group. High-fidelity applanation tonometry (Millar(®) , Sphygmocor(®) ) was used to measure carotid-femoral pulse wave velocity (PWV). After adjustment for relevant confounders, the ILI group had a significantly greater reduction in PWV than the LCD group; -0.4 (-0.6, -0.1) m/s, P = 0.004. When compared to the LCD group, the ILI group showed a larger reduction in systolic and diastolic blood pressure -5 (-9, -1) and -5 (-7, -2) mmHg, P = 0.038 and P ≤ 0.001 respectively, whereas no difference was observed regarding pulse pressure, P = 0.661. No significant differences between groups were found regarding the loss of fat mass, P = 0.259, but the loss of muscle mass was larger in the LCD group, 0.8 (0.5, 1.1) kg, P ≤ 0.001.
Despite the limitations of a nonrandomized design, our findings indicate that for morbidly obese individuals a moderate caloric restriction combined with aerobic physical exercise is associated with a greater decline in PWV than a LCD alone.
动脉僵硬度是心血管发病率和死亡率的独立预测因子。本研究旨在比较低热量饮食（LCD）和强化生活方式干预方案（ILI）对病态肥胖个体动脉僵硬度的 7 周影响。
非随机临床试验。LCD 提供 900 千卡/天，LCD 组的参与者被指示保持其习惯性的身体活动水平。ILI 包括每周 3 天进行 2 次 90 分钟的监督训练，强度为中等到高强度（4-8 METs），并限制热量摄入 1000 千卡/天。
共有 179 人完成了研究，ILI 组 88 人（56 名女性），LCD 组 91 人（57 名女性）。使用高保真平板张力测量法（Millar（®），Sphygmocor（®））测量颈股脉搏波速度（PWV）。在调整相关混杂因素后，ILI 组的 PWV 降低幅度明显大于 LCD 组；-0.4（-0.6，-0.1）m/s，P=0.004。与 LCD 组相比，ILI 组收缩压和舒张压的降低幅度更大，分别为-5（-9，-1）和-5（-7，-2）mmHg，P=0.038 和 P≤0.001，而脉压无差异，P=0.661。两组间脂肪量的减少无显著差异，P=0.259，但 LCD 组的肌肉量减少更大，0.8（0.5，1.1）kg，P≤0.001。
尽管存在非随机设计的局限性，但我们的研究结果表明，对于病态肥胖者，中等热量限制结合有氧运动与单独的 LCD 相比，与 PWV 下降幅度更大相关。
