Affiliation:
1. Wake Forest School of Medicine Winston‐Salem North Carolina USA
2. Harrington Heart and Vascular Institute, University Hospitals Cleveland Medical Center Case Western Reserve University School of Medicine Cleveland Ohio USA
3. University of Michigan Ann Arbor Michigan USA
4. University of Texas Health Science Center San Antonio Texas USA
5. Center of Investigation of Endocrinlogy and Nutrition University of Valladolid, Hospital clínico Universitario de Valladolid Valladolid Spain
6. EpidStrategies, A Division of Tox Strategies Inc. Katy Texas USA
7. Nestlé Health Science Lausanne Switzerland
Abstract
AbstractAimThe effects of weight loss with a partial or total meal replacement programme (MRP) on atherosclerotic cardiovascular disease (ASCVD) risk factors are not fully understood, in particular in people at higher CV risk. In the 52‐week randomized controlled OPTIWIN study in men and women with obesity, meal replacement programme (total for first 26 weeks, partial for the ensuing 26 weeks) with OPTIFAST (OP) resulted in significantly greater weight loss compared with a low‐calorie food‐based (FB) dietary plan, both as part of a comprehensive lifestyle intervention [OP (n = 135)/FB (n = 138) week 26: −12.4%/−6.0%, p < .001; week 52: −10.5%/−5.5%, p < .001]. Here, we examined effects on ASCVD risk factors and 10‐year ASCVD risk.Materials and MethodsParticipants with body mass index 30‐55 kg/m2 and age 18‐70 years, and not on anti‐obesity medications, were recruited. The effects on systolic and diastolic blood pressure (SBP, DBP), lipid parameters and 10‐year ASCVD risk were analysed as changes over time using linear mixed models. Subgroup analyses were conducted for changes in SBP, DBP and ASCVD risk by categories of age (<40, 40‐59, ≥60 years), baseline SBP (</≥130 mmHg) and sex.ResultsBaseline characteristics were well balanced (OP/FB females 86%/79%, mean age 47/47 years, body mass index 38.4/39.2 kg/m2, 10‐year ASCVD risk <5% 87%/74%, dysglycaemia 52%/50%). At week 26, SBP/DBP were significantly reduced with OP versus FB, and a greater proportion achieved BP ≤130/80 mmHg [odds ratio 2.11 (95% confidence interval 1.10, 4.03), p = .024]. All lipid parameters as well as 10‐year ASCVD risk were significantly improved with OP versus FB. A similar, but slightly attenuated pattern was observed at 52 weeks. Across subgroups, greater reductions for SBP, DBP and ASCVD risk were generally seen with OP versus FB with quantitatively higher baseline SBP and age, and in men.ConclusionsIn people with obesity at low ASCVD risk, OP significantly reduced cardiovascular risk factors and 10‐year predicted risk for ASCVD.
Subject
Endocrinology,Endocrinology, Diabetes and Metabolism,Internal Medicine