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Diabetes Obes Metab. 2018 Dec;20(12):2840-2851. doi: 10.1111/dom.13466. Epub 2018 Aug 7.

Men and women respond differently to rapid weight loss: Metabolic outcomes of a multi-centre intervention study after a low-energy diet in 2500 overweight, individuals with pre-diabetes (PREVIEW).

Author information

1
Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark.
2
School for Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands.
3
MRC/ARUK Centre for Musculoskeletal Ageing Research, National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, School of Life Sciences, University of Nottingham, Nottingham, NG7 2UH, UK.
4
Department of Nutrition, Food Science and Physiology, Center for Nutrition Research, University of Navarra, Pamplona, Spain.
5
CIBERObn, Obesity and Nutrition, Instituto de Salud Carlos III, Madrid, Spain.
6
IMDEA Alimentación, Madrid, Spain.
7
Department of Pharmacology and Toxicology, Medical University of Sofia, Sofia, Bulgaria.
8
Human Nutrition Unit, School of Biological Sciences, University of Auckland, Auckland, New Zealand.
9
Department of Exercise and Health Sciences, University of Stuttgart, Stuttgart, Germany.
10
Obesity Research Unit, Research Program Unit, Diabetes and Obesity, University of Helsinki, Helsinki, Finland.
11
Obesity Center, Abdominal Center, Endocrinology, Helsinki University Hospital, University of Helsinki, Helsinki, Finland.
12
National Institute for Health and Welfare THL, Helsinki, Finland.
13
Department of Nutrition and Movement Sciences, School for Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands.
14
School of Life Sciences, University of Nottingham, Nottingham, UK.
15
Charles Perkins Centre and School of Life and Environmental Biosciences, University of Sydney, Sydney, Australia.
16
Department of Food and Nutrition, University of Helsinki, Helsinki, Finland.

Abstract

AIMS:

The PREVIEW lifestyle intervention study (ClinicalTrials.gov Identifier: NCT01777893) is, to date, the largest, multinational study concerning prevention of type-2 diabetes. We hypothesized that the initial, fixed low-energy diet (LED) would induce different metabolic outcomes in men vs women.

MATERIALS AND METHODS:

All participants followed a LED (3.4 MJ/810 kcal/daily) for 8 weeks (Cambridge Weight Plan). Participants were recruited from 8 sites in Europe, Australia and New Zealand. Those eligible for inclusion were overweight (BMI ≥ 25 kg/m2 ) individuals with pre-diabetes according to ADA-criteria. Outcomes of interest included changes in insulin resistance, fat mass (FM), fat-free mass (FFM) and metabolic syndrome Z-score.

RESULTS:

In total, 2224 individuals (1504 women, 720 men) attended the baseline visit and 2020 (90.8%) completed the follow-up visit. Following the LED, weight loss was 16% greater in men than in women (11.8% vs 10.3%, respectively) but improvements in insulin resistance were similar. HOMA-IR decreased by 1.50 ± 0.15 in men and by 1.35 ± 0.15 in women (ns). After adjusting for differences in weight loss, men had larger reductions in metabolic syndrome Z-score, C-peptide, FM and heart rate, while women had larger reductions in HDL cholesterol, FFM, hip circumference and pulse pressure. Following the LED, 35% of participants of both genders had reverted to normo-glycaemia.

CONCLUSIONS:

An 8-week LED induced different effects in women than in men. These findings are clinically important and suggest gender-specific changes after weight loss. It is important to investigate whether the greater decreases in FFM, hip circumference and HDL cholesterol in women after rapid weight loss compromise weight loss maintenance and future cardiovascular health.

KEYWORDS:

dietary intervention; obesity; pre-diabetes; prevention; weight loss

PMID:
30088336
PMCID:
PMC6282840
DOI:
10.1111/dom.13466
[Indexed for MEDLINE]
Free PMC Article

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