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Pancreas. 2001 Aug ;23 (2):197-203
11484922
Cit:9
Center for Human Nutrition, School of Medicine, University of California at Los Angeles, 90095-1742, USA. iyip@mednet.ucla.edu
INTRODUCTION: The relation between insulin-leptin-visceral fat axis during weight loss has not been studied previously. AIMS: To evaluate the insulin, leptin, and abdominal adiposity relation during weight loss in patients with upper body obesity. METHODOLOGY: Twenty volunteers (7 men, 13 women) with mean age 50.6+/-6.3 (SD) and upper body obesity (weight 105.4+/-12.3 kg, BMI 35.9+/-2.5 kg/m2) were recruited. Participants were enrolled in a one-arm clinical study using a calorie-deficient diet and an escalating dose regimen of sibutramine, starting with 5 mg daily and increasing in 5-mg increments to 20 mg per day. Body weight, insulin, leptin, glucose, lipids, abdominal computed tomography (CT), and total body electrical conductance (TOBEC) were measured serially at weeks 0, 4, 8, 12, and 24. RESULTS: Eighteen patients completed the 6-month study: one man and one woman discontinued because of adverse events. With diet and sibutramine, body weight was significantly and continuously reduced throughout the 6-month study. There was a 16.0%(p = 0.0001) reduction in body weight (p < 0.001) and 22.5%(p = 0.0001) decrease in total body fat mass. Abdominal CT scans showed a 28.3%(p = 0.0001) reduction in total abdominal fat, a 26.0%(p = 0.0001) reduction in subcutaneous fat (p < 0.001), and a 31.0%(p = 0.0003) reduction in visceral fat (p < 0.001). There was a 32.0%(p = 0.0008) reduction in leptin levels and 37.9%(p = 0.0001) reduction in insulin levels between baseline and week 4, but no further significant reduction in leptin and insulin levels was observed for the duration of the study. There was a significant correlation between insulin and leptin concentrations throughout the study (p = 0.0001). Leptin was presented as a function of insulin measured at the same time. Significant associations between visceral abdominal fat, subcutaneous fat, and leptin were also observed. CONCLUSION: In this study, we found that leptin and insulin were related in weight loss. The data suggest that insulin may act as a strong regulator of leptin secretion during weight loss and that circulating leptin levels can be predicted by insulin level. Using sibutramine in conjunction with hypocaloric diet reduced body weight and decreased fat mass significantly. Visceral and subcutaneous abdominal fat depots were shown to decrease. Whether sibutramine exerts any selective reduction of visceral abdominal fat as opposed to total body fat mass will require further clinical investigation.
Latest citations:
Kazunori Ohkawara,
Yoshio Nakata,
Shigeharu Numao,
Hiroyuki Sasai,
Yasutomi Katayama,
Tomoaki Matsuo,
Tomohiro Okura,
Kiyoji Tanaka
Health Promotion and Exercise Program, National Institute of Health and Nutrition, Tokyo, Japan.
Objective: Serial measurements were used to examine the response of coronary heart disease (CHD) risk factors to regional fat changes during weight reduction. Methods: Nine Japanese obese men participated in a diet-induced weight loss program. Regional fat masses, abdominal visceral fat area (VFA), subcutaneous fat area (SFA) and CHD risk factors, including total (TC), high (HDLC)- and low-density lipoprotein cholesterol (LDLC), triglycerides (TG), fasting plasma glucose, immunoreactive insulin, homeostasis model assessment of insulin resistance (HOMA-IR), and glycosylated hemoglobin A(1c)(HbA(1c)) were assessed at baseline and after 1, 2 and 3 months. Results: Meanweight reduction during the study was -11.9 +/- 4.2 kg, which was associated with a gradual, significant decrease (p < 0.05) in arm, leg and trunk fat masses, VFA and SFA. The levels of TC, LDLC and TG decreased significantly within 1 month and remained at these values, whereas HDLC, HOMA-IR, and HbA(1c) did not change. There was no significant correlation between changes in regional fat masses and CHD risk factors in any period studied. Conclusions: CHD risk factors do not necessarily respond in the same manner as changes in body fat during diet-induced moderate weight reduction.
Clin Exp Med. 2009 Nov 25;:
19937362
Cit:1
Department of Internal Medicine, Division of Endocrinology and Metabolism, School of Medicine, Akdeniz University, 07070, Antalya, Turkey, drsari@hotmail.com.
Sibutramine and metformin are drugs commonly used to obtain weight loss. We aimed to compare the effects of sibutramine alone with that of sibutramine plus metformin combination on weight loss, insulin sensitivity, leptin and C reactive protein in obese women. Seventy obese women were included. After a diet period of month (baseline), each individual was randomly assigned to receive 15 mg sibutramine (sibutramine group; n = 36) or 15 mg sibutramine plus 1,700 mg metformin per day (sibutramine plus metformin group; n = 34) during the next 12 months. Body weight, insulin resistance by the homeostasis model assessment model (HOMA-IR), leptin and C reactive protein were measured at baseline, after 3 months and after 12 months. Mean weight losses in sibutramine and sibutramine plus metformin groups were 5.3 +/- 4.0%(P < 0.001) and 6.8 +/- 3.9%(P < 0.001) after 3 months, and 10.5 +/- 4.4%(P < 0.001) and 15.7 +/- 4.6%(P = 0.007) after 12 months, respectively. HOMA-IR value also decreased in both sibutramine (P = 0.045 and P = 0.002) and sibutramine plus metformin groups (P = 0.04 and P = 0.015) after 3 and 12 months, respectively. Similarly, serum leptin levels decreased in both sibutramine (P = 0.04, P = 0.01) and sibutramine plus metformin groups (P = 0.023, P = 0.025) after 3 and 12 months, respectively. There was also significant reductions in serum C reactive protein levels in both sibutramine (P = 0.045, P = 0.02) and sibutramine plus metformin groups (P = 0.007, P = 0.001) after 3 and 12 months, respectively. These decrements of body weight, HOMA-IR, serum leptin and C reactive protein levels were not statistical significance between these two groups both after 3 and 12 months (P > 0.05). Combination of sibutramine with metformin did not result in any further effects on weight loss, insulin resistance, leptin and C reactive protein levels when compared to sibutramine alone.
Joyce M Richey,
Orison O Woolcott,
Darko Stefanovski,
L Nicole Harrison,
Dan Zheng,
Maya Lottati,
Isabel R Hsu,
Stella P Kim,
Morvarid Kabir,
Karyn J Catalano,
Jenny D Chiu,
Viorica Ionut,
Cathryn Kolka,
Vahe Mooradian,
Richard N Bergman
Keck School of Medicine of USC.
We investigated whether rimonabant, a type 1 cannabinoid receptor antagonist, reduces visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) in dogs maintained on a hypercaloric high-fat diet (HHFD). To determine whether energy expenditure contributed to body weight changes we also calculated resting metabolic rate. Twenty male dogs received either rimonabant (1.25 mg . kg(-1). d(-1), orally; n = 11) or placebo (n = 9) for 16 weeks, concomitant with a HHFD. VAT, SAT and non-fat tissue were measured by magnetic resonance imaging. Resting metabolic rate was assessed by indirect calorimetry. By week 16 of treatment, rimonabant dogs lost 2.5% of their body weight (P = 0.029), while in placebo dogs body weight increased by 6.2%(P < 0.001). Rimonabant reduced food intake (P = 0.027), concomitant with a reduction of SAT by 19.5%(P < 0.001). In contrast with the VAT increase with placebo (P < 0.01), VAT did not change with rimonabant. Non-fat tissue remained unchanged in both groups. Body weight loss was not associated with either resting metabolic rate (R(2)= 0.24; P = 0.154) or food intake (R(2)= 0.24; P = 0.166). In conclusion, rimonabant reduced body weight together with a reduction in abdominal fat, mainly due to SAT loss. Body weight changes were not associated with either resting metabolic rate or food intake. The findings provide evidence of a peripheral effect of rimonabant to reduce adiposity and body weight, possibly through a direct effect on adipose tissue. Key words: Adipose tissue, Body weight, Energy expenditure, Magnetic resonance.
Int J Obes (Lond). 2008 Jan 8;:
18180786
Cit:12
Background:Visceral adipose tissue (VAT) is associated with greater obesity-related metabolic disturbance. Many studies have reported preferential loss of VAT with weight loss.Objective:This systematic review looks for factors associated with preferential loss of VAT relative to subcutaneous abdominal fat (SAT) during weight loss.Design:Medline and Embase were searched for imaging-based measurements of VAT and subcutaneous abdominal adipose tissue (SAT) before and after weight loss interventions. We examine for factors that influences the percentage change in VAT versus SAT (%deltaV/%deltaS) with weight loss. Linear regression analyses were performed on the complete data set and on subgroups of studies. Factors examined included percentage weight loss, degree of caloric restriction, exercise, initial body mass index (BMI), gender, time of follow-up and baseline VAT/SAT.Results:There were 61 studies with a total of 98 cohort time points extracted. Percentage weight loss was the only variable that influenced %deltaV/%deltaS (r=-0.29, P=0.005). Modest weight loss generated preferential loss of VAT, but with greater weight loss this effect was attenuated. The method of weight loss was not an influence with one exception. Very-low-calorie diets (VLCDs) provided exceptional short-term (<4 weeks) preferential VAT loss. But this effect was lost by 12-14 weeks.Conclusions:Visceral adipose tissue is lost preferentially with modest weight loss, but the effect is attenuated with greater weight loss. Acute caloric restriction, using VLCD, produces early preferential loss of VAT. These observations may help to explain the metabolic benefits of modest weight loss.International Journal of Obesity advance online publication, 8 January 2008; doi:10.1038/sj.ijo.0803761.
Research Fellow, Department of Vascular Surgery, Athens University Medical School, Greece.
Leptin seems to regulate various physiological mechanisms besides body weight. Leptin plays a role in vascular biology and pathology as well as renal function. In addition, leptin has been implicated in the regulation of fertility and reproduction. The effect of pharmaceutical agents on circulating plasma leptin levels has been assessed. Among the drugs investigated are glitazones, statins, fibrates, serotonin reuptake inhibitors and cannabinoid-1 receptor antagonists. Since these agents are used to treat pathological conditions there is a potential role for leptin in these states. The degree of involvement of leptin in several pathophysiological states needs to be defined to aid in the development of potentially useful therapeutic agents.
Metabolism. 2005 Jul ;54 (7):866-75
15988694
Ifigenia Giannopoulou,
Bo Fernhall,
Robert Carhart,
Ruth S Weinstock,
Tracy Baynard,
Arturo Figueroa,
Jill A Kanaley
Department of Exercise Science, Syracuse University, NY 13244, USA.
This study examined the independent and combined effects of diet and exercise on adipocytokine and inflammatory cytokines in postmenopausal women with type 2 diabetes. Using a randomized, controlled design, 33 women (age, 50-70 years) were assigned to diet alone (D), exercise alone (EX), or diet + exercise (D + E) for 14 weeks. Before and after the interventions, blood samples for adipocytokines and inflammatory markers were drawn, a meal test was performed, and abdominal fat distribution was measured by magnetic resonance imaging (MRI). Body weight decreased approximately 4.5 +/- 0.6 kg ( P <.05) after the D and D + E interventions, whereas only small changes in body weight were found with the exercise-alone intervention. Plasma C-reactive protein levels were decreased by approximately 15% with all 3 interventions, whereas leptin levels were reduced with the D and D + E intervention (D: pre = 48.7 +/- 6.0, post = 38.9 +/- 5.0 ng/mL; D + E: pre = 38.5 +/- 6.0, post = 22.9 +/- 5.0 ng/mL; P <.05) with no differences between groups. There was a trend for leptin levels to decrease in the EX group ( P =.06). Plasma resistin levels were not altered by the 3 interventions from pre- to posttreatment (D: pre = 6.9 +/- 0.6, post = 6.2 +/- 0.4 ng/mL; D + E: pre = 5.6 +/- 0.6, post = 5.7 +/- 0.4 ng/mL; E: pre = 6.2 +/- 0.6, post = 5.9 +/- 0.6 ng/mL, P >.05), and no differences in adiponectin and tumor necrosis factor alpha (TNF- alpha ) levels were found. Visceral adipose tissue and tumor necrosis factor alpha were the only predictors of calculated insulin resistance ( P <.05), explaining 43% of the variability. A typically prescribed weight loss program with lifestyle changes resulted in few changes in adipocytokines and inflammatory cytokines in older women with type 2 diabetes, suggesting that dramatic weight loss or clinical interventions are needed.
Department of Internal Medicine, Medical School, University of Ioannina, Greece.
BACKGROUND: Obesity is associated with an increased incidence of diabetes, hypertension, dyslipidaemia and coronary artery disease. Current management strategies of obesity include lifestyle management strategies of obesity include lifestyle interventions and pharmaco therapy. Sibutramine is a drug with established efficacy in weight reduction and maintenance of weight loss. It reduces food intake and attenuates the fall in reduces food intake and attenuates the fall in metabolic rate associated with weight loss. OBJECTIVE: To review the metabolic effects associated with sibutramine use. METHODS: Relevant articles were identified through a Medline search (up to December 2004). RESULTS: Weight loss with sibutramine treatment is associated with improved insulin sensitivity and a fall in glycosylated haemoglobin levels in type 2 diabetic patients. In most trials sibutramine exerted favourable effects on lipids, especially exerted favourable effects on lipids, especially on high density lipoprotein (HDL) cholesterol and triglycerides, as well as on the total:HDL cholesterol ratio. Sibutramine also lowers serum uric acid concentrations. Furthermore, this drug seems to favourably influence adipocytokines; it reduces serum leptin and resistin levels and increases adiponectin levels. Sibutramine also exerts a beneficial effect on hyper androgenaemia in obese women with polycystic ovary syndrome. Preliminary findings also suggest that weight loss following treatment with sibutramine is useful in patients with non-alcoholic fatty liver disease (NAFLD). CONCLUSION: Weight loss following sibutramine administration is associated with several favourable metabolic effects.
Endocrinology and Nephrology Divisions, Hospital do Rim e da Hipertensão, Universidade Federal de São Paulo, São Paulo, Brazil. ale_faria@uol.com.br
OBJECTIVE: The objective of this study is to assess the effects of sibutramine on body weight, body fat distribution, insulin resistance, plasma leptin, lipid profile and blood pressure profiles in hypertensive obese patients. METHODS: Eighty-six central obese hypertensive patients (BMI = 39 +/- 5 kg/m(2), 84% of women, 48 +/- 8.5 years old) were placed on a hypocaloric diet and placebo therapy for 4 weeks. They were then randomized to receive sibutramine (10 mg) or placebo for 24 weeks. Both, before therapy and at the end of the study, the waist and hip circumferences were measured and the waist/hip ratio (WHR) was calculated; abdominal ultrasonography was performed in order to estimate the amount of subcutaneous fat (SF) and visceral fat (VF), and the visceral/subcutaneous ratio. Beyond HOMA-r, another insulin resistance index (IRIp) was calculated by means of the formula: peak of blood glucose after oral glucose load x plasma insulin level/10(4). Fasting plasma leptin and lipid levels were also determined. RESULTS: Sibutramine induced greater weight reduction than placebo (6.7 vs. 2.5%, p < 0.001). Reductions in WHR (0.97 +/- 0.08 vs. 0.94 +/- 0.07, p < 0.01), IRIp (0.11 +/- 0.07 vs. 0.09 +/- 0.06 mmol mu/l(2)) and VF (6.4 +/- 2.4-6.0 +/- 2.4 cm, p < 0.01) were observed only with sibutramine. Plasma leptin decreased with placebo (24 +/- 15 vs. 18 +/- 10 UI/l, p < 0.01), but not with sibutramine (18.8 +/- 8.4 vs. 18.2 +/- 13.2 UI/l). No clinically significant change in lipid profile was observed in both groups. Moreover, office and 24-h blood pressure values did not change during placebo or sibutramine therapy, whereas a significant increase in office heart rate, from 78.3 +/- 7.3-82 +/- 7.9 b.p.m., p = 0.02, was observed with sibutramine. CONCLUSIONS: Sibutramine therapy induced greater body weight loss than placebo in hypertensive obese patients. This was associated with WHR reduction, decreases in VF and insulin resistance. The maintenance of leptin levels during sibutramine therapy may be important to avoid weight recovery, although this finding must be confirmed by other prospective studies.
Endocrine. 2003 Jul ;21 (2):163-7
12897381
Cit:4
VA Puget Sound Health Care System Mental Illness Research, Education and Clinical Center (MIRECC) and Department of Psychiatry, University of Washington, Seattle, WA 98108, USA. drasmuss@u.washington.edu
We previously demonstrated that daily melatonin administration to middle-aged rats to restore youthful plasma melatonin levels also decreased body weight, visceral fat, plasma leptin, and plasma insulin to more youthful levels, without detectable changes in consumption of chow diet. We now evaluate:(a) whether melatonin alters consumption of a more precisely quantifiable liquid diet similar in high-fat content to the typical American diet;(b) differences between melatonin-induced endocrine responses in the fasted vs fed state; and (c) time course of these responses. Ten-month-old male Sprague- Dawley rats received liquid diet containing either 0.2 micro g/mL melatonin (MELATONIN) or vehicle (CONTROL)(n = 14/treatment); the diet was available throughout each night, but was removed for the final 10 h of each daytime. MELATONIN rats gained 4% body weight during the first 2 wk and then stabilized, whereas CONTROL rats continued to gain for an additional week, achieving 8% gain (p < 0.05 vs MELATONIN). During the first 3 wk, afternoon tail-blood leptin, but not insulin, levels decreased in melatonin-treated rats (p < 0.05 vs CONTROL). After 8 wk, half of the rats were killed at the midpoint of the dark period (NIGHT; fed) and half at the end of the light period (DAYTIME; fasted). NIGHT but not DAYTIME plasma leptin levels were decreased in MELATONIN rats, whereas DAYTIME but not NIGHT plasma insulin levels were decreased (p < 0.05 vs CONTROL). Melatonin treatment did not alter cumulative food consumption. Thus, melatonin decreased weight gain in response to high-fat diet, decreased plasma leptin levels within 3 wk-before decreasing plasma insulin-and exerted these metabolic effects independent of total food consumption.
Other papers by authors:
I Yip,
V L Go,
S DeShields,
P Saltsman,
M Bellman,
G Thames,
S Murray,
H J Wang,
R Elashoff,
D Heber
Center for Human Nutrition, University of California, Los Angeles School of Medicine, Los Angeles, California 90095-1742, USA.
OBJECTIVE: Although weight management is an important component in the treatment of type 2 diabetes, there has been concern about the use of liquid meal replacements (MRs) in treating obese patients with type 2 diabetes because of the sugar content of the MRs. The goal of this study was to evaluate the safety and feasibility of using MRs for weight loss in obese patients with type 2 diabetes. RESEARCH METHODS AND PROCEDURES: Seventy-five subjects with type 2 diabetes, treated only with oral agents, were recruited for this 12-week clinical study. Subjects were randomized into three groups using either a MR containing lactose, fructose, and sucrose, a MR in which fructose and sucrose were replaced with oligosaccharides (sugar-free Slim-Fast), or an exchange diet plan (EDP) using the proportion of macronutrients recommended by the American Diabetes Association. RESULTS: Fifty-seven patients (41 MR and 16 EDP) finished the study. None developed serious adverse effects, including major hypoglycemic reactions. Weight losses in the MR 1 and MR 2 groups were comparable (6.4% and 6.7%, respectively) and greater than the weight loss in the EDP group (4.9%). Fasting glucose level was significantly reduced in the MR group compared with the EDP group (p = 0.012). There was a significant reduction in the MR group in total cholesterol and low-density lipoprotein cholesterol that was not seen in the EDP group. DISCUSSION: We have shown that liquid MRs are a safe and effective weight loss tool for obese subjects with type 2 diabetes, and can result in improvements in body weight, glucose, insulin, hemoglobin A1c and lipid levels.
David Geffen School of Medicine, Center for Human Nutrition, University of California, Los Angeles, CA 90095-1742, USA. zli@mednet.ucla.edu
BACKGROUND: Achieving significant weight loss and glycemic control in diabetic patients remains a challenging task. OBJECTIVE: This study compared the effects of a soy-based meal replacement (MR) plan vs an individualized diet plan (IDP; as recommended by the American Diabetes Association) on weight loss and metabolic profile. DESIGN/SUBJECTS: A total of 104 subjects were randomized prospectively to the two treatments for a total of 12 months. RESULTS: In all, 77 of the 104 subjects completed the study. Percentage weight loss in MR group (4.57+/-0.81%) was significantly greater (P<0.05) than in IDP group (2.25+/-0.72%). Fasting plasma glucose was significantly reduced in MR group (126.4+/-4.9 mg/dl) compared with IDP group (152.5+/-6.6 mg/dl, P<0.0001) at 6 months but not at 12 months. Controlling for baseline levels, hemoglobin Alc level improved by 0.49+/-0.22% for those receiving MR when compared to IDP group (P<0.05). A greater number of subjects in MR group reduced their use of sulfonylureas (P<0.0001) and metformin (P<0.05) as compared to IDP group. High-sensitivity C-reactive protein (hs-CRP) decreased -26.3%(P = 0.019) in MR group compared to -7.06%(P = 0.338) in IDP group at 6 months. Similar changes were observed at 12 months with MR groups, with hs-CRP decreasing by -25.0%(P = 0.019) compared to -18.7%(P = 0.179) in IDP group. CONCLUSION: This study demonstrates that MR is a viable strategy for weight reduction in diabetic patients, resulting in beneficial changes in measures of glycemic control and reduction of medications.
Center for Human Nutrition, University of California Los Angeles, 90095-1742, USA. sbowerman@mednet.ucla.edu
Most primary care physicians do not treat obesity, citing lack of time, resources, insurance reimbursement, and knowledge of effective interventions as significant barriers. To address this need, a 10-minute intervention delivered by the primary care physician was coupled with individual dietary counseling sessions delivered by a registered dietitian via telephone with an automated calling system (House-Calls, Mobile, AL). Patients were seen for follow-up by their physician at weeks 4, 12, 24, 36 and 52. A total of 252 patients (202 women and 50 men) were referred by 18 primary care physicians to the program. The comorbid conditions reported for all patients at baseline included low back pain, 29%(n = 72); hypertension, 45%(n = 113); hypercholesterolemia, 41%(n = 104); type 2 diabetes, 10%(n = 26); and sleep apnea, 5%(n = 12). When offered a choice of meal plans based on foods or meal replacements, two-thirds of patients (n = 166) chose to use meal replacements (Ultra Slim-Fast; Slim-Fast Foods Co., West Palm Beach, FL) at least once daily. Baseline weights of subjects averaged 200 +/- 46 lb for women (n = 202) and 237 +/- 45 lb for men (n = 50). Patients completing 6 months in the program lost an average of 19.0 +/- 4.0 lb for women (n = 94) and 15.5 +/- 8.2 lb for men (n = 26). Physicians reported a high degree of satisfaction with the program, suggesting that a brief, effective physician-directed program with nutritionist support by telephone can be implemented in a busy primary care office.
BACKGROUND: We examined the cholesterol-lowering effects of a proprietary Chinese red-yeast-rice supplement in an American population consuming a diet similar to the American Heart Association Step I diet using a double-blind, placebo-controlled, prospectively randomized 12-wk controlled trial at a university research center. OBJECTIVE: We evaluated the lipid-lowering effects of this red-yeast-rice dietary supplement in US adults separate from effects of diet alone. DESIGN: Eighty-three healthy subjects (46 men and 37 women aged 34-78 y) with hyperlipidemia [total cholesterol, 5.28-8.74 mmol/L (204-338 mg/dL); LDL cholesterol, 3.31-7.16 mmol/L (128-277 mg/dL); triacylglycerol, 0.62-2.78 mmol/L (55-246 mg/dL); and HDL cholesterol 0.78-2.46 mmol/L (30-95 mg/dL)] who were not being treated with lipid-lowering drugs participated. Subjects were treated with red yeast rice (2.4 g/d) or placebo and instructed to consume a diet providing 30% of energy from fat,<10% from saturated fat, and <300 mg cholesterol daily. Main outcome measures were total cholesterol, total triacylglycerol, and HDL and LDL cholesterol measured at weeks 8, 9, 11, and 12. RESULTS: Total cholesterol concentrations decreased significantly between baseline and 8 wk in the red-yeast-rice-treated group compared with the placebo-treated group [(x+/-SD) 6.57+/-0.93 mmol/L (254+/-36 mg/dL) to 5.38+/-0.80 mmol/L (208+/-31 mg/dL); P < 0.001]. LDL cholesterol and total triacylglycerol were also reduced with the supplement. HDL cholesterol did not change significantly. CONCLUSIONS: Red yeast rice significantly reduces total cholesterol, LDL cholesterol, and total triacylglycerol concentrations compared with placebo and provides a new, novel, food-based approach to lowering cholesterol in the general population.
Division of Clinical Nutrition, University of California, Los Angeles, School of Medicine 90024-1742.
Eur J Clin Nutr. 2007 Mar 28;:
17392697
Cit:3
Z Li,
W J Aronson,
J R Arteaga,
K Hong,
G Thames,
S M Henning,
W Liu,
R Elashoff,
J M Ashley,
D Heber
[1] 1Center for Human Nutrition, David Geffen School of Medicine, University of California, Los Angeles, CA, USA [2] 2VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA.
Objectives:To evaluate the feasibility and long-term compliance with a low-fat diet supplemented with soy protein in men at increased risk for recurrence after radical prostatectomy.Design:Randomized, control study.Setting:Academic center in USA.Subject:Forty men who had undergone radical prostatectomy and were at increased risk for recurrence.Intervention:Low-fat (15% fat), high-fiber (18 g/1000 kcal) diet supplemented with 40 g soy protein isolate (n=26) was compared to USDA recommended diet (n=14).Results:Over 4 years, subjects in the intervention group but not in the control group made and sustained significant changes in their diet as measured by the dietary assessment instruments and urinary isoflavone excretion. In the intervention group, dietary fat intake was reduced from 33.46+/-1.27% energy/day to 21.04+/-1.74%(P<0.05), fiber intake increased from 14.6+/-1.06 to 21.05+/-2.29 g/day. The insulin growth factor-1 (IGF-1) level was decreased from 260.4+/-8.6 ng/ml at baseline to 220.5+/-7.9 ng/ml at 6 months (P<0.05) in the intervention group with no significant change in the control group. An ex vivo assay demonstrated inhibition of LNCaP cell growth (-20.0+/-7.7%, P<0.05) by sera from patients in the intervention group after 6 months of dietary change compared to baseline.Conclusion:These data suggest that long-term low-fat dietary interventions as part of prospective randomized trials in prostate cancer survivors are feasible, and lead to reductions in circulating hormones or other growth factors stimulating prostate cancer growth ex vivo.European Journal of Clinical Nutrition advance online publication, 28 March 2007; doi:10.1038/sj.ejcn.1602743.
Center for Human Nutrition, David Geffen School of Medicine, University of California, Los Angeles, CA 90095-1742, USA. kurthong@mednet.ucla.edu
OBJECTIVE: To evaluate the efficacy of very low calorie diet (VLCD) in black and white obese women. Changes in weight, metabolic profile, and body composition are assessed. METHOD: Patients are enrolled in a self-paid, university-based, outpatient weight loss program. All are prescribed VLCD (500-800 Cal/day), an exercise regimen, and group behavioral counseling. Black and white patients are matched for age, weight, body mass index, and by metabolic syndrome (MS) status. RESULTS: A total of 304 black and white women (152 in each group) were included the analysis. Approximately 40% of patients had MS (white women: 39.5%; black women: 41.2%). Mean baseline weights were similar. After 12 weeks, weight reduction of 9.97% was seen in white women and 9.02% drop was seen in black women (both P<0.0001). However, the degree of weight change was not different between the groups (P = 0.244). Marked improvements in fasting glucose, total cholesterol, LDL, triglyceride, and blood pressures (BP) were observed (all P<0.01); however, no difference between cohorts were seen. Patients with MS had higher baseline weight, BP, glucose and triglyceride levels when compared to patients without MS (all P<0.01). Significant reductions in % body fat were seen in white and black patients, independent of MS status. CONCLUSION: Obese patients, independent of race, were able to achieve significant weight loss when enrolled in a structured outpatient program. Weight loss significantly correlated with all aspects of MS. Our results suggest that differences seen in past studies may be influenced by socioeconomic and behavioral factors rather than differences in physiological response to dieting.
Nutr Cancer. 2001 ;40 (2):149-56
11962250
Cit:33
Department of Surgery, University of California, Los Angeles, CA 90095, USA.
Investigators have shown that green tea may decrease the risk of cancer. It is widely accepted that the main active component of green tea is epigallocatechin-3-gallate (EGCG). In this study, we examined the effect of green tea on breast cancer growth and endothelial cells in in vitro assays and in animal models. Furthermore, we compared the potency of the different catechin components of green tea extract (GTE), including EGCG. Our data showed that mixed GTE and its individual catechin components were effective in inhibiting breast cancer and endothelial cell proliferation. In mouse experiments, GTE suppressed xenograft size and decreased the tumor vessel density. Our results demonstrated the value of all catechins and argued for the use of a mixed GTE as a botanical dietary supplement, rather than purified EGCG, in future clinical trials.
Am Surg. 2001 Dec ;67 (12):1128-35
11768815
Cit:17
Department of Surgery, VA Greater Los Angeles Health Care System and the UCLA Center for Human Nutrition, California 90073, USA.
Bariatric surgery is being performed in increasing numbers in an era when reimbursements are being reduced. Academic health centers bear the responsibility for training surgeons to perform these operations yet must keep costs to a minimum and retain high quality. The UCLA Bariatric Surgery Program developed a clinical pathway for the pre- and postoperative management for gastric bypass patients to achieve these goals. Medical records for 182 consecutive gastric bypass patients were retrospectively reviewed before implementation of the pathway (Group I) during the fiscal year of 1998/1999. Data on average length of stay, average intensive care unit length of stay, average standard variable cost, percentage readmission rate, and percentage return to the operating room were collected. This information was compared with the data collected prospectively from 182 patients after implementation of the pathway in July of 1999 (Group II) during the fiscal year of 1999/2000. Hospital cost per admission was reduced by 40 per cent in Group II compared with Group I (P < 0.02). The average length of stay was reduced from 4.05 days in Group I to 3.17 days in Group II (P < 0.033). Overall readmission rate was decreased from 4.2 per cent in Group I to 3.2 per cent in Group II (P < 0.05). There were no differences in morbidities between both groups. The pathway reduced costs by reducing the hospital length of stay, intensive care unit utilization, and readmission rates. Quality was maintained as evidenced by a similar pattern of postoperative morbidities yet readmission rates were reduced. Our results indicate that implementation of a clinical pathway for bariatric surgery reduces cost and improves quality of care in an academic institution.
Department of Surgery, VA Greater Los Angeles Health Care System, Los Angeles, California 90073, USA. elivings@ucla.edu
BACKGROUND: Following gastric restrictive surgery, morbidly obese patients rarely achieve their ideal body weight defined by Metropolitan Life tables. The final body weight will depend on the initial body composition because there will be greater weight loss from fat than lean body mass. The purpose of this study was to develop a mathematical model that accurately estimates the rate and extent of weight loss following gastric bypass surgery. METHODS: Patients underwent gastric bypass followed by intensive medical therapy and serial bioelectrical impedance analysis (BIA) body composition measurements. Differential equations were derived to model weight loss. RESULTS: Weight loss in the fat and lean body compartments followed monoexponential decay kinetics with differing rate constants. Total body weight loss (W(T)) at time t was W(T)= k(f)(k(f)- k(l))(W(f(o))e(-k(f)t)+ W(l(o))e(-k(l)t)), where W(fo) and W(lo) are the initial fat and lean body masses determined by BIA and k(f) and k(l) are the rate constants for the fat and lean compartments, respectively. Following surgically induced weight loss, k(f)= 7.61 +/- 1.27 x 10(-2), and k(l)=-0.93 +/- 0.13 x 10(-2), with the ratio of residual sum of the squares to the total sum of the squares of 98.8%. CONCLUSION: Accurate prediction of weight loss depends on the initial fat and lean compartment mass since each of these loses weight at a different rate and to a different extent. When these effects are accounted for, the total body weight loss can be accurately predicted for any given time following surgery.
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Endocr J. 2010 Jul 31;:
20686275
Center for Molecular and Vascular Biology, Katholieke Universiteit Leuven, Leuven, Belgium.
Ageing is associated with an increase in visceral obesity in men and women. Although wild-type mice with a C57Bl/6 genetic background are extensively used in studies on obesity and metabolism, little information is available on age-associated changes in their adipose tissues. We have evaluated development and composition of subcutaneous (SC) and gonadal (GON) adipose tissue in male C57Bl/6 mice at the ages of 10 weeks, 12 months or 24 months, while kept on normal chow. Total body weight as well as SC and GON fat mass significantly increased between 10 weeks and 12 months, but markedly decreased again up to 24 months of age. Adipocyte size in both fat depots and blood vessel size in GON fat followed this trend. Plasma leptin levels correlated positively with body weight and SC or GON fat mass. Both 12 and 24 months old mice displayed better insulin sensitivity as compared to 10 weeks old counterparts, reflected by significantly decreased plasma levels of insulin and/or glucose. Thus, ageing of C57Bl/6 male mice is associated with a biphasic pattern (increase up to 12 months followed by a decrease up to 24 months) of body weight, SC and GON fat mass, adipocyte and blood vessel size.
Eur J Endocrinol. 2010 Jun 29;:
20587580
Morten Frost,
Torben Nielsen,
Kristian Wraae,
Elke Pieters,
Claus Hagen,
Sigri Beckers,
Fenna De Freitas,
Kim Brixen,
Wim Van Hul,
Marianne Andersen
M Frost, Department of Endocrinology, Odense University Hospital, Odense, Denmark.
Both animal and human studies have associated the endocannabinoid system with obesity and markers of metabolic dysfunction. Blockade of the cannabinoid receptor 1 (CB1) caused weight loss and reduction in waist size in both obese and type II diabetics. Recent studies on common variants of the CB1 receptor gene (CNR1) and the link to obesity have been conflicting. The aim of the present study was to evaluate whether selected common variants of the CNR1 are associated with measures of obesity and fat distribution. The single polymorphisms (SNP) rs806381, rs10485179 and rs1049353 were genotyped and body fat and fat distribution were assessed by use of dual energy x-ray absorptiometry and magnetic resonance imaging in a population-based study comprising of 783 Danish men, aged 20-29 years. The rs806381 polymorphism was significantly associated with visceral fat mass only, whereas the rs1049353 was significantly and directly associated with visceral and intermuscular fat mass. Neither of the SNPs analysed were associated with total body fat mass or subcutaneous fat mass. The results point towards a link between common variants of the CNR1 and fat distribution in young men.
Am J Clin Nutr. 2010 Jun 2;:
20519560
Emanuella De Lucia Rolfe,
Ruth Jf Loos,
Céline Druet,
Ronald P Stolk,
Ulf Ekelund,
Simon J Griffin,
Nita G Forouhi,
Nicholas J Wareham,
Ken K Ong
Medical Research Council Epidemiology Unit, Institute of Metabolic Science, Cambridge, United Kingdom, and the Department of Epidemiology, Groningen University, Groningen, Netherlands.
BACKGROUND: Several studies reported inverse associations between birth weight and central adiposity in adults. However, few studied investigated the contributions of different abdominal fat compartments. OBJECTIVE: We examined associations between birth weight and adult visceral and subcutaneous abdominal fat in the population-based Fenland study. DESIGN: A total of 1092 adults (437 men and 655 women) aged 30-55 y had available data on reported birth weight, standard anthropometric measures, and visceral and subcutaneous abdominal fat estimated by ultrasound. In a subgroup (n = 766), dual-energy X-ray absorptiometry (DXA) assessment of total abdominal fat was performed. Linear regression models were used to analyze relations between birth weight and the various fat variables adjusted for sex, age, education, smoking, and body mass index (BMI). RESULTS: After adjustment for adult BMI, there was an inverse association between birth weight and total abdominal fat [B (partial regression coefficient expressed as SD/1-kg change in birth weight)=-0.09, P = 0.002] and visceral fat (B =-0.07, P = 0.01) but not between birth weight and subcutaneous abdominal fat (B =-0.01, P = 0.3). Tests for interaction showed that adult BMI modified the association between birth weight and visceral fat (P for interaction = 0.01). In stratified analysis, the association between birth weight and visceral fat was apparent only in individuals with the highest BMI tertile (B =-0.08, P = 0.04). CONCLUSIONS: The inverse association between birth weight and adult abdominal fat appeared to be specific to visceral fat. However, associations with birth weight were apparent only after adjustment for adult BMI. Therefore, we suggest that rapid postnatal weight gain, rather than birth weight alone, leads to increased visceral fat.
Atherosclerosis. 2010 Apr 21;:
20466372
Department of Nutrition, Université de Montréal, Montréal, Québec, Canada; Clinical Research Institute of Montréal (IRCM), Montréal, Québec, Canada.
OBJECTIVE: Large inter-individual variations exist in changes in inflammation and insulin resistance (IR) in response to hypocaloric-interventions in obese subjects that are not explained by weight-loss per se. We identified the number of serum apoB-lipoproteins (serum apoB) as the primary predictor of inflammatory markers in post-menopausal overweight/obese women. As apoB-lipoproteins are related to inflammation and inflammation promotes IR, we hypothesized that the reduction in inflammation and IR following hypocaloric-interventions is associated with the reduction in serum apoB. METHODS/RESULTS: After a 6-month hypocaloric-dietary-intervention in 56 overweight/obese post-menopausal women, there was a significant reduction in weight, total, subcutaneous abdominal and visceral abdominal fat mass, apoB, Lp(a), hsCRP, orosomucoid, haptoglobin and IR (increased M(clamp)) and an increase in LDL-C/apoB ratio. In regression analysis,% change in apoB was the primary predictor of % changes in hsCRP (R(2)=0.22), orosomucoid (R(2)=0.35), haptoglobin (R(2)=0.43) and M(clamp)(R(2)=0.17). When the study population was split around baseline median apoB (0.97g/L), women who were above median apoB (N=27) had significant reduction in apoB (-17%), hsCRP (-24%), orosomucoid (-8%), haptoglobin (-18%) and IR (M(clamp)+14%). On the other hand, women below median apoB (N=29) had no significant changes in these parameters despite equivalent reduction in weight and fat depots in the two groups. CONCLUSION: Reduction in apoB associated strongly and independently with the reduction in inflammatory markers and IR following a hypocaloric-diet in overweight/obese women. We hypothesize that the elevated apoB phenotype may be key therapeutic target to reduce obesity-associated inflammation and IR maximally by hypocaloric-dietary-interventions.
J Appl Physiol. 2010 Mar 18;:
20299621
Aamer Abbas,
Lidia S Szczepaniak,
Meryem Tuncel,
Jonathan Michael McGavock,
Beverley Adams-Huet,
Paul J Fadel,
Zhongyun Wang,
Debbie Arbique,
Ronald Victor,
Wanpen Vongpatanasin
Texas tech University Health Sciences Center.
Obesity is thought to lead to sympathetic overactivity as a compensatory adjustment to weight gain. However, most of the experimental support for the hypothesis has been derived from white cohorts. Our previous study in blacks indicated that sympathetic nerve activity (SNA) is closely correlated with body mass index (BMI) only in women while, in black men, SNA is elevated and dissociated from adiposity. To further determine if total and regional adiposity is a determinant of SNA in blacks, we performed a prospective weight loss study in 12 normotensive obese black men and 9 obese black women. SNA, BMI, and abdominal fat mass were measured before and 16 weeks after hypocaloric diet. The major new findings is that, in obese black men, the dietary-induced weight loss of 11.3+/-0.8 kg resulted in reduction in plasma leptin, insulin, and visceral abdominal fat but had no effect on SNA (from baseline of 26+/-4 to 28+/-3 bursts/min, p = NS). In contrast, in black women, weight loss of 8.0+/-0.9 kg caused similar reduction in plasma leptin, insulin, and visceral abdominal fat and led to reduction in SNA by 40%(from baseline of 22+/-2 to 13+/-3 bursts/min, p < 0.05). In conclusion, these new data from prospective study provide the strong support for a major adiposity-independent sympathetic activity in black men and adiposity-related sympathetic activity in black women. Key words: obesity, insulin, blacks, sympathetic nervous system.
Hypertension. 2010 Mar 8;:
20212267
A Laura Dengo,
Elizabeth A Dennis,
Jeb S Orr,
Elaina L Marinik,
Elizabeth Ehrlich,
Brenda M Davy,
Kevin P Davy
Human Integrative Physiology Laboratory, Department of Human Nutrition, Foods, and Exercise, Virginia Polytechnic Institute and State University, Blacksburg, Va.
We tested the hypothesis that weight loss via a hypocaloric diet would reduce arterial stiffness in overweight and obese middle-aged and older adults. Thirty-six individuals were randomly assigned to a weight loss (n=25; age: 61.2+/-0.8 years; body mass index: 30.0+/-0.6 kg/m(2)) or a control (n=11; age: 66.1+/-1.9 years; body mass index: 31.8+/-1.4 kg/m(2)) group. Arterial stiffness was measured via carotid artery ultrasonography combined with applanation tonometry and carotid-femoral pulse wave velocity via applanation tonometry at baseline and after the 12-week intervention. Body weight, body fat, abdominal adiposity, blood pressure, beta-stiffness index, and carotid-femoral pulse wave velocity were similar in the 2 groups at baseline (all P>0.05). Body weight (-7.1+/-0.7 versus -0.7+/-1.1 kg), body fat, and abdominal adiposity decreased in the weight loss group but not in the control group (all P<0.05). Brachial systolic and diastolic blood pressures declined (P<0.05) only in the weight loss group. Central systolic and pulse pressures did not change significantly in either group. beta-Stiffness index (-1.24+/-0.22 versus 0.52+/-0.37 U) and carotid-femoral pulse wave velocity (-187+/-29 versus 15+/-42 cm/s) decreased in the weight loss group but not in the control group (all P<0.05). The reductions in carotid-femoral pulse wave velocity were correlated with reductions in total body and abdominal adiposity (r=0.357-0.602; all P<0.05). However, neither total body nor abdominal adiposity independently predicted reductions in arterial stiffness indices. In summary, our findings indicate that weight loss reduces arterial stiffness in overweight/obese middle-aged and older adults, and the magnitudes of these improvements are related to the loss of total and abdominal adiposity.
Muhammad Aslam,
Aaron W Eckhauser,
Cindy A Dorminy,
Cynthia M Dossett,
Leena Choi,
Maciej S Buchowski
Department of Medicine, Vanderbilt University Medical Center, 21st Ave. South, Nashville, TN 37232.
BACKGROUND/OBJECTIVES: Monitoring changes in total fat mass and abdominal adiposity are important in understanding the impact of different types of weight loss interventions on health risks. Our objective was to assess the usefulness of anthropometry and bioelectrical impedance analysis (BIA) in predicting fat mass changes during moderate weight loss. SUBJECTS/METHODS: Fat mass changes were assessed in 34 overweight adults (24 females, 10 males) after a 12-week supervised weight loss induced by caloric restriction (-30% of requirement) using BIA and DXA. Agreement between BIA and DXA measurements were assessed by Bland-Altman plots. Linear regression modeling was used to predict body and truncal fat mass from anthropometric measures. RESULTS: Diet intervention resulted in a significant decrease in body weight (- 7.86 +/- 2.87 kg), body mass index (BMI - 2.69 +/- 0.98 kg/m(2)), total body fat (- 5.22 +/- 2.32 kg), truncal fat (- 2.80 +/- 1.94 kg) and waist circumference (- 5.52 +/- 3.57 cm). BMI and body weight were highly correlated with body fat (0.83 and 0.92 in females and 0.94 and 0.92 in males respectively) and truncal fat (0.75 and 0.87 in females; 0.90 and 0.84 in males respectively) during weight loss. Waist circumference was more correlated with truncal fat in males than females (0.94 vs. 0.85 in females). Compared to DXA, BIA underestimated total body fat changes in males (- 8.8 kg, p<0.001) and overestimated total body fat changes in females (+ 2.1 kg, p< 0.001). CONCLUSIONS: Body mass index, body weight, and waist circumference provide simple and more accurate than BIA estimates of relative changes in total and truncal fat during moderate weight loss in adults.
Int J Obes (Lond). 2009 Jul 28;:
19636317
Division of Genetic Epidemiology, Department of Medical Genetics, Molecular and Clinical Pharmacology, Innsbruck Medical University, Schöpfstrasse, Innsbruck, Austria.
Background:Lipoprotein(a)[Lp(a)] is considered an independent risk factor for cardiovascular disease. Its concentration is mainly determined by the kringle-IV repeat copy number variation (CNV) at the apolipoprotein(a)[apo(a)] locus.Objective:We aimed to investigate the immediate effect of weight reduction on plasma Lp(a) levels and its dependency on the apo(a) CNV in obese children.Design:We performed a prospective longitudinal intervention study of a low-fat hypocaloric diet conducted in a 3-week dietary camp for obese children. In all, 140 obese participants (54 boys and 86 girls) with a mean age of 12.5+/-1.6 years and a mean relative body mass index (BMI) before treatment of 165.6+/-24.7% were included. Body weight and plasma levels of Lp(a), lipids, apolipoproteins A-I and B, insulin, and C-reactive protein were determined before the onset and after the end of the intervention. In addition, the number of apo(a) kringle-IV repeats were determined using sodium dodecyl sulfate agarose gel electrophoresis.Results:The mean loss of body weight was 5.0+/-1.3 kg (-6.6%), resulting in a mean decrease of the relative BMI of 6.6%. Blood chemistry revealed significant changes in all parameters, especially in Lp(a), with a decrease from 24.4+/-30.6 to 17.9+/-22.6 mg per 100 ml or -19%(P<0.001). The decrease of Lp(a) levels was higher in the group with low compared with high molecular weight apo(a) phenotypes (-23.9 vs -16.6%).Conclusions:Weight reduction in obese children is associated with significant changes in Lp(a) levels, especially in subjects with high pre-treatment Lp(a) concentrations. This effect is markedly influenced by the molecular phenotype at the copy-number variable apo(a) locus.International Journal of Obesity advance online publication, 28 July 2009; doi:10.1038/ijo.2009.144.
Department of Internal and Laboratory Medicine, Sternberk Hospital, Sternberk, Czech Republic.
Adipocyte-fatty acid binding protein (A-FABP) is a biomarker of adiposity and metabolic syndrome. The aim of our work was to investigate the effect of weight reduction on serum A-FABP value. In the study, we analyzed a group of 189 probands suffering from obesity (102 women and 87 men; aged 57.3+/-12 years) initially, after a 3-month low-fat diet and once again 3 months after the termination of the diet for serum A-FABP, insulin, glucose, total cholesterol, HDL-cholesterol, LDL-cholesterol, and triglycerides. Basal biomarker concentrations were typical of the metabolic syndrome, and moreover A-FABP correlated with Quicki and BMI. We observed a reduction in BMI in 145 subjects who were divided into two subgroups: A-with persistent BMI reduction even after 6 months, B-with BMI reduction after 3 months and its regress after 6 months. Individuals with rise or no BMI difference were signed as subgroup C. In subgroup A, A-FABP level increased and returned to the earlier level (42.3 vs 68.3 vs 37.1 microg/l) and correlated with the markers of the metabolic syndrome. In subgroup B, A-FABP level increased less significantly, however elevated A-FABP level persisted for 6 months (41.9 vs 53.6 vs 50.7 microg/l). Subgroup C (n=54) showed no difference in A-FABP after 3-month diet and after next 3 months. The A-FABP value correlated with the some components of the metabolic syndrome. In conclusion, we describe that serum A-FABP might be a prognostic marker of body weight loss suggesting a preventive therapeutic intervention. J. Clin. Lab. Anal. 22:380-382, 2008.(c) 2008 Wiley-Liss, Inc.
Institute of Endocrinology and Nutrition, Medicine School and Unit of Investigation, Hospital Rio Hortega, University of Valladolid, Valladolid, Spain.
OBJECTIVE: A transition G to A at codon 54 of FABP2 was associated with high insulin resistance and different dietary response. The aim of our study was to investigate the influence of this polymorphism on weight loss and metabolic changes secondary to two hypocaloric diets. SUBJECTS AND METHODS: A sample of 204 obesity patients was analyzed. Before and after 2 months of hypocaloric diet, a nutritional evaluation was performed. Patients were randomly allocated to diet I (low-fat diet) or II (low carbohydrate diet). RESULTS: With diet Type I and in the wild group (Ala54/Ala54), BMI, weight, fat mass, waist circumference, waist to hip ratio, systolic and diastolic blood pressures, total cholesterol, triglyceride and insulin levels decreased. In the mutant group (Ala54/Thr54 and Thr54/Thr54), BMI, weight, waist circumference and fat mass decreased. In the wild group with diet Type II, the same parameters that group I decreased and glucose levels, too. In the mutant group, BMI, weight, waist circumference and fat mass decreased. Only leptin levels have a significant decrease in the wild group with both diets (diet I: 30.7%; p<0.05 and diet II: 15.85%; p<0.05). CONCLUSION: Similar weight loss is associated with different changes, depending on the FABP genotype with both diets. Weight loss is associated with a more deep decrease in serum leptin concentration with low-fat diet.