Date Available

12-14-2011

Year of Publication

2005

Document Type

Dissertation

College

Graduate School

Department

Nutritional Sciences

First Advisor

James W. Anderson

Abstract

Obesity increases the risk for the development of cardiovascular disease, type 2 diabetes and other co-morbid conditions. Type 2 diabetes also is often associated with excessive visceral abdominal fat. Weight loss in obese individuals decreases the risk for developing the co-morbid conditions. Individuals with type 2 diabetes often have a greater difficulty in controlling these complications compared to individuals without type 2 diabetes. The purpose of this study was to evaluate adherence to a medically-supervised low-energy diet (LED) weight loss program and changes in body composition and metabolic parameters after weight loss in women with and without type 2 diabetes. Subjects consisted of Caucasian women, between the ages of 40 to 65 years, with BMIs between 30 and 45 kg/m2. There was no significant difference in BMI between the groups at study initiation (38.1 kg/m2, diabetics (DM) and 36.0 kg/m2, non-diabetics (NDM), p=0.2314). All subjects participated in the HMR Program for 16 weeks. Twenty-nine subjects completed the weight loss phase (18 diabetics, 11 non-diabetics) and were evaluated for change in weight, body composition, and blood parameters. Data were analyzed by repeated-measures ANCOVA and students t-tests using SAS version 8.02. DM and NDM lost 11.7% and 16% of body weight, respectively (p=0.6474). Results indicate DM has more total lean tissue (p=0.004), more total body fat (p=0.04), more total abdominal tissue (p=0.001), more visceral adipose tissue (p=0.001) and lost less percent body fat (p=0.04) than NDM after 16 weeks of weight loss. After weight loss there was no significant difference in leptin, ghrelin or adiponectin levels. DM had greater insulin (p=0.05), HOMA-IR (pandlt;0.0001), glucose (pandlt;0.0001), HbA1c (pandlt;0.0001), resistin (p=0.04) and PAI-1 (p=0.02). There were no differences after weight loss in lipid levels, blood pressure, diet compliance or exercise. The data show that medically-supervised LEDs are safe and effective for treating obesity in individuals with type 2 diabetes. Cardiovascular risk factors improved in both NDM and DM subjects with weight loss. The findings also suggest that insulin and metabolically dysfunctional lean tissue may play a critical role in the complex axes affecting changes in body composition and inflammation in individuals with type 2 diabetes.

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