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PubMed1998

Impact of the age at menarche on adult body composition in healthy pre- and postmenopausal women.

The present study focuses on the impact of age at menarche on body composition development during adulthood. With 459 healthy middle-class women between 18 and 67 years (x = 41.5) the association between age at menarche and body composition was tested. Body composition, described by absolute and relative amount of fat mass, lean body mass, and bone mass, was estimated by means of dual energy x-ray absorptiometry. In order to exclude the influence of the menopausal transition on body composition, pre- and postmenopausal females were examined separately. The absolute amount of body fat was significantly lower within the group of women whose menarche occurred later. However, postmenopausal females exhibit less significant relations between the two trait systems than premenopausal women. This may be due to the impact of menopausal transition which affected the hormone levels and body composition development independently from the adolescent hormonal transition. While in both proband groups the quantitative amount of body fat was significantly related to menarcheal age, a significant relation between menarcheal age and adult body fat distribution could not be verified.

Adolescent↗
PubMed1997

The relation between "long-term exposure" to lifestyle during youth and young adulthood and risk factors for cardiovascular disease at adult age.

PURPOSE: To investigate the relationship between lifestyle (dietary intake of macronutrients, smoking behavior, alcohol consumption and daily physical activity) from 13-29 years of age ("long-term exposure") and cardiovascular disease (CVD) risk factors (lipoprotein levels, blood pressure, body fatness, and body composition) at the age of 29 years. METHODS: The study was part of the Amsterdam Growth and Health Study, which began in 1977, and in which repeated measurements were carried out over a period of 17 years on 181 subjects (98 females and 83 males). RESULTS: "Long-term exposure" to smoking behavior was inversely related to high density lipoprotein cholesterol (HDL) levels (p = 0.02) and positively to the total cholesterol/HDL ratio (p = 0.05). Both smoking behavior and alcohol consumption were inversely related to blood pressure (p < 0.01). "Long-term exposure" to daily physical activity was inversely related to body fatness (p < 0.01), but for females positively to the waist/hip ratio (p < 0.01). No relationship was found between the dietary intake of macronutrients and the CVD risk factors. When "long-term exposure" was limited to adolescence (13-16 years of age) only the relationship between daily physical activity and the waist/hip ratio for females remained significant (p < 0.01). CONCLUSIONS: "Long-term" smoking behavior was related to a high risk profile regarding hypercholesterolemia, but to a low risk profile regarding blood pressure. The latter was also found for "long-term" alcohol consumption. "Long-term" daily physical activity was related to a low risk profile regarding body fatness; but for females, surprisingly, to a high risk profile regarding body fat distribution.

Adolescent↗
PubMed1997

Menopause-associated changes in plasma lipids, insulin-like growth factor I and blood pressure: a longitudinal study.

We examined the effects of the menopause transition on plasma lipids, insulin-like growth factor I (IGF-I) and blood pressure. An initial cohort of 38, non-smoking, healthy premenopausal women (44-48 years) were examined at baseline and after a 6-year follow-up period. At follow-up, 18 women had spontaneously stopped menstruating, whereas 17 women remained premenopausal. Women who experienced natural menopause showed a greater decline in high-density lipoproteins (-5 +/- 4 mg dL-1 vs. -1 +/- 3 mg dL-1; P < 0.01) and a greater increase in low-density lipoproteins (13 +/- 12 vs. 5 +/- 10 mg dL-1; P < 0.05) and fasting triglycerides (14 +/- 15 vs. 5 +/- 11 mg dL-1; P < 0.05) than women who remained premenopausal. No menopause effect was noted for total cholesterol. We noted a greater decline in IGF-I levels in women who experienced a natural menopause (-21 +/- 11 ng mL-1) than women who remained postmenopausal (-4 +/- 10 ng mL-1). Systolic blood pressure increased in postmenopausal (13 +/- 10 mmHg) compared with premenopausal women (5 +/- 4 mmHg: P < 0.01), whereas no menopause effect was noted for diastolic blood pressure. The increase in the waist-to-hip ratio was related to a decrease in high-density lipoprotein (r = -0.49; P < 0.05) and increase in low-density lipoprotein (r = 0.48; P < 0.05). The decline in IGF-I was related to the decline in reported leisure time physical activity (0.44: P < 0.05). We conclude that the natural menopause transition is associated with a worsening of the lipid profile and decline in IGF-I, which might be mitigated by deleterious changes in body fat distribution and physical activity.

Adult↗
PubMedDate not supplied

Role of obesity and fat distribution in non-insulin-dependent diabetes mellitus in Mexican Americans and non-Hispanic whites.

Recent data have suggested that central obesity is related positively to the prevalence of non-insulin-dependent diabetes mellitus (NIDDM). We examined whether central obesity (measured by the ratio of subscapular to triceps skinfold) was predictive of NIDDM prevalence independently of overall obesity (measured by body mass index, BMI) in 1231 Mexican Americans and 939 non-Hispanic whites who participated in the San Antonio Heart Study, a population-based survey of diabetes and cardiovascular risk factors. Mexican Americans are characterized by higher rates of NIDDM, greater overall obesity, and more central body fat distribution than age-matched non-Hispanic whites. Using multiple logistic regression with age, ethnicity, BMI, and central obesity as covariates, overall obesity was positively associated with NIDDM prevalence in both sexes (P less than 0.001) but central obesity was related to NIDDM prevalence only in women. Our data suggest that the effect of centrality decreases at higher levels of centrality. While both BMI and centrality narrow the ethnic difference in NIDDM prevalence, Mexican Americans still have an increased risk of NIDDM (odds ratio = 2.33 in men and 1.80 in women), suggesting that other factors, possibly genetic, may also be important determinants of the ethnic differences in NIDDM prevalence.

Adult↗
PubMed1994

Are gender differences in cardiovascular disease risk factors explained by the level of visceral adipose tissue?

It has been suggested that the lower prevalence of cardiovascular disease in women before menopause in comparison with men may be explained by differences in body fat distribution, plasma lipoprotein levels and indices of plasma glucose-insulin homeostasis. Thus, gender differences in visceral adipose tissue accumulation measured by computed tomography and metabolic variables were studied in 80 men and 69 pre-menopausal women, aged 23-50 years. Despite the fact that women had higher levels of total body fat (p < 0.0001), they displayed lower areas of abdominal visceral adipose tissue (p < 0.06) and a lower ratio of abdominal visceral to mid-thigh adipose tissue areas than men (p < 0.0001). After adjustment for body fat mass, women generally displayed a more favourable risk profile than men which included higher plasma HDL2-cholesterol and lower plasma insulin, apolipoprotein B and triglyceride levels (p < 0.01). Metabolic variables adjusted for body fat mass were then compared between genders after control for differences in abdominal visceral adipose tissue area. After such controls, variables related to plasma glucose-insulin homeostasis were no longer significantly different between men and women. Gender differences for plasma concentrations of triglyceride, apolipoprotein B and the ratio of HDL2-cholesterol/HDL3-cholesterol also disappeared, whereas plasma concentrations of HDL-cholesterol, HDL2-cholesterol as well as the ratio of HDL-cholesterol/total cholesterol remained significantly higher in women than in men (p < 0.01). These results suggest that abdominal visceral adipose tissue is an important correlate of gender differences in cardiovascular disease risk. However, additional factors are likely to be involved in gender differences in plasma HDL-cholesterol levels.

Adipose Tissue↗
PubMed2002

Effect of glucose tolerance status on PAI-1 plasma levels in overweight and obese subjects.

OBJECTIVE: The aim of our study was to examine whether plasminogen activator inhibitor-1 (PAI-1) plasma levels varied as a function of differences in glucose tolerance status independently of body fatness, body-fat distribution, and insulin sensitivity. RESEARCH METHODS AND PROCEDURES: Plasma PAI-1 antigen levels, along with insulin resistance [measured by homeostatic model assessment (HOMA(IR))], central fat accumulation, body composition, blood pressure, and fasting concentrations of glucose, insulin, and lipids, were measured in 229 overweight and obese [body mass index (BMI) > or =25 kg/m(2)) subjects with normal glucose tolerance (NGT) and in 44 age- and BMI-matched subjects with impaired glucose tolerance (IGT). RESULTS: Plasma PAI-1 antigen levels were significantly higher in IGT than in NGT subjects. Log PAI-1 was positively correlated with BMI, HOMA(IR), and log insulin, and inversely associated with high-density lipoprotein-cholesterol both in IGT and in NGT individuals. On the other hand, log PAI-1 was positively correlated with waist circumference, fat mass (FM), fat-free mass, systolic and diastolic blood pressure, and log triglycerides only in the NGT group. After multivariate analyses, the strongest determinants of PAI-1 levels were BMI, FM, waist circumference, and high-density lipoprotein cholesterol in the NGT group and only HOMA(IR) in the IGT cohort. DISCUSSION: This study demonstrates that PAI-1 concentrations are higher in IGT than in NGT subjects. Furthermore, we suggest that the influences of total adiposity, central fat, and insulin resistance, main determinants of PAI-1 concentrations, are different according to the degree of glucose tolerance.

Adolescent↗
PubMed2006

The obesity epidemic and its cardiovascular consequences.

PURPOSE OF REVIEW: Obesity has reached global epidemic proportions because of an increasingly obesogenic environment. This review examines the association between obesity, and in particular visceral fat, as a risk factor for cardiovascular disease and mortality. RECENT FINDINGS: The World Health Organization defines obesity based on the body mass index. Recently the waist-to-hip ratio has been shown to be a significantly stronger predictor of cardiovascular events than body mass index. The metabolic syndrome and its evolving definition represent a cluster of metabolic risk factors which help predict cardiovascular disease and mortality. Although insulin resistance plays a central role in the pathophysiology of the metabolic syndrome, there is limited support for therapy with insulin sensitizers, thiazolidinediones, in patients with coronary artery disease. The current anti-obesity drugs, orlistat and sibutramine, have only a modest effect on weight loss. The blockade of the endocannabinoid system with rimonabant, however, may be a promising new strategy. SUMMARY: Obesity is associated with significant increase in cardiovascular risk. Lifestyle modification remains the cornerstone of management although anti-obesity medications may be indicated in high risk individuals with comorbid disease.

Appetite Depressants↗
PubMed1994

Insulin resistance, lipoproteins, body fat and hemostasis in nonobese men with angina and a normal or abnormal coronary angiogram.

OBJECTIVES: The aim of this study was to compare metabolic risk factors in men with anginal chest pain and a normal or abnormal coronary angiogram with those in healthy men. BACKGROUND: Risk factors for coronary heart disease, including lipoprotein abnormalities, hypertension and adiposity, may be metabolically interlinked, with insulin resistance and hyperinsulinemia being pivotal to these disturbances. METHODS: Glucose and insulin metabolism, lipids and lipoproteins, hemostasis, blood pressure and body fat distribution were measured in 77 nonobese middle-aged men who had anginal chest pain (39 with an abnormal coronary angiogram and 38 with no detectable angiographic abnormality) and were compared with those of 40 healthy men of similar age and body mass index. RESULTS: Patients with chest pain had higher insulin responses to an intravenous glucose challenge, lower insulin sensitivity, lower high density lipoprotein (HDL) and subfraction 2 cholesterol, lower apolipoprotein AI, higher triglycerides, greater android fat and higher systolic blood pressure at rest compared with levels in healthy control subjects (p < 0.05). Those with an abnormal coronary angiogram had lower tissue plasminogen activator levels, higher plasminogen activator inhibitor 1 levels and more android fat than did those with a normal angiogram (p < 0.05). Insulin sensitivity correlated positively with HDL (p < 0.05) and subfraction 2 (p < 0.001) cholesterol and negatively with triglycerides (p < 0.01), android fat proportion (p < 0.01) and systolic blood pressure (p < 0.05), whereas insulin response showed converse correlations. CONCLUSIONS: These findings provide new evidence of the central role of insulin resistance and hyperinsulinemia in the development of risk factors associated with coronary heart disease.

Adult↗
PubMed2003

Changes in anthropometry with testosterone therapy in a female with gender identity disorder.

A 31-year-old regularly menstruating Japanese female was referred to our outpatient clinic by a psychiatrist. She had been diagnosed as having gender identity disorder by detailed counseling and clinical intervention 3 years earlier. After obtaining fully informed written consent, we treated her with 125 mg of testosterone enanthate, intramuscularly, every 2 weeks for 4 months. Serum testosterone levels increased to the normal male value (from 28 to 432 ng/dL). Although menstrual cycle remained regular, her voice became lower after 4 months of therapy. Body weight, body mass index, and lean body mass increased, while body fat mass and percentage of body fat decreased. However, trunk-leg fat ratio did not change during the observation period. During testosterone therapy, a disproportionate increase in lean body mass and decrease in body fat mass are early onset events, while the shift toward upper body fat distribution may be a late onset event along with increase in BMD.

Adult↗
PubMed1992

Does lipid oxidation differ in gynoid and android obese women?

This study was performed to investigate whether body fat distribution influences resting metabolic rate and lipid oxidation in obese individuals. Eighty-nine obese women were divided in two groups (android obese, n = 36, BMI = 31.1 +/- 4.5 kg/m2 (mean +/- s.d.); gynoid obese, n = 53, BMI = 29.9 +/- 4.5 kg/m2 on the basis of their waist/hip ratio (0.86 +/- 0.05 vs 0.75 +/- 0.04 respectively). Body weight, per cent body fat and fat-free mass were similar in the two groups. Moreover, resting metabolic rate and respiratory quotient were also identical in android and gynoid obese women, indicating that there was no intergroup difference in the absolute level of lipid oxidation. If, like most other android obese women, they had higher rates of lipolysis and plasma FFA concentrations, the failure of android obese individuals to exhibit a higher lipid oxidation than gynoid obese women may partly explain their increased risk to develop metabolic complications.

Adipose Tissue↗
PubMed1996

Six-month overnight administration of intraperitoneal amino acids does not improve lean mass.

UNLABELLED: Intraperitoneal administration of 1% amino acid dialysis solution in patients on continuous peritoneal dialysis (CAPD) is associated with improvement in plasma amino acid concentrations and inconsistent results with respect to nitrogen balance. Whether alteration(s) in lean mass and body fat distribution also occur remains controversial. Therefore 18 patients (P), on CAPD for at least 6 months, were assigned in a prospective and controlled fashion to receive overnight either a 1% amino acid (AA-P) or a 1.36% glucose (Glu-P) containing dialysis solution. Body composition was investigated using whole body dual energy X-ray absorptiometry (Hologic QDR 1000/W). In P receiving glucose (n = 9), total body fat mass increased (+1.0 +/- 0.4 kg, mean +/- SEM, p < 0.03), whereas in patients on amino acids (n = 9), it decreased (-0.6 +/- 0.3, p < 0.02). This decrease in fat mass in AA-P was attributable to a decrease in upper body fat (-0.6 +/- 0.2, p < 0.02), whereas in Glu-P, it increased (+0.9 +/- 0.03, p < 0.03). No change in lower body fat was observed in either group. Total body lean mass remained similar in both groups during the six months of study (AA-P: 46.6 +/- 2.9 kg vs 47.0 +/- 3.0 kg, Glu-P 50.8 +/- 3.2 vs 50.1 +/- 2.2 kg baseline vs 6 months, respectively). In AA-P plasma urea concentrations increased from 25 +/- 2 to 34 +/- 3 mmol/l (p < 0.05), whereas plasma bicarbonate concentrations were similar before and after 6 months of therapy in either group. Plasma albumin and transferrin concentrations did not change in either group. Protein catabolic rate increased in AA-P (p < 0.01), whereas K x t/V did not change as a consequence of either therapy. CONCLUSION: Reduction in the amount of glucose in the peritoneal dialysate and the addition of amino acids decreases, whereas continuous dialysis with overnight glucose increases upper body fat over a 6-month period. However, no changes in protein stores were observed with the addition of amino acids. Therefore overnight peritoneal dialysis with amino acids offers minor advantages to protein-malnourished patients on CAPD, but may be of benefit in overweight CAPD patients.

Absorptiometry, Photon↗
PubMed2006

Omental and subcutaneous adipose tissue steroid levels in obese men.

We examined plasma and fat tissue sex steroid levels in a sample of 28 men aged 24.8-62.2 years (average BMI value of 46.3 +/- 12.7 kg/m(2)). Abdominal adipose tissue biopsies were obtained during general or obesity surgery. Omental and subcutaneous adipose tissue steroid levels were measured by gas chromatography and chemical ionization mass spectrometry after appropriate extraction procedures. BMI and waist circumference were negatively correlated with plasma testosterone (r = -0.49 and -0.50, respectively, p < 0.01) and dihydrotestosterone (r = -0.58 and -0.56, respectively, p < 0.01), and positively associated with estrone levels (r = 0.64 and 0.62, respectively, p < 0.001). Regional differences in adipose tissue steroid levels were observed for dihydrotestosterone (p < 0.005), androstenedione (p < 0.0001) and dehydroepiandrosterone levels (p < 0.05), which were all significantly more concentrated in omental versus subcutaneous fat. Positive significant associations were found between circulating level of a steroid and its concentration in omental and subcutaneous adipose tissue, for estrone (r = 0.72 and 0.57, respectively, p < 0.01), testosterone (r = 0.66 and 0.58, respectively, p < 0.01) and dihydrotestosterone (r = 0.58 and 0.45, respectively, p < 0.05). Positive correlations were observed between plasma dehydroepiandrosterone-sulfate and omental (r = 0.56, p < 0.01) as well as subcutaneous adipose tissue dehydroepiandrosterone level (r = 0.38, p = 0.05). Positive significant associations were found between omental adipocyte responsiveness to positive lipolytic stimuli (isoproterenol, dibutyryl cyclic AMP and forskolin) and plasma or omental fat tissue androgen levels. In conclusion, although plasma androgen or estrogen levels are strong correlates of adipose tissue steroid content both in the omental and subcutaneous fat depots, regional differences may be observed. Androgen concentration differences in omental versus subcutaneous adipose tissue suggest a depot-specific impact of these hormones on adipocyte function and metabolism.

Abdominal Fat↗
PubMed1999

A sibling-pair analysis of fasting lipids and anthropometric measurements and their relationship to hypertension.

Fifty non-diabetic, young Chinese hypertensives were compared to their normotensive siblings with respect to body fat distribution and fasting lipid and glucose (FPG) profiles. Sitting BP in hypertensives met conventional hypertension criteria after a 4-week washout period on placebo. Hypertensives had greater body mass index (BMI), subscapular skin-fold thickness (SFT), waist circumference (W), waist-to-height (WHtR) and waist-to-hip ratio (WHR), p<0.0001 for all. Higher triglycerides (p=0.004) and lower HDL-cholesterol (p=0.015) concentrations were also observed. Weight, W, WHtR and BMI were higher in hypertensives in both male (n=9) and female gender-concordant sibling pairs (n=21). Higher WHR, hip circumference and subscapular SFT were only seen in the male hypertensives. Hypertension is associated with central adiposity and adverse lipid profiles in this group of young hypertensives, supporting the hypothesis that obesity, particularly central, is closely associated with hypertension in Chinese as in other ethnic groups.

Adult↗
PubMed1996

Association between intra-abdominal fat and hypertension in android obese diabetics.

We have examined the relationship between visceral fat measured by MRI on a transverse cut through L3, insulin sensitivity assessed by the somatostatin-insulin-glucose test, and arterial blood pressure in 18 obese (11 women and 7 men), non insulin-dependent diabetic patients with android body fat distribution. Extent of visceral fat and insulin sensitivity were not different between women and men. Insulin sensitivity correlated significantly with visceral fat (r = -0.54, p < 0.05) but not with body mass index, L3 subcutaneous fat, or with waist to hip circumference ratio. Moreover, insulin sensitivity was lower in hypertensive compared to normotensive diabetic patients (Steady State Plasma Glucose = 18.8 +/- 3 mmol/l vs 15.1 +/- 3.3 mmol/l p < 0.05) and L3 visceral fat was greater (238 +/- 70 cm2 vs 106 +/- 36 cm2 p < 0.01), although there were no differences in body mass index, L3 subcutaneous fat, waist to hip circumference ratio or age. In conclusion, visceral fat quantity correlates with insulin sensitivity and blood pressure in android obese diabetics with similar morphotype (comparable body mass index and waist to hip circumference ratio).

Abdomen↗
PubMed2001

Slower activation of insulin action in upper body obesity.

To determine the influence of body fat distribution on kinetic aspects of insulin action, we have monitored the rate of increase of glucose infusion during 6-hour hyperinsulinemic (40 mU/m2/min) euglycemic clamps in 10 patients with upper body obesity (body mass index [BMI], 41 +/- 3 kg/m2; waist-to-hip ratio [WHR], > 1.00 for men and > 0.85 for women), 12 patients with lower body obesity (BMI, 40 +/- 2 kg/m2; WHR, < 1.00 for men and < 0.85 for women), and 5 control subjects (BMI, < 30 kg/m2; WHR, < 1.00 for men and < 0.85 for women). In all subjects, glucose infusion rate (GIR) to maintain euglycemia increased during the clamp studies to achieve maximal, steady state values after the fourth to fifth hour. During the first 2 hours of clamp, mean GIR (GIR20-120min) (traditional approach to assess insulin sensitivity) was lower (P < 0.05) in the upper body obesity group than in the lower body obesity group (2.12 +/- 0.14 and 3.03 +/- 0.33 mg/kg per min, respectively). In contrast, the maximal steady-state GIR (GIRMAX) (calculated as mean GIR during the sixth hour of clamp) was similar in the upper body and in the lower body obesity groups (4.48 +/- 0.45 and 4.57 +/- 0.36 mg/kg per min, respectively). Control subjects exhibited higher values of both GIR20-120min and GIRMAX (5.57 +/- 0.67 and 7.05 +/- 0.59 mg/kg per min, respectively) than those of both groups of obese patients. The time to reach half-maximal GIR (T1/2) was greater (P < .05) in the upper body obesity (94 +/- 12 min) than that in the lower body obesity (41 +/- 5 min) and in the control group (30 +/- 5 min). In pooled subjects, BMI correlated with GIRMAX (n = 27, R = -.75, P < .001), but not with T1/2 (R = .21). Similarly, whole body percent fat mass, as assessed by bioelectrical impedance analysis, correlated with GIRMAX (n = 16, R = -.79, P < .001), but not with T1/2 (R = .10). In contrast, WHR closely correlated with T1/2 (n = 27, R = .78, P < .001), but not with GIRMAX (R = .11). We conclude that upper body obesity is associated with a slower rate of activation of insulin action on glucose metabolism, whereas total body adiposity selectively affects the maximal, steady-state insulin effect.

Body Constitution↗
PubMed1990

Visceral fat accumulation in men is positively associated with insulin, glucose, and C-peptide levels, but negatively with testosterone levels.

Twenty-three healthy men (age 25 to 50 years), covering a wide range of fatness and body fat distribution, were studied. An oral glucose tolerance test was performed and adipose tissue areas were calculated from computed tomography (CT) scans made at the level of L4/L5. Visceral fat area was associated with elevated concentrations of insulin and C-peptide and with glucose intolerance before and after the oral glucose load. Concentrations of sex-hormone-binding globulin (SHBG), as well as total and free testosterone, were negatively correlated with waist/hip circumference ratio and visceral fat area and also negatively associated with increased glucose, insulin, and C-peptide concentrations. In multiple linear regression, adjusting for age, body mass index, and visceral fat area, serum concentrations of free testosterone were still negatively correlated with glucose, insulin, and C-peptide levels. Without claiming any causality in the observed associations, we conclude that, unlike in women, abdominal fat distribution, insulin, glucose, and C-peptide levels are negatively associated with serum testosterone levels in men.

Adipose Tissue↗
PubMed2000

Effects of neonatal handling on sympathoadrenal activity and body composition in adult male rats.

Neonatal handling permanently alters the hypothalamic-pituitary-adrenal (HPA) response to stress. Because the sympathetic nervous system (SNS) and adrenal medulla also participate in stress responses, the impact of daily handling between birth and weaning on SNS and adrenal medullary function was examined in adult rats using techniques of [(3)H]norepinephrine ([(3)H]NE) turnover and urinary catecholamine excretion. Handled animals exhibited a 23% reduction in [(3)H]NE turnover in heart and a 53% decrease in spleen. [(3)H]NE turnover in brown adipose tissue, stomach, and kidney did not differ between handled and nonhandled animals. In contrast, urinary epinephrine (Epi) excretion was significantly greater in handled rats in response to a 3-day fast than in nonhandled animals. Although body weight, weight gain in response to dietary enrichment with sucrose or lard, or body fat content did not differ in handled and nonhandled animals, handled rats displayed heavier abdominal fat depots than nonhandled animals, implying a difference in body fat distribution. Neonatal handling thus leads to decreased sympathetic activity within specific subdivisions of the SNS and, by contrast, to increased adrenal medullary responsiveness.

Adipose Tissue↗
PubMed1992

Effect of 4-wk treatment of obesity by very-low-calorie diet on anthropometric, metabolic, and hormonal indexes.

One-month treatment of obese patients (body mass index, 39.44 +/- 0.94, measured in kg/m2) with a very-low-calorie diet (VLCD) resulted in a significant weight loss, which was higher in men than in women. In contrast, the decrease of percent fat content was higher in gynoid obese women than in men or women with android fat distribution. In females fat mobilization was depressed at the thigh region where a substantially lower percent decrement of thigh skinfold thickness was demonstrated in comparison with males. VLCD treatment positively affected blood pressure and concentrations of total cholesterol, triglyceride, insulin, and cortisol. Total cholesterol-high-density-lipoprotein (HDL) cholesterol ratio remained unchanged and HDL cholesterol in serum significantly declined. Indexes of body fat distribution were not significantly influenced by the short-term treatment by VLCD except waist-hip ratio, which declined in android obese females. VLCD does not decrease a tolerance of physical exercise, as the metabolic response to submaximal workload on a cycle ergometer as well as the responses of cortisol, growth hormone, and prolactin remained unchanged after the treatment.

Adipose Tissue↗