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)

Pia Christensen*, Thomas Meinert Larsen, Margriet Westerterp-Plantenga, Ian Macdonald, J. Alfredo Martinez, Svetoslav Handjiev, Sally Poppitt, Sylvia Hansen, Christian Ritz, Arne Astrup, Laura Pastor-Sanz, Finn Sando-Pedersen, Kirsi H. Pietilainen, Jouko Sundvall, Mathijs Drummen, Moira A. Taylor, Santiago Navas-Carretero, Teodora Handjieva-Darlenska, Shannon Brodie, Marta P. SilvestreMaija Huttunen-Lenz, Jennie Brand-Miller, Mikael Fogelholm, Anne Raben

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

76 Citations (Web of Science)

Abstract

Aims Materials and methods The PREVIEW lifestyle intervention study ( 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. 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/m(2)) 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 Conclusions 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. 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.

Original languageEnglish
Pages (from-to)2840-2851
Number of pages12
JournalDiabetes Obesity & Metabolism
Volume20
Issue number12
DOIs
Publication statusPublished - Dec 2018

Keywords

  • dietary intervention
  • obesity
  • prevention
  • weight loss
  • pre-diabetes
  • LOW-CALORIE DIET
  • GENDER-DIFFERENCES
  • BARIATRIC SURGERY
  • PHYSICAL-ACTIVITY
  • BODY-COMPOSITION
  • FAT
  • MAINTENANCE
  • MANAGEMENT
  • REDUCTION
  • EXERCISE

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