title: The STEDMAN project: biophysical, biochemical and metabolic effects of a behavioral weight loss intervention during weight loss, maintenance, and regain.
abstract: The Study of the Effects of Diet on Metabolism and Nutrition (STEDMAN) Project uses comprehensive metabolic profiling to probe biochemical mechanisms of weight loss in humans. Measurements at baseline, 2 and 4 weeks, 6 and 12 months included diet, body composition, metabolic rate, hormones, and 80 intermediary metabolites measured by mass spectrometry. In 27 obese adults in a behavioral weight loss intervention, median weight decreased 13.9 lb over the first 6 months, then reverted towards baseline by 12 months. Insulin resistance (HOMA) was partially ameliorated in the first 6 months and showed sustained improvement at 12 months despite weight regain. Ghrelin increased with weight loss and reverted to baseline, whereas leptin and PYY fell at 6 months and remained persistently low. NPY levels did not change. Factors possibly contributing to sustained improvement in insulin sensitivity despite weight regain include adiponectin (increased by 12 months), IGF-1 (increased during weight loss and continued to increase during weight regain), and visceral fat (fell at 6 months but did not change thereafter). We observed a persistent reduction in free fatty acids, branched chain amino acids, and related metabolites that may contribute to improved insulin action. These findings provide evidence for sustained benefits of weight loss in obese humans and insights into mechanisms.
authors.affiliation: Department of Medicine, Sarah W Stedman Nutrition and Metabolism Center, Duke University Medical Center, Durham, North Carolina 27710, USA. lien0002@mc.duke.edu
authors.forename: Lillian F
authors.initials: LF
authors.lastname: Lien
authors.forename: Andrea M
authors.initials: AM
authors.lastname: Haqq
authors.forename: Michelle
authors.initials: M
authors.lastname: Arlotto
authors.forename: Cris A
authors.initials: CA
authors.lastname: Slentz
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Muehlbauer
authors.forename: Ross L
authors.initials: RL
authors.lastname: McMahon
authors.forename: James
authors.initials: J
authors.lastname: Rochon
authors.forename: Dianne
authors.initials: D
authors.lastname: Gallup
authors.forename: James R
authors.initials: JR
authors.lastname: Bain
authors.forename: Olga
authors.initials: O
authors.lastname: Ilkayeva
authors.forename: Brett R
authors.initials: BR
authors.lastname: Wenner
authors.forename: Robert D
authors.initials: RD
authors.lastname: Stevens
authors.forename: David S
authors.initials: DS
authors.lastname: Millington
authors.forename: Deborah M
authors.initials: DM
authors.lastname: Muoio
authors.forename: Mark D
authors.initials: MD
authors.lastname: Butler
authors.forename: Christopher B
authors.initials: CB
authors.lastname: Newgard
authors.forename: Laura P
authors.initials: LP
authors.lastname: Svetkey
mesh_terms: D052242:Adiponectin / Q000378:metabolism; D000328:Adult; D001521:Behavior Therapy; D015415:Biomarkers / Q000378:metabolism; D001835:Body Weight; D004032:Diet; D004734:Energy Metabolism; D005260:Female; D054439:Ghrelin / Q000378:metabolism; D006801:Humans; D007333:Insulin Resistance; D007334:Insulin-Like Growth Factor I / Q000378:metabolism; D020738:Leptin / Q000378:metabolism; D008875:Middle Aged; D009478:Neuropeptide Y / Q000378:metabolism; D009765:Obesity / Q000178:diet therapy*; D019894:Peptide YY / Q000378:metabolism; D015430:Weight Gain; D015431:Weight Loss
chemical_list: D052242:Adiponectin; D015415:Biomarkers; D054439:Ghrelin; D020738:Leptin; D009478:Neuropeptide Y; D019894:Peptide YY; D007334:Insulin-Like Growth Factor I