title: Arterial stiffness, lifestyle intervention and a low-calorie diet in morbidly obese patients-a nonrandomized clinical trial.
abstract: OBJECTIVE
  Arterial stiffness is an independent predictor of cardiovascular morbidity and mortality. This study aimed to compare the 7-week effect of a low-calorie diet (LCD) and an intensive lifestyle intervention program (ILI) on arterial stiffness in morbidly obese individuals.
  
  
  METHODS
  Nonrandomized clinical trial. The LCD provided 900 kcal/day, and participants in the LCD group were instructed to maintain their habitual physical activity level. The ILI included two 90-min supervised training sessions 3 days a week at moderate to high intensity (4-8 METs) and a caloric restriction of 1000 kcal/day.
  
  
  RESULTS
  A total of 179 individuals completed the study, 88 (56 women) in the ILI group and 91 (57 women) in the LCD group. High-fidelity applanation tonometry (Millar(®) , Sphygmocor(®) ) was used to measure carotid-femoral pulse wave velocity (PWV). After adjustment for relevant confounders, the ILI group had a significantly greater reduction in PWV than the LCD group; -0.4 (-0.6, -0.1) m/s, P = 0.004. When compared to the LCD group, the ILI group showed a larger reduction in systolic and diastolic blood pressure -5 (-9, -1) and -5 (-7, -2) mmHg, P = 0.038 and P ≤ 0.001 respectively, whereas no difference was observed regarding pulse pressure, P = 0.661. No significant differences between groups were found regarding the loss of fat mass, P = 0.259, but the loss of muscle mass was larger in the LCD group, 0.8 (0.5, 1.1) kg, P ≤ 0.001.
  
  
  CONCLUSIONS
  Despite the limitations of a nonrandomized design, our findings indicate that for morbidly obese individuals a moderate caloric restriction combined with aerobic physical exercise is associated with a greater decline in PWV than a LCD alone.
authors.affiliation: Morbid Obesity Center, Vestfold Hospital Trust, Tønsberg, Norway. njord.nordstrand@siv.no
authors.forename: N
authors.initials: N
authors.lastname: Nordstrand
authors.forename: E
authors.initials: E
authors.lastname: Gjevestad
authors.forename: J K
authors.initials: JK
authors.lastname: Hertel
authors.forename: L K
authors.initials: LK
authors.lastname: Johnson
authors.forename: E
authors.initials: E
authors.lastname: Saltvedt
authors.forename: J
authors.initials: J
authors.lastname: Røislien
authors.forename: J
authors.initials: J
authors.lastname: Hjelmesaeth
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000032:analysis; D001794:Blood Pressure; D001823:Body Composition; D015992:Body Mass Index; D031204:Caloric Restriction; D002318:Cardiovascular Diseases / Q000517:prevention & control; D002784:Cholesterol / Q000097:blood; D005260:Female; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D009767:Obesity, Morbid / Q000628:therapy*; D011446:Prospective Studies; D063177:Pulse Wave Analysis; D012307:Risk Factors; D014280:Triglycerides / Q000097:blood; D059289:Vascular Stiffness; D015431:Weight Loss
chemical_list: D001786:Blood Glucose; D014280:Triglycerides; D002784:Cholesterol