title: Maintaining a clinical weight loss after intensive lifestyle intervention is the key to cardiometabolic health.
abstract: Intensive lifestyle interventions (ILI) are criticised for ineffective obesity treatment because weight loss over time is modest and thus of limited clinical relevance. However, a subgroup (5-30%) maintains a clinical weight loss >10%, but it is not clear if cardiometabolic health follows this pattern. The aim was to study the effect of different magnitudes of weight loss maintenance after ILI on cardiometabolic health.
  
  
  
  Eighty out of 2420 former participants (age: 36±1, BMI: 38±1, (means ±SE)) in an 11-12-week ILI were recruited into 3 groups; clinical weight loss maintenance (>10% weight loss), moderate maintenance (1-10%), and weight regain based on weight loss at follow-up (5.3±0.4years). Weight loss during the ILI was achieved by increased physical activity and hypo-caloric diet. Dual X-ray Absorptiometry, blood sample, skeletal muscle biopsy and VO2maxtest were used to determine cardiometabolic health at follow-up.
  
  
  
  At follow-up, the clinical weight loss maintenance group scored better in the following variables compared to the other groups: BMI (31±1, 33±2, 43±2kg/m2), composition (34±2, 40±1, 49±1% fat), visceral adipose tissue (0.8±0.2, 1.7±0.5, 2.4±0.4kg), plasma triglycerides (0.8±0.2, 1.3±0.4, 1.6±0.3mmol/L), plasma glucose (4.9±0.1, 5.9±0.4, 5.9±0.1mmol/L), Hb1Ac (5.1±0.0, 5.6±0.2, 5.8±0.2%), protein content in skeletal muscle of GLUT4 (1.5±0.2, 0.9±0.1, 1.0±0.1 AU) and hexokinase II (1.6±0.2, 1.0±0.2, 0.7±0.1 AU), citrate synthase activity (155±6, 130±5, 113±5μmol/g/min) and VO2max(49±1, 43±1, 41±1mL/min/FFM) (p<0.05).
  
  
  
  Cardiometabolic health is better in participants who have maintained >10% weight loss compared to moderate weight loss and weight regain.
authors.affiliation: Center for Healthy Aging, Department of Biomedical Sciences, XLab, University of Copenhagen, Denmark; Department for Physiotherapy and Occupational Therapy, Metropolitan University College, Copenhagen, Denmark. Electronic address: sunedj@sund.ku.dk.
authors.forename: Sune
authors.initials: S
authors.lastname: Dandanell
authors.affiliation: Center for Healthy Aging, Department of Biomedical Sciences, XLab, University of Copenhagen, Denmark.
authors.forename: Camilla
authors.initials: C
authors.lastname: Skovborg
authors.affiliation: Center for Healthy Aging, Department of Biomedical Sciences, XLab, University of Copenhagen, Denmark; Department for Physiotherapy and Occupational Therapy, Metropolitan University College, Copenhagen, Denmark.
authors.forename: Charlotte Boslev
authors.initials: CB
authors.lastname: Præst
authors.affiliation: Center for Healthy Aging, Department of Biomedical Sciences, XLab, University of Copenhagen, Denmark.
authors.forename: Kasper Bøgh
authors.initials: KB
authors.lastname: Kristensen
authors.affiliation: Center for Healthy Aging, Department of Biomedical Sciences, XLab, University of Copenhagen, Denmark; Department for Physiotherapy and Occupational Therapy, Metropolitan University College, Copenhagen, Denmark.
authors.forename: Malene Glerup
authors.initials: MG
authors.lastname: Nielsen
authors.affiliation: Center for Healthy Aging, Department of Biomedical Sciences, XLab, University of Copenhagen, Denmark.
authors.forename: Sofie
authors.initials: S
authors.lastname: Lionett
authors.affiliation: Center for Healthy Aging, Department of Biomedical Sciences, XLab, University of Copenhagen, Denmark.
authors.forename: Sofie Drevsholt
authors.initials: SD
authors.lastname: Jørgensen
authors.affiliation: Center for Healthy Aging, Department of Biomedical Sciences, XLab, University of Copenhagen, Denmark.
authors.forename: Andreas
authors.initials: A
authors.lastname: Vigelsø
authors.affiliation: Center for Healthy Aging, Department of Biomedical Sciences, XLab, University of Copenhagen, Denmark; Geriatrics, Bispebjerg University Hospital, Copenhagen, Denmark.
authors.forename: Flemming
authors.initials: F
authors.lastname: Dela
authors.affiliation: Center for Healthy Aging, Department of Biomedical Sciences, XLab, University of Copenhagen, Denmark.
authors.forename: Jørn Wulff
authors.initials: JW
authors.lastname: Helge
mesh_terms: D015502:Absorptiometry, Photon; D000293:Adolescent; D000328:Adult; D001786:Blood Glucose / Q000378:metabolism; D001823:Body Composition; D015992:Body Mass Index; D000068959:Body Weight Maintenance; D002318:Cardiovascular Diseases / Q000517:prevention & control*; D002784:Cholesterol / Q000097:blood; D004032:Diet; D015444:Exercise; D005260:Female; D051275:Glucose Transporter Type 4 / Q000097:blood; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D008019:Life Style; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000628:therapy*; D012307:Risk Factors; D014280:Triglycerides / Q000097:blood; D015431:Weight Loss; D055815:Young Adult
chemical_list: D001786:Blood Glucose; D002784:Cholesterol; D051275:Glucose Transporter Type 4; D006442:Glycated Hemoglobin; D014280:Triglycerides; C495692:SLC2A4 protein, human
keywords: Body composition; Insulin resistance; Molecular mechanisms; Physical activity