WEIGHT-LOSS WITH VERY-LOW-CALORIE DIET AND CARDIOVASCULAR RISK-FACTORS IN MODERATELY OBESE WOMEN - ONE-YEAR FOLLOW-UP-STUDY INCLUDING AMBULATORY BLOOD-PRESSURE MONITORING

OBJECTIVE: The beneficial effects of weight loss with a very-low-calor ie diet (VLCD) on cardiovascular risk factors have been reported at th e end of energy restriction. As the effects, especially on blood press ure, may not remain constant during weight maintenance, we studied the longer-term effects of weight loss on 24 h ambulatory blood pressure (ABP), lipids, glucose and insulin. DESIGN: Prospective study of a 17- week weight loss programme containing an eight-week VLCD period and fo llowup visit at one-year. SUBJECTS: Twenty-nine moderately obese, norm otensive or mildly hypertensive women. The mean +/- s.d. body mass ind ex (BMI) was 36.0 +/- 2.6 kg/m(2) and mean age 40.3 +/- 8.3 y. RESULTS : In the last week of the VLCD, the mean (s.d.) weight loss was 12.4 /- 3.3 kg (P < 0.001), at the end of the programme 15.1 +/- 4.4 kg (P < 0.001 vs baseline), and at one-year follow-up 10.7 +/- 7.6 kg (P < 0 .001 vs baseline). Mean 24 h ABP decreased 8.0/4.6 mmHg (P < 0.001 for both) on the last week of the VLCD, at the end of the programme, the systolic ABP decrease was 4.7 mmHg (P < 0.01 vs baseline) and diastoli c 2.1 mmHg (not statistically significant (NS) vs baseline). At one-ye ar follow-up, the mean systolic ABP decrease was 4.1 mmHg (P < 0.01 vs baseline) and mean diastolic 3.0 mmHg (P < 0.05 vs baseline). Sodium excretion decreased 55 mmol/24 h in the last VLCD week (P < 0.01) and returned to baseline after that. At the one-year follow-up, beneficial changes, compared with baseline, were observed in mean serum glucose (-0.28 mmol/l, P < 0.05), triglyceride (-0.35 mmol/l, P < 0.01) and HD L cholesterol (+0.16 mmol/l, P < 0.001). CONCLUSIONS: This weight loss programme with a VLCD enabled obese subjects to lose weight and decre ase cardiovascular risks. Despite some regain in weight during follow- up, the beneficial effects were overall maintained over the year. Sodi um intake tended to increase during follow-up. Information on sodium r estriction should be included in weight loss programmes.