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Body composition and metabolic effects of a diet and exercise weight loss regimen on obese, HIV-infected women.
Metabolism 2006; 55(10):1327-36M

Abstract

HIV has classically been a wasting disease. However, in the United States, obesity is increasingly common among HIV-infected individuals receiving effective antiviral treatment. The risks of obesity are unclear in HIV, although the increased prevalence of diabetes and cardiovascular disease in the presence or absence of obesity causes growing concern. This study aimed to assess the effects of weight loss (through energy restriction combined with aerobic and resistance exercise) on body composition, body fat distribution, resting energy expenditure, quality of life (QOL), strength and fitness, and metabolic risk factors in obese, HIV-infected women. Eighteen HIV-infected women with a body mass index of 30 or more completed a 12-week weight loss program. Before and after the intervention, body composition and fat distribution by dual energy x-ray absorptiometry and whole-body magnetic resonance imaging, resting energy expenditure by indirect calorimetry, QOL, strength, and fitness were measured. Insulin sensitivity by intravenous glucose tolerance test and circulating cardiovascular risk factors (including lipids, tissue plasminogen activator, and plasminogen activator inhibitor 1) were measured in a subset (n = 9). Daily food intake and total body weight decreased (mean +/- SD) by 3195 +/- 477 kJ and 6.7 +/- 4.2 kg, respectively. Weight lost was 95.5% fat by dual energy x-ray absorptiometry or 6.2 L of subcutaneous adipose tissue, 0.7 L visceral adipose tissue, and 0.8 L skeletal muscle by magnetic resonance imaging. Resting energy expenditure fell approximately 419 kJ, strength and fitness increased by 28.9% +/- 18.5% and 36.8% +/- 41.6%, respectively, and QOL improved in 11 of 13 dimensions. There was significant insulin resistance in the subset with metabolic measurements at baseline, and at follow-up there was no improvement in fasting glucose, insulin, or insulin sensitivity, nor was there any change in fasting lipids, tissue plasminogen activator, or plasminogen activator inhibitor 1. There was no significant change in CD4 count or HIV viral load. In conclusion, moderate weight loss achieved by a short-term program of diet and exercise in obese HIV-positive women appears safe and induces loss of adiposity in both the subcutaneous adipose tissue and visceral adipose tissue regions. Despite reduced food intake, weight and fat loss, as well as improvements in strength, fitness, and QOL, the lack of improvement in metabolic parameters suggests that additional interventions may be necessary to reduce the risk of diabetes and cardiovascular disease in this population.

Authors+Show Affiliations

Gastrointestinal Division, St. Luke's-Roosevelt Hospital Center, Columbia University College of Physicians and Surgeons, New York, NY 10025, USA. eengelson@chpnet.orgNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

16979403

Citation

Engelson, Ellen S., et al. "Body Composition and Metabolic Effects of a Diet and Exercise Weight Loss Regimen On Obese, HIV-infected Women." Metabolism: Clinical and Experimental, vol. 55, no. 10, 2006, pp. 1327-36.
Engelson ES, Agin D, Kenya S, et al. Body composition and metabolic effects of a diet and exercise weight loss regimen on obese, HIV-infected women. Metab Clin Exp. 2006;55(10):1327-36.
Engelson, E. S., Agin, D., Kenya, S., Werber-Zion, G., Luty, B., Albu, J. B., & Kotler, D. P. (2006). Body composition and metabolic effects of a diet and exercise weight loss regimen on obese, HIV-infected women. Metabolism: Clinical and Experimental, 55(10), pp. 1327-36.
Engelson ES, et al. Body Composition and Metabolic Effects of a Diet and Exercise Weight Loss Regimen On Obese, HIV-infected Women. Metab Clin Exp. 2006;55(10):1327-36. PubMed PMID: 16979403.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Body composition and metabolic effects of a diet and exercise weight loss regimen on obese, HIV-infected women. AU - Engelson,Ellen S, AU - Agin,Denise, AU - Kenya,Sonjia, AU - Werber-Zion,Galila, AU - Luty,Besa, AU - Albu,Jeanine B, AU - Kotler,Donald P, PY - 2005/10/18/received PY - 2006/05/18/accepted PY - 2006/9/19/pubmed PY - 2006/11/1/medline PY - 2006/9/19/entrez SP - 1327 EP - 36 JF - Metabolism: clinical and experimental JO - Metab. Clin. Exp. VL - 55 IS - 10 N2 - HIV has classically been a wasting disease. However, in the United States, obesity is increasingly common among HIV-infected individuals receiving effective antiviral treatment. The risks of obesity are unclear in HIV, although the increased prevalence of diabetes and cardiovascular disease in the presence or absence of obesity causes growing concern. This study aimed to assess the effects of weight loss (through energy restriction combined with aerobic and resistance exercise) on body composition, body fat distribution, resting energy expenditure, quality of life (QOL), strength and fitness, and metabolic risk factors in obese, HIV-infected women. Eighteen HIV-infected women with a body mass index of 30 or more completed a 12-week weight loss program. Before and after the intervention, body composition and fat distribution by dual energy x-ray absorptiometry and whole-body magnetic resonance imaging, resting energy expenditure by indirect calorimetry, QOL, strength, and fitness were measured. Insulin sensitivity by intravenous glucose tolerance test and circulating cardiovascular risk factors (including lipids, tissue plasminogen activator, and plasminogen activator inhibitor 1) were measured in a subset (n = 9). Daily food intake and total body weight decreased (mean +/- SD) by 3195 +/- 477 kJ and 6.7 +/- 4.2 kg, respectively. Weight lost was 95.5% fat by dual energy x-ray absorptiometry or 6.2 L of subcutaneous adipose tissue, 0.7 L visceral adipose tissue, and 0.8 L skeletal muscle by magnetic resonance imaging. Resting energy expenditure fell approximately 419 kJ, strength and fitness increased by 28.9% +/- 18.5% and 36.8% +/- 41.6%, respectively, and QOL improved in 11 of 13 dimensions. There was significant insulin resistance in the subset with metabolic measurements at baseline, and at follow-up there was no improvement in fasting glucose, insulin, or insulin sensitivity, nor was there any change in fasting lipids, tissue plasminogen activator, or plasminogen activator inhibitor 1. There was no significant change in CD4 count or HIV viral load. In conclusion, moderate weight loss achieved by a short-term program of diet and exercise in obese HIV-positive women appears safe and induces loss of adiposity in both the subcutaneous adipose tissue and visceral adipose tissue regions. Despite reduced food intake, weight and fat loss, as well as improvements in strength, fitness, and QOL, the lack of improvement in metabolic parameters suggests that additional interventions may be necessary to reduce the risk of diabetes and cardiovascular disease in this population. SN - 0026-0495 UR - https://www.unboundmedicine.com/medline/citation/16979403/Body_composition_and_metabolic_effects_of_a_diet_and_exercise_weight_loss_regimen_on_obese_HIV_infected_women_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0026-0495(06)00185-5 DB - PRIME DP - Unbound Medicine ER -