The effect of exercise training on leptin levels in obese males.

Maastricht University, Department of Human Biology, The Netherlands. The effect of endurance training on plasma leptin levels was investigated in 15 obese male subjects (age 37.3 +/- 5.2 yr, body weight 96.5 +/- 13.6 kg, and body mass index 29.8 +/- 3.0 kg/m2) in a weight loss and exercise program. After 4 mo of treatment consisting of a very low energy diet (VLED) and endurance exercise training (3-4 times weekly, 1 h sessions, moderate intensity), two groups were formed. One group continued the exercise sessions (trained subjects, n = 7) and the other group stopped with the exercise program (control, n = 8). Measurements of anthropometry, aerobic power, and fasted blood samples were executed at fixed time points (0, 2, 4, 10, and 16 mo). With partial regression analysis, keeping the changes in insulin and body fat percentage constant, it was shown that the number of hours of exercise training was significantly correlated with changes in leptin levels, during the 16-mo period (r = 0.56, P < 0.05). Changes in insulin levels were significantly related to the changes in leptin levels (r = 0.47, P < 0.05), which were less for changes in body fat percentage (r = 0.42, P = 0.07). During the VLED, the change in insulin concentration affected leptin levels significantly (r = 0.79) but changes in body fat percentage were not noted. It is concluded that endurance exercise training decreased plasma leptin levels independently of changes in plasma insulin levels and body fat percentage

The effect of a lifestyle intervention on type 2 diabetes pathophysiology and remission: the Stevenshof pilot study

Although lifestyle interventions can lead to diabetes remission, it is unclear to what extent type 2 diabetes (T2D) remission alters or improves the underlying pathophysiology of the disease. Here, we assess the effects of a lifestyle intervention on T2D reversal or remission and the effects on the underlying pathology. In a Dutch primary care setting, 15 adults with an average T2D duration of 13.4 years who were (pharmacologically) treated for T2D received a diabetes subtyping ("diabetyping") lifestyle intervention (DLI) for six months, aiming for T2D remission. T2D subtype was determined based on an OGTT. Insulin and sulphonylurea (SU) derivative treatment could be terminated for all participants. Body weight, waist/hip ratio, triglyceride levels, HbA1c, fasting, and 2h glucose were significantly improved after three and six months of intervention. Remission and reversal were achieved in two and three participants, respectively. Indices of insulin resistance and beta cell capacity improved, but never reached healthy values, resulting in unchanged T2D subtypes. Our study implies that achieving diabetes remission in individuals with a longer T2D duration is possible, but underlying pathology is only minimally affected, possibly due to an impaired beta cell function. Thus, even when T2D remission is achieved, patients need to continue adhering to lifestyle therapy.Diabetes mellitus: pathophysiological changes and therap

Predictors of weight maintenance

Objective: To obtain predictors of weight maintenance after a weight-loss intervention. Research Methods and Procedures: An overall analysis of data from two-long intervention studies [n = 67 women; age: 37.9±1.0 years; body weight (BW): 87.0±1.2 kg; body mass index: 32.1±0.5 kg·m-2; % body fat: 42.4±0.5%]. Subjects were measured before a very low energy diet (month 0), after the very low energy diet of 2 months (month 2) and after a 14-month follow-up phase (at 16 months), in which fiber or a carbohydrate-containing food supplement was supplied. The baseline measurements and the changes in parameters induced by the diet intervention were used to predict the changes in BW in the follow-up phase [ABW(2-16)]. Results: Multiple regression analysis revealed that 50% (p<0.001) of the variability in weight regain could be explained by pphysiological and behavioral factors. These were: frequency of previous dieting (r2 = 0.27, p<0.05), hunger score (measured with the three-factor eating behavior questionnaire), and change in 24-hour resting metabolic rate (RMR). Frequent dieters showed significantly more weight regain than less frequent dieters (8.8±1.0 kg vs. 5.1±0.8 kg, p<0.01). Subjects having parents with obesity regained almost significantly more weight than subjects with lean parents (8.5±0.2 kg vs. 5.1±1.5 kg, respectively; p = 0.06). Discussion: Physiological (ΔRMR-24 hours) and behavioral factors (previous frequency of dieting and hunger score) predicted failure of weight maintenance and, as such, can be used to identify women who are at risk for weight regain. Copyright © 1999 NAASO