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Impact of Weight Loss on Patients with High TC/HDL Ratios
Grant L, Gotthelf L
Obes 2008; 16 suppl: s308
Objective: Making lifestyle changes (including physical activity, weight and nutritional changes) is the recommended initial approach to reduce many health risk factors. The purpose of this study was to document the changes in lifestyle and medical risk factors for patients with elevated total/HDL cholesterol (TC/HDL) ratios who participated in a weight loss program.
Methods & Subjects: Patients who entered the HMR Program for Weight Management™ with high TC/HDL (≥ 5.0) and were not taking cholesterol medications, either initially or on follow-up, were included. Patients (n=331) also had to have completed an initial health risk appraisal (HRA) and a follow-up HRA in 2006 or later.
Program: HMR offers a range of weight-loss treatment options, including medically supervised low and very low-calorie diets, moderately restricted diets and phone-based programs as well as long-term maintenance. The program is based on measurable, evidence-based variables allowing for specific goals to be set and compliance to be tracked. All options for weight loss and maintenance focus on the same lifestyle changes: increased physical activity (≥ 2000 kcal/wk); use of meal replacements (≥ 35/wk in weight loss and 14/wk in maintenance); increased vegetable and fruit intake (≥ 35/wk) is included in some weight-loss options and in maintenance.
Results:
| Measure |
Initial
|
Follow-up
(Avg. = 3 years)
|
Changes |
| Weight |
265 lbs. |
216 lbs.
|
-49 lbs. (18.5%) |
Total Cholesterol/HDL
|
5.36
|
3.97 |
-25.9% |
Triglycerides
|
196 |
124 |
-36.7 |
Systolic Blood Pressure
|
129 |
121 |
-8 mmHg |
Diastolic Blood Pressure
|
80
|
75 |
-5 mmHg |
Fasting Blood Glucose
|
104
|
94
|
-9.6% |
• Patients made substantial lifestyle changes: physical activity increased from an average of 657 kcals/wk to 1896 kcals/wk; dietary fat decreased from an average of 40.5% to 28%; and vegetable and fruit intake increased considerably.
• Both the statistically calculated cancer and cardiovascular risk scores decreased from high risk to moderate risk.
• The average number of elevated risk factors decreased from 8 to 3 and total risk factor score on the HRA declined from +30 (the average American male is +25 and female is +23) to +2 (0 is the Healthy American score).
Conclusions: In summary, patients with elevated TC/HDL who made lifestyle changes in a weight management program substantially reduced all measured medical risk factors, including elevated TC/HDL, without the need for cholesterol lowering medications.
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