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Modest weight loss improves cardiometabolic profile in South Asian adults
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South Asian adults with overweight and impaired glucose tolerance assigned to lifestyle intervention who lose a modest amount of weight over 3 years saw small improvements in biomarkers for cardiometabolic risk, according to study findings.
“We know that people of South Asian ethnicity are a group particularly at risk from complications that result from being overweight, such as type 2 diabetes,” Paul Welsh, PhD, a research fellow at the BHF Glasgow Cardiovascular Research Centre, University of Glasgow, Scotland, told Endocrine Today. “Our study shows that even modest weight loss in South Asians who are overweight and have impaired glucose metabolism is associated with a small improvement in important markers such as liver enzymes, glycemia and insulin resistance. This in itself in encouraging, as it shows we can theoretically improve long-term health prospects with a lifestyle approach that achieves weight loss.”
Paul Welsh
Welsh and colleagues analyzed data from 171 adults of Pakistani or Indian origin aged at least 35 years participating in the Prevention of Diabetes and Obesity in South Asians (PODOSA) study, a nonmasked, family-clustered, randomized controlled trial conducted in Scottish communities. All participants had overweight or obesity and IGT, but were free of diabetes at baseline; the family cook was asked to be willing to cooperate with the trial. Participants were randomly assigned to intervention consisting of information and demonstrations on healthy shopping and cooking practices and 15 visits from a dietitian during 3 years of follow-up (n = 85) or to a control group that included standard written and verbal advice on healthy eating, diabetes prevention, promotion of physical activity and information on other weight-control services during four visits (at baseline, and then annually; n = 86). Researchers measured cardiometabolic biomarkers at baseline and 3 years and estimated the association between change in weight and change in biomarkers.
At 3 years, the intervention group lost a mean of 1.14 kg vs. a mean gain of 0.3 kg in the control group, for an adjusted mean loss of 1.44 kg in the intervention group (95% CI, 0.18-2.71). The intervention group saw a mean waist circumference reduction of 2.22 cm vs. a reduction of 0.63 cm in the control group, for an adjusted mean reduction of 1.59 cm (95% CI, 0.08-3.09). Researchers found no evidence that the intervention had any significant effect on the mean values of any biomarkers of cardiometabolic risk.
As a single cohort, a linear regression model showed that every 1 kg of weight reduction during follow-up was associated with a reduction in triglycerides (–1.3%; P = .048), alanine aminotransferase (–2.5%; P = .032), gamma-glutamyl transferase (–2.2%; P = .04), leptin (–6.5%; P < .0001), insulin (–3.7%; P < .001), fasting glucose (–0.8%; P < .001), 2-hour glucose (–2.3%; P < .001) and HOMA-IR (–4.5%; P < .001).
There was no evidence of associations with other lipid measures, tissue plasminogen activator, markers of inflammation or blood pressure, according to researchers.
Although the study findings show that weight loss can produce measurable cardiometabolic benefits, achieving desirable and clinically relevant weight loss is difficult for this population, according to Welsh.
“We need to optimize and develop more culturally sensitive complex interventions,” Welsh said. – by Regina Schaffer
For more information:
Paul Welsh, PhD, can be reached at the BHF Glasgow Cardiovascular Research Centre, University of Glasgow, 126 University Place, Glasgow, G12 8TA; email: Paul.Welsh@glasgow.ac.uk
Disclosure: One of the researchers reports receiving research grants, lecture fees and serving as a consultant or advisory board member for AstraZeneca, Bayer, Boehringer Ingelheim, Eli Lilly, Impeto Medical, Merck, Sanofi-Aventis, Novartis, Novo Nordisk and Servier. Welsh reports no relevant financial disclosures.
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