Christensen P, et al. - Experts tested the presumption that the initial, fixed low-energy diet (LED) would induce different metabolic outcomes in men vs women. In women than in men different effects were induced by an 8-week LED. After adjusting for differences in weight loss, larger reductions in metabolic syndrome Z-score, C-peptide, FM and heart rate were seen in men, whereas larger reductions in HDL cholesterol, fat-free mass (FFM), hip circumference and pulse pressure were seen in women. A total of 35% of participants of both genders had reverted to normo-glycaemia after the LED. Findings suggested the clinical importance of these findings and suggested gender-specific changes following weight loss. To investigate if the weight loss maintenance and future cardiovascular health was compromised with the greater decreases in FFM, hip circumference and HDL cholesterol in women after rapid weight loss was important.

Methods

For 8 weeks, all participants followed a LED (3.4 MJ/810 kcal/daily) (Cambridge Weight Plan).
• Researchers recruited the participants from 8 sites in Europe, Australia and New Zealand.
• The patients that were eligible for inclusion were overweight (BMI ≥ 25 kg/m²) individuals with pre-diabetes according to ADA-criteria.
• Changes in insulin resistance, fat mass (FM), fat-free mass (FFM) and metabolic syndrome Z-score were the outcomes of interest.

Results

• As per data, in total, 2224 individuals (1504 women, 720 men) attended the baseline visit and 2020 (90.8%) completed the follow-up visit.
• Following the LED, compared to women, weight loss was 16% greater in men (11.8% vs 10.3%, respectively) but improvements in insulin resistance were similar.
• In men, HOMA-IR decreased by 1.50 ± 0.15 and 15 in women it decreased by 1.35 ± 0. (ns).
• Results demonstrated that after adjusting for differences in weight loss, men demonstrated larger reductions in metabolic syndrome Z-score, C-peptide, FM and heart rate, while women had larger reductions in HDL cholesterol, FFM, hip circumference and pulse pressure.
• Findings suggested that after the LED, 35% of participants of both genders had reverted to normo-glycaemia.