Very low calorie diets are associated with transient ventricular impairment before reversal of diastolic dysfunction in obesity

Objectives Very low calorie diets (VLCDs) are effective at clearing hepatic steatosis and improving insulin sensitivity. Whilst long-term weight loss is beneficial to the cardiovascular system, the acute elevation in fatty acids during caloric restriction is potentially detrimental to cardiac metabo...

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Bibliographic Details
Published in:International Journal of Obesity 2019-12, Vol.43 (12), p.2536-2544
Main Authors: Rayner, Jennifer J., Abdesselam, Ines, Peterzan, Mark A., Akoumianakis, Ioannis, Akawi, Nadia, Antoniades, Charalambos, Tomlinson, Jeremy W., Neubauer, Stefan, Rider, Oliver J.
Format: Article
Language:English
Subjects:
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692/699/2743/393
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Adult
Aorta
Blood Pressure - physiology
Body weight loss
Caloric Restriction - adverse effects
Cardiomyopathies - etiology
Cardiomyopathies - physiopathology
Cardiovascular system
Coronary artery disease
Diabetes mellitus
Diet
Dietary restrictions
Echocardiography
Epidemiology
Fatty acids
Fatty liver
Fatty Liver - physiopathology
Female
Health Promotion and Disease Prevention
Heart
Heart diseases
Humans
Hypocaloric diet
Insulin
Insulin resistance
Internal Medicine
Intra-Abdominal Fat - physiology
Liver
Low calorie
Magnetic resonance imaging
Male
Medicine
Medicine & Public Health
Metabolic Diseases
Metabolism
Middle Aged
Nutrient deficiency
Obesity
Obesity - diet therapy
Physiological aspects
Public Health
Steatosis
Stiffness
Triglycerides
Triglycerides - blood
Ventricle
Ventricular Dysfunction - etiology
Ventricular Dysfunction - physiopathology
Weight control
Weight Loss
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Summary:Objectives Very low calorie diets (VLCDs) are effective at clearing hepatic steatosis and improving insulin sensitivity. Whilst long-term weight loss is beneficial to the cardiovascular system, the acute elevation in fatty acids during caloric restriction is potentially detrimental to cardiac metabolism and function. We sought to investigate any cardiovascular changes occurring over the course of a modern VLCD regime, alongside the expected peripheral metabolic improvements. Methods 25 obese volunteers (BMI 36.8 ± 5.8 kg/m 2 ) underwent magnetic resonance imaging, echocardiography, metabolic profiling, and bio-impedance analysis before 1 and 8 weeks following a VLCD (800 kcal/day). Results were compared to 15 age- and sex-matched controls. Results After 1 week of VLCD, despite only modest weight loss, significant drops occurred in liver fat and insulin resistance (HOMA-IR; by 14–50%, all p  
ISSN:0307-0565
1476-5497
DOI:10.1038/s41366-018-0263-2