A High-Protein and Low-Glycemic Formula Diet Improves Blood Pressure and Other Hemodynamic Parameters in High-Risk Individuals

Abstract

Low-caloric formula diets can improve hemodynamic parameters of patients with type 2 diabetes. We, therefore, hypothesized that persons with overweight or obesity can benefit from a high-protein, low-glycemic but moderate-caloric formula diet. This post-hoc analysis of the Almased Concept against Overweight and Obesity and Related Health Risk- (ACOORH) trial investigated the impact of a lifestyle intervention combined with a formula diet (INT, n = 308) compared to a control group with lifestyle intervention alone (CON, n = 155) on hemodynamic parameters (systolic and diastolic blood pressure (SBP, DBP), resting heart rate (HR), and pulse wave velocity (PWV)) in high-risk individuals with prehypertension or hypertension. INT replaced meals during the first 6 months (1 week: 3 meals/day; 2–4 weeks: 2 meals/day; 5–26 weeks: 1 meal/day). Study duration was 12 months. From the starting cohort, 304 (68.3%, INT: n = 216; CON: n = 101) participants had a complete dataset. Compared to CON, INT significantly reduced more SBP (−7.3 mmHg 95% CI [−9.2; −5.3] vs. −3.3 mmHg [−5.9; −0.8], p < 0.049) and DBP (−3.7 mmHg [−4.9; −2.5] vs. −1.4 mmHg [−3.1; 0.2], p < 0.028) after 12 months. Compared to CON, INT showed a pronounced reduction in resting HR and PWV after 6 months but both lost significance after 12 months. Changes in SBP, DBP, and PWV were significantly associated positively with changes in body weight and fat mass (all p < 0.05) and resting HR correlated positively with fasting insulin (p < 0.001) after 12 months. Combining a lifestyle intervention with a high-protein and low-glycemic formula diet improves hemodynamic parameters to a greater extent than lifestyle intervention alone in high-risk individuals with overweight and obesity.

Early and Strong Leptin Reduction Is Predictive for Long-Term Weight Loss during High-Protein, Low-Glycaemic Meal Replacement—A Subanalysis of the Randomised-Controlled ACOORH Trial

“…Our data confirmed that it was not the baseline leptin concentration, but an early and distinct leptin lowering [33,34] within the first month of intensive meal replacement that was predictive for long-term weight loss and this is in line with other dietary intervention studies demonstrating lower leptin levels in subjects without weight regain [35]. By using the meal replacement, not only effects on leptin and weight, but also an improvement in blood pressure could be observed [19], which could be explained by the fact that leptin mediates the relationship between fat mass and blood pressure [22]. In a previous work, we showed that the reduction of fasting insulin played an important role in weight reduction [18] and in combination with leptin we could demonstrate that those people with the strongest leptin reduction and tendencial higher insulin reduction had lost weight most effectively.…”

“…The ACOORH study is an international, multicentre randomised-controlled trial analysing the effect of a meal-replacement based lifestyle intervention in overweight or obese persons with components of the metabolic syndrome. Details had been published before [15][16][17][18][19]. In brief, individuals aged 21-65 years, with a body mass index (BMI) of 27-35 kg/m 2 and/or a waist circumference of ≥88 (females) or ≥102 cm (males) and fulfilling at least one of the following criteria of the metabolic syndrome: (a) fasting blood glucose (FBG) 100-125 mg/dL, (b) triglycerides 150-400 mg/dL, (c) high-density lipoprotein (HDL)-cholesterol < 40 mg/dL, or (d) untreated systolic blood pressure of 140-160 mmHg or diastolic blood pressure of 90-100 mmHg or anti-hypertensive medication were eligible for participation.…”

“…During all study visits, anthropometrical data (BMI, body weight, fat mass, lean body mass) were measured and blood was collected as described before [15][16][17][18][19]. Leptin, fasting insulin, interleukin (IL)-6, and C-reactive protein (CRP) were analysed in an accredited medical laboratory (Synlab, Leinfelden, Germany) according to previous reports [20,21] and ratios for leptin/body weight, leptin/fat mass, insulin/body weight, and insulin/fat mass were calculated.…”

“…This might be caused by leptin resistance, which inhibits appropriate appetite control [14]. The international, multicentre ALMASED-Conceptagainst-Overweight-and-Obesity-and-Related-Health-Risk (ACOORH) study [15][16][17][18][19] is a randomised-controlled trial designed to compare the effects of a meal replacement-based lifestyle intervention vs. lifestyle intervention alone in overweight or obese adults with risk factors of the metabolic syndrome. With an estimated treatment difference (ETD) of −3.2 kg [−4.0; −2.5] (p < 0.001), previously published data demonstrated significantly higher weight reduction in the meal replacement intervention group compared to the control group after 3 months [15] accompanied by significantly stronger reductions of insulin and inflammation markers [18].…”

Cuffless and Touchless Measurement of Blood Pressure from Ballistocardiogram Based on a Body Weight Scale

“…When the physical activities of people are limited, their dietary assessment will be an important issue to control weight. Moreover, a diet rich in fruits, vegetables, low-fat dairy products, fiber and minerals, would produce a potent antihypertensive effect [3,4]. Many studies show that there is a positive relationship between being overweight or obese and blood pressure (BP) with the risk of hypertension [5,6].…”