Short Term Caloric Restriction and Biofeedback Enhance Psychological Wellbeing and Reduce Overweight in Healthy Women

Abstract

Obesity is highly prevalent, causing substantial cardiovascular and mental health morbidity. Women show increased risk for mental health disorders, that is multiplied in obesity and related to cellular and psychological stress that can be targeted by non-pharmacological interventions. A total of 43 women underwent two weeks of caloric restriction, half of which also received 7 h of individualized clinical psychological intervention including psychoeducation, mindfulness, and heart-rate-variability biofeedback. Effects on body mass index (BMI), fatty liver index (FLI), bioimpedance measures, serum parameters, perceived stress (PSS), burn-out susceptibility (burn out diagnostic inventory) and dimensional psychiatric symptom load (brief symptom inventory, BSI) were analyzed with linear mixed effects models. Caloric restriction led to a reduction in BMI, body fat and FLI, decreased serum concentrations of leptin, PSS score, BSI dimensions and global severity index (all p ≤ 0.0001, withstanding Bonferroni–Holm correction). Benefits of add-on biofeedback were observed for BMI reduction (p = 0.041). Caloric restriction was effective in ameliorating both psychological wellbeing and metabolic functions following a BMI reduction. Biofeedback boosted effects on BMI reduction and the combinative therapy may be protective against common progression to mental health and cardiovascular disorders in overweight women while comparing favorably to pharmacological interventions in terms of side-effects and acceptability.

The effects of short‐term caloric restriction on cardiometabolic health in overweight/obese men and women: A single‐arm trial

“…A more recent study, again in women, of CR (700 kcal intake) over 2 weeks observed significant reductions in BMI, %body fat, and psychological parameters, though the study included multiple interventional parameters (e.g., counseling, massage, etc.) (Kautzky et al., 2021). In the current study of Ow/Ob men and women, using 3 days of more aggressive CR or very low‐calorie diet (VLCD, ca.…”

“…Caloric restriction is not a novel approach of losing weight, in those that desire to do so, and has even been purported to induce health benefits beyond weight loss (Fontana et al., 2010; Holloszy & Fontana, 2007; Jakobsdottir et al., 2016; Kautzky et al., 2021; Kraus et al., 2019; Ravussin et al., 2015). The CALERIE trial might be one of the more prominent controlled trials of long CR, achieving 12% reduction in caloric intake, yielded an average weight loss 7.5 kg over 2 years in healthy weight men and women (Kraus et al., 2019).…”

“…More recent work on short‐term (1–2 weeks) CR (700–1000 kcal/d intake) in Ow or Ob women suggests improved body weight and body composition CR (Jakobsdottir et al., 2016; Kautzky et al., 2021). Though the simple act of reducing caloric intake over time with CR, or intermittent fasting (IF), results in caloric deficit and contributes to weight loss in Ow/Ob (Harris et al., 2018; Most & Redman, 2020).…”

“…Such caloric deficit engages the “metabolic switch” (Patikorn et al., 2021), which is the subsequent transformation of liver metabolism, “switching” from predominately carbohydrate/glucose in the liver/muscle to ketones derived from adipocytes, and further adaptations such as improved ability to cope with metabolic stress and glucose handling (Miller et al., 1997). The time course for the metabolic switch has been suggested to be 72 h, but studies of short‐term CR often do not assess changes in substrate utilization (Jakobsdottir et al., 2016; Kautzky et al., 2021). Given the impaired ability of Ow/Ob to oxidize fat (Kelley et al., 1999), metabolic switching could improve the ability to utilize fat (Grajower & Horne, 2019), and might reduce fat mass.…”