Effects of modified lifestyle intervention education on arterial stiffness, inflammatory and metabolic risk markers in overweight and obese subjects

Obesity is a global epidemic disease affecting almost all parts of the world. The prevalence of obesity has increased rapidly in the last ten years in Malaysia. Obesity increases the risk of medical problems and cardiovascular diseases. Lifestyle modification by improving dietary intake combined with increasing physical activity is the recommended method for the improvement in body composition. The objective of this study is to determine the effects of lifestyle intervention education on weight loss and anthropometric measurements, arterial stiffness, metabolic and inflammatory cardiovascular risk markers. This prospective intervention study involved 25 overweight and obese subjects (21 females and 4 males; mean age 36.8 years) who completed a nine months education programme on modified lifestyle intervention. During the intervention, all subjects were regularly counselled to increase physical activity levels by Sports Science lecturer and to modify their diet by dietitians. Study measurements were performed at baseline, 3, 6, and 9 months. Arterial stiffness was estimated non-invasively using pulse wave velocity (PWV) and augmentation index (AI) obtained via pulse wave analysis (PWA). Anthropometric measurements (weight, height, body mass index, waist and hip circumference), body composition (body fat percentage and visceral fat), blood pressure, lipid profile, and fasting plasma glucose were also measured. Levels of the inflammatory marker, high sensitivity C-reactive protein (hsCRP) and homeostasis model assessment (HOMA) for insulin sensitivity (HOMA% S), insulin secretory capacity (HOMA% B), and insulin resistance (HOMA-IR) were also measured in this study. There were significant reductions in body weight (75.8 ± 15.1 kg vs 73.6 ± 17.1 kg, p = 0.019), waist and hip circumferences (89.2 ± 8.3 cm vs 86.4 ± 9.4 cm, p = 0.013 and 107.2 ± 10.0 vs 104.0 ± 11.8 cm, p=0.005) after nine months intervention. Body fat percentage and visceral fat levels were marginally reduced (p = 0.058 and p = 0.059). Significant improvements were seen in aortic systolic blood pressure (p = 0.02), serum fasting insulin (p = 0.001), HOMA% S (p = 0.003), HOMA% B (p = 0.002), HOMA-IR (p=0.007) and hsCRP (p=0.01) after 9 months. However, no significant differences were seen in arterial stiffness parameters, brachial blood pressure, fasting plasma glucose and lipid profile after intervention. Nine months lifestyle intervention education programme resulted in a small but significant weight loss which was associated with significant improvements in waist and hip circumference, systolic aortic blood pressure, insulin sensitivity, insulin resistance and hsCRP