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Department of Nutritional Sciences (I.E.L., K.L.H., K.L.W., T.L.Z., S.I.K., M.L.F.), University of Connecticut, Storrs, Connecticut
School of Allied Health (R.A.B., J.Z.I.), University of Connecticut, Storrs, Connecticut
Department of Animal & Nutritional Sciences, The University of New Hampshire, Durham, New Hampshire (I.E.L.)
Address reprint requests to: Maria Luz Fernandez, PhD, University of Connecticut, Department of Nutritional Sciences 3624 Horsebarn Road Extension, U 4017, Storrs, CT 06269. E-mail: maria-luz.fernandez{at}uconn.edu
Objective: To determine the effects of a weight loss program, including dietary modifications, increased physical activity and dietary supplement (L-carnitine or placebo) on anthropometrics, leptin, insulin, the metabolic syndrome (MS) and insulin resistance in overweight /obese premenopausal women.
Methods: Participants consumed a hypocaloric diet; 30% protein, 30% fat and 40% carbohydrate in addition to increasing number of steps/day. Carnitine supplementation followed a randomized double blind protocol. Protocol lasted for 10 weeks. Seventy subjects (35 in the control and 35 in the carnitine group) completed the intervention. Anthropometrics, plasma insulin and leptin concentrations and body composition were measured. The number of subjects with the MetSyn and insulin resistance, were assessed at baseline and post-intervention.
Results: Because there were no significant differences between the carnitine and the placebo groups for all measured parameters, participants were grouped together for all analysis. Subjects decreased total energy (–26.6%, p < 0.01) and energy from carbohydrate (–17.3%, p < 0.01) and increased energy from protein by 67% (p < 0.01) and number of steps/day (42.6%, p < 0.01). Body weight (–4.6%, p < 0.001), body mass index (–4.5%, p < 0.01), waist circumference (–6.5%, p < 0.01), total fat mass (–1.7%, p < 0.01), trunk fat mass (–2.0%, p < 0.01), insulin (– 17.9%, p < 0.01) and leptin (–5.9%, p < 0.05) decreased after the intervention. Ten of 19 participants with insulin resistance became insulin sensitive and 7 of 8 participants with the MetSyn no longer had the syndrome after the intervention.
Conclusion: Moderate increases in physical activity and a hypocaloric/high protein diet resulted in multiple beneficial effects on body anthropometrics and insulin sensitivity. Realistic dietary and physical activity goals must be the focus of intervention strategies for overweight and obese individuals.
Key words: premenopausal women, body composition, weight loss, insulin resistance, metabolic syndrome
Abbreviations: CHD=coronary heart disease • CPT-1=carnitine palmitoyltransferase • DM2=diabetes mellitus type 2 • DXA=dual X-ray absorption • FFQ=food frequency questionnaire • HDL-C=HDL cholesterol • IPAQ=international physical activity questionnaire • LCFA=long chain fatty acid • LDL-C=LDL-cholesterol • MS=metabolic syndrome • NDS=nutrient database system • TG-triglycerides
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