Cardiovascular health effects of moderate weight loss
This thesis describes the results of dietetic led weight management for weight loss in three different groups of subjects: overweight; overweight with angina; and those whose body weight was close to the healthy upper BMI of 25 kg/m2. It forms part of a growing literature examining moderate weight loss as a success outcome in weight management. The work in this thesis addresses an important general research question; whether the effect of modest weight loss per se on established risk factors for IHD was similar across a number of subject groups. The specific aims were to examine the effect of moderate weight loss on the established IHD risk factors, fibrinogen, factor VII activity, plasma and whole blood viscosity, PAI activity and t-PA antigen. The role of modest weight loss on the adrenal hormone DHEAS was also studied. The conclusion of this thesis is that modest weight loss, (around 4%) which can be achieved through well planned dietetic management, does produce important reductions in IHD risk. The weight loss achieved was similar in groups with BMI > 28 kg/m2, with or without IHD, but less in absolute terms in individuals with baseline weights near the top of the healthy (acceptable range). Reductions in factor VII activity and RCA were related to the amount of weight loss, but the reductions were not greater in those with higher baseline values and existing IHD. The falls in factor VII activity and RCA were accompanied by falls in other established IHD risk factors, plasma lipid concentrations and blood pressure.