“Short-term intensive lifestyle therapy in a worksite setting improves cardiometabolic health in people with obesity”

Journal of the Endocrine Society

Objective: The purpose of this study was to conduct a short-term, randomized, controlled trial to evaluate the feasibility and clinical efficacy of treatment with the Pritikin Program in an outpatient worksite setting.

Methods: Cardiometabolic outcomes were evaluated in people with overweight/obesity and ≥2 metabolic abnormalities (high triglycerides, low high-density lipoprotein (HDL) cholesterol, high blood pressure, HbA1c > 5.7%), before and after they were randomized to 6 weeks of standard care (n = 26) or intensive lifestyle therapy, based on the Pritikin Program (n = 28). Participants in the lifestyle intervention group were provided all food as packed-out meals and participated in group nutrition, behavioral education, cooking classes, and exercise sessions 3 times per week at a worksite location.

Results: Compared with standard care, intensive lifestyle therapy decreased body weight (−5.0% vs −0.5%), HbA1c (−15.5% vs +2.3%), plasma total cholesterol (−9.8% vs +7.7%), low-density lipoprotein cholesterol (−10.3% vs +9.3%) and triglyceride (−21.7% vs +3.0%) concentrations, and systolic blood pressure (−7.0% vs 0%) (all P values < .02), and increased exercise tolerance (time to exhaustion walking on a treadmill by +23.7% vs +4.5%; P < .001).

Conclusion: This study demonstrates the feasibility and clinical effectiveness of short-term, intensive outpatient lifestyle therapy in people with overweight/obesity and increased risk of coronary heart disease when all food is provided and the intervention is conducted at a convenient worksite setting.

“Dietary weight loss-induced improvements in metabolic function are enhanced by exercise in people with obesity and prediabetes”

Nature Metabolism

Objective: The purpose of this study was to determine whether regular exercise has additional therapeutic effects for people with obesity and prediabetes participating in a dietary weight loss program.

Results: Whole-body (primarily muscle) insulin sensitivity (primary outcome) was 2-fold greater (P = 0.006) after 10% weight loss induced by calorie restriction plus exercise training (Diet+EX; n = 8, 6 women) than 10% weight loss induced by calorie restriction alone (Diet-ONLY; n = 8, 4 women) in participants in two concurrent studies. The greater improvement in insulin sensitivity was accompanied by increased muscle expression of genes involved in mitochondrial biogenesis, energy metabolism, and angiogenesis (secondary outcomes) in the Diet+EX group.

Conclusion: These results demonstrate that regular exercise during a diet-induced weight loss program has profound additional metabolic benefits in people with obesity and prediabetes.