Long-term serum lipid lowering, behavior modification, and weight loss in obese women

Reduced calorie intake, changes in the composition of foods ingested, and increased physical activity are the usual initial recommended therapies for the obesity that often accompanies hypercholesterolemia and other hyperlipidemias. Collectively resulting in weight loss, these behavioral changes are known to produce short-term (< or = 7- to 9-mo) reductions in serum cholesterol and other lipids. In contrast, previous long-term (> or = 1-yr) investigations fail to disclose a cholesterol-lowering effect of weight loss, although the subjects in these studies were not hypercholesterolemic. The aim of our investigation was to examine the long-term changes in serum lipids that occurred in a representative cohort of healthy obese (n = 45, body mass index mean +/- SD 39.0 +/- 8.6 kg/m2) women after they completed a 15-wk conventional behavior-modification program. The serum cholesterol level of this cohort was elevated at baseline (6.18 +/- 1.41 mM, > or = 75th percentile). At the time of follow-up (17.0 +/- 7.0 mo), there were significant decreases in body weight (-16.7 kg, p < 0.001) and reductions in serum total (-0.53 mM, p < 0.01) and low-density lipoprotein (-0.35 mM, p < 0.05) cholesterol. Serum triglyceride levels also decreased significantly (-0.38 mM, p < 0.001), and serum high-density lipoprotein levels remained unchanged; the ratio of high-density lipoprotein total cholesterol increased significantly (p < 0.05) relative to baseline levels. Multiple stepwise regression analysis indicated that the best predictor of percentage change in each respective lipid was its own baseline level.(ABSTRACT TRUNCATED AT 250 WORDS)