Wednesday, August 3, 2011

- 66% Body Fat! 7 Weeks of Intense (!) Exercise and Moderate (!) Caloric Restriction Transforms Biggest Losers into Healthy Winners. Improvements Persist 4 Month After.

Image 1: Coming soon
on NBC - the next season
of the Biggest Loser; this
time big couples
I don't know if you have followed the 'Biggest Loser" TV show. Other than the show itself, which I obviously must have missed (I still wonder how that could happen ;-), the recently published study (Ashmadi. 2011) on the effects combined intense exercise and moderate caloric restriction had on the 17 sedentary, morbidly obese contestants (32+/-11 years; 50/50 men/women), of which 3 were excluded from the study, because their arteries were not yet VERSTOPFT enough, really got my intention. After all, finally someone got the order of the words "intense" and "moderate" in relation to exercise and caloric restriction right... its no longer about starving yourself and walking from the couch to the refrigerator, when your weight has gone up into regions (>>300lbs+), where no man, god-beware woman, had gone before (I guess the introduction of high fructose corn syrup and trans-fats were to the average American what the Warp drive was for Captain Kirk ;-)...

In the three month, the show was aired, the participants who were voted off by their peers on a weekly base exercised 3.3 +/-2.1 h a day, of which only 50% were initially supervised. They received lectures on "exercise and general dietary measures" - which certainly did not match the quality of the information you are served on the SuppVersity on a daily base - and they were instructed to consume a diet with a macronutrient ratio of 30:45:35 (protein /carbohydrate / fat) that would provide them with at leas 70% of their resting daily energy expenditure (RDEE), which was (unfortunately) not measured but calculated by the following standard equation: RDEE = 21.6 x lean mass [in kg] + 370
Figure 1: Markers related to blood glucose, blood lipid, heart health and body composition of 14 morbidly obese participants of the "Biggest Loser" TV show 7 month after baseline (3 month after the show)
(data adapted from Ashmadi. 2011)
It really does not matter, whether you saw the visual results on TV or not, from the data I plotted in figure 1, alone, you can tell that the "big losers" really transformed their lives. Four months after the show was wrapped, the mean weight loss among the 14 subjects that were included in this study still amounted to >132lbs, of which more than 80% were fat - thank god, they got the order of intense and moderate right! What you could not see on the TV pictures, though, were the profound health effects:
serum insulin level (-52%), glucose (-21%), high-sensitivity CRP (-81%), HbA1c (-11%) [indicator of long term blood glucose levels], PAI-1 (-49%) [plasminogen activator inhibitor-1], TNFRII (-12%) [tumor necrosis factor receptor-II], and CIMT (-25%) [carotid intima media thickness]
Video 1: Stopping at 20s won't get you lean. Intensity in the gym, moderation in the kitchen. These are the keys to success - Bob, knew it all along. And you better don't make him angry ;-)
all decreased significantly, whereas the scientists recorded profound increases of positive markers of metabolic and heart health, such as a +132% improvement of the carotid artery distensibility index [CaDI], a whopping 344% and 94% increase in resistin and adiponectin, respectively and +73% higher levels of Lp(a).

While, as a diligent and well-informed student of the SuppVersity, you should not have learned anything completely new from the study, I bet you have a friend or relative who still has not got the attribution of intense exercise and moderate diet right and is just about to lose the last lbs of lean mass on the latest starvation diet from people magazine. In that case you better do it like Bob (see video 1) and tell him/her the way to go.