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dc.contributor.authorPaisey, Richard
dc.contributor.authorDaniels, Charles
dc.contributor.authorHowitt, Will
dc.contributor.authorGreatorex, Derek
dc.contributor.authorCampbell, Claire
dc.contributor.authorPaisey, Christopher
dc.contributor.authorPaisey, Rosamund
dc.contributor.authorFrost, Julie
dc.contributor.authorBromige, Robert
dc.date.accessioned2022-03-09T10:00:17Z
dc.date.available2022-03-09T10:00:17Z
dc.date.issued2022
dc.date.submitted2021-09-03
dc.identifier.citationBMJ Nutrition, Prevention & Health, page e000363
dc.identifier.issn2516-5542
dc.identifier.otherbmjnph-2021-000363
dc.identifier.urihttps://www.repository.cam.ac.uk/handle/1810/334804
dc.description.abstractObjective: To assess weight loss maintenance, diabetes status, mortality and morbidity 15 years after a very low calorie diet programme (VLCD) in patients with obesity. Design: General practice data bases were interrogated for subjects coded for group therapy with VLCD in the 1990s. Causes of death, occurrence of vascular disease and remission or development of diabetes were ascertained from patient records and national stroke and cardiovascular disease data bases. Results: 325 subjects engaged in the programme and had sufficient data for analysis. Baseline characteristics were: age 47.8±12. 8 years; body mass index (BMI) 36.1±6.8 kg/m2; 79.1% female/20.9% male; 13.5% had type 2 diabetes. After 15±4 years weight had changed from 97.9±19 kg at baseline to 100±20.8 kg. 10 with diabetes at baseline were in remission at 3 months, but only two remained in remission at 5 years. 50 new cases of type 2 diabetes and 11 of impaired fasting glucose developed during follow-up. Only 5.9% who remained healthy at follow-up had maintained >10% body weight reduction. Neither diabetes incidence nor diabetes free survival were related to percentage body weight lost during VLCD. Only baseline BMI was related to development of new impaired fasting glucose or diabetes by 15 years (p=0.007). 37 subjects had a cardiovascular event. Age (p=0.000002) and degree of weight loss after VLCD (p=0.03) were significantly associated with subsequent vascular events. Conclusion: Long-term maintenance of weight loss after VLCD was rare in this single centre retrospective study 15 years later. Glucose intolerance developed in 21.4%. Lasting remission of type 2 diabetes or prevention of later glucose intolerance were not achieved. Vascular events were more frequent in those who lost most weight. Risk management during weight regain should be studied in future to assess potential for reduction in adverse cardiovascular outcomes.
dc.languageen
dc.publisherBMJ
dc.subjectOriginal research
dc.subject1506
dc.subjectdiabetes mellitus
dc.subjectweight management
dc.subjectnutritional treatment
dc.titleBody weight, diabetes incidence vascular events and survival 15 years after very low calorie diet in community medical clinics in the UK.
dc.typeArticle
dc.date.updated2022-03-09T10:00:16Z
prism.publicationNameBMJ Nutr Prev Health
dc.identifier.doi10.17863/CAM.82234
dcterms.dateAccepted2022-02-20
rioxxterms.versionofrecord10.1136/bmjnph-2021-000363
rioxxterms.versionVoR
rioxxterms.licenseref.urihttp://creativecommons.org/licenses/by-nc/4.0/
rioxxterms.licenseref.startdate2022-03-03
dc.contributor.orcidPaisey, Richard [0000-0002-7790-2569]
dc.identifier.eissn2516-5542
pubs.funder-project-idTorbay Special medical projects (PS/MAO/T/PAIS001)
cam.issuedOnline2022-03-04
rioxxterms.freetoread.startdate2022-03-03
rioxxterms.freetoread.startdate2022-03-03


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