Henry Ford Hospital Medical Journal


We assessed the lipid and apolipoprotein effects of hypocaloric dieting, increased physical activity, and dietary modification in severely overweight adults (body mass index [BMI] 43.05 kg/m-). The 34 women and four men enrolled in the ambulatory weight control program donated blood before, during, and after hypocaloric dieting (420 kcal/day). Mean values before dieting included cholesterol of 223 mg/dL, high-density lipoprotein (HDL) cholesterol of 43 mg/dL, and cholesterol/HDL cholesterol of 5.90. This placed our subjects at high risk for coronary artery disease. Other values included triglycerides of 138 mg/dL, apolipoprotein A-l of 152 mg/dL. and apolipoprotein B/apolipoprotein A-l of 0.64. Significant reductions during hypocaloric dieting included mean cholesterol of 171 mg/dL, triglycerides of 99 mg/dL. and apolipoprotein A-l of 120 mg/dL. During weight maintenance (mean BMI 36.08 kg/m²). significant reductions compared to baseline included a mean cholesterol of204 mg/dL and cholesterol/HDL cholesterol of 4.60. Also, a significant increase occurred in HDL cholesterol (51 mg/dL). but a nonsignificant elevation was observed in apolipoprotein A-l (180 mg/dL). In four subjects, discordant ratios of cholesterol/HDL cholesterol or apolipoprotein B/apolipoprotein A-1 were seen. and one ratio improved in two subjects despite relapse of obesity. Changes in both HDL composition and HDL particle concentration may explain elevations of HDL cholesterol and apolipoprotein A-l after dieting. Discordance between lipid and apolipoprotein ratios may occur. Improvement in lipids or apolipoproteins may be seen despite regained weight.