The objective of this clinical trial is to verify whether the beneficial effects of weight loss on visceral fat measured by computed tomography and metabolic risk factors for coronary heart disease are maintained once high-risk patients without symptoms and with visceral obesity and dyslipidemia are stabilized and maintained for two additional years after a one-year weight loss (5-10%) program. Before entering the study, after the one-year intervention program, and after the 2-year maintenance period, participants will be asked to take part in multiple assessments: fasting lipid profile and apolipoproteins measurements, oral glucose tolerance test, anthropometric measurements, computed tomography, dual-energy X-ray absorptiometry, oral lipid tolerance test, measurements of inflammatory markers, physical activity and dietary diaries, cardiorespiratory fitness assessed by a submaximal treadmill test, and measurements of resting and exercise blood pressure. During the one-year intervention, participants will be closely monitored by the study's dietitians and kinesiologists to achieve the target weight loss. Dieticians will not recommend a daily energy deficit greater than 500 calories and will focus on foods rather than the nutrient composition of the diet. Participants will have access to the dieticians at all time, and appointments every two months will be required during the first year. Regarding physical activity, kinesiologists will supervise the exercise prescription which will aim at 160 minutes per week of moderate-intensity aerobic-exercise. The physical activity prescription will be adjusted by the kinesiologist according to the participant's preferences and habits. The investigators hypothesize that there will be a worsening in some features of the metabolic syndrome over the two-year weight maintenance period. However, it is suggested the greater the weight loss during the intervention, the less marked the deterioration will be. Finally, the investigators put forward that even in the absence of weight loss during the intervention, the lifestyle modification program will prevent visceral fat accumulation expected to be observed over the two-year maintenance period in the control group maintaining their usual behaviour.
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Changes in body weight following the lifestyle intervention and the maintenance period using dual-energy x-ray absorptiometry
Timeframe: After the 1-year intervention and at 3 years after the beginning of the study
Changes in visceral adipose tissue area following the lifestyle intervention and the maintenance period using computed tomography
Timeframe: After the 1-year intervention and at 3 years after the beginning of the study
Changes in visceral adipose tissue volume following the lifestyle intervention and the maintenance period using computed tomography
Timeframe: After the 1-year intervention and at 3 years after the beginning of the study
Changes in waist circumference following the lifestyle intervention and the maintenance period using a standardized measuring tape
Timeframe: After the 1-year intervention and at 3 years after the beginning of the study
Changes in subcutaneous adipose tissue area following the lifestyle intervention and the maintenance period
Timeframe: After the 1-year intervention and at 3 years after the beginning of the study
Changes in subcutaneous adipose tissue volume following the lifestyle intervention and the maintenance period
Timeframe: After the 1-year intervention and at 3 years after the beginning of the study