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Baseline serum folate level may be a predictive factor of weight loss in a morbid-obesity-management programme

Published online by Cambridge University Press:  08 March 2007

J. J. Gorgojo Martínez ,
F. Almodóvar Ruiz  and
S. Donnay Candil
J. J. Gorgojo Martínez*
Affiliation:
Unit of Endocrinology and Nutrition, Fundación Hospital Alcorcón, C/ Budapest 1, 28922 Alcorcón (Madrid), Spain
F. Almodóvar Ruiz
Affiliation:
Unit of Endocrinology and Nutrition, Fundación Hospital Alcorcón, C/ Budapest 1, 28922 Alcorcón (Madrid), Spain
S. Donnay Candil
Affiliation:
Unit of Endocrinology and Nutrition, Fundación Hospital Alcorcón, C/ Budapest 1, 28922 Alcorcón (Madrid), Spain
*
*Corresponding author: Dr Juan José Gorgojo Martínez, fax 34 916219901, email [email protected]
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Abstract

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Prompt identification of responders to non-surgical therapy is of utmost importance in attempting medical treatment in patients with clinically severe obesity before indication of bariatric surgery. The objectives of the present study were to assess the outcome at 1 year of morbidly obese patients undergoing a weight-loss medical programme and to detect baseline predictors of a loss ≥10 % of initial weight at the end of the follow-up. A longitudinal, prospective study of a cohort of morbidly obese patients (n 182; females 78 %; age 40·5 (sd 11·5) years; BMI 45·4 (sd 6·0) kg/m2) enrolled in a 1-year obesity-management programme based on lifestyle changes and pharmacological therapy. Significant laboratory and clinical variables were included in a binary logistic regression model in order to identify baseline independent factors for the prediction of a successful outcome in the programme. At 12 months of follow-up, twenty-one subjects (11·5 % of the initial cohort) had lost ≥10 % of baseline weight. A high serum folic acid level was the only independent predictor of weight loss at 1 year. A rise of 1 ng/ml in serum folate increased the chance of success by 28 % (adjusted odds ratio 1·28; 95 % CI 1·04, 1·58). We concluded that a medical-management programme of morbid obesity obtained limited results at 1 year, in agreement with other intervention studies. Serum folate may be useful as a pre-treatment predictor of response to a medical-management programme in patients with morbid obesity. Patients with low basal serum folate levels probably should be urged to change unhealthy eating patterns.

Keywords

Morbid obesityWeight lossTherapyFolic acid
Type
Research Article
Information
British Journal of Nutrition , Volume 96 , Issue 5 , November 2006 , pp. 956 - 964
Copyright
Copyright © The Nutrition Society 2006

References

Anonymous (1992) Gastrointestinal surgery for severe obesity: NIH Consensus Development Conference Statement. Am J Clin Nutr 55, 615S–619S.CrossRefGoogle Scholar
Aranceta, J, Pérez, C & Serra, L (2003) Prevalence of obesity in Spain: results of the SEEDO 2000 study (article in Spanish). Med Clin (Barc) 120, 608–612.CrossRefGoogle Scholar
Ayyad, C & Andersen, T (2000) Long-term efficacy of dietary treatment of obesity: a systematic review of studies published between 1931 and 1999. Obes Rev 1, 113–119.CrossRefGoogle ScholarPubMed
Bernier, M & Avard, J (1986) Self-efficacy, outcome and attrition in a weight-reduction program. Cogn Ther Res 10, 319–338.CrossRefGoogle Scholar
Clegg, A, Colquitt, J, Sidhu, M, Royle, P & Walter, A (2003) Clinical and cost effectiveness of surgery for morbid obesity: a systematic review and economic evaluation. Int J Obes 27, 1167–1177.CrossRefGoogle ScholarPubMed
Drenick, EJ, Bale, GS, Seltzer, FS & Johnson, DG (1980) Excessive mortality and causes of death in morbidly obese men. JAMA 243, 443–445.CrossRefGoogle ScholarPubMed
Flegal, KM, Carroll, MD, Ogden, CL & Johnson, CL (2002) Prevalence and trends in obesity among US adults, 1999–2000. JAMA 288, 1723–1727.CrossRefGoogle ScholarPubMed
Fung, TT, Rimm, EB, Spiegelman, D, Rifai, N, Tofler, GH, Willett, WC & Hu, FB (2001) Association between dietary patterns and plasma biomarkers of obesity and cardiovascular disease risk. Am J Clin Nutr 73, 61–67.CrossRefGoogle ScholarPubMed
Hansen, D, Astrup, A & Toubro, S (2001) Predictors of weight loss and maintenance during 2 years of treatment by sibutramine in obesity. Results from the European multi-centre STORM trial. Sibutramine Trial of Obesity Reduction and Maintenance. Int J Obes 25, 496–501.CrossRefGoogle ScholarPubMed
Herbert, V (1999) Folic acid. In Modern Nutrition in Health and Disease, pp. 433–446 [Shils, ME, Olson, JA, Shike, M and Ross, AC, editors]. Baltimore, MA: Williams and Wilkins.Google Scholar
Hirsch, S, Poniachick, J, Avendaño, M, Csendes, A, Burdiles, P, Smok, G, Diaz, JC & de la Maza, MP (2005) Serum folate and homocysteine levels in obese females with non-alcoholic fatty liver. Nutrition 21, 137–141.CrossRefGoogle ScholarPubMed
Kleinbaum, DG & Klein, M (2002) Modeling strategy for assessing interaction and confounding. In Logistic Regression: a Self-learning Text, pp. 191–226 [Kleinbaum, DG and Klein, M, editors]. New York: Springer-Verlag.Google Scholar
MacDonald, KG (2003) Overview of the epidemiology of obesity and the early history of procedures to remedy morbid obesity. Arch Surg 138, 357–360.CrossRefGoogle ScholarPubMed
Miller, WC, Koceja, DM & Hamilton, EJ (1997) A meta-analysis of the past 25 years of weight loss research using diet, exercise or diet plus exercise intervention. Int J Obes 21, 941–947.CrossRefGoogle ScholarPubMed
Moreno-Aliaga, MJ, Santos, JL, Martí, A & Martínez, JA (2005) Does weight loss prognosis depend on genetic make-up?. Obes Rev 6, 155–168.CrossRefGoogle ScholarPubMed
National Institutes of Health (2000) National Heart, Lung and Blood Institute Obesity Education Initiative Expert Panel on the Identification, Evaluation and Treatment of Overweight and Obesity in Adults. NIH Publication no. 00-4084. www.nhlbi.nih.org.Google Scholar
Padwal, R, Li, SK & Lau, DCW (2003) Long-term pharmacotherapy for overweight and obesity: a systematic review and meta-analysis of randomized controlled trials. Int J Obes 27, 1437–1446.CrossRefGoogle ScholarPubMed
Reinehr, T, Brylak, K, Alexy, U, Kersting, M & Andler, W (2003) Predictors to success in outpatient training in obese children and adolescents. Int J Obes 27, 1087–1092.CrossRefGoogle ScholarPubMed
Rissanen, A, Lean, M, Rössner, S, Segal, KR & Sjöstrom, L (2003) Predictive value of early weight loss in obesity management with orlistat: an evidence-based assessment of prescribing guidelines. Int J Obes 27, 103–109.CrossRefGoogle ScholarPubMed
Sjöström, L, Lindroos, AK & Peltonen, M (2004) Lifestyle, diabetes, and cardiovascular risk factors 10 years after bariatric surgery. N Engl J Med 351, 2683–2693.CrossRefGoogle Scholar
Teixeira, PJ, Going, SB, Houtkooper, LB, Cussler, EC, Metcalfe, LL, Blew, RM, Sardinha, LB & Lohman, TG (2004) Pretreatment predictors of attrition and successful wight management in women. Int J Obes 28, 1124–1133.CrossRefGoogle Scholar
Traverso, A, Ravera, G, Lagattolla, V, Testa, S & Adami, GF (2000) Weight loss after dieting with behavioral modification for obesity: the predicting efficiency of some psychometric data. Eat Weight Disord 5, 102–107.CrossRefGoogle ScholarPubMed
Wadden, TA (1993) Treatment of obesity by moderate and severe caloric restriction. Results of clinical research trials. Ann Intern Med 1197, 688–693.CrossRefGoogle Scholar