The evaluation of a telephonic wellness coaching intervention for weight reduction and wellness improvement in a community-based cohort of persons with serious mental illness.

Obesity and metabolic disturbances frequently occur in individuals with psychiatric disorders. This study evaluates a telephonically delivered lifestyle coaching intervention aimed at weight reduction and wellness improvement in psychiatric outpatients. A cohort of 761 participants was prospectively followed up for a period of 12 months. Lifestyle coaching was administered telephonically on a weekly basis for the first 3 months and monthly thereafter. During the study period, there was a significant reduction in weight and waist circumference as well as a significant increase in general health in the completer group. A total of 46% of the participants lost 5% or more of their baseline weight. Significant predictors of attrition at baseline were the presence of metabolic syndrome, younger age, chronic illness, and the diagnosis of a mood disorder. Dropout was significantly less in those participants who received support from a nominated caregiver. Telephonic lifestyle coaching is feasible in this population.

Conjugated linoleic acid versus high-oleic acid sunflower oil: effects on energy metabolism, glucose tolerance, blood lipids, appetite and body composition in regularly exercising individuals.

The aim of this study was to measure the effects of 12 weeks of conjugated linoleic acid (CLA) supplementation on body composition, RER, RMR, blood lipid profiles, insulin sensitivity and appetite in exercising, normal-weight persons. In this double-blind, randomised, controlled trial, sixty-two non-obese subjects (twenty-five men, thirty-seven women) received either 3.9 g/d CLA or 3.9 g high-oleic acid sunflower oil for 12 weeks. Prior to and after 12 weeks of supplementation, oral glucose tolerance, blood lipid concentrations, body composition (dual-energy X-ray absorptiometry and computerised tomography scans), RMR, resting and exercising RER and appetite were measured. There were no significant effects of CLA on body composition or distribution, RMR, RER or appetite. During the oral glucose tolerance tests, mean plasma insulin concentrations (0, 30, 120 min) were significantly lower (P= 0.04) in women who supplemented with CLA (24.3 (SD 9.7) to 20.4 (SD 8.5) microU/ml) compared to high-oleic acid sunflower oil control (23.7 (SD 9.8) to 26.0 (SD 8.8) microU/ml). Serum NEFA levels in response to oral glucose were attenuated in both men and women in the CLA (P=0.001) compared to control group. However, serum total cholesterol and LDL-cholesterol concentrations decreased in both groups and HDL-cholesterol concentrations decreased in women over 12 weeks (P=0.001, P=0.02, P=0.02, respectively). In conclusion, mixed-isomer CLA supplementation had a favourable effect on serum insulin and NEFA response to oral glucose in non-obese, regularly exercising women, but there were no CLA-specific effects on body composition, energy expenditure or appetite.

Variability in exercise capacity and metabolic response during endurance exercise after a low carbohydrate diet.

The impact of altered blood glucose concentrations on exercise metabolism and performance after a low carbohydrate (CHO) diet was investigated. In random order, 1 wk apart, 9 trained men underwent euglycemic (CI) or placebo (PI) clamps, while performing up to 150 min of cycling at 70% VO2(max), after 48 h on a low CHO diet. The range in improvement in endurance capacity with glucose infusion was large (28 +/- 26%, P < 0.05). Fifty-six percent of subjects in CI failed to complete 150 min of exercise despite maintenance of euglycemia, while only 2 subjects in PI completed 150 min of exercise, despite being hypoglycemic. Total CHO oxidation remained similar between trials. Despite longer exercise times in CI, similar amounts of muscle glycogen were used to PI. Maintenance of euglycemia in the CHO-depleted state might have an ergogenic effect, however, the effect is highly variable between individuals and independent of changes in CHO oxidation.