Biggest Losers Improve Their CIMT & Other Cardiovascular Risk Factors

If it seems like I'm catching up on my reading, that's because I am.  And thanks to a colleague who pointed out a study published online this summer looking at the health of the competitors in NBC's Biggest Loser TV series.  As most of you are well aware, the participants in the show are all morbidly obese.  They are then brought together to compete via intense exercise ~3hrs/d & moderate caloric restriction (never less than 70% resting metabolic rate in a 30:45:25 ratio of protein:carbohydrate:fat.

As any regular viewer of the show knows, these men & women (average 32yo) are usually able to lose at least 100 pounds, most of which is body fat, over the 7 months of filming.  The authors demonstrated a dramatic improvement in cardiovascular risk factors, both traditional & novel, from baseline to post-competition.  For instance, systolic & diastolic blood pressures dropped by 16mm Hg & 15mm Hg, respectively, from pre-hypertensive down to normal.  Glucose, Hemoglobin A1c & insulin dropped by 20mg/dL, 0.64 & 5mIU/mL respectively, from pre-diabetic down to normal.  With exercise, HDL increased by almost 14mg/dL, from just barely normal to almost optimal.

More importantly, the participants were able to decrease by ~25% their carotid intima media thickness (CIMT) rather dramatically in such a short period of time.  This implies that subclinical atherosclerosis is, in fact, reversible, at least in those who are willing to put in the effort.  Granted, the short duration of the TV series doesn't allow for observation of any improvement in clinical outcomes, eg cardiovascular events and/or mortality. However, the correlation between serum/plasma improvements and physiological measures, eg CIMT, gives us all hope, assuming we can put in the effort the participants did.

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