Managing Cardiometabolic Risk
Managing Cardiometabolic Risk in Abdominally Obese Patients
Nutrition
- 1Key Points (1 page)
- 2Managing abdominally obese patients at increased cardiometabolic risk: the nutritional perspective (1 page)
- 3Targeting excess body weight (1 page)
- 4CVD and its nutritional components (2 pages)
- 5Reducing blood pressure (1 page)
- 6Moderate alcohol consumption (1 page)
- 7The Mediterranean diet (1 page)
- 8Other dietary measures to lower CVD risk and cholesterol levels (2 pages)
- 9References (1 page)
Targeting excess body weight
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In overweight or obese patients, modest weight loss of roughly 5 to 10% of initial body weight can significantly decrease the severity of obesity-related risk factors (7, 8). When this initial goal is achieved and maintained for at least 6 months, further weight loss is necessary in order to improve outcomes. Weight reduction and maintenance guidelines established by the American Heart Association (AHA), the National Cholesterol Education Program-Adult Treatment Panel (NCEP-ATP III), and the North American Association for the Study of Obesity/National Institute of Health (NAASO/NIH) recommend that less than <30% of total calories should come from fat in order to induce a weight loss of 0.5 to 1 kg per week. These recommendations also use a moderate caloric deficit of 500 to 1,000 kcal/day to ensure weight loss is slow and progressive (7, 9-11). This caloric deficit is designed to produce an average loss of 10 kg after 6 months of therapy. This progressive approach to weight loss can improve insulin sensitivity and positively influence each metabolic abnormality (i.e., hypertension, diabetes, dyslipidemia, or pre-existing CVD) even if subjects rarely achieve their ideal weight. There are a host of weight-loss methods and strategies, and it is important to tailor measures to patients’ needs to help them achieve and maintain a lower body weight.
Table 1: 
Table 1: The NIH and NAASO practical guidelines for identifying, evaluating, and treating overweight and obesity in adults recommend a low-calorie diet (5, 7). In general, diets containing 1,000 to 1,200 kcal per day are suitable for most women. A diet containing 1,200 to 1,600 kcal per day is suitable for men and may be appropriate for women who weigh 75 kg or more in order to induce a moderate caloric deficit (Table 1) (7). Awareness of foods and overall eating patterns must be emphasized. Patients must also be educated to help them develop the nutritional skills they need to better cope with a “toxic” nutritional environment.
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