Changes in anthropometric and metabolic outcomes during and after a milk-based meal replacement programme in bariatric patients
Abdalgwad, Razk H. Ali
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During this work, I examined a cohort of patients with severe and complicated obesity undergoing a milk-based intensive weight management programme, examining changes in various traits in the short and medium term. Firstly, I helped to conduct a retrospective cohort study to examine the effect of this programme on weight and other anthropometric and metabolic variables among these patients over 24 weeks. The results of this study showed significant improvements in weight, BMI, HbA1c, lipid profiles and a reduction in most prescribed medications. Blood pressure did not significantly change, but there was a reduction in antihypertensive medication use. Thereafter, I described changes in alanine aminotransferase (ALT) levels over 24 weeks of the milk diet and unexpectedly I found that in the first eight weeks of the intervention, there was an increase in ALT and it was more pronounced in the group with high baseline ALT than in those with normal baseline ALT. I noted a significant reduction in ALT at the end of the programme which might indicate a reduction in liver fat content and steatosis. Finally, a more prolonged retrospective longitudinal cohort study was conducted by me to investigate the long-term changes in weight in completers of the milk diet. I showed that after initial significant weight loss there was regain in weight, most apparent and significant in the third and fourth years of follow up but this regain did not exceed the weight at the beginning of the programme. I noted that at six months, the degree of weight loss predicted weight regain in the first and third years of follow up (inverse relationship).