ABSTRACT OF THE DOCTORAL DISSERTATION

Name of student: Le Thi Huong Giang

Name of dissertation: "Overweight, obesity and Calorie limit supplement intervention effectiveness on overweight and obese 40-65 year old women in some districts of Hanoi city" (2016-2021).

Major: Nutrition

Code: 9720401

Academic advisors:            1. GS. Dr. Le Danh Tuyen

           2. Assoc. Dr. Bui Thi Nhung

Institution: National Institute of Nutrition

CONTENT

I. OVERVIEW

Overweight and obesity is increasing in all countries. Overweight and obesity increases the risk of insulin resistance, causes lipid metabolism disorders, and increases the risk of diseases such as hypertension, diabetes, cancer, cardiovascular events, and death. Calorie limit supplements with gymnema sylvestre natural essences, catechins in green tea leaves, imino sugar from mulberry leaves, chitosan from crabs, phaseolamin in kidney beans and kaempferia parviflora (black ginger) are thought by scientists to be a normal dietary supplement that works to reduce body fat.

Domestic research on supplements of natural origin improving weight status and reducing body fat in Overweight and obesity people has been rarely mentioned, especially among middle-aged women.

So, the study was conducted with the following two objectives in mind:

1. Describe overweight and obesity among women aged 40-65 in Ha Dong district and Chuong My district, Hanoi in 2016.

2. Evaluate the effectiveness of improving overweight, obesity and changing some biochemical indicators in women 40-65 years old with Calorie Limit supplements in Ha Dong district and Chuong My district, Hanoi.

Contribution of the study:

The research has provided valuable scientific information on the situation of overweight and obesity in women aged 40-65 years and revealed factors related to overweight and obesity such as age, central fat, visceral fat, diet... The prevalence of overweight and obesity among women 40-65 years old at the study site was (36,41%), the rate of abdominal obesity (78%), central obesity (98,1%), the prevalence of abdominal obesity in the group with a BMI of < 23 (kg/m2) accounted for 55,9%; and the group with a BMI of ≥ 23 (kg/m2) accounted for (92.8%).

The topic has proven the  effectiveness of Calorie Limit supplements  on overweight and obese women 40-65 years old, after 12 weeks of intervention, in the intervention group reduced body weight, reduced visceral  fat, reduced subcutaneous fat in the abdomen, reduced the incidence of metabolic syndrome,  and some biochemical indicators of the object of study. With the average weight reduced by 1,4 ± 0,95 kg, the average waist reduced by 4,41±2,14 cm, the average visceral fat decreased by 5,8 cm2 and the average abdominal subcutaneous fat decreased by 3,9 cm2.  The results also showed that the effectiveness of treatment reduced the incidence of Metabolic Syndrome when only 2 people were treated to reduce 1 case

II. RESEARCH METHODOLOGY

1. Study subjects: Women from 40 to 65 years old, living in the study area.

2. Research location: Cross-sectional investigation in 4 communes and wards: Chuc Son, Duong Noi, Phu La, Phu Nghia in Chuong My district and Ha Dong district; The intervention was conducted in: Chuc Son town, Chuong My district and Duong Noi ward, Ha Dong district - Hanoi city.

3. Study duration: cross-sectional study conducted from March to April 2016; Implementation intervention period (from 9/2016 to 12/2016). Data analysis, thesis completion from June 2017 to August 2022.

Sample size:

- The sample size of the cross-sectional study was 673 subjects.

- Sample size for intervention study: 112 subjects divided into 2 groups

Study design:

Phase 1: Cross-sectional investigation and assessment of overweight and obesity of women aged 40-65 years.

Phase 2: Community intervention trial, double-blind, controlled, and pre-intervention assessment. The study was divided into 2 groups: intervention group and control, Vietnamese women aged 40-65 years old and with body mass index (23 ≤ BMI ≤ 30kg/m²) will reduce fat area at L4 and L5 as well as BMI after 3 months of using Calorie Limit products. Intervention group: Chlorie limit supplements for 12 weeks. Control group: use placebo tablets. Collaborators fully documented daily pill use, monitored and collected feedback from subjects. 

III. CONCLUDE.

1. Overweight and obesity in women 40-65 years old in Ha Dong district and Chuong My district, Hanoi.

The cross-sectional survey of 673 study subjects who were women aged 40-65 years showed that:

-  The prevalence of overweight and obesity among women aged 40-65 years with a BMI of ≥ 23 kg/m2 at the study site was (36.41%). This rate is similar across age groups and living regions.

-  The average BMI of the study subjects was 24.1±3.0 kg/m2.

More than three-quarters (78%) of the study subjects had abdominal obesity (waist circumference > 80cm) and most (98.1%) had central obesity (WHR ≥ 0.8). The prevalence of abdominal obesity in the group with a BMI of < 23 (kg/m2) accounted for 55.9%; and the group with a BMI of ≥ 23 (kg/m2) accounted for (92.8%).

The proportion of study subjects using weight loss drugs accounted for 2.7%; Inner-city areas had a statistically significant higher utilization rate than suburbs with p=0.003.

2. Effective intervention of food supplements containing natural active ingredients Calorie Limit, improving overweight, obesity and changing some biochem ical indicators in women 40-65 years old.

Subjects who used Calorie Limit products during the 12-week study of the intervention group had improvements in weight status, visceral fat, subcutaneous fat in the abdomen, and reduced incidence of Metabolic Syndrome.

The effectiveness of the product supported weight reduction for the study subjects when the average intervention group lost 1.4 ± 0.95 kg of weight, while the average control group lost only 0.3 ± 1.12 kg of weight. The difference between the 2 groups was statistically significant with p = 0.000.

For waist circumference, the product helped the intervention subjects reduce their waist circumference by an average of 4.41±2.14 cm compared to the control group's average reduction of 0.2 ± 2.07 cm. The difference between the 2 groups was statistically significant with p = 0.000.

With visceral fat and abdominal subcutaneous fat, subjects in the intervention group lost an average of 5.8 cm2 of visceral fat and 3.9 cm2 of abdominal subcutaneous fat compared to the start of the study, a statistically significant difference with p = 0.000 and p = 0.010. While subjects in the control group increased an average total of 3.7cm2 in both of these indicators.

The total body fat area measured at L4, L5 of the intervention group decreased by 9.9 cm² meaningfully with (p = 0.000), the control group increased by a total of 3.7 cm² the difference was not statistically significant.

The effect of calorie limit after 12 weeks of intervention resulted in statistically significant reductions in biochemical indicators of blood glucose (mmol/L), HbA1c (%), insulin (UI), triglycerides (mmol/L), cholesterol (mmol/L), LDL-C (mmol/L), the mean of indicators in the intervention group decreased accordingly (4,7 ± 0,3; 4,6 ± 0,3); (5,5 ± 0,3; 5,2 ± 0,2); (7,8 ± 4,4; 7,5 ± 2,4); (2,2 ± 1,1; 1,9 ± 0,6); (5,0 ± 0,9; 4,8 ± 0,7); (3,0 ± 0,7; 2,7 ± 0,5).

Evaluation of the effectiveness of intervention through the NNT index (the number of people who need intervention to reduce one case): shows that the product is effective in treating the study subjects to reduce the incidence of HCCH when only 2 people need to be treated, 1 case is reduced after only 12 weeks of using the product (NNT  2; CI95%: 1,396 – 8,697) Statistically significant reduction.

IV. RECOMMENDATIONS

1. For groups of subjects with high rates of abdominal obesity and central obesity, high body mass index needs more attention, developing appropriate intervention strategies such as lifestyle medicine.

2. Calorie limit supplements have the effect of supporting body weight reduction, especially reducing visceral fat, abdominal wall fat, controlling metabolic syndrome component factors, so it is necessary to strengthen communication and advice about products to the right target groups.

3. Follow-up studies on a larger scale and longer time are needed to evaluate the effectiveness of dietary supplements Calorie limit containing natural active ingredients on lipid and glucose metabolism of the body in subjects with abdominal obesity rate, central fatness, high body mass index.

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