Diagnostic performance of weight loss to predict body fatness improvement in cardiac rehabilitation patients

Quinn R. Pack, Juan Pablo Rodriguez-Escudero, Randal J. Thomas, Ray W. Squires, Lezlie Johnson, Virend Somers, Francisco Lopez-Jimenez

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

PURPOSE: To determine the diagnostic performance of weight loss to identify fat mass loss in cardiac rehabilitation (CR) patients. METHODS: We included consecutive patients enrolled in early outpatient CR who underwent air displacement plethysmography with measurements of height, weight, and waist circumference at initiation and completion of CR. We calculated the accuracy of >1 kg of weight loss to predict a >1 kg loss of fat mass. RESULTS: We analyzed data from 142 patients (mean age ± SD = 60 ± 12 years), 74% male, 94% non-Hispanic whites, and body mass index (BMI) 29.9 ± 5.1 kg/m. Following 87 ± 49 days and 22 ± 9 CR sessions, there was a small but significant change in weight (-1.3 ± 3.8 kg), BMI (-0.4 ± 1.2 kg/m), fat mass (-2.6 ± 3.9 kg), lean mass (+1.3 ± 1.9 kg), and waist circumference (-4.3 ± 5.1 cm), P < .001 for all. Overall, patients who lost weight consistently lost fat mass, positive predictive value 0.91 (95% CI: 0.83-0.96). However, the negative predictive value of lack of weight loss to exclude fat mass loss was poor, 0.59 (95% CI: 0.52-0.64). Among patients who did not lose weight, waist circumference reduction was modestly predictive of fat mass loss (r = 0.33, P = .004.) CONCLUSIONS: Although weight loss in CR is indicative of fat mass loss in most patients, absence of weight loss, or even weight gain, would not necessarily rule out fat loss in a significant number of patients attending CR. These findings speak to the importance of body fatness measurements beyond BMI in the CR setting.

Original languageEnglish (US)
Pages (from-to)68-76
Number of pages9
JournalJournal of Cardiopulmonary Rehabilitation and Prevention
Volume33
Issue number2
DOIs
StatePublished - Mar 2013

Fingerprint

Weight Loss
Fats
Waist Circumference
Weights and Measures
Body Mass Index
Plethysmography
Cardiac Rehabilitation
Weight Gain
Outpatients
Air

Keywords

  • air displacement plethysmography
  • cardiac rehabilitation
  • negative predictive value
  • obesity
  • specificity
  • weight loss

ASJC Scopus subject areas

  • Rehabilitation
  • Cardiology and Cardiovascular Medicine
  • Pulmonary and Respiratory Medicine

Cite this

Diagnostic performance of weight loss to predict body fatness improvement in cardiac rehabilitation patients. / Pack, Quinn R.; Rodriguez-Escudero, Juan Pablo; Thomas, Randal J.; Squires, Ray W.; Johnson, Lezlie; Somers, Virend; Lopez-Jimenez, Francisco.

In: Journal of Cardiopulmonary Rehabilitation and Prevention, Vol. 33, No. 2, 03.2013, p. 68-76.

Research output: Contribution to journalArticle

Pack, Quinn R. ; Rodriguez-Escudero, Juan Pablo ; Thomas, Randal J. ; Squires, Ray W. ; Johnson, Lezlie ; Somers, Virend ; Lopez-Jimenez, Francisco. / Diagnostic performance of weight loss to predict body fatness improvement in cardiac rehabilitation patients. In: Journal of Cardiopulmonary Rehabilitation and Prevention. 2013 ; Vol. 33, No. 2. pp. 68-76.
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AB - PURPOSE: To determine the diagnostic performance of weight loss to identify fat mass loss in cardiac rehabilitation (CR) patients. METHODS: We included consecutive patients enrolled in early outpatient CR who underwent air displacement plethysmography with measurements of height, weight, and waist circumference at initiation and completion of CR. We calculated the accuracy of >1 kg of weight loss to predict a >1 kg loss of fat mass. RESULTS: We analyzed data from 142 patients (mean age ± SD = 60 ± 12 years), 74% male, 94% non-Hispanic whites, and body mass index (BMI) 29.9 ± 5.1 kg/m. Following 87 ± 49 days and 22 ± 9 CR sessions, there was a small but significant change in weight (-1.3 ± 3.8 kg), BMI (-0.4 ± 1.2 kg/m), fat mass (-2.6 ± 3.9 kg), lean mass (+1.3 ± 1.9 kg), and waist circumference (-4.3 ± 5.1 cm), P < .001 for all. Overall, patients who lost weight consistently lost fat mass, positive predictive value 0.91 (95% CI: 0.83-0.96). However, the negative predictive value of lack of weight loss to exclude fat mass loss was poor, 0.59 (95% CI: 0.52-0.64). Among patients who did not lose weight, waist circumference reduction was modestly predictive of fat mass loss (r = 0.33, P = .004.) CONCLUSIONS: Although weight loss in CR is indicative of fat mass loss in most patients, absence of weight loss, or even weight gain, would not necessarily rule out fat loss in a significant number of patients attending CR. These findings speak to the importance of body fatness measurements beyond BMI in the CR setting.

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