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There is limited evidence on the impact of weight loss via caloric restriction and aerobic exercise on Life’s Simple 7 (LS7), a health assessment tool used by the American Heart Association to promote and track cardiovascular health (CVH) via modifiable risk factors and health behaviors. Individuals with obesity have a greater prevalence of traditional and non-traditional cardiometabolic risk factors than lean individuals. Objective: Examine the effect of a weight loss intervention on LS7 and assess predictors of change in adults with obesity. Methods: Twenty-six adults (44.9 ± 9.7 years; weight: 93.9 ± 11.1 kg; body mass index: 34.1 ± 3.4 kg/m 2 ) participated in a 10-week medical weight loss program (OPTIFAST) and supervised exercise training program (50-75% VO 2 max) to achieve clinically significant weight loss (≥7% body weight). Poor, intermediate, and ideal CVH categories were defined as scores 0 to 4, 5 to 9, and 10 to 14, respectively. Baseline and post-weight loss LS7 scores were calculated via participant demographics, smoking status, anthropometry, physical activity level, diet intake, and blood lab reports. Paired samples t-test and Pearson’s correlations were used. Results: Mean weight loss was significant (-9.2 ± 3.6 kg, p < 0.001). Mean LS7 score significantly increased from baseline to weight loss (7.3 ± 1.5 vs. 9.6 ± 1.2, respectively, p < 0.001) and 57.7% of participants (15 of 26) improved to ideal CVH following weight loss. A significant inverse association was observed between change in LS7 and systolic blood pressure ( r = -0.41, p < 0.05), total cholesterol ( r = -0.45, p < 0.05), and glucose ( r = -0.41, p < 0.05). There were no further significant relationships with LS7 (i.e. change in weight, body mass index, physical activity, diastolic blood pressure). Discussion: A combined caloric restriction and aerobic exercise training intervention improved a multitude of cardiovascular disease risk factors. Previous epidemiological studies indicate meeting the ideal LS7 metrics is associated with 78% and 49% reduced risk of cardiovascular disease morbidity and mortality, respectively. Thus, the long-term modification of health behaviors and cardiometabolic risk factors to achieve ideal cardiovascular health may reduce risks of cardiovascular morbidity and mortality in individuals with obesity.

Objective: The OPTIFAST diet has known effects for weight loss, but little data exists on the effects of the diet on arterial stiffness. Methods: Overweight and obese (BMI: 34.5 + 4.0) adults (N=17) participated in a 10-week OPTIFAST™ weight loss program and supervised aerobic exercise training (50%-75% VO 2 max). The diet consisted of OPTIFAST meal replacement products with a goal of reducing total caloric intake to 800 kcals/day and attending a weekly weight management class. Aerobic exercise was performed 3 times per week and the exercise volume was progressed from 300 to 700 MET mins. per week at an intensity of 50%-75% VO2 max. The goal of study participants was to achieve a 7% weight loss. Carotid-to-femoral pulse wave velocity, blood pressure (aortic and brachial), vascular age, augmentation index and blood samples were measured in the morning after an overnight fast at baseline and follow-up. A paired t-test was performed to evaluate the change in outcomes variables. Results: The mean percent weight loss in the sample was 9.0% (-8.5 kg), with 83.3% of participants achieving 7% weight loss (94.1% achieving ≥5%). The adherence to the exercise program was 94.9% and attendance in the weight loss classes was 81.8%. There was a reduction in pulse wave velocity (-0.44 m/s, p=0.030), aortic systolic blood pressure (-10.5 mmHg, p0.05). Discussion: A hypo-caloric dietary program in combination with aerobic exercise training improves arterial stiffness, aortic blood pressure, and brachial blood pressure in overweight and obese adults An important limitation of the present study is that we cannot separate the health benefits of the diet from the exercise.