Outcomes and follow-up
BLOOD, SECONDARY, INSULIN RESISTANCE
The primary outcome was change in body mass index (BMI). The secondary outcomes included changes in body weight, body fat, waist circumference, waist-to-hip ratio (WHR), and metabolic risk factors. Body fat was quantified using IOI353 Body Composition Analyser (Jawon Medical, Gyeongsansi, South Korea). Blood samples were collected, after participants had fasted for over 8 h, to measure plasma glucose, fasting insulin, serum total cholesterol, serum triglyceride, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), uric acid, alanine aminotransferase (ALT), and aspartate aminotransferase (AST). Insulin resistance was evaluated by homeostasis model assessment-insulin resistance index (HOMA-IR), calculated as [plasma glucose (mmol/L) × serum insulin (mIU/L)]/22.5. All study outcomes were measured at baseline and weeks 4, 8, and 12.