AETIOLOGY AND DIFFERENTIATING CHARACTERISTICS OF PRIMARY VS. SECONDARY THROMBOCYTOSIS – THE CLOT THICKENS

Background: Overweight and obesity now affects two in three New Zealand adults. Of the many complications of obesity type 2 diabetes mellitus (T2DM) is one of the most challenging. It is associated with significant morbidity, cost and reduced life expectancy. The global prevalence of T2DM has quadrupled in the last 36 years. Dietary calorie restriction induces weight loss for the treatment of obesity and reverses dysglycaemia in T2DM in proportion to the degree of calorie restriction. There has been much interest in whether the timing of calorie restriction provides additional benefit to such a diet. One possible mechanism is an attenuation in the drop in basal metabolic rate commonly seen within a few weeks of starting an energy restricted diet. This reduction in basal metabolic rate is known as adaptive thermogenesis. Adaptive thermogenesis reduces the calorie requirements of a fasting individual below that expected for weight, thus reducing weight loss during a low-calorie diet. An attenuation in adaptive thermogenesis with intermittent fasting may promote more effective weight loss during dietary energy restriction.