Acta Obstet Gynecol Scand 2003: 82: 69–73 Copyright C Acta Obstet Gynecol Scand 2003

Printed in Denmark . All rights reservedActa Obstetricia et

Gynecologica ScandinavicaISSN 0001-6349

ORIGINAL ARTICLE

Laser acupuncture and low-calorie diet duringvisceral obesity therapy after menopausePIOTR WOZNIAK1, GRZEGORZ STACHOWIAK1, AGNIESZKA PIETA-DOLINSKA2 AND PRZEMYSLAW OSZUKOWSKI2

From the 1Specialistic Outpatient Clinics of Obstetrics and Female Diseases, and 2Department of Perinatology, PolishMother’s Memorial Hospital, Research Institute, Lod, Poland

Acta Obstet Gynecol Scand 2003; 82: 69–73. C Acta Obstet Gynecol Scand 2003

Background. To compare the efficiency of low-calorie diet and low-calorie diet appliedtogether with laser acupuncture in the therapy of visceral obesity in postmenopausal women.Methods. The study population consisted of 74 postmenopausal females with visceralobesity who were divided into two groups according to an employed 6-month slimmingprocedure. In the first group (nΩ36) a low-calorie diet was applied, while women in thesecond group (nΩ38) were on the same kind of diet, having additionally one cycle of laseracupuncture procedure at the same time. At baseline and at the end of the study, body weight,body mass index and waist-to-hip ratio were determined in all women.Results. After 6 trial months both groups exhibited a statistically significant drop in bodyweight, body mass index and waist-to-hip ratio. The mean reduction of body weight, bodymass index and waist-to-hip ratio was significantly higher in the second group of women(laser acupuncture plus low-calorie diet).Conclusions. (1) Our results testify that the combination of a low-calorie diet and laseracupuncture is characterized by a higher efficacy than a low-calorie diet alone in loweringbody weight, body mass index and waist-to-hip-ratio. (2) Laser acupuncture is an additionaluseful healing method in the therapy of visceral postmenopausal obesity.

Keywords: laser acupuncture, low-calorie diet, menopause, visceral obesity

Submitted 2 May, 2002Accepted 18 July, 2002

Epidemiological data report that obesity afflictswomen more often than men: 25–30% and 13–18%of the whole female and male populations, respec-tively (1).

Moreover, the fat content in the human bodytends to increase with aging. However, the reasonsfor obesity seem to be more intricate. The mostapparent, e.g. a gradual decline of metabolism by2% for every 10 years of a lifetime, low motor ac-tivity or bad dietary habits, make it obvious thatobesity also in Poland creates a very serious sal-ubrious problem. It is peculiarly evident after

Abbreviations:NIDDM: non insulin-dependent diabetes mellitus; HDL: highdensity lipoproteins; LDL: low density lipoproteins; FSH: fol-licle-stimulating hormone: E2: estradiol; BMI: body massindex; WHR: waist-to-hip ratio.

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menopause, where 60% of females are obese oroverweight (2).

Obesity means not only an impaired general ap-pearance, ill being, skeletal overloading, loweredphysical efficacy or menstrual disorders in pre-menopause but also an increased risk of many life-threatening illnesses: non insulin-dependent dia-betes mellitus (NIDDM), arterial hypertensionand atherosclerosis, coronary heart disease, andendometrial and breast cancers (3–5).

Androgens in adipose tissue are converted intoestrogens; hyperestrogenism in obese women is afactor predisposing to the development of hor-mone-dependent neoplasms such as endometrialand breast cancers (concentration of sex hormonebinding globulin is also reduced). Being overweightby more than 20kg results in a 20-fold increase inrisk of endometrial cancer (6).

70 P. Wozniak et al.

Women in their perimenopausal period exhibitmostly gynoid-type obesity, while after menopausevisceral (android) obesity tends to prevail. In-creased frequency of visceral obesity in post-menopausal women is connected with hormonalalterations at that time (7).

Visceral obesity with accompanying insulin re-sistance, hyperinsulinemia, impaired glucose toler-ance or NIDDM, dyslipidemia, arterial hyperten-sion and fibrinolytic disturbances is part of the so-called metabolic syndrome or syndrome X (8).

Typical therapy for obesity includes a low-cal-orie diet and exercise as well as various types ofslimming drugs. Also acupuncture has attainedgood therapeutic results in obese subjects (9).

First attempts to apply lasers in medicine werecarried out in the mid-1960s as therapy for pa-tients suffering from inoperable malignant mela-noma and wound healing, as well as for studies oncytophagy (10). In the early 1970s lasers of lowradiation power (so-called soft lasers) appeared forthe first time in acupuncture (11). During the last30 years the low radiation power lasers had enoughtime to become naturalized in acupuncture, andbecame broadly applied also in the fields of gyne-cology and obstetrics.

At present the most typical indications for acu-puncture laser therapy in gynecology are phlogisticstates within female reproductive organs, dysfunc-tional vaginal bleedings (e.g. juvenile metrorrha-gia, disorders of menstrual cycle such as oligo-menorrhoea) and barrenness (12).

In this present study we tried to assess the effi-cacy of simultaneously applying laser acupunctureand a low-calorie diet in the therapy of post-menopausal women with visceral obesity.

Materials and methods

A group of 74 obese female subjects of post-menopausal age (range 50–62years, mean 55.1∫4.0) was enrolled for this trial. All were recruitedfrom the patients’ visiting Specialistic OutpatientClinic at Polish Mothers Memorial Hospital, Re-search Institute (PMMH, RI), Lodz, Poland.

A thorough gynecologic and clinical examina-tion of each subject was performed, including ex-tensive blood chemistry. Qualifying criteria were:body mass index (BMI)30kg/m2, waist-to-hipratio (WHR) 0.8, and lack of pathology in thereproductive organs.

Women enrolled for the study were divided intotwo groups depending upon the type of slimmingtherapy to be applied. In the first group (nΩ36) alow-calorie diet only as a slimming method wasemployed for 6months, while the second group

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(nΩ38) received a combination therapy: a low-cal-orie diet together with laser acupuncture.

Baseline characteristics of both groups areshown in Table I.

The principles of the diet therapy in both groupsassumed that the energy supply should be 1000kcal below the daily calorie requirement calculatedfor each woman: 1200–1500 kcal per day on aver-age, 5–6 meals a day, consisting of proteins in 10–15%, fats in 25% and carbohydrates in 60–65%.Women were recommended to drink daily 3–4 l offluids between meals.

In the second group of women, together with thestart of dieting, laser acupuncture procedures werecommenced. According to our therapeutic proto-col, the laser acupuncture therapy was performedduring the first 6weeks of the trial: 12 acupunctureprocedures for each woman comprising two perweek.

We utilized Therapy Laser Model 1106M (LaserInstruments, Warsaw, Poland). Each point wasstimulated by a laser beam of the followingparameters: frequency, 900Hz; strength, 24 mW;energy, 0.1J; stimulation time, 10–15s/point; andexposure dose, 150s. The following corporal acu-puncture points were stimulated: Cv 12 (Zhong-wan), St 36 (Zusanli), St 25 (Tianshu), Liv 3(Taichong); P 6 (Neiguan), H 7 (Shenmen) for thepsychical aspect of the therapy; and auriculothera-py: 55 (Shenmen) and 87 (Stomach).

In each patient before the start and after the endof treatment, the body weight, BMI and WHRwere measured. Obtained results were statisticallyanalyzed using the Student’s t-test. For all par-ameters, arithmetical averages and standard devi-ations were calculated.

All laser acupuncture procedures were per-formed in the Acupuncture Office at PMMH, RI,Lodz.

Results

We obtained a statistically significant drop in bodyweight as well as in BMI during the 6months oftreatment. In the first group (low-calorie dietonly), body weight was decreased from 85.48∫8.48kg to 77.07 ∫7.7kg and BMI dropped from33.23 ∫1.90kg/m2 to 29.95∫1.66kg/m2 (p0.001). In the second group (low-calorie diet plusacupuncture), body weight was reduced from 85.5∫5.99kg to 72.68 ∫6.06kg and BMI droppedfrom 33.54 ∫1.77kg/m2 to 28.51 ∫2.00kg/m2; p0.001. Diminution of body weight and BMI wassignificantly higher in the group of women treatedwith a low-calorie diet and acupuncture (12.81∫2.85kg and 5.03 ∫1.08kg/m2, respectively) than in

Laser acupuncture and visceral obesity 71

Table I. Baseline group characteristics

Parameter Group 1 Group 2 p-value

Age (years) 55.19 (∫ 4.14) 54.92 (∫ 3.81) NSTime from LMP (years) 5.03 (∫ 4.37) 4.76 (∫ 3.88) NSBody weight (kg) 86.12 (∫ 8.13) 85.91 (∫ 6.04) NSBMI (kg/m2) 33.44 (∫ 1.78) 33.70 (∫ 1.71) NSWHR 0.93 (∫ 0.08) 0.95 (∫ 0.09) NSFSH (IU/l) 75.6 (∫ 29.7) 77.1 (∫ 28.5) NSE2 (pg/ml) 20.5 (∫ 12.7) 21.2 (∫ 11.8) NSWBC (103/ml) 5752 (∫ 1421) 5848 (∫ 1394) NSFasting glucose (mg/dl) 98.7 (∫ 23.7) 96.6 (∫ 19.8) NSTotal cholesterol (mg/dl) 238.1 (∫ 41.4) 230.9 (∫ 45.2) NSHDL cholesterol (mg/dl) 49.45 (∫ 13.14) 48.74 (∫ 12.63) NSLDL cholesterol (mg/dl) 157.61 (∫ 29.46) 151.4 (∫ 31.23) NSTriglycerides (mg/dl) 176.7 (∫ 69.8) 183.2 (∫ 76.7) NS

LMP Ω last menstrual period; BMI Ω body mass index; WHR Ω waist-to-hip ratio; FSH Ω follicle stimulating hormone; WBC Ω white blood cells (count).

Table II. Body weight, body mass index and waist-to-hip ratio data of both groups of obese women treated with either a low-calorie diet (Group 1) or a low-calorie diet combined with laser acupuncture (Group 2)

Group 1 Group 2 p-value

Body weight1 86.12 ∫ 8.13 85.91 ∫ 6.04 0.05Body weight2 77.29 ∫ 7.95 72.97 ∫ 5.98 0.01BMI1 33.44 ∫ 1.78 33.70 ∫ 1.71 0.05BMI2 30.03 ∫ 1.73 28.63 ∫ 1.98 0.01WHR1 0.93 ∫ 0.08 0.94 ∫ 0.09 0.05WHR2 0.85 ∫ 0.05 0.81 ∫ 0.06 0.01

BMI Ω body mass index; WHR Ω waist-to-hip ratio.BMI1, body weight1, WHR1 Ω before treatment; BMI2, body weight2, WHR2 Ω after treatment.

the low-calorie only group (8.41∫2.02kg and 3.28∫0.78kg/m2, respectively), p0.01.

Similar alterations were observed in the WHRvalues: in the first group WHR decreased from0.93 ∫0.08 to 0.85∫0.05 (p0.001), while in thesecond group it decreased from 0.94∫0.09 to 0.81∫0.06 (p0.001). Here, the higher WHR reduc-tion was observed also in the second group ofwomen: 0.13 ∫0.03 and 0.08∫0.02, respectively (p0.01).

All results (average values of the examined par-ameters plus standard deviations) are shown inTable II.

Discussion

There are many ways to determine the content offat tissue in humans, some of which are consider-ably time-consuming and expensive, whereas theuse of BMI and WHR is very simple and cheap.

Obesity is recognized as a BMI bigger than 30kg/m2. Enormous obesity, BMI more than 40kg/m2, considerably increases the death risk (13). Inwomen with visceral obesity (WHR0.8), highermortality resulting from coronary heart diseaseand cardiac infarction, circulatory failure, arterial

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hypertension, strokes and complications ofNIDDM is found (4).

In the treatment of obesity, two factors play animportant role: a low-calorie diet and increasedmotor activity. In some cases pharmacotherapyalso is added to intensify the slimming effect. Acu-puncture (or laser acupuncture) with its homeos-tatic activity may be applied here as an additionalmethod. Having treated obese postmenopausalwomen with classic needle acupuncture, we at-tained a significant decrease in both their bodyweight and BMI (9).

Obesity is a typical example of losing controlover organism function; acupuncture gives achance to primarily compensate for these dis-orders. According to traditional Chinese medicineall afflictions originate from energy deficiency inthe meridians St (stomach) and Sp (spleen), andin some cases also in meridian Ki (kidney). Veryimportant also is regular functioning of meridianLiv (liver), and the influence of acupuncture on themetabolism of the incretory glands in cases ofendocrinologic disturbances (14).

Before starting laser acupuncture procedures itis advisable to evaluate the energetic state of theorganism by use of the Ryodorak method. Meno-

72 P. Wozniak et al.

pausal obesity is pluricausal, and laser acupunc-ture with its stimulating and compensatory actionshould be always used individually (3). The bestresults in the treatment of obesity by laser acu-puncture brings the compensation of energy dis-orders in meridian St and Liv, then stimulation ofsome auricular points and points of psychical as-pects as well as a reduction of the energetic excessleading to hyperfunction of some incretory glands(hypophysis) (9). Disobedience to the two essentialelements in slimming therapy (low-calorie diet andmotor activity) by some postmenopausal womencaused, for example, by dietary habits and reluc-tance to exercise, makes alternative therapeuticmethods supplementary to hitherto existing treat-ments still in request.

Laser acupuncture manifests many advantageswhen applied to women: aseptic and painlessstimulation of acupoints, possibility of applicationwithin the facial area with no subsequent transienterythema, lack of tissue traumatization, the short-ness of the procedure and the possibility of veryprecise irradiation of acupoints thanks to the laserending provided by a point detector (10).

Laser acupuncture also has its drawbacks. Oneof them is the worse effects observed with the ther-apy of acute illnesses than in chronic processes(15). However, in the case of visceral obesity inmenopausal patients, which can be defined as achronic disease, the use of laser acupuncture seemsto be more suitable.

The number of papers in the medical literatureconcerning the application of laser acupuncture re-mains insufficient. We analyzed the Medline net-work data for the last 5years and failed to find anyexample of laser acupuncture application in thetherapy of gynecologic ailments. Only a few papersdealing with laser acupuncture referred to its appli-cation in the therapy of neck pain (16), carpal tun-nel syndrome (17), stenocardia with concomitantchronic cholecystitis (18), facial neuritis (19), duo-denal ulcer (20), paralysis in stroke (21), or inadults with attention-deficit hyperactivity disorder(22).

According to Meczeret et al. (23) the utmost ef-fects of action during laser acupuncture pro-cedures are obtained between the 3rd and 17thtreatment day. In some female patients treatedwith laser acupuncture, an initial lack of thera-peutic effects (after 4–5 procedures) occurs, mak-ing them feel discouraged and skeptical about themethod. A period of transient deterioration after5–7 procedures can even occur. Then, a distinctamelioration phase (observed also by us: hence ourwhole therapeutic cycle consisted of 12 pro-cedures) appears typically with the 8th or 9th pro-cedure. However, according to the opinion of many

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authors, the reaction of human organisms to laseracupuncture procedures does not vary consider-ably from that observed with classic needle therapy(10).

To conclude, laser acupuncture in the hands ofa skilled doctor can be a useful tool in controllingmenopausal obesity.

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Address for correspondence:Piotr WozniakSpecialistic Outpatient Clinics of Obstetrics and FemaleDiseasesPolish Mother’s Memorial HospitalResearch Institute93-338 LodPolande-mail: wozniak/mazurek.man.lodz.pl