Shedding pounds may benefit your heart -- even if some weight is
regained

Date:
March 28, 2023
Source:
American Heart Association
Summary:
Weight loss was associated with decreased risk factors for
cardiovascular disease and Type 2 diabetes for at least five
years -- even if some weight was regained, according to a review
of research on behavioral weight loss programs. People who lost
weight through an intensive behavioral weight loss program had
lower systolic blood pressure levels, total cholesterol-to-good
cholesterol ratio and HbA1c levels (a diabetes marker), when
compared to people who did not participate in a program or
participated in a lower-intensity behavioral program.


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FULL STORY ========================================================================== Losing weight with lifestyle changes in an intensive behavioral
weight loss program was associated with a decrease in risk factors for cardiovascular disease and Type 2 diabetes for at least five years --
even if some weight was regained, according to a systematic review of
research, published today in Circulation: Cardiovascular Quality and
Outcomes, a peer-reviewed American Heart Association journal.


========================================================================== People affected by obesity or who are overweight are at increased risk for
high cholesterol and high blood pressure -- factors that heighten risk
of cardiovascular disease; as well as insulin resistance, a precursor
to Type 2 diabetes. Globally, overweight and obesity contributed to 2.4
million deaths in 2020, according to the American Heart Association's
2023 Statistical Update.

Behavioral weight loss programs can help people lose and maintain a
healthy weight by encouraging lifestyle and behavior changes, such as
eating healthy foods and increasing physical activity. Regaining some
weight is common after behavioral weight loss programs. Some observational studies suggest this weight change pattern of weight loss followed by
weight regain may increase cardiovascular risk. However, according to
the authors of this analysis, data from randomized trials and long-term follow-up studies is lacking.

"Many doctors and patients recognize that weight loss is often followed
by weight regain, and they fear that this renders an attempt to lose
weight pointless," said study co-senior author Susan A. Jebb, Ph.D.,
a professor of diet and population health at the University of Oxford
in the United Kingdom.

"This concept has become a barrier to offering support to people to lose weight. For people with overweight or obesity issues, losing weight is
an effective way to reduce the risk of Type 2 diabetes and cardiovascular disease." In this review, researchers assessed international scientific studies available in 2018 to compare risk factors for cardiovascular
disease and Type 2 diabetes among people who followed an intensive
behavioral weight loss program to those who followed a less intensive or
no weight loss program. The studies in the analysis included diet and/or exercise interventions, partial or total meal replacement, intermittent fasting, or financial incentives contingent on weight loss. The studies
took place in a variety of settings and included varying modes of delivery
(in person, app-based, telephone, etc.).

Researchers combined the results of 124 studies totaling more than 50,000 participants, with an average follow-up of 28 months. They used the
combined results to estimate changes in risk factors for cardiovascular
disease and Type 2 diabetes after weight loss. The average weight
loss across the different studies ranged from 2-5 kilograms, or 5-10
pounds. Weight regain averaged 0.12 to 0.32 kg (0.26 pounds to 0.7 pounds)
a year. Participants were an average age 51 years old, with a body mass
index of 33, which is considered obese.

Compared to people in a less intensive program and those in no weight
loss program, participants who lost weight through an intensive weight
loss program had lower risk factors for cardiovascular disease and Type 2 diabetes. These lower risk factors lasted for at least five years after
the weight loss program ended.

Based on pooled results of the studies reviewed, on average:
* Systolic blood pressure, the top number in a blood pressure
reading, was
1.5 mm Hg (millimeters of mercury) lower at one year, and 0.4 mm
Hg lower at five years after participation in an intensive weight
loss program.

* In addition, the percentage of HbA1c, a protein in red blood
cells used
to test for diabetes, was reduced by 0.26 at both one and five
years after participation in an intensive weight loss program.

* The ratio of total cholesterol to good cholesterol - known as high-
density lipoprotein (HDL) cholesterol -- was 1.5 points lower one
year and five years after participation in an intensive weight
loss program.

These changes are important because they represent improvements at the population level, Jebb explained.

In a preliminary finding, the decreased risk of being diagnosed with cardiovascular disease or Type 2 diabetes also appeared to remain lower
even after weight regain. However, few studies followed people for more
than 5 years and "more information is needed to confirm whether this
potential benefit persists," Jebb said.

"Most trials look at whether new treatments are effective and focus on
weight change in the short-term rather than the effect on later disease,"
Jebb said.

"Individual studies are often too small to detect differences between
groups in the incidence of cardiovascular conditions because, fortunately,
they affect only a small proportion of the whole group, and studies
may not continue long enough to see the effects on 'hard' outcomes,
such as a new diagnosis of Type 2 diabetes or a heart attack.

"Our findings should provide reassurance that weight loss programs are effective in controlling cardiovascular risk factors and very likely to
reduce the incidence of cardiovascular disease," she said.

Evidence suggests that cardiovascular health is improved by following the American Heart Association's Life's Essential 8 health metrics: eating
healthy food, being physically active, not smoking, getting enough sleep, maintaining a healthy weight, and controlling cholesterol, blood sugar
and blood pressure levels.

The analysis had several limitations: information included in the review
was not updated after 2019 and the review focused on research papers
published in English, so eligible studies written in other languages
may have been missed.

An accompanying editorial notes that much remains to be understood about various weight loss interventions, their long-term impact and how this
impact may be diminished by regaining weight. Behavioral weight loss
programs constitute the backbone of weight management in clinical
practice. However, they are often resource intensive, and emerging
medication therapies are expensive, according to editorial authors Vishal
N. Rao, M.D., M.P.H., and Neha J. Pagidipati, M.D., M.P.H., both from the division of cardiology at Duke University School of Medicine in Durham,
North Carolina.

"The present study has interesting implications for the impact of weight
regain that may occur after pharmacologic therapies," they write. "What
is still unknown is whether these temporary improvements in weight and cardiometabolic risk factors after weight loss intervention (behavioral
or pharmacological) lead to long-term clinical benefit. In other words,
is it better to have lost and regained than never to have lost at all?"
* RELATED_TOPICS
o Health_&_Medicine
# Diet_and_Weight_Loss # Obesity # Fitness # Heart_Disease
# Diseases_and_Conditions # Diabetes # Cholesterol #
Men's_Health
* RELATED_TERMS
o Weight_Watchers o Cholesterol o Hyperthyroidism
o Diabetes_mellitus_type_1 o Erectile_dysfunction o
Physical_exercise o Low_density_lipoprotein o Fetus

========================================================================== Story Source: Materials provided by American_Heart_Association. Note:
Content may be edited for style and length.


========================================================================== Journal Reference:
1. Jamie Hartmann-Boyce, Annika Theodoulou, Jason L. Oke, Ailsa
R. Butler,
Anastasios Bastounis, Anna Dunnigan, Rimu Byadya, Linda
J. Cobiac, Peter Scarborough, F.D. Richard Hobbs, Falko
F. Sniehotta, Susan A. Jebb, Paul Aveyard. Long-Term Effect of
Weight Regain Following Behavioral Weight Management Programs on
Cardiometabolic Disease Incidence and Risk: Systematic Review and
Meta-Analysis. Circulation: Cardiovascular Quality and Outcomes,
2023; DOI: 10.1161/CIRCOUTCOMES.122.009348 ==========================================================================

Link to news story: https://www.sciencedaily.com/releases/2023/03/230328145442.htm

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