Weight loss at any age can result in long-term CV benefit

A decrease in BMI category at any age in adulthood was associated with improvement in CV risk factors, even if the weight loss was not sustained, according to new research published in The Lancet Diabetes & Endocrinology.

Researchers also found that longer exposure to adiposity was associated with worsening of CV risk factors, including elevated risk for diabetes, high systolic BP and increased carotid intima-media thickness.

The study included 1,273 participants from the National Survey of Health and Development Study who were followed up with since birth in 1946. Participants were classified as normal weight, overweight or obese in childhood and also at age 36, 43, 53 and 60 to 64 years.

Compared with normal weight, overweight and obesity were associated with higher carotid intima-media thickness (0.029 mm; 95% CI, 0.014-0.043) and higher systolic BP (7.95 mm Hg; 95% CI, 5.86-10).

In addition, increased carotid intima-media thickness, systolic BP, leptin, diabetes and reduced adiponectin were all associated with duration of exposure to adulthood adiposity (P<.0001 for all). However, the researchers found little effect from being overweight as a child.

Participants who dropped a BMI category at any time in adulthood, even if it was not sustained, had a lower carotid intima-media thickness (–0.034 mm; 95% CI, –0.056 to –0.013) and lower leptin concentrations (–0.4 ng/mL; 95% CI, –0.47 to –0.32) compared with those whose BMI did not decrease, according to the researchers.

“Our findings … support public health policies for lifestyle modifications for prevention and management of overweight and obese individuals of all ages,” they wrote.

In a related editorial, Elizabeth M. Cespedes, SM, and Frank B. Hu, MD, PhD, from Harvard School of Public Health, wrote that “these findings raise the possibility that early intervention could disrupt the lifelong patterns of adiposity that have been shown to have cumulative detrimental effects.”

Further research is necessary to determine whether the results of the study translate into a reduction in CV endpoints such as CHD and stroke, they wrote in the editorial.

For more information:

Cespedes EM. Lancet Diabetes Endocrinol. 2014;doi:10.1016/S2213-8587(14)70108-1.

Charakida M. Lancet Diabetes Endocrinol. 2014;doi:10.1016/S2213-8587(14)70103-2.

Disclosure: The study was funded by the Medical Research Council and the British Heart Foundation. Several researchers report financial ties with Arena, Janssen Pharmaceuticals, the Medical Research Council, Novo Nordisk and Vivus. Cespedes and Hu report no relevant financial disclosures.