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Large initial weight loss mitigates CVD risk
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A large initial weight loss can improve some risk factors for cardiovascular disease even if weight is regained, according to study findings published in Diabetes Care.
Rena R. Wing, PhD, professor of psychiatry and human behavior at the Alpert Medical School at Brown University and director of the Weight Control and Diabetes Research Center at The Miriam Hospital in Providence, Rhode Island, and colleagues used data from the Look AHEAD study, a randomized trial examining intensive lifestyle intervention in adults with overweight or obesity and type 2 diabetes.
The lifestyle intervention in Look AHEAD included group and individual sessions, reduced calorie intake and increased physical activity with the goal of producing a weight loss of at least 7% of total body weight.
Participants were divided into six groups based on weight-loss amount after intensive lifestyle intervention at year 1 and year 4: no weight loss (n = 158); moderate weight loss (years 1 and 4 weight loss of 3% to < 8%; n = 204); large weight loss (8%-20% at year 1 with < 3% weight regain at year 4; n = 251); moderate weight loss/full regain (year 1 weight 3% to < 8% below baseline; year 4 weight within 3% of baseline weight; n = 289); large weight loss/full regain (year 1 weight 8%-20%; year 4 weight within 3% of baseline; n = 210); large weight loss/partial regain (year 1 weight loss 8%-20%; year 4 weight 3%-8% of baseline; n = 316).
Among the no weight-loss, moderate weight-loss and large weight-loss groups, there were no systematic differences in changes in diastolic blood pressure or LDL cholesterol at year 1 or year 4. The large weight-loss group had the greatest improvements in HbA1c, systolic BP, HDL cholesterol and triglycerides at both year 1 and year 4.
HbA1c worsened over time in the no weight-loss, moderate weight-loss and large weight-loss groups when weight was maintained; the large weight-loss group seemed to have the smallest increases in HbA1c (P = .06) and levels were still below baseline at year 4. In the moderate weight-loss and large weight-loss group, LDL levels improved significantly from year 1 to year 4, and HDL was significantly improved in the large weight-loss group.
Among the no weight-loss group, moderate weight-loss/full-regain and large weight-loss/full-regain groups, there were no significant differences in any of the CVD risk factors at year 4 except for HbA1c level. Better long-term outcomes existed in the large weight-loss/full-regain group compared with the moderate weight-loss/full-regain group.
Compared with the moderate weight-loss group, the large weight-loss/partial-regain group had better mean risk factor changes for HbA1c levels (P = .005), HDL (P = .06) and triglycerides (P = .07).
“On average, participants who had an 8% to 20% weight loss at 1 year maintained their weight loss at year 4 (ie, regained < 3% between years 1 and 4) and achieved sustained improvements in levels of HbA1c, [systolic BP], triglycerides and HDL-[cholesterol],” the researchers wrote. “Even those who regained part of this weight loss over the next several years still had significant improvements in several of these parameters at 4 years relative to their baseline. Finally, we found that participants who lost 8% to 20% at 1 year and regained some or all of their weight loss had better long-term changes in HbA1c levels than those with more modest initial weight loss.” – by Amber Cox
Disclosure: The researchers report no relevant financial disclosures.
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