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   PID: hpt/lnx 1.9.0-cur 2019-01-08   
   TID: hpt/lnx 1.9.0-cur 2019-01-08   
    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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