Maintained weight loss improves cardiometabolic risk factors in diabetes
Among patients with diabetes who lost weight, those who maintained their weight loss significantly improved their cardiometabolic risk factors compared with those who regained weight, according to a study published in the Journal of the American Heart Association.
The benefits, including improvements in HDL, triglycerides, glucose, BP, waist circumference and diabetes control, were greatest among patients who lost at least 10% of their body weight and maintained at least 75% of their weight loss at 4 years, according to the researchers.
Maintaining weight loss
“Our findings suggest that in addition to focusing on weight loss, an increased emphasis should be placed on the importance of maintaining the weight loss over the long term,” Alice H. Lichtenstein, DSc, director of the cardiovascular nutrition laboratory at the Human Nutrition Research Center on Aging at Tufts University, said in a press release. “The bottom line is that maintaining the majority of the weight loss is essential to reducing cardiovascular risk.”
According to the study, at 1 year, patients who lost at least 10% of their initial weight experienced greater improvements than those who lost less than 10% in the following cardiometabolic risk factors:
- HDL, 1.18 mmol/L vs. 1.07 mmol/L in men (P < .0001); 1.37 mmol/L vs. 1.31 mmol/L in women (P = .016);
- mean triglycerides, 1.08 mmol/L vs. 1.46 mmol/L in men; 1.33 mmol/L vs. 1.56 mmol/L in women (P < .0001 for both);
- mean glucose, 6.65 mmol/L vs. 7.22 mmol/L in men; 6.55 mmol/L vs. 7.17 mmol/L in women (P < .0001 for both);
- mean waist circumference, 103.8 cm vs. 112.1 cm in men; 98.5 cm vs. 103.1 cm in women (P < .0001 for both);
- HbA1c, 6.1% vs. 6.6% in men; 6.3% vs. 6.7% in women (P < .0001 for both);
- systolic BP, 117.6 mm Hg vs. 133.7 mm Hg in men (P = .0001); and
- diastolic BP, 67.5 mm Hg vs. 70.3 mm Hg in men (P = .0001); 63.9 mm Hg vs. 66.2 mm Hg in women (P = .0002).
Patients who maintained their weight loss after 4 years were more likely to retain the cardiometabolic benefits from weight loss than patients who did not, according to the researchers.
Impact of weight regain
“The relationship between cardiometabolic risk factors and weight regain varied by sex and risk factor: Men and women responded similarly to weight regain on the basis of fasting glucose and HbA1c concentrations, but differently on the basis of plasma lipid concentrations and blood pressure,” Lichtenstein and colleagues wrote. “No single cut point of percentage weight loss regained was identied to maximize risk difference between individuals with successful weight loss maintenance and individuals who regained weight, but maintaining 75% of weight loss was generally benecial.”
Using data from the Look AHEAD trial, researchers analyzed participants with at least 3% initial weight loss (n = 1,561; mean age for men, 60 years; mean age for women, 58 years), accomplished during a 1-year intensive lifestyle intervention, to determine the effect of weight regain on cardiometabolic risk factors.
With 4-year follow-up data of patients who maintained weight loss or regained weight, researchers compared the change in cardiometabolic risk factors after initial weight loss, controlling for demographics, medications, and baseline and year 1 change in BMI. Additionally, the data were assessed separately in participants with less than 10% and at least 10% initial weight loss, and men and women.
“The ndings from this study emphasize the need to further investigate long-term impact of partial weight regain after a weight loss intervention given the challenge of keeping off all of weight lost,” the researchers wrote. – by Scott Buzby
Disclosures: The authors report no relevant financial disclosures.