By Linda Carroll -
NBC News
Losing weight -- even if you gain back a few pounds -- can help your heart in the long run, according to a study published Tuesday in the journal Circulation: Cardiovascular Quality and Outcomes.
These findings may be good news for those who have difficulty maintaining weight and fear the risks associated with recovery.
In the new study, the researchers analyzed data from 124 clinical trials with a total of more than 50,000 participants.
They found that risk factors for heart disease and type 2 diabetes decreased in people who lost weight through intensive behavioral programs.
The decreased risk persisted for years after the programs ended, even if some, but not all, of the lost weight was regained.
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"For as long as weight is lower than it otherwise would have been, risk factors for heart disease are lower than they would have been," study co-author Susan Jebb, a professor of diet and population health at the University of Oxford, UK.
In the US, 2 out of 5 adults are obese, according to the Centers for Disease Control and Prevention (CDC), and heart disease is the leading cause of death, with 697,000 deaths in 2020 .
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The new analysis included trials that looked at the impact of behavioral weight-management programs - those that provided, for example, counselling, training and education - on heart disease risk factors and that had follow-up periods of at least one year.
The median follow-up of the trials was 28 months.
The included studies compared people who participated in these intensive weight loss programs with those who followed less intensive programs or did not follow any programme.
Studies in the analysis included dietary or exercise interventions, or both, partial or full meal replacement, intermittent fasting, or financial incentives contingent on weight loss.
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The researchers found that the average weight loss in the included studies was 5 to 10 pounds, while the average weight regain was 5 to 8 pounds per year.
The average age of the participants at the start of the study was 51 and their average body mass index was 33, meaning they were obese.
Compared with control groups, participants in the intensive programs improved in several risk factors for heart disease:
Systolic blood pressure, on average, was 1.5 points lower one year later and still 0.4 points lower five years later.
Systolic pressure is the top number of a blood pressure reading.
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HbA1c, an indicator of a person's blood sugar level over the previous three months, decreased with weight loss and, although it started to rise again with weight regain, was still better compared to the control group one year and five years after completing the studies.
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The ratio of total cholesterol to HDL cholesterol, an indicator of LDL cholesterol levels, improved with weight loss, although those improvements were smaller as people regained weight.
Jebb acknowledged that improvements with weight loss start to reverse as a person gains weight again, but "at least the metabolic load on the body has been reduced for a period of time," adding: "That may be enough to delay the onset of diabetes, for example, which has great benefits for the heart.”
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The overall results suggested that the risk of developing diabetes or having a heart attack was also reduced, but there is less information on this, "because most trials do not have long follow-up," Jebb said.
A subset of the studies that did look at the risk of being diagnosed with heart disease or type 2 diabetes found that people who participated in intensive programs had a lower risk compared with those in control groups.
And the risk was still lower even after gaining weight.
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Dr. Sean Heffron, a preventive cardiologist and assistant professor of medicine at NYU Langone and the NYU Center for Cardiovascular Disease Prevention, agreed that what is still needed is information about the long-term impact on "the outcomes that really we care about: heart attack, stroke and death.”
"The people in this study were relatively young, and it takes a long time for people to die" of heart disease, he said.
Still, the results "support what we see clinically with various cardiovascular risk factors," said Heffron, who was not involved in the new research.
“They respond quite well to weight loss, even when the amounts are not large,” she added.
Dr. Matthew Tomey, an interventional cardiologist and associate professor of medicine and cardiology at New York's Icahn School of Medicine at Mount Sinai, compared weight loss episodes to money going into a bank account.
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Losing weight at any point in life brings gains through amelioration of risk factors, and that "is a health-promoting investment that pays off," said Tomey, who was not involved in the study. investigation.
“The reality is that it can be very difficult to reach and maintain a target body weight.
That doesn't mean you have to give up the search,” she said.
