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This article originally posted and appeared in  CardiovascularObesityAging & DiabetesIssue 731

Losing Weight at Any Age Can Improve Cardiovascular Health

Weight loss at any age in adulthood is worthwhile because it could yield long-term heart and vascular benefits.... 

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The results are from a study ongoing from 1946, examining the impact of lifelong patterns of weight change on cardiovascular risk factors in a group of British men and women followed since birth. They showed that the longer the exposure to excess body fat (adiposity) in adulthood the greater the cardiovascular-related problems in later life, including increased thickness of the carotid artery walls, raised systolic blood pressure, and increased risk of diabetes.

For the first time, the findings also indicate that adults who drop a BMI category - from obese to overweight, or from overweight to normal at any time during adult life, even if they regain weight, can reduce these cardiovascular manifestations.

The study used data from 1273 men and women from the UK Medical Research Council National Survey of Health and Development (NSHD). Participants were classified as normal weight, overweight, or obese in childhood and at 36, 43, 53, and 60-64 years of age. Cardiovascular phenotyping between the ages of 60 and 64 years with carotid intima media thickness (cIMT; a surrogate marker for cardiovascular events) was used to assess the effect of lifetime exposure to adiposity on cardiovascular risk factors.

Professor John Deanfield, lead author, from University College London (UCL) said, "Our study is unique because it followed individuals for such a long time, more than 60 years, and allowed us to assess the effect of modest, real-life changes in adiposity. Our findings suggest that losing weight at any age can result in long-term cardiovascular health benefits, and support public health strategies and lifestyle modifications that help individuals who are overweight or obese to lose weight at all ages."

Elizabeth Cespedes and Frank Hu from the Harvard School of Public Health, Boston, USA, commented on the study, "Although it is encouraging that even transitory weight loss during adulthood has cardiovascular benefits, only 2% of participants in the present study had a sustained reduction in BMI category in adulthood, underscoring the importance of weight maintenance and prevention of weight gain as priorities for public health programming and policy. Improvements in diet and increases in physical activity are crucial levers of long-term weight maintenance and prevention of weight gain in middle-age and early adulthood. Overweight individuals might have even greater health benefit from lifestyle changes such as increased physical activity than do normal weight individuals. The results of this study affirm a continued emphasis on public health policies that enable lifestyle changes to achieve and, especially, to maintain a healthy BMI."

They add that, "Ideally, future research will address long-term patterns of intentional versus unintentional weight loss, the means to achieve weight loss, and the weight loss maintenance necessary to reduce cardiovascular endpoints."

Practice Pearls:
  • The longer the exposure to excess body fat (adiposity) in adulthood the greater the cardiovascular-related problems in later life
  • Dropping a BMI category - from obese to overweight, or from overweight to normal - at any time during adult life, even if they regain weight, can reduce cardiovascular problems.
  • The conclusion from the study affirms that a continued emphasis on public health policies that enable lifestyle changes to achieve and, especially, to maintain a healthy BMI, is needed.

Lifelong patterns of BMI and cardiovascular phenotype in individuals aged 60–64 years in the 1946 British birth cohort study: an epidemiological study, Marietta Charakida, Tauseef Khan, William Johnson, Nick Finer, John Woodside, Peter H Whincup, Naveed Sattar, Diana Kuh, Rebecca Hardy, John Deanfield, The Lancet Diabetes & Endocrinology, DOI: 10.1016/S2213-8587(14)70103-2, published online 21 May 2014. 

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This article originally posted 29 May, 2014 and appeared in  CardiovascularObesityAging & DiabetesIssue 731

Past five issues: Diabetes Clinical Mastery Series Issue 247 | Issue 787 | Diabetes Clinical Mastery Series Issue 246 | SGLT-2 Inhibitors Special Edition June 2015 | Issue 786 |

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