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“Our findings show that at a population level, the greater the dispersion in BMI, the more [body mass index] “They have a higher risk of adverse cardiovascular events than people with less variation in BMI,” says Zakaria Almwaqat, MD, MPH, co-author of the study. He is a hospital internist and postdoctoral fellow in cardiovascular disease at Emory Healthcare in Atlanta.
About half of Americans do weight cycling.
The more weight you gain or lose, the greater your heart risk.
The study used data from two large cohorts: the Million Veterans Program, which included more than 92,000 US veterans, and the UK Biobank, which included 65,000 people.
The average age of the veteran group was 57 years and 88% were male. 10 percent were Hispanic, 24 percent were black, and 65 percent were white. The mean BMI was 30, and BMI measurements were taken multiple times over an average of 10 years. At least three measurements were required to participate in the study.
The average age of the UK group was also 57 years and 41.5 per cent were male. All subjects were white and had an average BMI of 27, which was significantly lower than the average for the veteran group.
Weight cycling was measured by averaging BMI measurements over the study period. For example, if one subject has three different her BMI measurements: 30, 31, and 32, the mean would be 31 and the standard deviation would be 1.
Participants were followed for approximately four years. During that time, researchers tracked the number of heart attacks, strokes, and deaths from heart disease.
Researchers found that weight cycling was associated with an increased risk of negative cardiovascular events in all racial and ethnic groups. In the veteran cohort, each standard deviation increase in BMI variation was associated with a 16 percent increased risk of cardiovascular events, including nonfatal heart attack, stroke, and death from heart disease.
In the UK Biobank cohort, each 1 standard deviation increase in BMI variation was associated with an 8% higher risk of cardiovascular death.
“We found that large changes in BMI correlated with a higher risk of adverse cardiovascular events in a dose-dependent manner,” says Dr. Almuwaqqat.
The study used each subject’s individual weight to calculate the standard deviation, making it difficult to pinpoint the exact amount of weight variation that would be considered high risk, Duke Health cardiologists said. says Dr. Nishant Shah. Durham, N.C., was not involved in this study.
“Instead, rapid changes over time, such as losing 20 pounds from baseline over 6 months and then gaining 20 pounds from baseline, are more likely to cause cardiovascular problems than sustained 20 pound weight loss.” “Consider it high risk, that’s what the research says,” he says.
Risks of weight cycling influenced by race and ethnicity
Researchers also found that the associated risks varied by race and ethnicity. The association between weight cycling and stroke was stronger in black participants, and the association between weight cycling and cardiovascular death was higher in white participants. The authors noted that risk may be influenced by race and gender, as the association was not as strong in the UK group.
Weight cycling can put extra stress on your heart
Dr. Shah says it’s unclear exactly why weight cycling may increase your risk of heart disease. “There are many hypotheses. For example, rapid changes in weight may put extra stress on the heart, causing vascular dysfunction or further inflammation of fatty tissue,” he says.
Rapid changes in weight can also be caused by other medical conditions, such as cancer, infections, and inflammatory diseases, which can put additional stress on people who already have heart disease. Shah says.
Striving for a healthy weight still has health benefits
The findings here don’t mean people should abandon all efforts to achieve a healthy weight, Shah says. “There are many benefits to weight loss, and people should strive to find ways to achieve sustainable weight loss,” he says.
He points out that obesity can lead to several serious comorbidities, including high blood pressure, high cholesterol, and type 2 diabetes, which can worsen overall heart disease risk.
“It’s also very difficult to draw many conclusions based on just one study. More data is needed to better understand the magnitude of BMI variation, which is of most concern,” he said. say.
It’s also worth noting that the veteran cohort included a much higher proportion of men than women, suggesting other risks and factors that the researchers didn’t account for led to this finding. That’s possible, Shah says.
Should these findings be a concern for people taking GLP-1 intermittently?
This study did not include people taking GLP-1. The data cannot answer this question because the participants had changes in BMI that were not caused by the medication, al-Mwaqat said.
“GLP-1 use is generally associated with reduced cardiovascular risk, but the impact of weight change in these populations is not clear,” he says.
GLP-1 drugs have several benefits when prescribed and taken properly, Shah says. “At the end of the day, it’s a very specific benefit-versus-risk assessment for the patient. Patients should have a conversation with their health care provider about what’s right for them,” he says.
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