Effects Of Rebound After Weight Loss On Coronary Heart Disease Risk Factors

Abstract

Many studies have revealed that comprehensive lifestyle therapy, involving diet, exercise, and behavioral modification, can lead to weight losses of 2 to 10 kg over 10 to 20 weeks and reduce coronary heart disease (CHD) risk factors. To sustain the effects of lifestyle therapy, long-term maintenance of the reduced weight would be required. However, many persons experience weight gain after relapsing toward their pre-intervention lifestyle. Few reports are currently available to indicate how much weight gain will reverse the effects on CHD risk factors. PURPOSE To examine longterm weight changes and correlative changes in CHD risk factors. METHODS One hundred fourteen overweight and obese women (age 46.5 ± 8.0 years, BMI 27.6 ± 2.8 kg/m2) were assigned to 2 groups: diet only (n = 35) and diet and exercise (n = 79). The women had participated in a 14-week weight-loss program and were retested 2 to 5 (3.6 ± 1.4) years later. RESULTS The mean weight before and after the program, and at follow-up was 67.7 ± 7.5 kg, 59.1 ± 7.0 kg, and 63.2 ± 8.0 kg, respectively. With the moderate rebound of weight, total cholesterol (219 ± 32 mg/dl, 197 ± 29 mg/dl, 218 ± 35 mg/dl), triglycerides (109 ± 84 mg/dl, 68 ± 29 mg/dl, 95 ± 57 mg/dl), and low-density lipoprotein cholesterol (133 ± 29 mg/dl, 120 ± 26 mg/dl, 134 ± 32 mg/dl) rebounded completely, while systolic blood pressure (132 ± 18 mmHg, 121 ± 15 mmHg, 123 ± 17 mmHg) and diastolic blood pressure (82 ± 10 mmHg, 76 ± 9 mmHg, 76 ± 11 mmHg) did not change after the program. Moderate rebounds were found in fasting plasma glucose (98 ± 25 mg/dl, 88 ± 13 mg/dl, 92 ± 15 mg/dl) and visceral fat (94.7 ± 49.5 cm2, 58.9 ± 34.5 cm2, 68.3 ± 41.1 cm2). No significant group differences in terms of rebound were found, although systolic blood pressure significantly regained in the diet only group, and visceral fat significantly regained in the diet and exercise group. CONCLUSIONS Weight gain (+3.9 kg) after weight loss (−8.6 kg) may reverse effects on CHD risk factors. Greater efforts to maintain reduced weight are needed for preventing CHD. Supported partly by Uehara Memorial Foundation, the 21st century COE program, and Tsukuba Advanced Research Alliance (TARA).