Type 2 diabetes: Weight regain reduces cardiovascular benefits

Recent studies have shown that people with type 2 diabetes who lose weight lower their risk of cardiovascular problems. But what happens if, after a time, they regain the weight they had lost?

New research warns that maintaining weight loss is crucial when it comes to reducing diabetes-associated cardiovascular risk.

Overweight and obesity are two of the top risk factors for developing type 2 diabetes, a metabolic condition in which the body is unable to process blood sugar effectively.

Once someone does develop diabetes, doctors will often suggest making dietary adjustments, not just to help keep blood sugar levels in check but also for weight loss.

The aim of this intervention is to help reduce the risk of stroke, heart disease, and other cardiovascular problems that have an association with diabetes.

Studies have confirmed that the more weight a person with diabetes loses, the more their cardiovascular risk diminishes. What happens, though, if a person regains some or all of that weight at some point?

That is the question that researchers from Tufts University in Boston, MA, and the University of Connecticut in Storrs aimed to answer in a recent study.

The study results — which appear in the Journal of the American Heart Association — suggest that maintaining weight loss is just as important as losing weight in the first place when it comes to keeping heart disease and health events, such as stroke, at bay.

Weight loss maintenance is crucial

The research team analyzed the data of 1,561 individuals with type 2 diabetes who took part in the Look AHEAD (Action for Health in Diabetes) trial. The program helped participants lose weight by forming more healthful eating habits and increasing their levels of physical activity.

The participants also received standard care for type 2 diabetes, which included information on managing this condition and targeted support.

The current trial looked at the data from participants who had an initial weight loss of at least 3% body weight as part of the 1 year intensive lifestyle intervention. They also looked at the follow-up data that Look AHEAD collected 4 years after the lifestyle intervention.

As part of the 3 year maintenance phase following the 1 year intervention, the participants attended monthly group meetings. They also continued to receive dietary recommendations and to participate in their physical activity program.

The researchers found that the people who had regained all or some of the weight that they had initially lost experienced a “deterioration” of the cardiovascular risk reduction that weight loss had provided.

In contrast, individuals with type 2 diabetes who had shed at least 10% of their initial body weight as part of the trial and managed to keep at least 75% of that weight off over the 4 year follow-up period maintained the cardiovascular benefits or even experienced an increase in risk reduction.

The risk factors that improved in people who lost weight and then maintained this weight loss included high density lipoprotein cholesterol (also known as “good” cholesterol), triglycerides, glucose (sugar), blood pressure, waist circumference, and overall diabetes symptom control.

“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,” says senior author Prof. Alice Lichtenstein.

The bottom line is that maintaining the majority of the weight loss is essential to reducing cardiovascular risk.”

Senior author Prof. Alice Lichtenstein

Going forward, the researchers note that it is important to keep assessing the long term effects of regaining weight following a weight loss program to understand how it affects health risk in the context of a type 2 diabetes diagnosis. They also state that it is important to focus on helping people maintain the initial weight loss to improve health outcomes.

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