Clinical Edge

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Unintentional vs Intentional Weight Loss and CVD

Metab Syndr Relat Disord; ePub 2019 Feb 7; Cui, et al

Substantial unintentional weight loss (UWL) may be accompanied or preceded by other biological changes that alter changes in cardiovascular disease (CVD) risk factors associated with intentional weight loss (IWL). This according to a recent study that examined annual changes in blood pressure and lipids associated with UWL vs IWL in 576 participants from the Coronary Artery Risk Development in Young Adults (CARDIA) study who had lost weight over 1 of 2 time intervals (ie, study years 5–7 or 7–10) and reported whether the weight loss was intentional at the end of the interval. They found:

  • After adjusting for age, sex, race, and field center, an annual weight loss <6% resulted in small improvements in lipids that were similar regardless of intentionality.
  • When annual weight loss was ≥6%, UWL was associated with less reduction in total cholesterol (−0.2 vs −10.4 mg/dL), low-density lipoprotein cholesterol (−3.2 vs −9.4 mg/dL), and triglycerides (−0.5 vs −19.0 mg/dL) compared with IWL.
  • Intentionality was not associated with the size of changes in blood pressure (systolic blood pressure: −2.7 vs −2.0 mmHg; diastolic blood pressure: −2.2 vs −1.3 mmHg) and high-density lipoprotein cholesterol (3.2 vs 2.7 mg/dL).

Cui Z, Cai J, Lewis CE, Stevens J. Changes in cardiovascular disease risk factors with unintentional versus intentional weight loss: The Coronary Artery Risk Development in Young Adults Study. [Published online ahead of print February 7, 2019]. Metab Syndr Relat Disord. doi:10.1089/met.2018.0114.