A recent study that looked at information from more than 20,000 American adults found that eating better and exercising more led to weight loss that reduced the risk of heart disease, but skipping meals and taking diet pills did not. results in little weight loss, weight stabilization, or weight gain.
The research was published recently in the Journal of the American Heart Association. However, the study results indicated that many of the study sample did not have their cardiovascular disease risk factors eliminated, even after losing 5% of their “clinically significant” body weight.
In fact, regardless of reported weight changes, whether up or down, the average composite score on eight risk factors for heart disease was the same across the entire sample of the study.
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The study is the first to compare weight loss strategies and outcomes in the context of the American Heart Association’s “Life’s Essential 8,” a checklist promoting heart disease risk reduction through research of recommended measurements for body weight, blood pressure, cholesterol, blood sugar, smoking, physical activity, diet and sleep.
The AHA first defined a construct of cardiovascular health with “Life’s Simple 7” measures in 2010, and updated recommendations to “Life’s Essential 8” in June 2022.
The Ohio State University researchers found that overall, American adults had an average score of 60 out of 100 on all eight measures, suggesting there is plenty of room for improvement, even among those whose diet and exercise behaviors helped move the needle on some measures.
“Life’s Essential 8 is a valuable tool that provides the building blocks for cardiovascular health, many of which are modifiable through behavioral change,” said study lead author Colleen Spees, associate professor of medical dietetics. at the Ohio School of Health and Rehabilitation Sciences. State.
“Based on the results of this study, we have a lot of work to do as a country,” she said. “Even though there were significant differences on several parameters between the groups, the fact remains that, overall, adults in this country do not adopt the 8 essential life behaviors that are directly correlated to heart health.”
Data for the analysis comes from 20,305 US adults aged 19 or older (average age 47) who participated in the National Health and Nutrition Survey (NHANES) between 2007 and 2016. participants indicated their smoking status, their physical activity, their average number of hours of sleep. per night, weight history and weight loss strategy, and what they had eaten in the previous 24 hours. Health exams and lab tests measured their body mass index, blood pressure, LDL (bad) cholesterol and blood sugar levels.
The Ohio State researchers used the data to determine the individuals’ values for Life’s Essential 8 parameters and rated the quality of their diet according to the Healthy Eating Index, which assesses adherence to US dietary guidelines for Americans.
Within the sample, 17,465 people had lost less than 5% of their body weight, maintained their weight or gained weight in the past year. The other 2,840 reported an intentional loss of at least 5% of their body weight during the same period.
“Clinically meaningful weight loss leads to improvements in some health indices,” Spees said. “People should be hopeful knowing that losing just 5% of their body weight is significant in terms of clinical improvements. It’s not a huge weight loss. It’s achievable for most, and I hope this inspires people instead of being paralyzed by a fear of failure.”
In this study, adults with clinically significant weight loss reported better diet quality, particularly with better scores on protein, refined grains and added sugars intakes, as well as more moderate physical activity and vigorous and lower LDL cholesterol than the group without clinically significant weight. loss. On the other hand, the weight loss group also had a higher average BMI and HbA1c blood sugar measurement and fewer hours of sleep, all measurements that would lower their Life’s Essential 8 composite score.
A greater proportion of people who did not lose at least 5% of their weight reported skipping meals or using prescription diet pills as weight loss strategies. Additional strategies reported by this group included low carbohydrate and liquid diets, taking laxatives or vomiting, and smoking.
“We’ve seen that people still gravitate towards unevidence-based approaches to weight loss that aren’t sustainable. What’s sustainable is changing behaviors and eating habits,” Spees said. .
With federal data estimating that more than 85% of the US adult population will be overweight or obese by 2030 (compared to the current rate of 73%), Spees said that to combat the related increase in heart disease and other health problems, a paradigm shift towards prevention is needed.
“We definitely need to move towards disease prevention rather than waiting for people to be diagnosed with a disease. It becomes quite overwhelming, and individuals may think it’s too late at this point,” he said. she stated.
One idea to consider, she said, would be prescriptions for regular visits with dietitians trained in behavior change, with insurance reimbursement similar to physical therapy.
“We have fantastic research, we have amazing educators,” she said. “What we don’t have is a policy that promotes optimal health across the lifespan, from pregnancy to adulthood.”