Body Weight Swings Linked to Cardiovascular Events, Death in Type 2


Experiencing fluctuations in body weight — outside the context of a lifestyle intervention program aimed at weight loss — is linked to a higher risk for serious cardiovascular events and death in people with type 2 diabetes, according to a new study published in the journal JAMA Network Open.

There is a large amount of evidence supporting the potential benefits of weight loss in people with obesity and type 2 diabetes. Losing weight has been shown to help improve insulin sensitivity and pancreatic beta cell function, regardless of whether it’s the result of dietary changes or bariatric (weight-loss) surgery. In people with type 2 who undergo bariatric surgery, the likelihood of experiencing diabetes remission — having normal blood glucose levels without the help of any oral or injected drugs, including insulin — is linked to the amount of weight lost following the surgery. In addition to bariatric surgery, low-calorie diets and meal replacements have been found to be effective for weight loss and diabetes remission. And in people with diabetes who have peripheral neuropathy, losing weight has been shown to potentially help relieve symptoms like numbness, burning, or tingling in the legs and feet.

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For the latest study, researchers looked at the variability of body weight in 3,604 adults with type 2 diabetes who took part in a clinical trial of an intensive lifestyle intervention — which was aimed at weight loss and other health improvements related to diabetes. But while some participants were assigned to take part in this intervention, others were assigned to a control (comparison) group. Over the course of four annual visits, all participants had their body-mass index (BMI, a measure of body weight that takes height into account) and waist circumference measured. They also had various health outcomes tracked, including any heart attacks or strokes, deaths from heart attacks or strokes, and death from all causes.

Over the course of the study’s follow-up period — a median of 6.7 years for each participant — there were 216 cardiovascular events (heart attacks and strokes), 33 deaths from cardiovascular events, and 166 total deaths. The researchers compared variability in BMI over the course of the study with these outcomes separately in the control group and in the intensive lifestyle intervention group.

High BMI variability not due to lifestyle changes linked to increased risk of cardiovascular events

In the control group, participants who fell in the top quarter of BMI variability — compared with those in the bottom quarter, whose BMI didn’t fluctuate much — were 4.06 times as likely to die of all causes, 15.28 times as likely to die from a cardiovascular event, and 2.16 times as likely to experience a cardiovascular event. In the lifestyle intervention group, participants who fell in the top quarter of BMI variability — compared with those in the bottom quarter — were 0.99 times as likely to die of all causes, 1.14 times as likely to die from a cardiovascular event, and 0.77 times as likely to experience a cardiovascular event.

The researchers concluded that in people with type 2 diabetes who weren’t assigned to a lifestyle intervention, having a fluctuating body weight was linked to significantly greater risks for cardiovascular events and death — especially death from a cardiovascular event. In people who were assigned to a lifestyle intervention, on the other hand, body weight changes were not significantly linked to these risks. These results suggest that large body weight changes that aren’t the result of consistent lifestyle changes may be harmful, while weight loss that results from consistently healthy lifestyle changes appears to be neutral or potentially beneficial when it comes to cardiovascular events and death.

Want to learn more about protecting your heart? Read “Be Heart Smart: Know Your Numbers,” “Does Diabetes Hurt Your Heart?” “Fight Off Heart Disease With These Five Heart-Healthy Foods” and “Lower Your Risk of Heart Disease.”

Originally Published March 22, 2022





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