A new study analyzing data on more than 20,000 US adults linked a healthy diet and increased exercise for weight loss to a lower risk of heart disease, skipping meals and minimal weight loss, weight maintenance or taking prescription diet pills with weight gain.
For many in the study sample, however, losing a “clinically significant” 5% of their body weight did not eliminate their risk factors for heart disease, the results showed. In fact, the mean composite score across the eight risk factors for heart disease was similar across the entire study population—regardless of reported weight changes, up or down.
This research was recently published in the Journal of the American Heart Association.
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The study is the first to compare weight loss strategies and outcomes with respect to the American Heart Association’s “Life’s Essential 8,” a checklist that promotes reducing the risk of heart disease by tracking recommended metrics for body weight, blood pressure, cholesterol, and blood pressure. Sugar, smoking, physical activity, diet and sleep. The AHA first defined the construct of cardiovascular health with “Life’s Simple 7” metrics in 2010, and updated the recommendations to “Life’s Essential 8” in June 2022.
Ohio State University researchers found that overall, U.S. adults scored an average of 60 out of 100 on the eight measures—suggesting there’s plenty of room for improvement even as diet and exercise behaviors help move the needle on some metrics.
“The 8 Essentials of Life are a valuable tool for providing key components for cardiovascular health, many of which can be modified through behavioral changes,” said Colleen Spees, associate professor of medical dietetics at Ohio State’s School of Health and Rehabilitation Sciences. State.
“Based on the findings of this study, we have a lot of work to do as a country,” she said. “Despite significant differences in many parameters between groups, the fact remains that as a whole, adults in this country are not adopting the 8 essential lifestyle behaviors that are directly related to heart health.”
Data for the analysis came from 20,305 US adults 19 or older (mean age 47 years) who participated in the National Health and Nutrition Examination Survey (NHANES) between 2007 and 2016. Participants reported their smoking status, physical activity, and average hours of sleep. per night, weight history and weight loss strategy, and what they ate in the previous 24 hours. Health examinations and laboratory tests measured their body mass index, blood pressure, LDL (bad) cholesterol and blood glucose.
Ohio State researchers used the data to determine people’s values for 8 essential life metrics and rated their diet quality according to the Healthy Eating Index, which measures adherence to the U.S. Dietary Guidelines for Americans.
Within the sample, 17,465 individuals lost less than 5% of their body weight, maintained their weight, or gained weight in the past year. Another 2,840 reported intentionally losing at least 5% of their body weight during the same time frame.
“Clinically significant weight loss improves some health indices,” Spies said. “People should feel hopeful knowing that losing just 5% of their body weight is meaningful in terms of clinical improvements. It’s not a huge weight loss. It’s achievable for many, and I hope that encourages people rather than paralyzes them. Fear of failure .”
In this study, adults with clinically significant weight loss reported higher diet quality, particularly better scores on intake of protein, refined grains and added sugars, as well as more moderate and vigorous physical activity and lower LDL cholesterol than the group without clinically significant weight loss. loss On the other hand, the weight loss group had higher average BMI and HbA1c blood sugar measurements and fewer hours of sleep — all metrics that lowered their overall quality of life Essential 8 score.
A large proportion of people who did not lose at least 5% of their weight reported skipping meals or using prescription diet pills as a weight loss strategy. Additional strategies reported by this group included low-carbohydrate and liquid diets, laxatives or emetics, and smoking.
“We see that people are still gravitating toward non-evidence-based approaches to weight loss, which are not sustainable. Sustainable means changing behaviors and eating habits,” Spees said.
Federal statistics predict that by 2030, more than 85% of the adult American population will be overweight or obese (compared to the current rate of 73%), a paradigm to prevent the associated increase in cardiovascular disease and other health problems. A shift toward prevention is in order.
“We need to move completely toward disease prevention as opposed to waiting until people are diagnosed with the disease. It’s very overwhelming, and people may realize at that point it’s too late,” she said.
One idea to consider, she said, would be prescriptions for regular appointments with registered dietitians trained in behavior change, complete with insurance reimbursement — like physical therapy.
“We have great research, we have incredible teachers,” she said. “What we don’t have are policies that promote optimal health across the lifespan, from pregnancy to old age.”
Study co-authors included first author Emily Hill (supported by a National Center for Advancing Clinical Science Fellowship), Lauren Kubellis, Randall Wexler and Christopher Taylor.
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