title: Weight cycling and high-density lipoprotein cholesterol in women: evidence of an adverse effect: a report from the NHLBI-sponsored WISE study. Women's Ischemia Syndrome Evaluation Study Group.
abstract: OBJECTIVE
  We undertook an analysis of weight cycling, coronary risk factors and angiographic coronary artery disease (CAD) in women.
  
  
  BACKGROUND
  The effect of weight cycling on cardiovascular mortality and morbidity is controversial, and the impact of weight cycling on cardiovascular risk factors is unclear.
  
  
  METHODS
  This is a cross-sectional population study of 485 women with coronary risk factors undergoing coronary angiography for evaluation of suspected myocardial ischemia enrolled in the Women's Ischemia Syndrome Evaluation (WISE). Reported lifetime weight cycling-defined as voluntary weight loss of at least 10 lbs at least 3 times--coronary risk factors including core laboratory determined blood lipoproteins and CAD, as determined by a core angiographic laboratory, are the main outcome measures.
  
  
  RESULTS
  Overall, 27% of women reported weight cycling--19% cycled 10 to 19 lbs, 6% cycled 20 to 49 lbs, and 2% cycled 50+ lbs. Reported weight cycling was associated with 7% lower high-density lipoprotein cholesterol (HDL-C) levels in women (p = 0.01). The HDL-C effect was directly related to the amount of weight cycled with women who lost > or = 50 lbs/cycle having HDL-C levels 27% lower than noncyclers (p = 0.0025). This finding was independent of other HDL-C modulators, including estrogen status, physical activity level, alcohol intake, body mass index, diabetes, beta-blocker use, cigarette smoking and race. Weight cycling was not associated with an increased prevalence of CAD in this population.
  
  
  CONCLUSIONS
  Weight cycling is associated with lower HDL-C in women of a magnitude that is known to be associated with an increased risk of cardiac events as demonstrated in prior clinical trials.
authors.affiliation: Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pennsylvania 15261, USA. olson@edc.gsph.pitt.edu
authors.forename: M B
authors.initials: MB
authors.lastname: Olson
authors.forename: S F
authors.initials: SF
authors.lastname: Kelsey
authors.forename: V
authors.initials: V
authors.lastname: Bittner
authors.forename: S E
authors.initials: SE
authors.lastname: Reis
authors.forename: N
authors.initials: N
authors.lastname: Reichek
authors.forename: E M
authors.initials: EM
authors.lastname: Handberg
authors.forename: C N
authors.initials: CN
authors.lastname: Merz
mesh_terms: D015992:Body Mass Index; D008076:Cholesterol, HDL / Q000097:blood*; D003327:Coronary Disease / Q000453:epidemiology* / Q000209:etiology*; D003430:Cross-Sectional Studies; D004038:Diet, Reducing / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008875:Middle Aged; D012307:Risk Factors; D015430:Weight Gain; D015431:Weight Loss
chemical_list: D008076:Cholesterol, HDL