Patterns of weight change associated with long-term weight change and cardiovascular disease risk factors in the Look AHEAD Study.
This article provides an assessment of the associations that weight-loss patterns during the first year of an intensive lifestyle intervention have with 4-year maintenance and health outcomes. Two components described patterns of weight change during the first year of intervention: one reflected the typical pattern of weight loss over the 12 months, but distinguished those who lost larger amounts across the monthly intervals from those who lost less. The second component reflected the weight change trajectory, and distinguished a pattern of initial weight loss followed by regain vs. a more sustained pattern of weight loss. Two thousand four hundred and thirty eight individuals aged 45-76 years with type 2 diabetes mellitus, who enrolled in the weight-loss intervention of a randomized clinical trial, were assigned scores according to how their weight losses reflected these patterns. Relationships these scores had with weight losses and health outcomes (glycosolated hemoglobin--hemoglobin A1c (HbA1c); systolic blood pressure, high-density lipoprotein (HDL)-cholesterol, and triglycerides) over 4 years were described. When compared to those with lower scores on the two components, both individuals who had larger month-to-month weight losses in year 1 and whose weight loss was more sustained during the first year had better maintenance of weight loss over 4 years, independent of characteristics traditionally linked to weight loss success (P < 0.001). While relationships with year 4 weight loss were stronger, the pattern of larger monthly weight loss during year 1 was also independently predictive of year 4 levels of HbA1c, HDL-cholesterol, and systolic blood pressure.
Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA.
Rebecca H
RH
Neiberg
Rena R
RR
Wing
George A
GA
Bray
David M
DM
Reboussin
Amy D
AD
Rickman
Karen C
KC
Johnson
Abbas E
AE
Kitabchi
Lucy F
LF
Faulconbridge
Dalane W
DW
Kitzman
Mark A
MA
Espeland
D000368:Aged; D015415:Biomarkers / Q000097:blood; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000503:physiopathology / Q000517:prevention & control*; D008076:Cholesterol, HDL / Q000097:blood; D003863:Depression / Q000453:epidemiology; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000453:epidemiology / Q000503:physiopathology; D003925:Diabetic Angiopathies / Q000453:epidemiology / Q000503:physiopathology / Q000517:prevention & control*; D004032:Diet; D015444:Exercise; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology / Q000503:physiopathology / Q000517:prevention & control*; D040242:Risk Reduction Behavior; D013997:Time Factors; D014481:United States / Q000453:epidemiology; D015430:Weight Gain; D015431:Weight Loss
D015415:Biomarkers; D008076:Cholesterol, HDL; D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human