Summary: A recent study on more than 20,000 U.S. adults indicates that individuals adopting healthier diets and exercising more were linked to weight loss that reduces the risk of heart disease. In contrast, those who skipped meals or took prescription diet pills saw little to no weight loss, weight maintenance, or even weight gain.
While the majority of participants who achieved a “clinically significant” 5% weight loss still exhibited cardiovascular disease risk factors, the American Heart Association’s “Life’s Essential 8” guidelines remain a useful tool in promoting heart disease risk reduction through the pursuit of recommended metrics for body weight, blood pressure, cholesterol, blood sugar, smoking, physical activity, diet, and sleep.
- The study is the first to compare weight-loss strategies and results in the context of the American Heart Association’s “Life’s Essential 8,” a checklist promoting heart disease risk reduction through the pursuit of recommended metrics for body weight, blood pressure, cholesterol, blood sugar, smoking, physical activity, diet and sleep.
- Skipping meals and taking prescription diet pills were associated with minimal weight loss, weight maintenance, or weight gain, and the study found that people are still gravitating to non-evidence-based approaches for weight loss, which are not sustainable.
- Adults who reported a clinically significant weight loss of 5% or more of their body weight had better scores on intakes of protein, refined grains, and added sugar, as well as more moderate and vigorous physical activity and lower LDL cholesterol, compared to those who didn’t achieve significant weight loss.
Source: Ohio State University
A new study analyzing data on over 20,000 U.S. adults links a healthier diet and increased exercise to weight loss that reduces heart disease risk – while associating skipping meals and taking prescription diet pills with minimal weight loss, weight maintenance or 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 cardiovascular disease, results showed. In fact, the average composite score on eight risk factors for heart disease was the same across the entirety of the study population – regardless of reported weight changes, up or down.
The study is the first to compare weight-loss strategies and results in the context of the American Heart Association’s “Life’s Essential 8,” a checklist promoting heart disease risk reduction through the pursuit of recommended metrics 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” metrics in 2010, and updated the recommendations to the “Life’s Essential 8” in June 2022.
The Ohio State University researchers found that overall, U.S. adults had an average score of 60 out of 100 on the eight measures – suggesting there is plenty of room for improvement even among those whose diet and exercise behaviors helped move the needle on some metrics.
“The Life’s Essential 8 is a valuable tool that provides the core components for cardiovascular health, many of which are modifiable through behavior change,” said senior study author Colleen Spees, associate professor of medical dietetics in the School of Health and Rehabilitation Sciences at Ohio State.
“Based on the findings in 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 as a whole, adults in this country are not adopting the Life’s Essential 8 behaviors that are directly correlated with heart health.”
The research was published recently in the Journal of the American Heart Association.
Data for the analysis came from 20,305 U.S. adults aged 19 or older (average age of 47) who participated in the National Health and Nutrition Examination Survey (NHANES) between 2007 and 2016.
Participants reported their smoking status, physical activity, average 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 glucose.
The Ohio State researchers used the data to determine individuals’ values for Life’s Essential 8 metrics and assessed their diet quality according to the Healthy Eating Index, which gauges adherence to U.S. Dietary Guidelines for Americans.
Within the sample, 17,465 individuals had lost less than 5% of their body weight, maintained their weight or gained weight in the past year. The other 2,840 reported intentional loss of at least 5% of their body weight in the same time frame.
“Clinically significant weight loss results in improvements in some health indices,” Spees said.
“People should feel hopeful in knowing that losing just 5% of their body weight is meaningful in terms of clinical improvements. This is not a huge weight loss. It’s achievable for most, and I would hope that incentives people instead of being paralyzed with a fear of failure.”
In this study, adults with clinically significant weight loss reported higher diet quality, particularly with better scores on intakes of protein, refined grains and added sugar, as well as more moderate and vigorous physical activity 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 measure and fewer hours of sleep – all metrics that would bring down their composite Life’s Essential 8 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-carb and liquid diets, taking laxatives or vomiting, and smoking.
“We saw that people are still gravitating to non-evidence-based approaches for weight loss, which are not sustainable. What is sustainable is changing behaviors and eating patterns,” Spees said.
With federal data estimating that more than 85% of the adult U.S. population will be overweight or obese by 2030 (compared to the current rate of 73%), Spees said that to fend off related increases in heart disease and other health problems, a paradigm shift toward prevention is in order.
“We absolutely need to be moving toward prevention of disease versus waiting until people are diagnosed with a disease. This becomes quite overwhelming, and individuals may feel it’s too late at that point,” she said.
One idea to consider, she said, would be prescriptions for regular visits with registered dietitians trained in behavior change, complete with insurance reimbursement – similar to physical therapy.
“We have fantastic research, we have incredible educators,” she said. “What we don’t have is policy that promotes optimal health across the lifespan, from pregnancy through older adulthood.”
Co-authors of the study included first author Emily Hill (supported by a National Center for Advancing Clinical Sciences fellowship), Lauren Cubellis, Randell Wexler and Christopher Taylor.
About this behavior and diet research news
Author: Emily Caldwell
Source: Ohio State University
Contact: Emily Caldwell – Ohio State University
Image: The image is credited to Neuroscience News
Original Research: Open access.
“Differences in Adherence to American Heart Association’s Life’s Essential 8, Diet Quality, and Weight Loss Strategies Between Those With and Without Recent Clinically Significant Weight Loss in a Nationally Representative Sample of US Adults” by Colleen Spees et al. Journal of the American Heart Association
Differences in Adherence to American Heart Association’s Life’s Essential 8, Diet Quality, and Weight Loss Strategies Between Those With and Without Recent Clinically Significant Weight Loss in a Nationally Representative Sample of US Adults
The American Heart Association defines ideal cardiovascular health based on 8 risk factors (Life’s Essential 8 [LE8]); a high LE8 score (range 0–100) reflects greater adherence to their recommendations. Weight status influences cardiovascular health, yet individuals may use detrimental diet and weight loss strategies to improve weight status. We assessed differences in LE8 adherence, diet quality, and weight loss strategies between those with and without a recent history of clinically significant weight loss (CSWL).
Methods and Results
Data from 2007 to 2016 National Health and Nutrition Examination Survey questionnaires, clinical measures, and 24‐hour dietary recalls were assessed to determine LE8 adherence, diet quality (Healthy Eating Index), and weight loss strategies between adults with: (1) intentional CSWL ≥5%; and (2) non‐CSWL <5%, weight maintenance, or weight gain over the past 12 months using ANCOVA and chi‐square tests. Those with CSWL demonstrated higher scores for diet quality (P=0.014), physical activity (P<0.001), and blood lipids (P<0.001). Those without CSWL reported lower BMI (P<0.001). There were no differences in total LE8 cardiovascular health scores between those with and without CSWL. More individuals with CSWL reported weight loss strategies of exercising (P=0.016); those without CSWL reported skipping meals (P=0.002) and using prescription diet pills (P<0.001).
Greater adherence to the LE8 recommendations was observed among individuals with CSWL, although overall LE8 scores were low. Future research should address the implementation of evidence‐based strategies that improve diet quality while promoting optimal cardiovascular health among those with intent to lose weight.