Healthy weight, appropriate exercise needed to ward off heart disease

In middle-aged adults, gradual weight loss not accompanied by appropriate levels of physical activity (PA) may worsen the risk of cardiovascular disease (CVD), a recent Korea study has found.

“In summary, this study found that the association between weight loss and the incidence of CVD risk were dependent on the level of PA, and independent of baseline body mass index (BMI),” the researchers said. “[T]hese results imply that both healthy weight and appropriate PA are necessary to reduce the risk of incident CVD.”

The study included 8,774 participants (mean age 52.1 years, 47.4 percent men) who were free of CVDs at baseline. Four weight trajectories were observed: gradual weight gain (with 9.5 percent of participants), stable weight (41.8 percent), slight weight loss (40.5 percent), and gradual weight loss (8.3 percent).

Over 16 years of follow-up, 741 new CVD cases were reported, yielding a cumulative incidence rate of 8.4 percent. Meanwhile, 577 all-cause deaths were reported.

Cox proportional hazards analysis showed that participants in the gradual weight loss trajectory with low levels of PA were more than twice at risk of CVD overall (hazard ratio [HR], 2.74, 95 percent confidence interval [CI], 1.74–4.30) and nonfatal CVD (HR, 2.89, 95 percent CI, 1.78–4.71). Such an effect was even stronger for fatal CVD, which was nearly five times as likely to occur in this patient subgroup (HR, 4.93, 95 percent CI, 1.85–13.13).

Similarly, these participants were nearly twice as likely to die from all causes (HR, 1.93, 95 percent CI 1.05–3.54).