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Abstract (Nakata Y in ACSM 2005)
Many studies have revealed that comprehensive lifestyle
therapy, involving diet, exercise, and behavioral modification, can
lead to weight losses of 2 to 10 kg over 10 to 20 weeks and reduce coronary
heart disease (CHD) risk factors. To sustain the effects of lifestyle
therapy, long-term maintenance of the reduced weight would be required.
However, many persons experience weight gain after relapsing toward
their pre-intervention lifestyle. Few reports are currently available
to indicate how much weight gain will reverse the effects on CHD risk
factors. PURPOSE: To examine long-term weight changes and correlative
changes in CHD risk factors. METHODS: One hundred fourteen
overweight and obese women (age 46.5 } 8.0 years, BMI 27.6 } 2.8 kg/m2)
were assigned to 2 groups: diet only (n = 35) and diet and exercise
(n = 79). The women had participated in a 14-week weight-loss program
and were retested 2 to 5 (3.6 } 1.4) years later. RESULTS:
The mean weight before and after the program, and at follow-up was 67.7
} 7.5 kg, 59.1 } 7.0 kg, and 63.2 } 8.0 kg, respectively. With the moderate
rebound of weight, total cholesterol (219 } 32 mg/dl, 197 } 29 mg/dl,
218 } 35 mg/dl), triglycerides (109 } 84 mg/dl, 68 } 29 mg/dl, 95 }
57 mg/dl), and low-density lipoprotein cholesterol (133 } 29 mg/dl,
120 } 26 mg/dl, 134 } 32 mg/dl) rebounded completely, while systolic
blood pressure (132 } 18 mmHg, 121 } 15 mmHg, 123 } 17 mmHg) and diastolic
blood pressure (82 } 10 mmHg, 76 } 9 mmHg, 76 } 11 mmHg) did not change
after the program. Moderate rebounds were found in fasting plasma glucose
(98 } 25 mg/dl, 88 } 13 mg/dl, 92 } 15 mg/dl) and visceral fat (94.7
} 49.5 cm2, 58.9 } 34.5 cm2, 68.3 } 41.1 cm2). No significant group
differences in terms of rebound were found, although systolic blood
pressure significantly regained in the diet only group, and visceral
fat significantly regained in the diet and exercise group. CONCLUSION:
Weight gain (+3.9 kg) after weight loss (-8.6 kg) may reverse effects
on CHD risk factors. Greater efforts to maintain reduced weight are
needed for preventing CHD.
Supported partly by Uehara Memorial Foundation, the
21st century COE program, and the Tanaka Project of TARA.