Differences in cardiovascular disease risk factors by weight history: the Aerobics Center Longitudinal Study

The objective of this study was to compare cardiovascular disease (CVD) risk factor levels in adults with a history of weight loss to levels in adults who did not lose weight, after both groups subsequently experienced an approximate 1-year interval of weight maintenance. Extant data from the Aerobics Center Longitudinal Study (ACLS) were used to identify 5,151 adults who were weight maintainers (maintained weight within ± 3.0% over two consecutive periods of ~1 year) or weight-loss maintainers (lost >3.0- <5.0% or ≥ 5.0% of body weight in the first interval and maintained that loss in the second interval). Mixed models regression was used to accommodate repeated measures and adjust for gender, age, smoking, cardiorespiratory fitness, decade of clinic visit, interval length, and BMI at the time of risk factor measurement. Coefficients from the model were used to calculate the adjusted risk factor levels in the three groups. Differences in total cholesterol (-3.8 mg/dl, 95% confidence interval: -5.5, -2.0), low-density lipoprotein (LDL) cholesterol (-3.0 mg/dl, confidence interval: -4.8, -1.1), triglycerides (-6.1 mg/dl, confidence interval: -10.6, -1.7) and diastolic blood pressure (-0.8 mg/dl, confidence interval: -1.4, -0.3) indicated that levels were slightly more favorable in the ≥ 5.0% weight-loss maintenance group than weight maintenance group. Levels were similar for glucose, high-density lipoprotein (HDL) cholesterol and systolic blood pressure. This work indicates that, when adjusted for covariates including current BMI, adults with a history of weight loss may have CVD risk factors to levels as good, or perhaps even better than, those observed in adults who maintain their weight.