Slight weight gain may not mean worse health

Adhering to proper diet will continue to improve some blood biomarkers, even if a few kilos return.

By JUDY SIEGEL-ITZKOVICH
weight loss, eating disorder_311 (photo credit: Thinkstock/Imagebank)
weight loss, eating disorder_311
(photo credit: Thinkstock/Imagebank)
Dieters who are discouraged when their weight yo-yos up and down should be encouraged by specific blood biomarkers just discovered by researchers at Ben-Gurion University of the Negev in Beersheba and colleagues in German that indicate their health is improving even if they are not always losing weight.
The research was published online on Wednesday night in the journal Diabetes Care. Long-term healthy dietary interventions frequently induce a swift weight decline, mainly in the first four to six months, followed by weight stabilization or regain, despite continued dieting. The partial regain may discourage people from sticking to healthier dietary habits.
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The study was conducted on 322 participants during the two-year Dietary Intervention Randomized Controlled Trial (DIRECT) performed by BGU and the Nuclear Research Center in the Negev. The participants were randomized into three different, but healthy interventions – low-fat, Mediterranean or low-carbohydrate diets. Strict adherence to the diets was maintained throughout the two-year period.
“This study tells us that we may have all been too tunnel-viewed on weight when it comes to healthy dieting. Although maintaining ideal body weight is linked to better health, when it comes to adopting healthier dietary habits in mild to moderately obese people, there are benefits beyond weight loss, such as decreasing inflammatory tone and elevating ‘good cholesterol’ (HDL),” Faculty of Health Sciences Prof. Assaf Rudich said.
“This is similar to what we have been learning in diabetes, in which we now understand not to deal just with glucose levels, but also relate to blood lipids, blood pressure, coagulation and so on,” he said.
In obesity, the researchers wrote, health benefits of persistently switching to healthier dieting extend beyond the single outcome of weight loss.
“In fact, important improvements that likely signify decreased risk for cardiovascular disease occur even despite weight regain, as long as dieting persists,” Rudich said.
The researchers identified two distinct patterns: “Pattern-A” includes biomarkers (insulin, triglycerides, leptin, chemerin, monocyte-chemotacticprotein- 1(MCP-1) and retinol-binding-protein- 4(RBP4)) whose dynamics tightly corresponded to changes in body weight; they significantly improved during the first six months of the “rapid weight-loss phase,” but then, unfortunately, significantly changed their trend to the opposite direction once participants started to regain weight (the “weight maintenance/regain phase,” during the seventh through 24th months).
On the other hand, the researchers identified a totally different pattern of biomarkers (“Pattern B,” which includes high-molecular-weight (HMW) adiponectin, HDL-cholesterol, high-sensitive Creactive protein (hsCRP), fetuin-A, progranulin, and vaspin). This displayed a continued, cumulative improvement throughout the intervention, despite the partial weight regain observed during months seven to 24 of continued dieting.
These patterns were similar, although of different magnitude, across the low-carb, Mediterranean and low-fat diets.
Along the same line of continued benefit of adopting healthier dietary habits, the research team published an article last year in Circulation (a journal of the American Heart Association) that participants in the DIRECT showed regression of the atherosclerotic plaque in their carotid artery, a process underlying a large percentage of the cases of stroke. Atherosclerosis was previously seen to regress only with medications or with quite extreme dietary regimens.
According to Prof. Iris Shai, principal investigator of the DIRECT, these findings contain a strong message for the public.
“Switching to a healthy lifestyle is a long-term strategy that should be done moderately but persistently.
There are no magic shortcuts. There is no doubt that moderate weight loss is an important goal for specific populations, and losing weight will indeed improve several markers that are rather tightly related to fat mass such as triglycerides, insulin and leptin. These, however, will tend to change similarly to weight dynamics.”
Yet, she said, “it is encouraging that adhering to a healthy diet per se will continue to improve other blood biomarkers, some of which quite strongly associate with improved cardio-metabolic health, likely because they reflect adipose tissue and other organs’ function, such as HDL-c, adiponectin and CRP. Such markers may signify long-term effects of the initial weight loss, or, maybe even more promisingly, reveal to us the capacity of healthier dietary habits to reverse obesity-associated adipose tissue and liver dysfunction,” Shai said.