Healthy Diet Provides Health Benefits, Even Without Weight Loss
Investigators find that patients with moderate weight loss or those who were weight resistant still had improvement in cardiometabolic health.
Adhering to a healthy diet might not result in weight loss, but it will still provide health benefits, according to results of a study published in European Journal of Preventive Cardiology. Investigators found that only one-third of individuals had long-term weight loss, but patients who had moderate weight loss or were weight resistant still had improvements in visceral adiposity and cardiometabolic risk, such as higher high-density lipoprotein and lower levels of leptin.1,2
Investigators find that patients with moderate weight loss or those who were weight resistant still had improvement in cardiometabolic health. | Image Credit: sonyakamoz - stock.adobe.com
"We have been conditioned to equate weight loss with health, and weight loss-resistant individuals are often labeled as failures,” Anat Yaskolka Meir, PhD, postdoctoral research fellow in the department of epidemiology at Harvard Chan School, said in a news release.2 “Our findings reframe how we define clinical success. People who do not lose weight can improve their metabolism and reduce their long-term risk for disease. That’s a message of hope, not failure.”
The investigators of the study aimed to estimate the improvement in cardiometabolic outcomes per modest weight loss and the potential baseline indicators from successful weight loss by pooling data from 3 landmark long-term weight loss intervention trials: DIRECT (NCT00160108), CENTRAL (NCT01530724), and DIRECT PLUS (NCT03020186).1
In DIRECT, investigators conducted a clinical study to compare low-fat, low-carbohydrate, and Mediterranean diets for weight loss. The primary outcome included weight loss and secondary outcomes included cardiovascular mediator measurements. In CENTRAL, patients compared the dynamics in fat depots using 2 dietary strategies—low fat and low carbohydrates—and analyzed the metabolic effects during weight loss and regain. The primary outcomes include body fat composition, obesity, and abdominal obesity, and secondary outcomes included lipid profile, glycemic control, inflammatory state, metabolomic, liver function, genetic signature, and epigenetics.3,4
Finally, in DIRECT PLUS, investigators explored the long-term intake of the Mediterranean diet and green-Mediterranean diet on increasing the effects of the diet and physical activity. The primary outcomes were abdominal fat, hepatic fat, and obesity, and secondary outcomes included brain anatomy, cognitive function, cardiac state, endothelial dysfunction, lipid profile, glycemic control, inflammatory state, metabolomic, liver function, and well-being among others.5
In the pooled analysis, there were 212 patients who were weight resistant, 277 who had moderate weight loss, and 272 who had successful weight loss. Patients who were weight loss resistant were generally older, female, had a lower weight circumference, and had lower liver enzymes. Investigators found that patients who were weight loss resistance had high-density lipoprotein cholesterol elevation and a decrease of visceral and intrahepatic fat. However, they also had increases in total cholesterol, chemerin, fasting plasma glucose (FPG), alanine transaminase, and triglycerides and c-reactive protein (CRP), according to the study authors.1
As for patients with moderate weight loss—reductions of up to 5% of their initial body weight—patients had improved waist circumference, systolic blood pressure, high-density lipoprotein cholesterol, triglycerides, insulin, Homeostatic Model Assessment of Insulin Resistance, CRP, leptin, liver enzymes, abdominal fat depots areas, and liver fat. Patients with more than 5% loss of body weight—successful weight loss— had the most improvements in health indicators, except for low-density lipoprotein cholesterol, total cholesterol, and FGP.1
Furthermore, each kilogram lost was associated with a 1.44% increase in high-density lipoprotein cholesterol, a 1.37% decrease in triglycerides, a 2.46% decrease in insulin, a 2.79% decrease in leptin, and a 0.49-unit decrease in liver fat.1
“This novel finding shows that some people may be biologically wired to respond differently to the same diet,” Iris Shai, PhD, RD, MPH, principal investigator of the nutrition trials and adjunct professor of nutrition at Harvard Chan School, said in the news release.1 “This isn’t just about willpower or discipline—it’s about biology. And now we’re getting close to understanding it.”
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