Moderate weight loss in obese people improves heart function

December 11, 2009

Obese patients who lost a moderate amount of weight by eating less and exercising more improved their cardiovascular health, says a study at Washington University School of Medicine in St. Louis.

The results of this two-year study, published in the Dec. 15, 2009, issue of the Journal of the American College of Cardiology, showed that weight loss led to improvement in four key measures of heart and vascular health. The improvements seen in the study participants included decreased thickness of heart muscle, improved pumping and relaxation functions of the heart and decreased thickness of the carotid artery walls. Heart muscle thickening and impaired pumping and relaxation functions are predictors of heart failure, and increased carotid wall thickness is a predictor of plaque formation.

The researchers studied 60 moderately obese individuals at regular intervals, and 46 people (78 percent) completed the entire two-year follow-up period. The participants ranged in age from 22 to 64 and had BMIs (body mass indexes) of between 30 and 44. During the study, the subjects were instructed to eat low-calorie diets (1,200 to 1,500 calories for women and 1,500 to 1,800 calories for men) and to exercise for about three and a half hours per week, principally walking.

On average, they lost weight for about six months, reaching a maximum loss of nine percent body weight or 22 pounds. Maximum cardiovascular benefit lagged behind weight loss, with the greatest improvement coming six to 12 months after the study began.

Starting at about six months, most participants slowly regained some of their lost weight. At the end of two years, the participants averaged about nine pounds below their initial weight. Even though they regained some weight, after two years they still retained some of the heart and blood vessel benefit they had received.

"Losing 20 or so pounds might seem daunting to some people, but we showed that even a more modest weight loss can yield heart and vascular benefits," says first author Lisa de las Fuentes, M.D., a Washington University heart specialist at Barnes-Jewish Hospital and assistant professor of medicine in the Cardiovascular Division at the School of Medicine. "It's important to realize that you can choose goals that are attainable and work progressively toward them. You don't necessarily need to lose 50 pounds to improve your heart function."

The study participants were randomly assigned to either low-carbohydrate or low-fat diets. Both diet groups experienced similar improvements in heart and vascular measurements. That's reassuring for people who prefer one type of diet over the other, says de las Fuentes.

None of the patients enrolled in the study had clinically evident signs of heart failure, such as shortness of breath, coughing or fluid buildup, and none were taking cholesterol-lowering medications. About a third of them were being treated for high blood pressure.

By using advanced echocardiography and ultrasound imaging to thoroughly characterize cardiovascular health, the researchers were able to show that at the start of the study, the patients had detectable, though modest, heart dysfunction -- their hearts were slightly thickened, the contraction and relaxation abilities of their hearts were somewhat abnormal and the walls of their carotid arteries were mildly thickened. Six to 12 months after dietary intervention began, these indicators of heart and vascular function had become significantly healthier, and participants' cholesterol and triglyceride levels also had improved.

"Over time, obesity leads to abnormal thickening of heart muscle because the heart works harder to pump blood throughout the body," de las Fuentes says. "After a while, the hearts of obese people can lose some of their pumping or relaxation ability, leading to heart failure. But our study suggests that by losing weight, people can turn back the clock and regain more youthful heart function."

De las Fuentes indicates the study is unique because it followed patients for such a long time and because researchers used advanced imaging technology to evaluate heart health. In addition, by following patients over two years, the investigators were able to document what happens as weight is regained, showing that improvements in heart and blood vessel health were gradually lost as patients put weight back on.

The study participants generally were not at a weight eligible for bariatric surgeries such as laparoscopic gastric banding or gastric bypass, so it's important that the study demonstrates a program of diet and exercise to achieve moderate weight loss can improve heart health, de las Fuentes says.
-end-
Other institutions that participated in the diet study were Temple University School of Medicine in Philadelphia and the University of Colorado Health Sciences Center in Denver.

de las Fuentes L, Waggoner AD, Mohammed BS, Stein RI, Miller III BV, Foster GD, Wyatt H, Klein S, Davila-Roman VG. Effect of moderate diet-induced weight loss and weight regain on cardiovascular structure and function. Journal of the American College of Cardiology. 2009;54:3276-81.

Funding from the National Institutes of Health, the Robert Wood Johnson Foundation and the Barnes-Jewish Hospital Foundation supported this research.

Washington University School of Medicine's 2,100 employed and volunteer faculty physicians also are the medical staff of Barnes-Jewish and St. Louis Children's hospitals. The School of Medicine is one of the leading medical research, teaching and patient care institutions in the nation, currently ranked third in the nation by U.S. News & World Report. Through its affiliations with Barnes-Jewish and St. Louis Children's hospitals, the School of Medicine is linked to BJC HealthCare.

Washington University School of Medicine

Related Heart Failure Articles from Brightsurf:

Top Science Tip Sheet on heart failure, heart muscle cells, heart attack and atrial fibrillation results
Newly discovered pathway may have potential for treating heart failure - New research model helps predict heart muscle cells' impact on heart function after injury - New mass spectrometry approach generates libraries of glycans in human heart tissue - Understanding heart damage after heart attack and treatment may provide clues for prevention - Understanding atrial fibrillation's effects on heart cells may help find treatments - New research may lead to therapy for heart failure caused by ICI cancer medication

Machining the heart: New predictor for helping to beat chronic heart failure
Researchers from Kanazawa University have used machine learning to predict which classes of chronic heart failure patients are most likely to experience heart failure death, and which are most likely to develop an arrhythmic death or sudden cardiac death.

Heart attacks, heart failure, stroke: COVID-19's dangerous cardiovascular complications
A new guide from emergency medicine doctors details the potentially deadly cardiovascular complications COVID-19 can cause.

Autoimmunity-associated heart dilation tied to heart-failure risk in type 1 diabetes
In people with type 1 diabetes without known cardiovascular disease, the presence of autoantibodies against heart muscle proteins was associated with cardiac magnetic resonance (CMR) imaging evidence of increased volume of the left ventricle (the heart's main pumping chamber), increased muscle mass, and reduced pumping function (ejection fraction), features that are associated with higher risk of failure in the general population

Transcendental Meditation prevents abnormal enlargement of the heart, reduces chronic heart failure
A randomized controlled study recently published in the Hypertension issue of Ethnicity & Disease found the Transcendental Meditation (TM) technique helps prevent abnormal enlargement of the heart compared to health education (HE) controls.

Beta blocker use identified as hospitalization risk factor in 'stiff heart' heart failure
A new study links the use of beta-blockers to heart failure hospitalizations among those with the common 'stiff heart' heart failure subtype.

Type 2 diabetes may affect heart structure and increase complications and death among heart failure patients of Asian ethnicity
The combination of heart failure and Type 2 diabetes can lead to structural changes in the heart, poorer quality of life and increased risk of death, according to a multi-country study in Asia.

Preventive drug therapy may increase right-sided heart failure risk in patients who receive heart devices
Patients treated preemptively with drugs to reduce the risk of right-sided heart failure after heart device implantation may experience the opposite effect and develop heart failure and post-operative bleeding more often than patients not receiving the drugs.

How the enzyme lipoxygenase drives heart failure after heart attacks
Heart failure after a heart attack is a global epidemic leading to heart failure pathology.

Novel heart pump shows superior outcomes in advanced heart failure
Severely ill patients with advanced heart failure who received a novel heart pump -- the HeartMate 3 left ventricular assist device (LVAD) -- suffered significantly fewer strokes, pump-related blood clots and bleeding episodes after two years, compared with similar patients who received an older, more established pump, according to research presented at the American College of Cardiology's 68th Annual Scientific Session.

Read More: Heart Failure News and Heart Failure Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.