These eight behaviors promote sustainable weight loss, study shows

Eat better: Follow a healthy, balanced diet

ISLAMABAD, (Online) - In the United States, more than 2 in 5 adults (42.4%) are obese. Obesity can lead to health problems including type 2 diabetes (T2D), heart disease, and some cancers.

Adopting a healthy lifestyle is a key strategy for reducing the risk of heart disease, stroke, and other major health concerns.

In June 2022, the American Heart Association (AHA) published “Life’s Essential “, a checklist containing eight lifestyle recommendations to improve and maintain heart health. These are:

1. Eat better: Follow a healthy, balanced diet consisting of unprocessed, nutrient-rich foods, including vegetables, fruits, whole grains, beans, legumes, nuts, plant-based proteins, lean animal proteins, skinless poultry, fish, and seafood.

2. Be more active: Aim for at least 150 minutes of moderate or 75 minutes of vigorous physical activity per week.

3. Quit tobacco: Smoking cessation is always recommended by experts for avoiding numerous health problems.

4. Get healthy sleep: Most adults need 7–9 hours of sleep each night.

5. Manage weight: Body mass index (BMI) is often used to assess a person’s weight or body composition, though this is not the only indicator of healthy weight or obesity.

6. Control cholesterol: It’s important to manage your levels of low-density-lipoprotein (LDL or “bad”) cholesterol for overall health.

7. Manage blood sugar: Tracking your levels of hemoglobin A1c can help you keep your blood sugar levels in check.

8. Manage blood pressure: Adults should maintain optimal blood pressure levels below 120/80 mm Hg.

The Life’s Essential 8 recommendations are considered crucial for heart health in the U.S., but it’s unknown whether people attempting to lose weight are adhering to them.

Recently, researchers from Ohio State University (OSU) examined adherence to Life’s Essential 8 among individuals with and without clinically significant intentional weight loss.

The results confirm what many people know to be true: that increased exercise and a healthy diet promote successful weight loss.

The findings appear in the Journal of the American Heart Association.

Weight loss: Diet quality and healthy lifestyle are key

The study, led by Colleen Spees, Ph.D., associate professor of medical dietetics, recruited 20,305 U.S. adults aged 19 or older. The median age was around 47 years old, approximately half (49.6%) were female, and 68.7% were non-Hispanic white individuals.

The subjects also participated in the National Health and Nutrition Examination Survey (NHANES) between 2007 and 2016. In the survey, participants were asked about their prior-year weight, smoking habits, physical activity, average hours of sleep per night, weight loss strategy, and what they had eaten in the previous 24 hours. Their BMI, blood pressure, LDL cholesterol, and blood glucose were measured through health exams and lab tests.

OSU researchers used the NHANES data to calculate the individuals’ Life’s Essential 8 scores and assess their diet quality according to the Healthy Eating Index, which measures adherence to U.S. Dietary Guidelines for Americans.

Out of 20,305 individuals, 2,840 had intentionally lost at least 5% of their body weight in the past year. The researchers defined this as “clinically significant weight loss.”

The remaining 17,465 individuals lost less than 5% of their body weight, maintained their weight, or gained weight in the past year.

Among individuals with clinically significant weight loss, 77.6% reported exercising to lose weight, compared with just 63.1% of those who did not lose at least 5% of their weight.

The researchers also looked at individual dietary components and found that subjects with clinically significant weight loss had better diet quality in terms of total protein foods, refined grains, and added sugars, although they had poorer diet quality with respect to sodium.

Diet pills and skipping meals may lead to ‘weight cycling’

Compared to subjects with clinically significant weight loss, individuals who lost less than 5% of their weight were more likely to skip meals or use prescription diet pills.

In their paper, Dr. Spees and coauthors underline that these strategies are not supported by scientific evidence, and that “their use is linked to clinically insignificant weight loss or weight gain, weight cycling, and increased CVD risk.”

Alice H. Lichtenstein D.Sc., Gershoff professor of nutrition science and policy and director of the Cardiovascular Nutrition Laboratory at Tufts University, who was not involved in the study, told Medical News Today that skipping meals and using diet pills “likely did not promote sustainable weight management because they did not result in long term deficits in caloric intake or elevation in calories burned (via physical activity).”

Peter M. Clifton, Ph.D., adjunct professor of nutrition at the University of South Australia, not involved in the study, had a different perspective on this matter.

Dr. Clifton said that people who adhere to a healthy diet and exercise regularly are more likely to achieve successful long-term weight loss “as they are more in control of their behavior.”

“Skipping meals and diet pills may be markers of less control rather than methods that don’t necessarily work. They may work well in other people,” he added.

Heart-healthy lifestyles affect weight loss

Individuals with clinically significant weight loss reported better diet quality, more moderate and vigorous physical activity, and lower non-LDL (“bad”) cholesterol, which contribute to better Life’s Essential 8 scores for diet, physical activity, and blood lipids.

Still, those with clinically significant weight loss also had significantly higher BMI scores and blood glucose and reported fewer hours of sleep.

These translate to worse Life’s Essential 8 scores for BMI, blood glucose, and sleep health compared to individuals who did not lose at least 5% of their body weight.

As a result, the average Life’s Essential 8 composite score was the same for both groups: 63.0 for the clinically significant weight loss group, and 63.4 for the group that did not lose at least 5% of their body weight (with 100 being the ideal score).

Since the study population was representative of the U.S. population, the results imply that cardiovascular health in the U.S. population remains well below optimal levels. This is consistent with the conclusions of previous research on this issue.

“Based on the findings in this study, we have a lot of work to do as a country,” Dr. Spees stated in a press release.

The findings of the study highlight the need for continued efforts to promote a heart-healthy lifestyle, even among individuals who have achieved clinically significant weight loss.