Fatness and Fluctuating Body Weight: Effect on Central Vasculature

Abstract

Weight Cycling (WC) is a prevalent behavior associated with adverse cardiovascular (CV) health. However, a 2010 review on the effects of WC and blood pressure (BP) determined that there was not enough evidence to draw definitive conclusions. Central BP is the principal predictor of CV risk compared to peripheral BP. The influence that WC may have specifically on central BP is unknown. Cross-sectional observation of self-reported history of WC on measures of CV health was undertaken. Seventy-five women completed a Weight and Lifestyle Inventory questionnaire, which is considered a reliable index of WC (r = 0.87, p < 0.001). Measures of visceral fat, BP, arterial stiffness, and VO2peak were taken. Regression equations were used to assess primary predictors of these outcomes. Seventy-five middle aged (39 ± 11 years), obese (32 ± 7 kg/m2), and relatively unfit (24 ± 8 ml·kg−1 min−1) women completed the study. Visceral fat was the strongest predictor of brachial systolic blood pressure (SBP; r2 = 0.283), brachial diastolic blood pressure (DBP; r2 = 0.176), central SBP (r2 = 0.375), and augmentation index (AIx; r2 = 0.535, all p < 0.001). VO2peak was the strongest predictor of central DBP (r2 = 0.062, p = 0.036) and augmentation pressure (AP; r2 = 0.491, p < 0.001). Weight cycling index was associated with visceral fat (r = 0.521, p < 0.001). Visceral fat was a mediator between WC and central SBP (confidence interval [CI] = 0.0053–0.0602), AP (CI = 0.0507–0.4915), AIx (CI = 0.0025–0.0699), and carotid-femoral pulse wave velocity (CI = 0.0115–0.1227; all p < 0.05). WC may increase visceral fat accumulation, which was associated with increased central SBP and measures of arterial stiffness.

Long-Term Body Mass Index Variability and Adverse Cardiovascular Outcomes

“…Animal studies have shown that weight cycling, as defined by weight loss followed by weight gain, is associated with loss of energy hemostasis and a rise in hunger and fall in satiety hormones, leading to adipocyte hyperplasia and maladaptive excess visceral fat accumulation . Human studies have linked weight change to vascular function deterioration and elevated BP via visceral fat accumultion . Epidemiological studies have consistently shown that weight change is likely to increase body fat and is associated with unfavorable metabolic and psychosocial attributes .…”

Differing Impact of Weight Cycling on Ambulatory Blood Pressure versus Conventional Blood Pressure Assessment: A Possible Explanation to Controversy

“…Zeigler et al7 found higher levels of WC were associated with increased laboratory BP values and arterial stiffness, mainly through the mediating impact of increased visceral fat. The current study supports the role of WC on abdominal obesity in that the WC group had a significantly higher waist-to-hip ratio compared to the NWC group.…”

“…The data for current study was collected in correlation with previous published work assessing the impact of WC on arterial stiffness 7. Sixty-five healthy, overweight/obese, nonsmoking, weight stable, Caucasian women with a body mass index (BMI) >25 kg/m 2 and age of 25–60 years were recruited.…”

Weight cycling is associated with adverse cardiometabolic markers in a cross-sectional representative US sample

“…25 However, results are aligned with the literature on lipids’ differences based on non-pharmacological interventions (eg, diet and exercise) and represent clinically meaningful risks. 26 One potential pathway that is hypothesised is that weight cycling promotes visceral fat accumulation, 27 which thereby leads to greater cardiometabolic risks.…”