Weight cycling and high-density lipoprotein cholesterol in women: Evidenceof an adverse effect - A report from the NHLBI-sponsored WISE study

OBJECTIVES We undertook an analysis of weight cycling, coronary risk factor s and angiographic coronary artery disease (CAD) in women. BACKGROUND The effect of weight cycling on cardiovascular mortality and mor bidity is controversial, and the impact of weighs cycling on cardiovascular risk factors is unclear. METHODS This is a cross-sectional population study of 485 women with corona ry risk factors undergoing coronary angiography for evaluation of suspected myocardial ischemia enrolled in the Women's Ischemia Syndrome Evaluation ( WISE). Reported lifetime weight cycling defined as voluntary weight loss of at least 10 lbs at least 3 times-coronary risk factors including core labo ratory determined blood lipoproteins and CAD, as determined by a core angio graphic laboratory, are the main outcome measures. RESULTS Overall, 27% of women reported weight cycling-19% cycled 10 to 19 l bs, 6% cycled 20 to 49 lbs, and 2% cycled 50+ Ibs. Reported weight cycling was associated with 7% lower high-density lipoprotein cholesterol (HDL-C) l evels in women (p = 0.01). The HDL-C effect was directly related to the amo unt of weight cycled with women who lost greater than or equal to 50 lbs/cy cle having HDL-C levels 27% lower than noncyclers (p = 0.0025). This findin g was independent of other HDL-C modulators, including estrogen status, phy sical activity level, alcohol intake, body mass index, diabetes, beta-block er use, cigarette smoking and race. Weight cycling was not associated with an increased prevalence of CAD in this population. CONCLUSIONS Weight cycling is associated with lower HDL-C in women of a mag nitude that is known to be associated with an increased risk of cardiac eve nts as demonstrated in prior clinical trials. (C) 2000 by the American Coll ege of Cardiology.