Maintain young adult weight to help deter cardiovascular risk.(Clinical Rounds)

NEW ORLEANS -- Young adults who maintain a stable body weight into middle age--or who at least manage to gain less than the American average of about 1 pound per year--may largely prevent progression of other cardiovascular risk factors and development of metabolic syndrome, Donald M. Lloyd-Jones, M.D., said at the annual scientific sessions of the American Heart Association.

This observation from the National Heart, Lung, and Blood Institute-sponsored Coronary Artery Risk Development in Young Adults (CARDIA) study carries a hopeful message that has important implications. It suggests that greater public health emphasis should be placed on achieving weight stabilization in young and middle-aged adults. That's a more realistic goal than long-term maintenance of weight loss, according to Dr. Lloyd-Jones of North-western University, Chicago.

CARDIA is an ongoing multicenter epidemiologic study of African American and white men and women who were 18-30 years old at enrollment in 1985-1986. Dr. Lloyd-Jones' analysis was restricted to the 2,476 participants who underwent all six examinations conducted during the first 15 years of follow-up.

Subjects whose body mass index (BMI) increased by more than 2 kg/[m.sup.2] from baseline through year 15--that's about a 15-lb weight gain in most people--displayed a steady deterioration in all the cardiovascular risk factors measured in the examinations, namely triglycerides, HDL cholesterol, fasting blood glucose and insulin, and blood pressure. In contrast, participants whose BMI remained steady or rose by no more than 2 kg/[m.sup.2], or who actually lost weight and kept it off, had essentially no change in their risk factors.

For example, serum triglycerides in men who maintained a stable BMI rose 1.01 mg/dL annually, compared with 4.31 mg/dL annually in men whose BMI increased by more than 2 kg/[m.sup.2], he noted.

"That sounds like small change, but if you take ...