All weight loss isn’t equal for reducing heart failure risk, study shows

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In a new study, researchers found reducing the level of body fat and waist size are linked to a lower risk of heart failure in patients with type 2 diabetes.

The findings suggest that all weight loss isn’t equal when it comes to mitigating the risk of heart disease.

The research was conducted by a team at UT Southwestern and elsewhere.

The burden of diabetes is increasing, with an estimated 700 million adults worldwide predicted to have this disease by 2045.

The vast majority of cases are type 2 diabetes, characterized by insulin resistance, an inability for cells to respond to insulin.

Type 2 diabetes doubles the risk of cardiovascular events such as heart failure and heart attacks.

Being overweight and obese are strong risk factors for both type 2 diabetes and heart disease, and patients are often counseled to lose weight to reduce the likelihood of developing both conditions.

However, not all weight loss is the same.

Fat mass accounts for fat in different parts of the body while lean mass is mostly muscle.

To help answer how different types of weight loss can affect cardiovascular disease, the team examined the effects of either an intensive lifestyle intervention focused on weight loss and physical activity or diabetes support and education in more than 5,000 overweight or obese adults with type 2 diabetes.

The study collected information on the volunteers’ weight, body composition, and waist circumference at the baseline and again one and four years later. It also tracked the incidence of heart failure in this group over a 12-year period.

Among the 5,103 participants, 257 developed heart failure over the follow-up period.

The team found that the more these volunteers lowered their fat mass and waist circumference, the lower were their chances of developing heart failure.

Just a 10% reduction in a fat mass led to a 22% lower risk of heart failure with preserved ejection fraction and a 24% lower risk of heart failure with reduced ejection fraction, two subtypes of this condition.

A decline in waist circumference significantly lowered the risk of heart failure with preserved injection fraction but not heart failure with reduced ejection fraction.

However, a decline in lean mass didn’t change the risk of heart failure at all.

These findings showed that reductions in specific, not all, body composition parameters are linked to heart failure.

More studies are needed to determine if reducing fat and retaining or increasing muscle may be more effective at decreasing the risk of heart failure, research that’s facilitated with the new equation to estimate body composition.

In the meantime, people may benefit from incorporating strategies toward this goal—such as resistance training—into their weight loss efforts.

One author of the study is Ambarish Pandey, M.D.

The study is published in Circulation.

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