STUDY: Obese people may lower their heart disease risk by losing a moderate amount of weight

JOURNAL: Circulation 2002;105

AUTHORS: Dr. Dario Giugliano

ABSTRACT: Obese people may lower their heart disease risk by losing a moderate amount of weight, as shedding pounds appears to cut blood levels of proteins involved in inflammation, according to Italian researchers.

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COMMENTARY: Obesity, a burgeoning problem in many developed nations, is a major risk factor for heart disease. Abdominal fat, in particular, is linked to an increased risk of cardiovascular disease.

Weight gain, especially around the abdomen, is also known to increase levels of immune system proteins called cytokines. Certain cytokines cause an inflammatory response, which can contribute to the formation of fatty deposits in the arteries known as atherosclerosis.

In the new study, a team led by Dr. Dario Giugliano from the Second University of Naples, Italy, wanted to see what effect weight reduction might have in reducing levels of circulating cytokines in obese individuals.

The researchers recruited 56 healthy obese women aged 25 to 44. At the beginning of the study, they compared the obese women with 40 normal-weight women of similar age.

The investigators found that obese women had increased levels of two cytokines--called tumor necrosis factor-alpha and interleukin 6--as well as increased expression of atherosclerosis-promoting proteins that are known to be triggered by increased cytokine levels.

After one year on a program of diet, exercise and behavioral counseling, each of the obese women lost at least 10% of their starting weight (about 22 pounds, on average). They also showed a significant reduction in their levels of cytokines and other potentially damaging proteins.

Weight loss represents a safe method for down regulating the inflammatory state and ameliorating blood-vessel dysfunction in obese women.

Cytokine levels returned toward normal values, even though women did not lose all their excess weight. This is reassuring, as the findings indicate that obese people need not reach a normal weight to reduce their heart risks. Instead losing around 10 to 20 pounds could make a difference.

Take home message is to get out there and be active.