Copyright © 2005 by the Johns Hopkins Bloomberg School of Public Health
ORIGINAL CONTRIBUTIONS |
Association of Intentional Changes in Body Weight with Coronary Heart Disease Event Rates in Overweight Subjects Who Have an Additional Coronary Risk Factor
1 Department of Epidemiology and Preventive Medicine, Tel-Aviv University, Tel Hashomer, Israel.
2 The Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, Tel Hashomer, Israel.
3 The Heart Institute, Sheba Medical Center, Tel Hashomer, Israel.
Despite evidence that weight loss improves the severity of coronary heart disease (CHD) risk factors, a direct association between weight loss and CHD incidence has not been demonstrated. In 1994–2001, the authors conducted an observational study of intentional weight loss as related to CHD incidence among patients recruited from a network of clinics in Israel who received nutritional counseling from a dietitian to support the medical recommendation to lose weight. Subjects were outpatients aged 50–75 years with a body mass index of 
27 kg/m2, without CHD or cancer but with at least one risk factor for CHD in addition to overweight. Outcomes were documented over 4 years by repeated weight measurements and by medical record verification. Among 1,669 patients, 224 (13.4%) incidents of CHD were recorded. For subjects who underwent at least 6 months of dietetic counseling, the risk-factor-adjusted odds ratio for CHD incidence associated with a weight loss of 4.5 kg (the median level of weight loss) was 0.57 (95% confidence interval: 0.39, 0.84). In this, the largest known study of its type reported to date, intentional weight loss from a 6-month diet predicted lower incidence of CHD over 4 years.
body weight; coronary disease; counseling; nutrition; weight loss
Abbreviations: BMI, body mass index; CHD, coronary heart disease; CI, confidence interval; SD, standard deviation.
Correspondence to Dr. Sigal Eilat-Adar, The Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, Tel-Hashomer 52621, Israel (e-mail: eilats{at}post.tau.ac.il).
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