It’s generally believed that wide swings in weight—up and down—are less healthy than simply being constantly overweight, although both situations are worse than maintaining a constantly normal weight.

Now medical science has clarified this issue: Weight fluctuations – i.e. the pattern of of major weight loss followed by partial or total regain (also termed weight cycling)—is strongly associated with higher mortality, more cardiovascular events, and new-onset diabetes, according to an analysis of a trial published in April, 2017, in the New England Journal of Medicine.

To examine this association, the investigators conducted an analysis of data from a randomized trial of therapy in patients with established coronary artery disease. In this analysis, they focused on 9,509 patients who had a median of 12 weight measurements during 5 years of follow-up.

The primary outcome measure—the composite rate of death from coronary heart disease of all types—was significantly associated with weight fluctuations, showing that the greater degrees of variability in body weight were linked to higher problem rates. When compared with the lowest fluctuations, patients with the highest variations had an increase in the risk of coronary events of 64%, an increase in the risk of stroke of 136%, and an increase in the risk of new-onset diabetes of 78%, and, overall, an increase in the risk of death of 124%. All these risks were independent of traditional risk factors such as blood pressure, diabetes, etc.

This association remained strong regardless of the patients’ weight at baseline, consistent among those of normal body weight and those who were overweight or obese.

Although this study was limited to patients with already established cardiovascular disease, the results accord well with the general belief that major weight fluctuations over long periods should be avoided.

But now we are learning that even short-term eating patterns may also help to protect against cardiovascular disease: According to a new scientific statement from the American Heart Association (AHA), which reviewed the health effects of specific eating patterns such as skipping breakfast, intermittent fasting, meal frequency, and timing of eating occasions. Their conclusions follow:

  • Irregular eating patterns appear less favorable for achieving a healthy cardiovascular profile.
  • Intentional eating with mindful attention to the timing and frequency of eating occasions could lead to healthier lifestyle and cardiovascular risk factor management.
  • There is evidence that both alternate-day fasting and periodic fasting may be effective for weight loss in the short run, although there are no data that indicate whether the weight loss can be sustained long term, and, as noted above, wide fluctuations would be counterproductive.
  • Daily breakfast consumption is helpful in promoting healthy dietary habits throughout the day, and I have covered this subject in detail in a previous post:


Keep your weight low and steady, and, above all, don’t forget breakfast!


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