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Impact of weight change, secular trends and ageing on cardiovascular risk factors: 10-year experiences from the SOS study

International Journal of Obesity volume 35, pages 1413–1420 (2011)Cite this article

Subjects

Abstract

Objective:

Many short-term studies indicate that 5% weight loss in the obese is enough to induce significant improvements of cardiovascular risk factors. However, it is not known what degree of weight loss is required to improve risk factors over a more extended period of time or how ageing and secular trends per se are influencing risk factors during long-term follow-up.

Methods:

Patients examined after 10 years in the intervention study Swedish Obese Subjects were used for the current analysis. Surgically treated subjects (n=959) and conventionally treated obese controls (n=842) were pooled to obtain a study group with a large range of weight changes. The patients were divided in 11 groups based on the amount of weight change. Analysis of covariance was used to determine the necessary weight change over 10 years for a significant alteration of a risk factor. In a linear regression of risk factor change by weight change, the y intercept was interpreted as the effect of 10 years ageing and secular trends on a given risk factor in the absence of weight change.

Results:

The necessary weight loss for significant improvement of risk factors ranged from 10 to 44 kg. At zero weight change, 10 years of ageing was associated with significant increases in systolic blood pressure, pulse pressure, high-density lipoprotein cholesterol and glucose, and with significant decreases in diastolic blood pressure, total cholesterol, triglycerides and insulin.

Conclusions:

The necessary weight loss to maintain a favourable effect on risk factors in an obese population is larger than previously indicated by short-term studies. Treatment effects are influenced by non-weight change-dependant shifts in risk factor levels.

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Acknowledgements

The SOS study is supported by grants from the Swedish Medical Research Council (05239), Hoffmann-La Roche and Ethicon. We are indebted to the staff members at the 480 primary health-care centres and 25 surgical departments that participated in the study. Finally, we are thankful to Professor Lars Sjöström and Professor Lena Carlsson for permitting us to use the SOS database.

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Authors and Affiliations

  1. Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska University Hospital, Göteborg, Sweden

    C D Sjöström, T Lystig & A K Lindroos

Authors
  1. C D Sjöström
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  2. T Lystig
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  3. A K Lindroos
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Corresponding author

Correspondence to C D Sjöström.

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Competing interests

CD Sjöström is a current employee of AstraZeneca and has received lecture and/or consulting fees from Sanofi-aventis, Ethicon and MSD. T Lystig is a current employee of Boehringer Ingelheim Pharmaceuticals, a former employee of AstraZeneca, and has stock ownership in Affymetrix, Amgen, AstraZeneca, Medco Health Solutions, Merck and Oncogenex Pharmaceuticals (no individual stock holding worth more than $10 000). AK Lindroos declares no potential conflict of interest.

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Disclaimer

The sponsors of the SOS study had no role in the study design, data collection, data analysis, data interpretation or writing the report. The corresponding author had full access to all the data in the study and had final responsibility for the decision to submit the manuscript for publication.

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Sjöström, C., Lystig, T. & Lindroos, A. Impact of weight change, secular trends and ageing on cardiovascular risk factors: 10-year experiences from the SOS study. Int J Obes 35, 1413–1420 (2011). https://doi.org/10.1038/ijo.2010.282

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