Abstract 4371083: Weight cycling and cardiovascular risk among midlife women.

Background: While weight loss is recommended for individuals who are overweight and/or obese to reduce CVD risk, long-term weight maintenance remains challenging and may result in weight cycling or “yo-yo dieting”. Few studies have evaluated associations between history of weight cycling and CVD risk, particularly among midlife women, a population vulnerable to both weight fluctuations and rising CVD risk. Hypothesis: Greater lifetime weight cycling will be associated with worse CVD risk and will vary by menopausal status. Methods: We analyzed baseline data from the American Heart Association Research Go Red (RGR) weight study of women ages 45-55 years (n=303; mean age: 49.9 ± 3.2, 16.2% racial/ethnic minority). Weight cycling, defined as losing and gaining 10 lbs. or more in one year, excluding pregnancy, was self-reported. Sleep patterns, perceived stress, and physical activity were assessed via validated questionnaires. Trained personnel collected measures of BMI, waist circumference, blood pressure, and fasting blood samples for lipids, glucose, HbA1C, C-reactive protein (CRP), and leptin. Multivariable logistic regression models evaluated associations between weight cycling and CVD risk factors, adjusting for age, race/ethnicity, education, health insurance status, pregnancy history, and menopausal status. Results: Over half (58.4%) of participants reported ≥3 episodes of weight cycling, with a mean of 5.1 (SD: 5.6) episodes in one year. Weight cycling ≥3 vs. <3 episodes was significantly associated with elevated BMI (OR: 6.933, 95% CI: 3.63-13.23, elevated waist circumference OR: 3.81, CI: 2.28–6.37), high blood pressure (OR: 2.07, CI: 1.17–3.65), low HDL cholesterol (OR: 1.95, CI: 1.18–3.22), elevated HbA1c (OR: 2.82, CI: 1.57–5.05), high CRP (OR: 2.95, CI: 1.64–5.31), and high leptin (OR: 4.02, CI: 2.13–7.58). Weight cycling was also associated with insufficient physical activity (OR: 1.79, CI: 1.04–3.06) and elevated risk of sleep apnea (OR: 3.20, CI: 1.91–5.34). Associations were stronger among premenopausal women vs peri- or post-menopausal. Conclusions: Frequent weight cycling was common in this sample of midlife women and was associated with a broad range of CVD risk factors, independent of sociodemographic and reproductive variables. These findings suggest that maintaining a stable weight, especially in earlier life, may be important for optimal cardiovascular health, but warrant prospective confirmation.