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      Dieting and weight cycling as risk factors for cardiometabolic diseases: who is really at risk?

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          Abstract

          Despite the poor prognosis of dieting in obesity management, which often results in repeated attempts at weight loss and hence weight cycling, the prevalence of dieting has increased continuously in the past decades in parallel to the steadily increasing prevalence of obesity. However, dieting and weight cycling are not limited to those who are obese or overweight as substantial proportions of the various population groups with normal body weight also attempt to lose weight. These include young and older adults as well as children and adolescents who perceive themselves as too fat (due to media, parental and social pressures), athletes in weight-sensitive competitive sports (i.e. mandatory weight categories, gravitational and aesthetic sports) or among performers for whom a slim image is professionally an advantage. Of particular concern is the emergence of evidence that some of the potentially negative health consequences of repeated dieting and weight cycling are more readily seen in people of normal body weight rather than in those who are overweight or obese. In particular, several metabolic and cardiovascular risk factors associated with weight cycling in normal-weight individuals have been identified from cross-sectional and prospective studies as well as from studies of experimentally induced weight cycling. In addition, findings from studies of experimental weight cycling have reinforced the notion that fluctuations of cardiovascular risk variables (such as blood pressure, heart rate, sympathetic activity, blood glucose, lipids and insulin) with probable repeated overshoots above normal values during periods of weight regain put an additional stress on the cardiovascular system. As the prevalence of diet-induced weight cycling is increasing due to the opposing forces of an 'obesigenic' environment and the media pressure for a slim figure (that even targets children), dieting and weight cycling is likely to become an increasingly serious public health issue.

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          Most cited references83

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          Risk factors for body dissatisfaction in adolescent girls: a longitudinal investigation.

          Because few prospective studies have examined predictors of body dissatisfaction--an established risk factor for eating disorders--the authors tested whether a set of sociocultural, biological, interpersonal, and affective factors predicted increases in body dissatisfaction using longitudinal data from adolescent girls (N = 496). Elevated adiposity, perceived pressure to be thin, thin-ideal internalization, and social support deficits predicted increases in body dissatisfaction, but early menarche, weight-related teasing, and depression did not. There was evidence of 2 distinct pathways to body dissatisfaction--1 involving pressure to be thin and 1 involving adiposity. Results support the contention that certain sociocultural, biological, and interpersonal factors increase the risk for body dissatisfaction, but suggest that other accepted risk factors are not related to this outcome.
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            Physiological profiles of elite judo athletes.

            To be successful in international competitions, judo athletes must achieve an excellent level of physical fitness and physical condition during training. This article reviews the physiological profiles of elite judo athletes from different sex, age and weight categories. Body fat is generally low for these athletes, except for the heavyweight competitors. In general, elite judo athletes presented higher upper body anaerobic power and capacity than non-elite athletes. Lower body dynamic strength seems to provide a distinction between elite and recreational judo players, but not high-level judo players competing for a spot on national teams. Even maximal isometric strength is not a discriminant variable among judo players. However, more studies focusing on isometric strength endurance are warranted. Although aerobic power and capacity are considered relevant to judo performance, the available data do not present differences among judo athletes from different competitive levels. Typical maximal oxygen uptake values are around 50-55 mL/kg/min for male and 40-45 mL/kg/min for female judo athletes. As for other variables, heavyweight competitors presented lower aerobic power values. The typical differences commonly observed between males and females in the general population are also seen in judo athletes when analysing anaerobic power and capacity, aerobic power, and maximal strength and power. However, further research is needed concerning the differences among the seven weight categories in which judo athletes compete.
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              Variability of body weight and health outcomes in the Framingham population.

              Fluctuation in body weight is a common phenomenon, due in part to the high prevalence of dieting. In this study we examined the associations between variability in body weight and health end points in subjects participating in the Framingham Heart Study, which involves follow-up examinations every two years after entry. The degree of variability of body weight was expressed as the coefficient of variation of each subject's measured body-mass-index values at the first eight biennial examinations during the study and on their recalled weight at 25 years of age. Using the 32-year follow-up data, we analyzed total mortality, mortality from coronary heart disease, and morbidity due to coronary heart disease and cancer in relation to intraindividual variation in body weight, including only end points that occurred after the 10th biennial examination. We used age-adjusted proportional-hazards regression for the data analysis. Subjects with highly variable body weights had increased total mortality (P = 0.005 for men, P = 0.01 for women), mortality from coronary heart disease (P = 0.009 for men, P = 0.009 for women), and morbidity due to coronary heart disease (P = 0.0009 for men, P = 0.006 for women). Using a multivariate analysis that also controlled for obesity, trends in weight over time, and five indicators of cardiovascular risk, we found that the positive associations between fluctuations in body weight and end points related to mortality and coronary heart disease could not be attributed to these potential confounding factors. The relative risks of these end points in subjects whose weight varied substantially, as compared with those whose weight was relatively stable, ranged from 1.27 to 1.93. Fluctuations in body weight may have negative health consequences, independent of obesity and the trend of body weight over time.
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                Author and article information

                Journal
                Obes Rev
                Obesity reviews : an official journal of the International Association for the Study of Obesity
                1467-789X
                1467-7881
                Feb 2015
                : 16 Suppl 1
                Affiliations
                [1 ] Department of Medicine/Division of Physiology, University of Fribourg, Fribourg, Switzerland.
                Article
                10.1111/obr.12251
                25614199
                3bce2e86-58b7-4971-bc1a-cc20a9ae628e
                © 2015 World Obesity.
                History

                Diabetes,hypertension,obesity,weight cycling
                Diabetes, hypertension, obesity, weight cycling

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