Long-term weight cycling in female Wistar rats: effects on metabolism

The impact of weight cycling on health outcomes in animal models: A systematic review and meta-analysis

The pattern of weight loss and regain, termed "weight cycling," is common in overweight individuals. It is unclear whether the well-established benefits of weight loss persist following weight regain or whether weight cycling is harmful. Human studies of weight cycling have conflicting results reflecting limitations of the observational designs of these studies. By controlling the macronutrient content of diets in animal studies, weight cycling can be studied in a highly controlled manner, thereby overcoming the limitations of human studies. We conducted a systematic review and meta-analysis of animal studies which assessed the health consequences of weight cycling. Studies were classified into those which compared weight cycling to lifelong obesity and those which compared weight cycling to later onset obesity. There were no differences in health outcomes between weight cycled animals and those with lifelong obesity, highlighting that weight regain reverses health benefits achieved by weight loss. In comparison with animals with later onset obesity, weight cycled animals had higher fasting glucose levels and more impaired glucose tolerance following weight regain. Our review of animal studies suggests that health benefits of diet-induced weight loss do not persist after weight regain and weight cycling results in adverse metabolic outcomes.

'Weighing' Losses and Gains: Evaluation of the Healthy Lifestyle Modification After Breast Cancer Pilot Program

Objectives

This pilot study sought to develop and evaluate a novel online group-based intervention (Healthy Lifestyle Modification after Breast Cancer; HLM-ABC) to help breast cancer survivors (BCSs) make healthy lifestyle changes intended to yield not only beneficial physical outcomes (i.e., weight loss, reduced body mass index) but also greater behavioral (e.g., increased physical activity, healthier eating), and psychosocial well-being (e.g., self-efficacy, motivation, body image).

Methods

An exploratory single-arm, mixed-method triangulation design was employed to evaluate the feasibility and preliminary effectiveness of the HLM-ABC intervention for overweight BCSs. Fourteen women participated in the 10-week intervention and completed quantitative measures of the above-mentioned outcomes at baseline, post-treatment, 6-month, and 12-month follow-up time points. Qualitative data were obtained post-treatment via semi-structured interviews and a treatment satisfaction questionnaire.

Results

Participants lost an average of 2.83% of their baseline weight (M = 196.65; SD = 38.59) by 1-year follow-up (M = 191.29; SD = 33.91), equal to a small effect size (d = -0.37). Despite achieving only modest weight loss, participants achieved meaningful gains in the form of increased physical activity (d = 0.2), discovery of gratifying movement, more intuitive eating habits (d = 1.12), greater bodily and emotional awareness, and positive shifts in beliefs about being able to make healthy choices regarding food (d = 0.63) and physical activity (d = 0.38). Furthermore, they demonstrated a slight improvement in body image (d = 0.36) and described feeling more self-compassionate, empowered, and acknowledging of variables beyond control (i.e., hormonal therapy, unsatisfactory surgery) that can present barriers to change.

Conclusion

After completing a 10-week online program, participants achieved meaningful and lasting changes on a number of healthful indicators, even when this did not correspond with a significant reduction in weight. Findings highlight the complex, multifaceted nature of "health" and lend support for promotion of healthier lifestyle following cancer treatment that encompasses not only physical weight, but also behavior, psychosocial well-being, and (often unmodifiable) circumstances such as life-preserving hormonal treatments.

Hypothalamic miR-219 regulates individual metabolic differences in response to diet-induced weight cycling

Consumption of a low calorie diet is the most common approach to lose weight. While generally effective at first, it is frequently followed by a relapse where the pre-diet weight is regained, and often exceeded. This pattern of repeated weight loss/regain is referred to as weight cycling and the resulting metabolic response varies greatly between individuals.

Objective

We attempted to address the issue of individual differences in the response to weight cycling in male mice.

Methods

We first exposed adult wild type mice to repeated cycles of high/low fat food. Next, using a lentiviral approach, we knocked-down or over-expressed miR-219 in the ventromedial hypothalamus (VMH) of an additional mouse cohort and performed a full metabolic assessment.

Results

Exposure of wild type males to weight cycling resulted in the division of the cohort into subsets of resistant versus metabolic-syndrome-prone (MS) animals, which differed in their metabolic profile and hypothalamic miR-219 levels. Lentiviral knock-down of miR-219 in the VMH led to exacerbation of metabolic syndrome. In contrast, over-expression of miR-219 resulted in moderation of the metabolic syndrome phenotype.

Conclusions

Our results suggest a role for miR-219 in the mediation of the metabolic phenotype resulting from repeated weight cycling.

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Repeated cycles of high fat diet induce different responses in adult males.

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Low miR-219 in ventromedial hypothalamus are linked to metabolic-syndrome proneness.

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Lentiviral knockdown of miR-219 induces metabolic-syndrome-prone phenotype.

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Lentiviral overexpression of miR-219 provides moderate protection from metabolic-syndrome.

Body Weight Cycling with Identical Diet Composition Does Not Affect Energy Balance and Has No Adverse Effect on Metabolic Health Parameters

Background: Body weight (BW) cycling, the yo-yo effect, is generally thought to have adverse effects on human metabolic health. However, human and animal experiments are limited in number and do not provide clear answers, partly due to large variations in experimental design, parameters measured, and definitions of BW cycling. Here, we examined the effect of repetitive BW cycling versus single- and non-cycling control groups, without alterations in diet composition, on steady state BW and metabolic parameters. Methods: We induced well-defined BW cycles on a semi-purified high fat diet in C57BL/6J mice, a well-described animal model for diet-induced obesity, and measured energy expenditure and relevant metabolic parameters. Results: Our setup indeed resulted in the intended BW changes and always reached a stage of energy balance. A history of weight cycling did not result in increased BW or fat mass compared with the control group, nor in deteriorated serum concentrations of glucose, adipokines and serum triglyceride and free fatty acid (FFA) concentrations. If anything, BW tended to be reduced, presumably because of a reduced overall energy intake in BW cycling animals. Conclusion: Repeated cycling in BW without changes in diet composition does not lead to impaired metabolic health nor increased BW (gain).

Unstable bodyweight and incident type 2 diabetes mellitus: A meta-analysis

AIMS/INTRODUCTION

The present meta-analysis aimed to clarify the association of unstable bodyweight with the risk of type 2 diabetes mellitus, an association that has been controversial among longitudinal studies.

MATERIALS AND METHODS

An electronic literature search using EMBASE and MEDLINE was followed up to 31 August 2016. The relative risks (RRs) of type 2 diabetes mellitus in individuals with unstable bodyweight were pooled using the inverse variance method.

RESULTS

Eight studies were eligible for the meta-analysis. The median duration of measurements of weight change and follow-up years for ascertaining type 2 diabetes mellitus were 13.5 and 9.4 years, respectively. The pooled RR for the least vs most stable category was 1.33 (95% confidence interval 1.12-1.57). Between-study heterogeneity was statistically significant (P = 0.048). Whether type 2 diabetes mellitus was ascertained by blood testing explained 66.0% of the variance in the logarithm of RR (P = 0.02). In three studies in which blood testing was carried out, type 2 diabetes mellitus risk was not significant (RR 1.06, 95% confidence interval 0.91-1.25). Furthermore, publication bias that inflated type 2 diabetes mellitus risk was statistically detected by Egger's test (P = 0.09).

CONCLUSIONS

Unstable bodyweight might be modestly associated with the elevated risk of type 2 diabetes mellitus; although serious biases, such as diagnostic suspicion bias and publication bias, made it difficult to assess this association.

Metabolic dysfunction following weight cycling in male mice

Background

Combatting over-weight or obesity can lead to large fluctuations in an individual’s body weight, often referred to as weight cycling or “yo-yo” dieting. Current evidence regarding the potentially damaging effects of these changes is conflicting.

Methods

Here, we assess the metabolic effects of weight cycling in a murine model, comprising three dietary switches to normal or high fat diets at 6 week intervals; male C57BL/6 mice were fed either a control (C) or high fat (F) diet for 6 weeks (n=140/group). C and F groups were then either maintained on their initial diet (CC and FF respectively) or switched to a high fat (CF) or control (FC) diet (n=35/group). For the final 6 week interval, CC and CF groups were returned to the control diet (CCC and CFC groups) while FC and FF groups were placed on a high fat diet (FCF and FFF) (n=28/group).

Results

For the majority of metabolic outcomes changes aligned with dietary switches; however assessment of neuropeptides and receptors involved in appetite regulation and reward signalling pathways reveal variable patterns of expression. Furthermore, we demonstrate that multiple cycling events leads to a significant increase in internal fat deposition, even when compared to animals maintained on a high fat diet (Internal Fat: FCF: 7.4 ± 0.2g vs. FFF: 5.6 ± 0.2g; p<0.01).

Conclusions

Increased internal adipose tissue is strongly linked to the development of metabolic syndrome associated conditions such as type 2 diabetes, cardiovascular disease and hypertension. While further work will be required to elucidate the mechanisms underlying the neuronal control of energy homeostasis, these studies provide a causative link between weight cycling and adverse health.

Weight cycling increases T-cell accumulation in adipose tissue and impairs systemic glucose tolerance

Obesity is one of the leading causes of morbidity in the U.S. Accumulation of proinflammatory immune cells in adipose tissue (AT) contributes to the development of obesity-associated disorders. Weight loss is the ideal method to counteract the negative consequences of obesity; however, losses are rarely maintained, leading to bouts of weight cycling. Fluctuations in weight have been associated with worsened metabolic and cardiovascular outcomes; yet, the mechanisms explaining this potential correlation are not known. For determination of whether weight cycling modulates AT immune cell populations, inflammation, and insulin resistance, mice were subjected to a diet-switch protocol designed to induce weight cycling. Weight-cycled mice displayed decreased systemic glucose tolerance and impaired AT insulin sensitivity when compared with mice that gained weight but did not cycle. AT macrophage number and polarization were not modulated by weight cycling. However, weight cycling did increase the number of CD4(+) and CD8(+) T cells in AT. Expression of multiple T helper 1-associated cytokines was also elevated subsequent to weight cycling. Additionally, CD8(+) effector memory T cells were present in AT of both obese and weight-cycled mice. These studies indicate that an exaggerated adaptive immune response in AT may contribute to metabolic dysfunction during weight cycling.

Pathophysiologic mechanisms of obesity and related metabolic disorders: an epidemiologic study using questionnaire and serologic biomarkers

BACKGROUND

It is still unclear whether individuals with the same degree of obesity but different weight histories since young adulthood have different insulin concentration, prevalence of metabolic syndrome components and their clustering.

METHODS

A cross-sectional study was conducted on 3,399 (for weight difference analysis) and 1,879 (for weight fluctuation analysis) Japanese men aged 40-59 years. Weight difference was calculated by subtracting the recalled weight at about 25 years old from the current weight. The root mean square error around the slope of weight on age (weight - RMSE) was calculated by a simple linear regression model, in which the subject's actual weights at ages 20, 25, 30, 40 years and 5 years prior to the study, as well as current weight, were dependent variables against the subject's age as the independent variable. Each metabolic syndrome component was defined as follows: serum triglycerides ≥150 mg/dL; HDL-cholesterol <40 mg/dL; fasting glucose ≥110 mg/dL; and blood pressure ≥140/90 mm Hg.

RESULTS

Those who gained <10%, <20%, or 20% or more in weight had a significantly higher than unity odds ratio of having two or more metabolic syndrome components in relation to those whose weight remained stable: 1.28 (95% confidence interval: 0.95-1.73), 2.49 (1.91-3.24), and 5.30 (3.97-7.07), respectively. Weight-RMSE was significantly and positively associated with fasting insulin concentration independent of current weight, weight-slope or other lifestyle-related factors.

CONCLUSIONS

Metabolic syndrome components would likely tend to cluster more in individuals with large weight gain on a physiologic basis characterized by high fasting insulin concentration. Furthermore, weight fluctuation was suggested to increase the risk of fasting hyperinsulinemia.

Long-Term Body Weight Fluctuation is Associated With Metabolic Syndrome Independent of Current Body Mass Index Among Japanese Men

BACKGROUND

The relation between weight fluctuation and the risk of cardiovascular disease (CVD) is fairly consistent, although the physiologic basis for the relationship is uncertain. In the present study the association between long-term weight fluctuation and the development of metabolic syndrome (MS), a potent CVD risk factor, was investigated.

METHODS AND RESULTS

A cross-sectional study of 664 Japanese men aged 40-49 years was conducted. The root mean square error around the slope of weight on age (weight - RMSE) was calculated by a simple linear regression model, in which the subject's actual weights at ages 20, 25, 30 years and 5 years prior to the study, as well as current weight, were dependent variables against the subject's age as the independent variable. Weight-RMSE was significantly and positively associated with the prevalence of each MS components (high blood pressure, hypertriglyceridemia, low-high density lipoprotein-cholesterol, high fasting glucose, and obesity). Such associations, as well as clustering of the MS component together with RMSE increase, were apparent among subjects with body mass index (BMI) <25 kg/m2, although the prevalence of MS or its components was much higher among overweight subjects (BMI >or=25 kg/m2).

CONCLUSIONS

Development of MS possibly explains the risk of CVD not only in overweight or obese persons, but also in normal-weight persons with large weight fluctuation.

Association between weight fluctuation and fasting insulin concentration in Japanese men

OBJECTIVE

To investigate whether long-term weight fluctuation is associated with the fasting serum insulin concentration.

DESIGN AND SUBJECTS

Weight histories of 1932 male Japanese workers aged 40-59 y were analyzed in relation to their current fasting serum insulin concentration.

MEASUREMENTS

Individual weight fluctuation was calculated by root mean square error (RMSE) along the linear regression line of weight measured at five to six different ages.

RESULTS

The mean RMSE and fasting insulin concentration were 1.22 kg and 4.5 microU/ml, respectively. The multivariate adjusted insulin level became higher with the increase in weight fluctuation. Subanalysis stratified by current body mass index (BMI) showed that the multivariate adjusted insulin level in individuals in the top quartile of fluctuation was 4.3 microU/ml, against 3.9 microU/ml in those in the bottom quartile (P=0.018, analysis of covariance (ANCOVA)) in the normal weight subgroup with current BMI below 25 kg/m(2). In the overweight subgroup with BMI 25 kg/m(2) or above, the level was 6.9 microU/ml in individuals in the top quartile and 6.2 microU/ml in those in the bottom quartile (P=0.054, ANCOVA).

CONCLUSION

The results suggest that weight fluctuation increases the risk of developing hyperinsulinemia. Prospective observations together with measurement of changes in adiposity are needed for confirmation.

The effect of repeated episodes of dietary restriction and refeeding on systolic blood pressure and food intake in exercise-trained normotensive rats

OBJECTIVE

To explore the effects of weight cycling and exercise on blood pressure and macronutrient intake in Sprague-Dawley rats.

RESEARCH METHODS AND PROCEDURES

Female Sprague-Dawley rats (n = 62; 5 months old) were assigned to an ad libitum (Con) or weight-cycled (Cyc) group. They were either sedentary (Con-Sed and Cyc-Sed) or exercise-trained (Con-Ex and Cyc-Ex) on a motorized treadmill (20 m/minute; 60 minutes/day; 6 days/week). The Cyc groups underwent 2 cycles of 3 weeks of 60% food restriction followed by 5 weeks of ad libitum refeeding using a macronutrient self-selection diet. Body mass and food intake were analyzed weekly. Systolic blood pressure (SBP) was measured at baseline and during the first and fifth weeks of each refeeding.

RESULTS

For both cycling periods, SBP was elevated in Cyc vs. Con groups at Week 1 of refeeding, but was similar among groups by Week 5 of refeeding. Both Con groups had greater total energy intake than the Cyc groups for both cycling periods (Cycle 1: 2882.2 +/- 75.1, Con-Sed; 2916.1 +/- 67.1, Con-Ex; 2692.2 +/- 58.7, Cyc-Sed; and 2780.5 +/- 52.4 kcal, Cyc-Ex) (Cycle 2: 2815.8 +/- 75.1, Con-Sed; 2938.8 +/- 49.4, Con-Ex; 2577.1 +/- 60.5, Cyc-Sed; and 2643.5 +/- 65.9 kcal, Cyc-Ex). Relative fat intake (percentage of total kcal/week) was significantly less for Con-Ex and Cyc-Ex than Con-Sed and Cyc-Sed throughout both refeeding periods.

DISCUSSION

Weight cycling failed to produce significant sustained effects on SBP, body mass, or food intake. Exercise training, irrespective of diet, lowered dietary fat intake.

Obesity due to high fat diet decreases the sympathetic nervous and cardiovascular responses to intracerebroventricular leptin in rats

Obesity is associated with an increase in plasma leptin levels primarily derived from enhanced expression of the leptin gene in the adipose tissue. Leptin levels and expression are higher in females than males. The main functions of leptin are to decrease food intake and increase sympathetic nerve activity, especially in the brown adipose tissue. The high levels of leptin in obese, female rats suggest leptin resistance. In this article we describe experiments designed to investigate the effect of the intracerebroventricular (i.c.v.) administration of leptin on lumbar sympathetic nerve activity (LSNA) and cardiovascular parameters in female rats fed a low fat diet (control), a high fat diet (obese), or high fat diet followed by a period of food restrictions (reduced). The i.c.v. leptin administration increased LSNA in control rats, but decreased it in obese rats. In weight reduced animals the LSNA response to leptin returned to control levels. The i.c.v. leptin increased the mean arterial pressure in control and wt. reduced rats, but not in obese animals. The heart rate did not respond to leptin in any animal group. These results suggest that obesity decreases the central nervous system (CNS)-mediated lumbar sympathetic nervous and cardiovascular responses to leptin and that these responses recover following food restriction and wt. reduction. We conclude that obesity is associated with a decreased CNS response to leptin leading to a decrease in leptin effects to increase the activities of the autonomic nervous and cardiovascular systems.

Chronic weight cycling increases oxidative DNA damage levels in mammary gland of female rats fed a high-fat diet

Oxidative DNA damage levels may be a marker of breast cancer risk that is modulated by diet. We examined the effects of a high-fat diet fed in varying feeding regimens on levels of 5-hydroxymethyl-2'-deoxyuridine (5-OHmU), an oxidized thymidine residue, in DNA from mammary gland of aging female rats. A total of 48 rats were randomly divided into four groups: ad libitum fed (AL), weight cycled above baseline (WC-G), weight cycled below baseline (WC-L), or energy restricted (ER) for 28 weeks. WC groups were fed repeated ad libitum/restricted amounts of the diet. At sacrifice, both WC groups had body weights similar to the ER group but higher levels of 5-OHmU (p < 0.01). 5-OHmU levels were higher in the WC groups than in the AL group, even though body weights of the WC groups were significantly lower (p < 0.001). These results indicate that a history of weight cycling, even when body weight is reduced, can have adverse effects on 5-OHmU levels in mammary gland DNA, a potential biomarker of cancer risk. Constant control of calories for the maintenance of body weight, therefore, may be more beneficial.