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 For people with coronary artery disease, rapidly losing and regaining weight — or “yo-yo” dieting — may increase the risk for deadly heart attacks and strokes, a new study suggests. 
 
 Scientists prospectively followed 9,509 men and women with stable coronary artery disease, examining them and recording their weight an average of 12 times over five years. The median body weight variation over the period was 3.8 pounds per visit. 
 
 After adjusting for other risk factors, they found that compared with the one-fifth of people with the lowest weight variability, the one-fifth with the highest had a 78 percent higher risk of new onset diabetes, a 117 percent higher risk of heart attack, a 136 percent higher risk of stroke, and a 124 percent higher risk of death. The study, sponsored by Pfizer, is in The New England Journal of Medicine. 
 
 “It’s important to lose weight,” said the lead author, Dr. Sripal Bangalore, an associate professor of medicine at the New York University School of Medicine, “but this data says you have to keep it off. Many times people are motivated until they lose the weight, and then they feel they can take it easy. Maybe this information can be used as motivation to keep the weight off.” ||||| Past studies have associated yo-yo dieting with increased risk of poor heart health. For individuals with pre-existing heart disease, however, new research finds that the health consequences of repeatedly losing and gaining weight may be even more severe. 
 
 
 
 Researchers have found that yo-yo dieting may have serious health implications for people with coronary heart disease. Researchers have found that yo-yo dieting may have serious health implications for people with coronary heart disease. 
 
 Researchers found that people with coronary heart disease who had experienced large fluctuations in weight over an average of 4.7 years were at much higher risk of heart attack, stroke, and death than people who experienced little change in body weight. 
 
 Lead study author Dr. Sripal Bangalore, of the Cardiovascular Clinical Research Center at NYU Langone Medical Center in New York, and colleagues recently reported their results in the New England Journal of Medicine. 
 
 Yo-yo dieting - also known as "weight cycling" or the "yo-yo effect" - is defined as repeated cycles of weight loss and weight gain. 
 
 A number of studies have documented the possible health risks of yo-yo dieting. One study reported by Medical News Today last year, for example, uncovered a link between weight cycling and greater risk of death from heart disease. 
 
 The new research from Dr. Bangalore and colleagues builds on those findings, revealing how yo-yo dieting may impact the health of individuals who have pre-existing coronary heart disease. 
 
 Coronary heart disease (CHD) - also referred to as coronary artery disease - is the most common form of heart disease among men and women in the United States. Each year, the condition kills more than 370,000 people in the country. 
 
 CHD is characterized by atherosclerosis - the buildup of plaque in the coronary arteries, which are those that supply the heart with oxygen-rich blood. This plaque buildup may block the blood supply to the heart, which can lead to angina (severe chest pain) or heart attack. 
 
 Largest weight fluctuations linked to 124 percent more deaths 
 
 For their study, Dr. Bangalore and colleagues analyzed the data of 9,509 men and women with CHD aged between 35 and 75 years. 
 
 As well as CHD, all subjects had high cholesterol levels and a history of other heart problems. Around half of the participants were undergoing intensive cholesterol-lowering therapy. 
 
 Over a median follow-up period of 4.7 years, participants were monitored for changes in body weight, and the researchers looked at whether these changes were associated with poorer outcomes. 
 
 Subjects with the greatest changes in body weight experienced a weight fluctuation of up to 3.9 kilograms (around 8.6 pounds) during follow-up, while those with the smallest body weight changes had weight fluctuations of 0.9 kilograms (around 2 pounds). 
 
 The team found that for individuals who were overweight or obese at study baseline, there were 117 percent more heart attacks, 124 percent more deaths, and 136 percent more strokes among those who experienced the largest changes in body weight, compared with those who experienced the smallest body weight changes. 
 
 Additionally, the researchers found a link between changes in body weight and increased risk of new-onset diabetes. 
 
 These findings remained after accounting for participants' average body weight and the presence of common risk factors for heart disease, the authors note. 
 
 Findings raise concerns about weight fluctuation in people with CHD 
 
 Dr. Bangalore and team say that their study is only observational, so it is unable to prove cause-and-effect between yo-yo dieting and increased risk of heart attack, stroke, and death among people with CHD. 
 
 Additionally, the authors point to a number of limitations. For example, they were unable to pinpoint precisely why subjects lost or gained weight during follow-up. As such, it is possible that pre-existing heart problems led to weight changes. 
 
 Still, the researchers believe that their results warrant further investigation. 
 
 "Our findings suggest that we need to be concerned about weight fluctuation in this group that is already at high risk due to coronary disease. Even though this analysis was not designed to find out the causes of increased risk with body weight fluctuations, we need to examine how we can help Americans keep weight off, rather than having it go up and down." Dr. Sripal Bangalore 
 
 Learn how yo-yo dieting may be triggered by changes in gut microbes. ||||| NEW ORLEANS, Nov. 15, 2016 -- Repeatedly losing and regaining weight, known as weight cycling or yo-yo dieting, may increase the risk of death from heart disease among postmenopausal women who were of normal weight at the start of the study, according to research presented at the American Heart Association's Scientific Sessions 2016. 
 
 "Weight cycling is an emerging global health concern associated with attempts of weight loss, but there have been inconsistent results about the health hazards for those who experience weight cycling behavior," said Somwail Rasla, M.D., study lead author and internal medicine resident at Memorial Hospital of Rhode Island, Alpert Medical School, Brown University, in Providence, Rhode Island. 
 
 Researchers classified self-reported weight history from 158,063 post-menopausal women into four categories: stable weight, steady gain, maintained weight loss, and weight cycling. During a follow-up of 11.4 years, they found: 
 
 Women considered "normal-weight" at the start of the study who lost and regained weight had about three and a half times higher risk for sudden cardiac death than women whose weight remained stable. 
 
 Weight cycling in the normal-weight women was also associated with a 66 percent increased risk for coronary heart disease deaths. 
 
 No increase in either type of death occurred among overweight or obese women reporting weight cycling. 
 
 Similarly, no increase in death occurred among women who reported that they gained weight but did not lose it or, in the opposite scenario, that they lost weight without gaining it back. 
 
 Evidence indicates that being overweight in midlife increases the risk of dying from two types of heart disease. In the first type, coronary heart disease, the blood vessels to the heart become blocked by fat and other substances, decreasing blood flow to the heart. In the second type, sudden cardiac death, the heart's electrical system abruptly stops working, causing death. It is unclear whether losing and regaining weight in adulthood also increases the risk of death from these heart diseases, so the investigators looked at this relationship among postmenopausal women. 
 
 The study has several limitations. First, the study was observational, therefore it could only show association and not a cause and effect relationship. In addition, the study relied on self-reports, which could be inaccurate. Since sudden cardiac death occurred relatively infrequently, the cases that did occur could have resulted from chance. Finally, the study included only older women. 
 
 "More research is needed before any recommendations can be made for clinical care regarding the risks of weight cycling, since these results apply only to postmenopausal women and not to younger-aged women or men," Rasla said. 
 
 In the United States and worldwide, heart disease is the leading cause of death. Obesity is a major risk factor, along with high blood pressure and cholesterol, diabetes, physical inactivity, poor diet, and smoking. One way to lower your risk factors is by following the American Heart Association's Life's Simple 7 program, which recommends: (1) manage blood pressure; (2) control cholesterol; (3) reduce blood sugar; (4) get active; (5) eat better; (6) maintain normal weight; and (7) stop smoking. 
 
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 Co-authors are Marina Garas, D.O.; Mary B. Roberts, M.S.; Molly E. Waring, Ph.D.; Christine M. Albert, M.D., M.P.H.; Deepika Laddu, Ph.D.; Marcia L Stefanick, Ph.D.; David K. Garas, M.B.A.; and Charles B. Eaton, M.D., M.S. Author disclosures are on the abstract. 
 
 This study is funded by the National Heart Lung and Blood Institute. 
 
 Note: Scientific presentation time is 10:45 a.m. CT, Tuesday, Nov. 15 in the Science and Technology Hall, Population Science Section. 
 
 Additional Resources: 
 
 AHA expert perspective video (via Skype) interview clips (for download/edit) and infographic related to this news release are on the right column of the release link at http://newsroom. heart. org/ news/ yo-yo-dieting-dangerous-even-if-youre-not-overweight?preview= 4b43dc5a7dd762b7a35ea3c7bf52c731 
 
 Video clips with researchers/authors of the studies will be added to the release link after embargo. 
 
 For more news at AHA Scientific Sessions 2016, follow us on Twitter @HeartNews #AHA16.
– Losing weight is one thing, keeping it off quite another. And now researchers are finding that among those with coronary heart disease (CHD)—which the Mayo Clinic reports develops from damaged or diseased blood vessels typically caused by blockage and inflammation—yo-yo dieting may dramatically increase the risk of stroke, heart attack, and death. Reporting in the New England Journal of Medicine, researchers say they followed nearly 10,000 men and women with CHD between the ages of 35 and 75 for about five years, monitoring changes in body weight and other health outcomes. The takeaway? "It's important to lose weight, but this data says you have to keep it off," lead researcher Dr. Sripal Bangalore at the New York University School of Medicine tells the New York Times. The highest weight fluctuation was on average 8.6 pounds over five years, while the smallest body weight changes averaged closer to two pounds, reports Medical News Today. Those who were already overweight or obese at the beginning of the study and who experienced the highest level of weight fluctuation experienced 124% more deaths, 136% more strokes, and 117% more heart attacks, meaning these CHD patients were more than twice as likely to suffer these negative outcomes in just a few years than people with CHD whose weight only fluctuated two pounds. This doesn't pinpoint a cause, as pre-existing heart problems could be the culprit, but researchers hope to study this correlation further. (Yo-yo dieting is bad for women's hearts in general.)