medwireNews: Simply maintaining weight during adulthood, at a population level, could prevent one in five diabetes cases, report researchers.
“While primary weight maintenance in adulthood is challenging, it should be considered in contrast to the even more difficult challenge of weight loss and subsequent secondary weight maintenance,” say Patrik Wennberg (Umeå University, Sweden) and co-authors.
Among 33,184 Swedish adults aged 30–60 years, each 1% increase in bodyweight during 10 years of follow-up was associated with a significant 5% increase in the risk for diabetes. This was the case irrespective of participants’ baseline bodyweight, despite the absolute risk for diabetes being higher in those with higher starting body mass index (BMI).
Overall, 56.6% of the participants gained weight during follow-up, while 29.1% remained stable and 14.2% lost weight. The population attributable fraction (PAF) of diabetes was 21.9% for weight gain, meaning that a little over one in five cases of diabetes could be prevented if middle-aged adults in the general population maintained their BMI within 1.0 kg/m2 of baseline.
Furthermore, about two in five cases (PAF of 42.4%) would be prevented if the weight of the middle-aged population fell by an average of 5% or 1.5 kg/m2.
“This is equivalent to weight loss of between 3.0 and 6.0 kg for an individual measuring 172.5 cm (the average adult height in Sweden),” notes the team in BMC Public Health.
When restricted to participants who were overweight or obese at baseline (around 45%), the PAF for weight maintenance was 14.3% and that for weight loss was 23.3%.
“The potential of primary weight maintenance in reducing diabetes risk and burden is an important public health message, and a population-based approach to promote primary weight maintenance (reduce or prevent weight gain in middle age) is desirable as a complement to targeting individuals at high risk,” say the researchers.
They note, however, that there is little evidence to date supporting specific population-level interventions for weight maintenance or loss.
“The barriers and facilitators associated with primary weight maintenance are complex, and any effective approach will require changes to policy, environments and health care systems, and incorporate multiple levels and components,” they conclude.
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