The inverted U-shaped relationship between weight loss percentage and cardiovascular health scores

PURPOSE: Obesity is a significant risk factor for cardiovascular disease; however, the impact of weight loss on cardiovascular health (CVH) in individuals with specific obesity patterns remains incompletely understood. The objective of our study was to investigate the relationship weight loss percentage and CVH scores across individuals with various obesity patterns. METHODS: Our study utilized data from the National Health and Nutrition Examination Survey conducted between 2007 and 2018, involving a total of 12,835 participants aged 16 years or older, to conduct a cross-sectional analysis. Multiple linear regression and multinomial logistic regression methods were used to assess the correlation between the weight loss percentage and the CVH scores. Additionally, restricted cubic spline analysis was employed to examine the nonlinear relationship between the two variables. RESULTS: Compared to individuals with a weight loss percentage < 0%, participants with weight loss percentages of 0–5% and 5.1–10% showed improved CVH scores, with β values of 2.85 (95% CI 2.32–3.38) and 2.55 (95% CI 1.69–3.4), respectively. Regarding different obesity patterns, compared to participants with a weight loss percentage < 0%, participants with a weight loss percentage of 0–5% showed an increase in CVH scores in the normal weight and overweight/general obesity (OGO) groups, with β values of 1.45 (95% CI 0.7–2.19) and 1.22 (95% CI 0.46–1.97), respectively. Restricted cubic spline analysis revealed a significant inverted U-shaped relationship between the weight loss percentage and the CVH scores (with optimal CVH scores at 3%). CONCLUSIONS: There was an inverted U-shaped relationship between weight loss percentage and CVH scores, with moderate weight loss (0–10%, optimal value of 3%) being associated with improved CVH scores, especially among individuals with OGO. LEVEL V: Opinions of respected authorities, based on descriptive studies, narrative reviews, clinical experience, or reports of expert committees. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s40519-023-01619-3.