Including Mixed Tree Nut Snacks in a Weight Loss and Weight Maintenance Intervention Resulted in Weight Loss and Increased Satiety

Abstract Objectives Tree nuts are an excellent dietary source of protein and healthy fat leading to increased satiety. Tree nuts also provide polyphenols, vitamins and minerals supporting the immune response. However, there is a concern that tree nuts are not suitable to be included in a weight loss diet due to their fat content. Therefore, it was the objective of the study to test whether including mixed tree nuts in a weight loss and maintenance program will lead to weight loss by increasing satiety and decreasing inflammation. Methods We performed a randomized, controlled, two-arm study in 95 overweight individuals consuming 1.5 oz of mixed tree nuts daily (n = 56) or equal amount of calories in the form of a pretzel snack (n = 39) as part of a hypocaloric weight loss diet (−500 calories of resting metabolic rate) for 12 wks followed by an isocaloric weight maintenance program for an additional 12 wks. Results The dropout rate was significantly lower in the tree nut (16.4%) compared to the pretzel (35.9%) group. Participants experienced significant weight loss (12 wks: −1.6 and −1.9 and 24 wks: −1.5 kg and −1.4 kg) in the tree nut and pretzel group, respectively, without difference between groups at any time point. In addition, both groups showed a significant decrease in diastolic blood pressure at 12 wks and a significant increase in satiety at 24 wks, but only participants in the mixed tree nut group showed significant decrease in heart rate at 4, 12 and 24 wks. Plasma oleic acid concentration was significantly increased at 12 and 24 wks in the tree nut group, while in the pretzel group plasma oleic acid was significantly increased and stearic acid decreased at 12 wks and linolenic acid was increased at 24 wks. No change in fasting plasma triglyceride, total cholesterol and HDL-cholesterol was observed in both groups. No change in inflammatory markers except plasma MCP-1 was decreased significantly in the tree nut group at 4 wks. Conclusions In summary, including mixed tree nuts in a weight loss and maintenance diet can maintain compliance and promote weight loss similar to standard weight loss and maintenance diets. Although both, the mixed tree nut diet and pretzel diet resulted in decreased diastolic blood pressure, only consumption of the mixed tree nut diet led to significantly decreased heart rate and increased study retention. Funding Sources International Tree Nut Council.

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Mixed Tree Nut Snacks Compared to Refined Carbohydrate Snacks Resulted in Weight Loss and Increased Satiety during Both Weight Loss and Weight Maintenance: A 24-Week Randomized Controlled Trial

Nutrients ◽

10.3390/nu13051512 ◽

2021 ◽

Vol 13 (5) ◽

pp. 1512

Author(s):

Jing Wang ◽

Sijia Wang ◽

Susanne M. Henning ◽

Tianyu Qin ◽

Yajing Pan ◽

...

Keyword(s):

Heart Rate ◽

Weight Loss ◽

Oleic Acid ◽

Controlled Trial ◽

Weight Maintenance ◽

Caloric Content ◽

Randomized Controlled ◽

Weight Loss Diet ◽

Maintenance Program ◽

Excellent Source

Mixed tree nuts (MTNs) are an excellent source of protein and healthy fat contributing to satiety. However, their relatively high caloric content might not be beneficial in a weight loss diet. The present study was designed to test whether including MTNs in a weight loss and maintenance program interferes with weight management compared to a refined carbohydrate pretzel snack (PS). We performed a randomized, controlled, two-arm study in 95 overweight individuals consuming 1.5 oz of MTNs or PS daily as part of a hypocaloric weight loss diet (−500 kcal) over 12 weeks followed by an isocaloric weight maintenance program for 12 weeks. Participants in both groups experienced significant weight loss (12 weeks: −1.6 and −1.9 and 24 weeks: −1.5 and −1.4 kg) compared to baseline in the MTN and PS groups, respectively. However, there was no difference in weight loss and other outcome parameters between the MTN and PS groups. The MTN group showed a significant increase in satiety at 24 weeks. Both groups had a decrease in diastolic blood pressure at 12 weeks. Participants in the MTN group showed significant decreases in heart rate at 4, 12, and 24 weeks. Plasma oleic acid was significantly increased at 12 and 24 weeks in the MTN group but only at 12 weeks in the PS group. Plasma MCP-1 was decreased significantly in the MTN group at 4 weeks. In summary, participants in both groups lost weight, but only the MTN intervention increased satiety at 24 weeks, enhanced retention, decreased heart rate, and increased serum oleic acid at 24 weeks.

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Obesity does not Impair Ambulatory Cardiovascular and Autonomic Responses Post-exercise

International Journal of Sports Medicine ◽

10.1055/a-1393-6184 ◽

2021 ◽

Author(s):

Gabriel Kolesny Tricot ◽

Fabiula Isoton Isoton Novelli ◽

Lucieli Teresa Cambri

Keyword(s):

Blood Pressure ◽

Heart Rate ◽

Diastolic Blood Pressure ◽

Maximal Exercise ◽

Young Men ◽

Autonomic Modulation ◽

Incremental Test ◽

Post Exercise ◽

Cardiac Autonomic Modulation ◽

Main Effect

AbstractThis study aimed to assess whether obesity and/or maximal exercise can change 24 h cardiac autonomic modulation and blood pressure in young men. Thirty-nine men (n: 20; 21.9±1.8 kg·m−2, and n: 19; 32.9±2.4 kg·m−2) were randomly assigned to perform a control (non-exercise) and an experimental day exercise (after maximal incremental test). Cardiac autonomic modulation was evaluated through frequency domain heart rate variability (HRV). Obesity did not impair the ambulatory HRV (p>0.05), however higher diastolic blood pressure during asleep time (p=0.02; group main effect) was observed. The 24 h and awake heart rate was higher on the experimental day (p<0.05; day main effect), regardless of obesity. Hypotension on the experimental day, compared to control day, was observed (p<0.05). Obesity indicators were significantly correlated with heart rate during asleep time (Rho=0.34 to 0.36) and with ambulatory blood pressure(r/Rho=0.32 to 0.53). Furthermore, the HRV threshold workload was significantly correlated with ambulatory heart rate (r/Rho=− 0.38 to−0.52). Finally, ambulatory HRV in obese young men was preserved; however, diastolic blood pressure was increased during asleep time. Maximal exercise caused heart rate increase and 24h hypotension, with decreased cardiac autonomic modulation in the first hour, regardless of obesity.

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Cardiovascular Responding during Anger and Fear Imagery

Psychological Reports ◽

10.2466/pr0.1982.50.1.219 ◽

1982 ◽

Vol 50 (1) ◽

pp. 219-230 ◽

Cited By ~ 53

Author(s):

Richard J. Roberts ◽

Theodore C. Weerts

Keyword(s):

College Students ◽

Blood Pressure ◽

Heart Rate ◽

Systolic Blood Pressure ◽

Diastolic Blood Pressure ◽

Scene Change ◽

Emotional Responding ◽

Analysis Of Change ◽

Screening Interview

This study was designed to determine if visualization of anger- and fear-provoking scenes produced differential physiological patterns similar to those produced by in vivo manipulations. Normotensive college students were selected on the basis of their responses to newly developed Anger and Fear/Anxiety questionnaires and for their ability to construct arousing scenes during a screening interview. In a 2 × 2 design (intensity × emotion), four scenes (high and low anger, high and low fear) were constructed individually for each of 16 subjects to imagine. Diastolic blood pressure, systolic blood pressure, and heart rate were monitored during visualization of each scene. Change in diastolic blood pressure was significantly greater for high anger than for high fear as predicted. Analysis of change in heart rate and systolic blood pressure showed significant effects for intensity only. These results provide further support for the concept of physiological differentiation in human emotion and suggest the utility of imagery for systematic study of human emotional responding.

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Effect of Anesthesia Techniques on Pain Severity, Hemodynamic Changes, and Patients’ Satisfaction in Elective Cesarean Section

ACTA MEDICA IRANICA ◽

10.18502/acta.v57i7.2328 ◽

2020 ◽

Author(s):

Abdollah Jafarzadeh ◽

Maryam Hadavi ◽

Gholamhossein Hasanshahi ◽

Mohsen Rezaeian ◽

Reza Vazirinejad ◽

...

Keyword(s):

Blood Pressure ◽

Heart Rate ◽

Postoperative Pain ◽

Cesarean Section ◽

Diastolic Blood Pressure ◽

Elective Cesarean Section ◽

Hemodynamic Changes ◽

Apgar Scores ◽

Patients Satisfaction ◽

Elective Cesarean

The severity of postoperative pain and hemodynamic changes during and post-cesarean section have a direct effect on the neonatal and maternal condition. This study aimed to compare pain severity, hemodynamic changes, and patient satisfaction following two anesthesia techniques in elective cesarean section. In this blinded study, 60 women who were candidate for cesarean section were allocated into two equal groups of general anesthesia (GA) and spinal anesthesia (SA). Systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR), and O2 Saturation at pre cesarean (T0), the uterine incision time (T1), end of surgery (T2), 6h (T3), 12h (T4), and 24 hours post-cesarean (T5) were measured. A Visual Analog Scale assessed post-cesarean pain, 6, 12, and 24 hours post-cesarean. Gender, birth weight, first- and fifth- minutes’ apgar score was recorded in the checklists. The VAS score was significantly higher in the GA group at 6h, 12h, and 24 hours post-cesarean (P=0.014, P=0.002, P=0.017, respectively). SBP and DBP at T1 in the GA group were significantly higher than in the S.A group (P<0.001). The heart rate at T0 and T1 in the GA group was lower than the SA group (P=0.001, P=0.045 respectively). The difference between the apgar scores of the two groups was not significant. SA for cesarean section was associated with lower postoperative pain, systolic and diastolic blood pressure. However, the two groups had no significant difference in terms of patients’ satisfaction and apgar scores. © 2019 Tehran University of Medical Sciences. All rights reserved. Acta Med Iran 2019;57(7):424-429.

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A pilot study investigating the relationship between heart rate variability and blood pressure in young adults at risk for cardiovascular disease

Clinical Hypertension ◽

10.1186/s40885-021-00185-z ◽

2022 ◽

Vol 28 (1) ◽

Author(s):

Linda P. Bolin ◽

Amelia D. Saul ◽

Lauren L. Bethune Scroggs ◽

Carolyn Horne

Keyword(s):

Blood Pressure ◽

Cardiovascular Disease ◽

Heart Rate ◽

Heart Rate Variability ◽

Pilot Study ◽

Family History ◽

Diastolic Blood Pressure ◽

Biofeedback Training ◽

Paced Breathing ◽

History Of

Abstract Background Cardiovascular disease is one of the leading causes of death globally with hypertension being a primary cause of premature death from this disease process. Individuals with a family history of cardiovascular disease and hypertension are at a greater risk for developing the same sequela. Autonomic cardiac control is important in the level of cardiac function. One intervention that is effective in improving cardiovascular function is heart rate variability biofeedback training. The purpose of our study was to determine the effectiveness of heart rate biofeedback training on HRV and blood pressure in individuals with a family history of cardiovascular disease. Methods Thirty-four participants (76.5% female, 22.7 ± 4.3 years) completed a baseline assessment and training using an established short-term HRV protocol followed by two weeks of at-home paced breathing employing a smartphone application. The participants were then reassessed in a biofeedback clinic. Results The participants physiological measures showed a significant increase in means between pre and post intervention of SDNN (t (32) = 2.177, p =.037) and TP, (t (32) = 2.327 p = .026). Correlation noted a medium effect on diastolic blood pressure and high frequency heart rate variability, F, r = .41, n =33, p < .05. A multiple regression with all predictor variables in the model found no significance with diastolic and systolic blood pressure. Conclusions The findings from this pilot study demonstrated that a two-week paced breathing intervention may assist in reducing heart rate and diastolic blood pressure while improving heart rate variability.

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Comparison of Ropivacaine-Fentanyl with Bupivacaine-Fentanyl for Labour Epidural Analgesia

The Open Anesthesiology Journal ◽

10.2174/2589645802014010108 ◽

2020 ◽

Vol 14 (1) ◽

pp. 108-114

Author(s):

Kalpana Kulkarni ◽

Rahul Patil

Keyword(s):

Blood Pressure ◽

Heart Rate ◽

Epidural Analgesia ◽

Diastolic Blood Pressure ◽

Diastolic Pressure ◽

Vas Score ◽

Group I ◽

Significant Difference ◽

Labour Epidural Analgesia ◽

Group Ii

Background: Bupivacaine with opioid is commonly used for labour epidural analgesia. Ropivacaine is considered as an alternative to bupivacaine due to its lower cardiovascular complications. However, there is a controversy regarding the efficacy of these drugs as some studies suggest equivalent action, whereas others report that ropivacaine produces less motor blockade. The study aimed to compare the effect of ropivacaine-fentanyl and bupivacaine-fentanyl for labour analgesia. Materials and Methods: The prospective randomized study was performed on 60 parturients, divided into two groups of 30 subjects each. Group I received 10ml of bupivacaine 0.1% + fentanyl 2µg/ml and Group II received 10ml of ropivacaine 0.1% + fentanyl 2µg/ml by epidural catheter. Pre-anaesthetic evaluation was performed on all the participants and all were administered metoclopramide 0.25mg/kg and ondansetron 0.08-0.1mg/kg intravenously as premedication. The baseline and post anaesthesia systolic, diastolic blood pressure, heart rate, VAS score, degree of motor block, sedation and APGAR score of the baby were recorded. The data were tabulated and statistically analyzed. Results: When compared, there was no significant difference in systolic/diastolic blood pressure in two groups except at 360 min where diastolic pressure was low in group II. Significantly higher heart rate at 30 min (P=0.0003), 120 min (0.006), and 300 min (P=0.001) was observed in group I subjects. VAS score was significantly less at 180 min (P=0.019) and 300 min (P=0.019) in group II. Adverse effects such as fetal bradycardia, nausea/vomiting and hypotension observed were clinically insignificance when compared in two groups. Conclusion: Bupivacaine and ropivacaine produce an equal degree of analgesia and hemodynamic stability in 0.1% of concentration when added with 2µg/ml fentanyl . However, heart rate was well maintained with lower VAS scores in group II receiving ropivacaine. No significant difference in the side effects between the two groups. Hence, Ropivacaine can be used as a safe alternative to bupivacaine for labour epidural analgesia.

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Evaluation of the Cardiovascular Effects of Clonidine in Neonates Treated for Neonatal Abstinence Syndrome

The Journal of Pediatric Pharmacology and Therapeutics ◽

10.5863/1551-6776-23.6.473 ◽

2018 ◽

Vol 23 (6) ◽

pp. 473-478

Author(s):

Raymond P. Meddock ◽

Deirdre Bloemer

Keyword(s):

Blood Pressure ◽

Heart Rate ◽

Diastolic Blood Pressure ◽

Neonatal Intensive Care ◽

Dose Range ◽

Safety Data ◽

Cardiovascular Effects ◽

Neonatal Abstinence Syndrome ◽

Abstinence Syndrome

OBJECTIVES Neonatal abstinence syndrome (NAS) is characterized by withdrawal symptoms in neonates exposed to legal or illegal substances in utero, and it is often managed with medications such as opiates, phenobarbital, and clonidine. Clonidine use is increasing, but further safety data regarding its use in neonates are warranted. This study evaluated the effects of clonidine on heart rate and blood pressure in neonates treated for NAS at doses up to 24 mcg/kg/day. METHODS A retrospective review via the electronic medical record of infants at least 35 weeks' gestation treated adjunctively with clonidine for NAS in the neonatal intensive care unit at St Elizabeth was conducted. Heart rate, and systolic and diastolic blood pressure were recorded at baseline, while on different dose ranges of clonidine (small: ≤1.5 mcg/kg per dose every 3 hours; medium: >1.5 to 2 mcg/kg per dose every 3 hours; and large: >2 mcg/kg to 3 mcg/kg per dose every 3 hours), and upon discontinuation. RESULTS A total of 64 infants treated with clonidine for NAS between August 2015 and December 2016 were included. Heart rate decreased in all clonidine dose ranges compared with baseline (average reduction of 7 bpm [CI: −12 to −2], 9 bpm [CI: −16 to −2], and 10 bpm [CI: −18 to −1] for the small, medium, and large dose ranges, respectively; p < 0.0001). Systolic and diastolic blood pressure were not significantly different from baseline when infants were receiving any dose of clonidine, except diastolic blood pressure while on medium–dose range clonidine, where diastolic blood pressure was higher than baseline (p = 0.0128). Increases in systolic and diastolic blood pressure were evident upon discontinuation of clonidine (p < 0.0001 and p = 0.0156, respectively). CONCLUSIONS Clonidine doses up to 24 mcg/kg/day are well tolerated in neonates ≥35 weeks' gestation treated for NAS. Any decreases in heart rate are likely clinically insignificant, and increases in blood pressure upon discontinuing clonidine are mild and may be mitigated further with extended discontinuation protocols. Further trials should be conducted to evaluate the long-term safety of clonidine in this population.

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COMPARISON STUDY OF IVABRADINE WITH METOPROLOL IN MANAGEMENT OF ACUTE CORONARY SYNDROME

International Journal of Medical and Biomedical Studies ◽

10.32553/ijmbs.v5i9.2201 ◽

2021 ◽

Vol 5 (9) ◽

Author(s):

Rishman Tandi ◽

Tanvi Kumar ◽

Amritpal Singh Kahlon ◽

Aaftab Sethi

Keyword(s):

Blood Pressure ◽

Heart Rate ◽

Acute Coronary Syndrome ◽

Systolic Blood Pressure ◽

Diastolic Blood Pressure ◽

Beta Blocker ◽

Beta Blockers ◽

Coronary Syndrome ◽

Group A ◽

Group B

Introduction: Acute coronary syndrome remains as one of the most important causes for morbidity and mortality in developed countries. Therefore, evidence-based management strategy is required to offset the loss of health during an acute coronary syndrome. An effective approach includes both medical and surgical methods. This study was conducted to evaluate the medical method of management. Objective: To study blood pressure and heart rate variability after administration of Ivabradine or metoprolol in cases with acute coronary syndrome. Materials and methods: The study was a Prospective single center observational study conducted in patients attending Cardiology Intensive Care Unit in Nayyar Heart and Superspecialty Hospital, a tertiary care centre located in an urban area. All patients with Acute coronary syndrome admitted to the emergency or cardiac care unit were analysed with ECG as a preliminary diagnostic test and confirmed with troponin markers. They were either given Ivabradine or Metoprolol. Baseline evaluation and follow up was done and necessary data was collected and analysed. Results: 100 patients were included in the study out of which 50 were given Metoprolol (Group A) and 50 were given Ivabradine (Group B). Themean age of studied cases was found to be 66.54 years in group A and 68.69 years in group B. It was observed that there was a fall in heart rate by 26.8 beats per minute with beta blocker and 24.4 beats per minute with Ivabradine. In case of blood pressure measurement, in patients with beta blocker administration, there was a fall of 25 mm Hg in systolic blood pressure and 17 mm Hg in diastolic blood pressure However, with Ivabradine there was only a fall of 8mm Hg in systolic Blood pressure and 6 mm Hg in diastolic blood pressure. Conclusion: Although Metoprolol is the drug of choice to decrease heart rate and blood pressure in acute coronary syndrome, Ivabradine is being increasingly used in cases where beta blockers are contraindicated as it has similar efficacy in lowering heart rate without compromising contractility of cardiac muscle, thereby maintaining LVEF and blood pressure. Keywords: Acute coronary syndrome, Beta Blockers, Metoprolol, Ivabradine.

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Exploring the relationship between schizophrenia and cardiovascular disease: A genetic correlation and multivariable Mendelian randomization study

10.1101/2021.07.09.21260260 ◽

2021 ◽

Author(s):

Rada R Veeneman ◽

Jentien M Vermeulen ◽

Abdel Abdellaoui ◽

Eleanor Sanderson ◽

Robyn E Wootton ◽

...

Keyword(s):

Heart Failure ◽

Blood Pressure ◽

Heart Rate ◽

Heart Rate Variability ◽

Diastolic Blood Pressure ◽

Mendelian Randomization ◽

Genetic Correlations ◽

Lipid Levels ◽

Early Repolarization ◽

Artery Disease

Importance: Individuals with schizophrenia have a reduced life-expectancy compared to the general population, largely due to an increased risk of cardiovascular disease (CVD). Clinical and epidemiological studies have been unable to fully unravel the nature of this relationship. Objective: Investigate genetic correlations and potential bi-directional effects between liability to schizophrenia and CVD. Design, setting, and participants: We obtained summary-data of genome-wide-association studies of schizophrenia (N=130,644), heart failure (N=977,323), coronary artery disease (N=332,477), systolic and diastolic blood pressure (N=757,601), heart rate variability (N=46,952), QT interval (N=103,331), early repolarization and dilated cardiomyopathy ECG patterns (N=63,700). We computed genetic correlations with linkage disequilibrium score regression and conducted bi-directional Mendelian randomization (MR). With multivariable MR, we investigated whether associations were mediated by smoking, body mass index, physical activity, lipid levels, or type 2 diabetes. To ensure robustness, we applied a range of sensitivity methods. Main outcomes and measures: Schizophrenia, heart failure, coronary artery disease, systolic blood pressure, diastolic blood pressure, heart rate variability, QT interval, early repolarization, dilated cardiomyopathy. Results: Genetic correlations between liability to schizophrenia and CVD were close to zero (-0.02 to 0.04). With MR, we found robust evidence that liability to schizophrenia increases heart failure risk. This effect remained consistent with multivariable MR. There was also evidence that liability to schizophrenia increases early repolarization risk, largely mediated by BMI and lipid levels. Finally, there was evidence that liability to schizophrenia increases heart rate variability, a direction of effect contrasting previous studies. In the other direction, there was weak evidence that higher systolic, but not diastolic, blood pressure increases schizophrenia risk. Conclusions and relevance: Our findings indicate that liability to schizophrenia increases the risk of heart failure, and that this is not mediated by key health behaviours. This is consistent with the notion that schizophrenia is characterised by a systemic dysregulation of the body (including inflammation and oxidative stress) with detrimental effects on the heart. To decrease cardiovascular mortality among schizophrenia patients, priority should lie with optimal treatment and interventions in early stages of psychoses. We also identified early repolarization, currently understudied, as a potential CVD marker among patients with schizophrenia.

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Abstract 44: Cardiometabolic Responses to Weight Change are Different between Obese and Normal Weight Adults Who are Metabolically Healthy: The Atherosclerosis Risk in Communities Study

Circulation ◽

10.1161/circ.131.suppl_1.44 ◽

2015 ◽

Vol 131 (suppl_1) ◽

Author(s):

Zhaohui Cui ◽

Kimberly P Truesdale ◽

Patrick T Bradshaw ◽

Jianwen Cai ◽

June Stevens

Keyword(s):

Risk Factors ◽

Blood Pressure ◽

Weight Loss ◽

Weight Gain ◽

Weight Change ◽

Weight Maintenance ◽

Cvd Risk Factors ◽

Cvd Risk ◽

Obese Adults ◽

Metabolically Healthy

Introduction: The 2013 AHA/ACC/TOS Guideline for the Management of Overweight and Obesity in Adults recommended weight loss for obese adults in order to reduce their cardiovascular disease (CVD) risk. However, not all obese adults develop CVD and approximately 17% of obese Americans in the 1999-2004 NHANES were metabolically healthy. The absence of abnormal CVD risk factors in this subgroup of obese adults indicates that some individuals are resistant to excess adiposity and positive energy balance, and raises the question of whether all obese adults should be recommended for weight loss treatment. We know of no study that has examined whether metabolically healthy obese (MHO) adults respond to weight changes the same way as metabolically healthy normal weight adults (MHNW). Also, no study has compared the effects of weight loss, weight maintenance and weight gain on CVD risk factors in MHO adults. Hypothesis: We hypothesized that the effects of weight change would be different in MHNW and MHO adults, with MHO adults having less stable risk factors, and that weight loss has a protective effect on CVD risk factors in the MHO compared to weight maintenance and weight gain. Methods: Data were from 2,710 MHO and MHNW participants in the Atherosclerosis Risk in Communities (ARIC) study. Four examinations yielded 4,541 observations over sequential 3-year intervals. Metabolically healthy was defined as absence of all components of metabolic syndrome, excluding waist circumference, at the beginning of a 3-year interval. Mixed effect models were applied to individually compare changes in five CVD risk factors (systolic blood pressure, diastolic blood pressure, triglycerides, high-density lipoprotein cholesterol and glucose) in MHO and MHNW adults within 3 weight change categories (<3% weight loss, weight maintenance (±3%) and >3% weight gain). Results: Weight loss was associated with small or no changes in the five CVD risk factors in both MHO and MHNW adults. Weight maintenance was associated with larger increases in MHO compared to MHNW adults in triglycerides (mean ± standard error: 10.0±1.7 vs. 6.5±1.0 mg/dL) and glucose (1.7±0.4 vs. 0.9±0.2 mg/dL). Weight gain was associated with larger increases in systolic (8.6±0.6 vs. 6.2±0.4 mmHg) and diastolic (3.9±0.4 vs. 2.5±0.3 mmHg) blood pressure, triglycerides (22.0±1.8 vs. 16.0±1.1 mg/dL) and glucose (4.9±0.4 vs. 1.9±0.3 mg/dL) among the MHO compared to the MHNW. MHO weight losers experienced more favorable changes in the five CVD risk factors compared to MHO weight maintainers (p<0.04) or gainers (p<0.0001). Conclusions: We showed that compared to MHNW, MHO adults experienced similar changes in CVD risk factors with weight loss and larger increases with weight maintenance and gain. Our study supports the 2013 Guideline that primary health care providers should recommend weight loss treatment for MHO patients.

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