Body-weight cycling, often referred to as yo-yo dieting, has been found to significantly elevate the risk of kidney disease in individuals with type 1 diabetes, no matter their body mass index (BMI) or other usual risk factors, as revealed in a recent study.
Body-weight cycling, commonly known as yo-yo dieting, has been identified as a major risk factor for kidney disease in individuals with type 1 diabetes, independent of body mass index (BMI) and other standard risk factors, according to a new study published in the Endocrine Society’s Journal of Clinical Endocrinology & Metabolism.
Yo-yo dieting involves the cycle of consistently losing and regaining weight over the years. Reports suggest that this phenomenon affects up to 35% of men and 55% of women.
This dieting approach has been linked to an increased likelihood of heart-related events in both the general populace and individuals with type 2 diabetes, and more recently, it has been recognized in those with type 1 diabetes.
This study marks the first instance of demonstrating a connection between yo-yo dieting and kidney-related issues in individuals with type 1 diabetes. Traditionally, type 1 diabetes was viewed as a condition associated with lean individuals. However, similar to the general population, obesity rates are also climbing among those diagnosed with type 1 diabetes, the authors highlight.
Lead author Marion Camoin, M.D., from the Centre Hospitalier Universitaire de Bordeaux, France, stated, “We demonstrated that significant fluctuations in body weight are related to a heightened risk of various outcomes associated with diabetic kidney disease (DKD) progressions in individuals with type 1 diabetes, regardless of established DKD risk factors. To our knowledge, this is the first research displaying this connection.”
Researchers from France analyzed six years of body weight data from 1,432 participants involved in the Diabetes Control and Complications Trial (DCCT)/Epidemiology of Diabetes Interventions and Complications (EDIC) study.
To identify yo-yo dieting patterns, the primary measure used was known as “variability independent of the mean” (VIM), which evaluates weight changes above and below a person’s average weight.
Utilizing the weight fluctuation data, the researchers assessed six criteria to determine kidney function decline and the progression towards chronic kidney disease. The primary criterion assessed was the “estimated glomerular filtration rate” (eGFR), which gauges how effectively the kidneys filter out toxins from the bloodstream.
According to the study, participants who showed larger weight fluctuations had a 40% decline in eGFR from their baseline values. Those with significant weight changes were also more likely to show moderately and severely increased albuminuria, a condition characterized by the abnormal presence of the protein albumin in urine. High albumin levels are typically seen in patients suffering from kidney disease.
Similar kidney disease findings were corroborated by other indices evaluated in the study.
Potential Risk Factors of Body-Weight Cycling
The exact mechanisms that connect body-weight cycling to renal risk are not yet completely understood, the authors acknowledge. However, they propose several hypotheses, including the notion that insulin therapy, essential for treating type 1 diabetes, may contribute to body-weight fluctuations. Additional theories suggest that body-weight cycling may put extra stress on the heart, potentially leading to kidney and vascular damage.
The authors of the current study recommend strategies aimed at reducing the risks associated with yo-yo dieting and, consequently, the development of kidney disease:
“Efforts directed at weight loss for individuals with type 1 diabetes should prioritize long-term weight maintenance, as maintaining stable weight may positively influence health outcomes.”
