To the Editor.
—The article by Dr Katzel and colleagues1 shows that a 10% dietary weight loss significantly improved coronary artery disease (CAD) risk in healthy obese men, more than aerobic exercise training. This suggests 2 questions of importance to the roughly 30% of Americans who are medium weight: are the findings of Katzel and colleagues applicable to medium-weight persons, especially those with elevated CAD risk? And what is the optimal leanness for minimizing CAD risk? Results of intervention and epidemiologic studies suggest that the answer to the first question is yes, and that optimal leanness is very lean, represented by a body mass index (BMI) of approximately 20 to 22 kg/m2.Weight loss studies in nonobese persons show that dietary, or diet and exercise weight loss significantly reduces CAD risk. Walford et al2 found that a 14% weight loss after 6 months of diet and exercise
Greenberg J. Weight Loss vs Exercise to Reduce Coronary Artery Disease Risk Factors. JAMA. 1996;275(20):1545–1546. doi:10.1001/jama.1996.03530440023026
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