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Previous Volume 333:686-692 September 14, 1995 Number 11 Next

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ABSTRACT

Background Weight loss and fluctuations in weight have been associated with increased risks of death from cardiovascular disease and from all causes. The clinical and public health implications of these associations are unclear.

Methods We examined the long-term relation of weight change and fluctuation in weight with mortality over a 6-year period in 6537 middle-aged Japanese American men enrolled in the Honolulu Heart Program, a prospective study (mean follow-up, 14.5 years).

Results Men who had a weight loss of 4.5 kg or more or who had large fluctuations in weight (or both) over a six-year period were, on average, in poorer health than their peers whose weight was more stable. After the exclusion of subjects who died during the first five years of follow-up and after adjustment for confounding factors, a weight loss of more than 4.5 kg was associated with the risk of death from all causes, with the exception of death from cancer. The subjects whose weight fluctuated the most had a significantly higher risk of death from cardiovascular causes (relative risk, 1.41; 95 percent confidence interval, 1.03 to 1.93), death from noncardiovascular and noncancerous causes (relative risk, 1.53; 95 percent confidence interval, 1.12 to 2.10), and death from all causes (relative risk, 1.25; 95 percent confidence interval, 1.05 to 1.48). However, the associations of weight loss and variation in weight with death from cardiovascular causes and from noncardiovascular and noncancerous causes were not found among healthy men who had never smoked.

Conclusions The associations between weight loss or fluctuation and mortality were partially explained by confounding factors and by the presence of preexisting disease. However, weight loss and weight fluctuation were unrelated to death among healthy men who had never smoked. Thus, concern about the health hazards of weight loss and variation may not be applicable to otherwise healthy people.

Source Information

From the Division of Epidemiology, School of Public Health, University of Minnesota, Minneapolis (C.I.); the Honolulu Epidemiology Research Unit, Division of Epidemiology and Clinical Applications, National Heart, Lung, and Blood Institute, Bethesda, Md. (D.S.S., C.M.B.); and the Department of Medicine, John A. Burns School of Medicine, University of Hawaii at Manoa, Manoa (H.P.).

Address reprint requests to Dr. Iribarren at the Division of Epidemiology, School of Public Health, University of Minnesota, 1300 S. Second St., Suite 300, Minneapolis, MN 55454-1015.

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