FREE NEJM E-TOC    HOME   |   SUBSCRIBE   |   CURRENT ISSUE   |   PAST ISSUES   |   COLLECTIONS   |   Search Term  Advanced Search

Sign in | Get NEJM's E-Mail Table of Contents — Free | Subscribe

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

	Full Text PDF Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited PubMed Citation

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.

Full Text of this Article

This article has been cited by other articles:

• Sauvaget, C., Ramadas, K., Thomas, G., Vinoda, J., Thara, S., Sankaranarayanan, R. (2008). Body mass index, weight change and mortality risk in a prospective study in India. Int J Epidemiol 37: 990-1004 [Abstract] [Full Text]  
• Pednekar, M. S, Hakama, M., Hebert, J. R, Gupta, P. C (2008). Association of body mass index with all-cause and cause-specific mortality: findings from a prospective cohort study in Mumbai (Bombay), India. Int J Epidemiol 37: 524-535 [Abstract] [Full Text]  
• Sogaard, A. J., Meyer, H. E., Tonstad, S., Haheim, L. L., Holme, I. (2008). Weight Cycling and Risk of Forearm Fractures: A 28-Year Follow-up of Men in the Oslo Study. Am J Epidemiol 167: 1005-1013 [Abstract] [Full Text]  
• Corrada, M. M., Kawas, C. H., Mozaffar, F., Paganini-Hill, A. (2006). Association of Body Mass Index and Weight Change with All-Cause Mortality in the Elderly. Am J Epidemiol 163: 938-949 [Abstract] [Full Text]  
• Lee, J. S., Kritchevsky, S. B., Tylavsky, F., Harris, T., Simonsick, E. M., Rubin, S. M., Newman, A. B., for the Health ABC Study, (2005). Weight Change, Weight Change Intention, and the Incidence of Mobility Limitation in Well-Functioning Community-Dwelling Older Adults. Journals of Gerontology Series A: Biological Sciences and Medical Sciences 60: 1007-1012 [Abstract] [Full Text]  
• Eilat-Adar, S., Eldar, M., Goldbourt, U. (2005). Association of Intentional Changes in Body Weight with Coronary Heart Disease Event Rates in Overweight Subjects Who Have an Additional Coronary Risk Factor. Am J Epidemiol 161: 352-358 [Abstract] [Full Text]  
• Maru, S., van Der Schouw, Y. T, Gimbrere, C. H., Grobbee, D. E, Peeters, P. H. (2004). Body mass index and short-term weight change in relation to mortality in Dutch women after age 50 y. Am. J. Clin. Nutr. 80: 231-236 [Abstract] [Full Text]  
• Wannamethee, S. G., Shaper, A. G., Walker, M. (2002). Weight Change, Weight Fluctuation, and Mortality. Arch Intern Med 162: 2575-2580 [Abstract] [Full Text]  
• Liu, L., Bopp, M. M., Roberson, P. K., Sullivan, D. H. (2002). Undernutrition and Risk of Mortality in Elderly Patients Within 1 Year of Hospital Discharge. Journals of Gerontology Series A: Biological Sciences and Medical Sciences 57: M741-746 [Abstract] [Full Text]  
• Wysoker, A. (2002). A Conceptual Model of Weight Loss and Weight Regain: An Intervention for Change. J Am Psychiatr Nurses Assoc 8: 168-173 [Abstract]  
• Somes, G. W., Kritchevsky, S. B., Shorr, R. I., Pahor, M., Applegate, W. B. (2002). Body Mass Index, Weight Change, and Death in Older Adults: The Systolic Hypertension in the Elderly Program. Am J Epidemiol 156: 132-138 [Abstract] [Full Text]  
• Wannamethee, S., Shaper, A., Walker, M (2001). Weight change, body weight and mortality: the impact of smoking and ill health. Int J Epidemiol 30: 777-786 [Abstract] [Full Text]  
• Lee, I-M., Blair, S. N., Allison, D. B., Folsom, A. R., Harris, T. B., Manson, J. E., Wing, R. R. (2001). Epidemiologic Data on the Relationships of Caloric Intake, Energy Balance, and Weight Gain Over the Life Span With Longevity and Morbidity. Journals of Gerontology Series A: Biological Sciences and Medical Sciences 56: 7-19 [Abstract] [Full Text]  
• Dyer, A. R., Stamler, J., Greenland, P. (2000). Associations of Weight Change and Weight Variability with Cardiovascular and All-Cause Mortality in the Chicago Western Electric Company Study. Am J Epidemiol 152: 324-333 [Abstract] [Full Text]  
• Korkeila, M., Rissanen, A., Kaprio, J., Sorensen, T. I., Koskenvuo, M. (1999). Weight-loss attempts and risk of major weight gain: a prospective study in Finnish adults. Am. J. Clin. Nutr. 70: 965-975 [Abstract] [Full Text]  
• Anker, S. D., Coats, A. J. S. (1999). Cardiac Cachexia: A Syndrome With Impaired Survival and Immune and Neuroendocrine Activation. Chest 115: 836-847 [Abstract] [Full Text]  
• Fried, L. P., Kronmal, R. A., Newman, A. B., Bild, D. E., Mittelmark, M. B., Polak, J. F., Robbins, J. A., Gardin, J. M., for the Cardiovascular Health Study Collaborative, (1998). Risk Factors for 5-Year Mortality in Older Adults: The Cardiovascular Health Study. JAMA 279: 585-592 [Abstract] [Full Text]  
• Ciliska, D. (1998). Evaluation of Two Nondieting Interventions for Obese Women. West J Nurs Res 20: 119-135 [Abstract]  
• Russell, R. M. (1996). Nutrition. JAMA 275: 1828-1829 [Abstract]  
• Garrow, J S (1995). Penalties of shifting weight. BMJ 311: 1653-1654 [Full Text]  
• Byers, T. (1995). Body Weight and Mortality. NEJM 333: 723-724 [Full Text]