From: Doug Skrecky (oberon@vcn.bc.ca)
Date: Tue Jan 05 1999 - 01:16:44 MST
Authors
Yaari S. Goldbourt U.
Institution
Computing Center, Bar-Ilan University, Ramat-Gan, Israel.
Title
Voluntary and involuntary
weight loss: associations with long term
mortality in 9,228 middle-aged and elderly men.
Source
American Journal of Epidemiology. 148(6):546-55, 1998 Sep 15.
Abstract
Recent studies have suggested that weight
loss in middle-aged persons antecedes increased mortality.
Therefore, the authors sought to examine the association between changes in
body weight and subsequent mortality, according to
self-reported dieting status. The authors followed 9,228 men aged 40-65 years
in 1963, for whom weight changes between 1963 and 1968 were
recorded and extensive clinical, anthropometric, biochemical, and dietary
assessments were made. Of these men, 2,471 reported being on a diet when
first examined in 1963, and 636 were dieting primarily to lose
weight. Mortality follow-up covered an 18-year period
(1968-1986). Men who lost 5 kg or more between 1963 and 1968 ("extreme
weight losers") exhibited the following age-pooled risks of
mortality relative to the stable weight group: for total
mortality, 1.36 (95% confidence interval (CI) 1.20-1.55); for all
cardiovascular disease mortality, 1.40 (95% CI 1.16-1.69); for all
non-cardiovascular disease mortality, 1.33 (95% CI 1.11-1.59); for coronary
heart disease mortality, 1.55 (95% CI 1.25-1.93); and for cancer mortality,
0.90 (95% CI 0.65-1.24). After adjustment for differences in coronary heart
disease risk factor levels and morbidity between these groups at the end of
the weight change period (1968), the excess risks associated
with extreme weight loss declined by
approximately one third. They declined further if adjustment was made for
1963 (pre-weight-change period) morbidity and risk factor
levels. Being on a slimming diet, as reported in 1963, was associated with an
approximate doubling of excess mortality in men with extreme
weight loss. Weight
loss in 1963-1968 coincided with an increased incidence of
coronary heart disease and diabetes mellitus and a declining level of serum
total cholesterol. This and other studies indicate that both
voluntary and involuntary
weight loss might be associated with a
small increase in the risk of all-cause mortality.
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