From: Doug Skrecky (oberon@vcn.bc.ca)
Date: Sat Jun 05 1999 - 15:07:15 MDT
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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