Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Paper
  • Published:

Intentional weight loss and incidence of obesity-related cancers: the Iowa Women's Health Study

International Journal of Obesity volume 27, pages 1447–1452 (2003)Cite this article

Abstract

OBJECTIVE: To examine the association of voluntary vs involuntary weight loss with incidence of cancer in older women.

DESIGN: Prospective cohort study from 1993 to 2000, with cancer incidence identified through record linkage to a cancer registry.

SUBJECTS: A total of 21 707 postmenopausal women initially free of cancer.

MESUREMENTS: Women completed a questionnaire about intentional and unintentional weight loss episodes of ≥20 pounds during adulthood.

RESULTS: Compared with women who never had any ≥20 pounds weight loss episode, women who ever experienced intentional weight loss ≥20 pounds but no unintentional weight loss had incidence rates lower by 11% for any cancer (RR=0.89, 95% CI 0.79–1.00), by 19% for breast cancer (RR=0.81, 95% CI 0.66–1.00), by 9% for colon cancer (RR=0.91, 95% CI 0.66–1.24), by 4% for endometrial cancer (RR=0.96, 95% CI 0.61–1.52), and by 14% for all obesity-related cancer (RR=0.86, 95% CI 0.74–1.01) after adjusting for age, body mass index, waist-to-hip ratio, physical activity, education, marital status, smoking status, pack-years of cigarettes, current estrogen use, alcohol use, parity, and multivitamin use. Furthermore, although overweight women were at increased risk of several cancers, women who experienced intentional weight loss episodes of 20 or more pounds and were not currently overweight were observed to have an incidence of cancer similar to nonoverweight women who never lost weight. Unintentional weight loss episodes were not associated with decreased cancer risk.

CONCLUSIONS: These findings suggest that intentional weight loss might reduce risk of obesity-related cancers.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Similar content being viewed by others

References

  1. Flegal KM, Carroll MD, Ogden CL, Johnson CL . Prevalence and trends in obesity among US adults, 1999–2000. JAMA 2002; 288: 1723–1727.

    Article  PubMed  Google Scholar 

  2. Kuczmarski RJ, Carroll MD, Flegal KM, Troiano RP . Varying body mass index cutoff points to describe overweight prevalence among US adults: NHANES III (1988 to 1994). Obes Res 1997; 5: 542–548.

    CAS  PubMed  Google Scholar 

  3. Flegal KM, Carroll MD, Kuczmarski RJ, Johnson CL . Overweight and obesity in the United States: prevalence and trends, 1960–1994. Int J Obes Relat Metab Disord 1998; 22: 39–47.

    CAS  PubMed  Google Scholar 

  4. National Task Force on the Prevention and Treatment of Obesity. Overweight, obesity, and health risk. Arch Intern Med 2000; 160: 898–904.

  5. National Institutes of Health. National Institutes of Health Consensus Development Conference Statement: health implications of obesity. Ann Intern Med 1985; 103: 147–151.

  6. Folsom AR, Kaye SA, Prineas RJ, Potter JD, Gapstur SM, Wallace RB . Increased incidence of carcinoma of the breast associated with abdominal adiposity in postmenopausal women. Am J Epidemiol 1990; 131: 794–803.

    CAS  PubMed  Google Scholar 

  7. Fund WCR. Food, nutrition, and the prevention of cancer: a global perspective. American Institute for Cancer Research: Washington, DC; 1997.

  8. Brownell KD, Jeffery RW . Improving long-term weight loss: pushing the limits of treatment. Behav Ther 1987; 18: 353–374.

    Google Scholar 

  9. Williamson DF, Serdula MK, Anda RF, Levy A, Byers T . Weight loss attempts in adults: goals, duration, and rate of weight loss. Am J Public Health 1992; 82: 1251–1257.

    CAS  PubMed  PubMed Central  Google Scholar 

  10. Serdula MK, Mokdad AH, Williamson DF, Galuska DA, Mendlein JM, Heath GW . Prevalence of attempting weight loss and strategies for controlling weight. JAMA 1999; 282: 1353–1358.

    CAS  PubMed  Google Scholar 

  11. Andres R, Muller DC, Sorkin JD . Long-term effects of change in body weight on all-cause mortality. A review. Ann Intern Med 1993; 119 (7 Part 2): 737–743.

    CAS  PubMed  Google Scholar 

  12. Blair SN, Shaten J, Brownell K, Collins G, Lissner L . Body weight change, all-cause mortality, and cause-specific mortality in the Multiple Risk Factor Intervention Trial. Ann Intern Med 1993; 119 (7 Part 2): 749–757.

    CAS  PubMed  Google Scholar 

  13. Folsom AR, French SA, Zheng W, Baxter JE, Jeffery RW . Weight variability and mortality: the Iowa Women's Health Study. Int J Obes Relat Metab Disord 1996; 20: 704–709.

    CAS  PubMed  Google Scholar 

  14. French SA, Folsom AR, Jeffery RW, Williamson DF . Prospective study of intentionality of weight loss and mortality in older women: the Iowa Women's Health Study. Am J Epidemiol 1999; 149: 504–514.

    CAS  PubMed  Google Scholar 

  15. Lee IM, Paffenbarger Jr RS . Change in body weight and longevity. JAMA 1992; 268: 2045–2049.

    CAS  PubMed  Google Scholar 

  16. Lissner L, Odell PM, D'Agostino RB, Stokes III J, Kreger BE, Belanger AJ, Brownell KD . Variability of body weight and health outcomes in the Framingham population. N Engl J Med 1991; 324: 1839–1844.

    CAS  PubMed  Google Scholar 

  17. Pamuk ER, Williamson DF, Madans J, Serdula MK, Kleinman JC, Byers T . Weight loss and mortality in a national cohort of adults, 1971–1987. Am J Epidemiol 1992; 136: 686–697.

    CAS  PubMed  Google Scholar 

  18. Kassirer JP, Angell M . Losing weight—an ill-fated New Year's resolution. N Engl J Med 1998; 338: 52–54.

    CAS  PubMed  Google Scholar 

  19. Pamuk ER, Williamson DF, Serdula MK, Madans J, Byers TE . Weight loss and subsequent death in a cohort of US adults. Ann Intern Med 1993; 119 (7 Part 2): 744–748.

    CAS  PubMed  Google Scholar 

  20. Reynolds MW, Fredman L, Langenberg P, Magaziner J . Weight, weight change, mortality in a random sample of older community-dwelling women. J Am Geriatr Soc 1999; 47: 1409–1414.

    CAS  PubMed  Google Scholar 

  21. French SA, Folsom AR, Jeffery RW, Zheng W, Mink PJ, Baxter JE . Weight variability and incident disease in older women: the Iowa Women's Health Study. Int J Obes Relat Metab Disord 1997; 21: 217–223.

    CAS  PubMed  Google Scholar 

  22. Williamson DF, Pamuk E, Thun M, Flanders D, Byers T, Heath C . Prospective study of intentional weight loss and mortality in never-smoking overweight US white women aged 40–64 years. Am J Epidemiol 1995; 141: 1128–1141.

    CAS  PubMed  Google Scholar 

  23. Bisgard KM, Folsom AR, Hong C-P, Sellers TA . Mortality and cancer rates in nonrespondents to a prospective study of older women: 5-year follow-up. Am J Epidemiol 1994; 139: 990–1000.

    CAS  PubMed  Google Scholar 

  24. Kushi LH, Kaye SA, Folsom AR, Soler JT, Prineas RJ . Accuracy and reliability of self-measurement of body girths. Am J Epidemiol 1988; 128: 740–748.

    CAS  PubMed  Google Scholar 

  25. French SA, Jeffery RW, Folsom AR, Williamson DF, Byers T . Weight variability in a population-based sample of older women: intercorrelation and reliability of measures. Int J Obes Relat Metab Disord 1995; 19: 22–29.

    CAS  PubMed  Google Scholar 

  26. Meltzer AA, Everhart JE . Self-reported substantial 1-year weight change among men and women in the United States. Obes Res 1995; 3 (Suppl 2): 123s–134s.

    PubMed  Google Scholar 

  27. Meltzer AA, Everhart JE . Unintentional weight loss in the United States. Am J Epidemiol 1995; 142: 1039–1046.

    CAS  PubMed  Google Scholar 

Download references

Acknowledgements

The Iowa Women's Health Study was funded by a grant (RO1 CA39742) from the National Cancer Institute. The contents of this paper are solely the responsibilities of the authors and do not necessarily represent the official view of the National Cancer Institute. We thank Dr Simone French for previous work that helped define the weight loss categories, Ms Ching Ping Hong for SAS programming advice, and Ms Laura Kemmis for manuscript preparation.

Author information

Authors and Affiliations

  1. Division of Epidemiology, University of Minnesota, Minneapolis, MN, USA

    E D Parker & A R Folsom

Authors
  1. E D Parker
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. A R Folsom
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to A R Folsom.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Parker, E., Folsom, A. Intentional weight loss and incidence of obesity-related cancers: the Iowa Women's Health Study. Int J Obes 27, 1447–1452 (2003). https://doi.org/10.1038/sj.ijo.0802437

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/sj.ijo.0802437

Keywords

This article is cited by

Search

Advanced search

Quick links