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Epidemiology and Population Health

Long-term weight changes in obese young adult men and subsequent all-cause mortality

International Journal of Obesity volume 37, pages 1020–1025 (2013)Cite this article

Subjects

Abstract

BACKGROUND:

Although the expectation is that weight gain increases mortality and weight loss among those overweight reduces mortality, results on weight gain and mortality in young adults are conflicting, and weight loss is less explored. We investigated the association between long-term weight change and all-cause mortality in a broad range of body mass index (BMI) in young men.

METHODS:

Among 362200 Danish draftees, examined between 1943 and 1977, all obese (BMI ⩾31.0 kg m−2; n=1930), and a random 1% sample of the others (n=3601) were identified at a mean age of 20 years (range: 18–25 years). All the obese and half the controls were re-examined between 4 and 40 years later (mean age 35 years). Weight changes were defined as: weight loss <−0.1 kg m−2 per year, weight stability within ±0.1 kg m−2 per year and weight gain >0.1 kg m−2 per year. Hazard ratios (HR) and 95% confidence intervals (CI) were estimated using Cox regression.

RESULTS:

Among the 908 obese and 1073 controls followed for 30 years after re-examination 220 and 232 died. HR of the weight stable obese was 2.32 (CI: 1.56–3.44) compared with the weight stable controls. In the obese cohort there was no association between weight loss, adjusted for initial BMI, and mortality (HR: 0.99; CI: 0.68–1.45) compared with weight stable obese. Too few controls lost weight to allow assessment of weight loss. Weight gain was associated with increased mortality in the obese (HR: 1.50; CI: 1.07–2.10) and controls (HR: 1.54; CI: 1.14–2.09) compared with weight stable obese and controls, respectively. Neither the time between the two examinations, life-style factors nor exclusion of diseased individuals influenced the results.

CONCLUSIONS:

Although there were increased mortality of the weight-stable obese compared with controls, there was no association between weight loss and mortality in the obese. Weight gain increased mortality regardless of the initial weight.

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References

  1. Berrington de GA, Hartge P, Cerhan JR, Flint AJ, Hannan L, MacInnis RJ et al. Body-mass index and mortality among 1.46 million white adults. N Engl J Med 2010; 363: 2211–2219.

    Article  Google Scholar 

  2. McGee DL . Body mass index and mortality: a meta-analysis based on person-level data from twenty-six observational studies. Ann Epidemiol 2005; 15: 87–97.

    Article  Google Scholar 

  3. Pischon T, Boeing H, Hoffmann K, Bergmann M, Schulze MB, Overvad K et al. General and abdominal adiposity and risk of death in Europe. N Engl J Med 2008; 359: 2105–2120.

    Article  CAS  Google Scholar 

  4. Prospective Studies Collaboration. Whitlock G, Lewington S, Sherliker P, Clarke R, Emberson J, Halsey J et al. Body-mass index and cause-specific mortality in 900 000 adults: collaborative analyses of 57 prospective studies. Lancet 2009; 373: 1083–1096.

    Article  Google Scholar 

  5. Zimmermann E, Holst C, Sørensen TIA . Morbidity, including fatal morbidity, throughout life in men entering adult life as obese. PLoS ONE 2011; 6: e18546.

    Article  CAS  Google Scholar 

  6. Zimmermann E, Holst C, Sørensen TIA . Lifelong doubling of mortality in men entering adult life as obese. Int J Obes 2011; 35: 1193–1199.

    Article  CAS  Google Scholar 

  7. Rhoads GG, Kagan A . The relation of coronary disease, stroke, and mortality to weight in youth and in middle age. Lancet 1983; 1: 492–495.

    Article  CAS  Google Scholar 

  8. Rosengren A, Wedel H, Wilhelmsen L . Body weight and weight gain during adult life in men in relation to coronary heart disease and mortality. A prospective population study. Eur Heart J 1999; 20: 269–277.

    Article  CAS  Google Scholar 

  9. Shimazu T, Kuriyama S, Ohmori-Matsuda K, Kikuchi N, Nakaya N, Tsuji I . Increase in body mass index category since age 20 years and all-cause mortality: a prospective cohort study (the Ohsaki Study). Int J Obes 2009; 33: 490–496.

    Article  CAS  Google Scholar 

  10. Jeffreys M, McCarron P, Gunnell D, McEwen J, Smith GD . Body mass index in early and mid-adulthood, and subsequent mortality: a historical cohort study. Int J Obes Relat Metab Disord 2003; 27: 1391–1397.

    Article  CAS  Google Scholar 

  11. Yarnell JW, Patterson CC, Thomas HF, Sweetnam PM . Comparison of weight in middle age, weight at 18 years, and weight change between, in predicting subsequent 14 year mortality and coronary events: Caerphilly Prospective Study. J Epidemiol Community Health 2000; 54: 344–348.

    Article  CAS  Google Scholar 

  12. The Danish National Board of Health (online source), http://www.sst.dk/publ/Publ2011/BOFO/Vaegttab/10vejeVaegttab.pdf, accessed 24 April 2012.

  13. Aucott L, Poobalan A, Smith WC, Avenell A, Jung R, Broom J et al. Weight loss in obese diabetic and non-diabetic individuals and long-term diabetes outcomes--a systematic review. Diabetes Obes Metab 2004; 6: 85–94.

    Article  CAS  Google Scholar 

  14. Bacon SL, Sherwood A, Hinderliter A, Blumenthal JA . Effects of exercise, diet and weight loss on high blood pressure. Sports Med 2004; 34: 307–316.

    Article  Google Scholar 

  15. Poobalan A, Aucott L, Smith WC, Avenell A, Jung R, Broom J et al. Effects of weight loss in overweight/obese individuals and long-term lipid outcomes-a systematic review. Obes Rev 2004; 5: 43–50.

    Article  CAS  Google Scholar 

  16. Simonsen MK, Hundrup YA, Obel EB, Gronbaek M, Heitmann BL . Intentional weight loss and mortality among initially healthy men and women. Nutr Rev 2008; 66: 375–386.

    Article  Google Scholar 

  17. Harrington M, Gibson S, Cottrell RC . A review and meta-analysis of the effect of weight loss on all-cause mortality risk. Nutr Res Rev 2009; 22: 93–108.

    Article  Google Scholar 

  18. Berentzen T, Sørensen TIA . Effects of intended weight loss on morbidity and mortality: possible explanations of controversial results. Nutr Rev 2006; 64: 502–507.

    Article  Google Scholar 

  19. Berentzen TL, Jakobsen MU, Halkjaer J, Tjonneland A, Overvad K, Sørensen TIA . Changes in waist circumference and mortality in middle-aged men and women. PLoS ONE 2010; 5: e13097.

    Article  Google Scholar 

  20. Sonne-Holm S, Sørensen TIA . Post-war course of the prevalence of extreme overweight among Danish young men. J Chronic Dis 1977; 30: 351–358.

    Article  CAS  Google Scholar 

  21. Sørensen TIA, Sonne-Holm S . Mortality in extremely overweight young men. J Chronic Dis 1977; 30: 359–367.

    Article  Google Scholar 

  22. Christensen U, Sonne-Holm S, Sørensen TIA . Constant median body mass index of Danish young men, 1943-1977. Hum Biol 1981; 53: 403–410.

    CAS  Google Scholar 

  23. Sonne-Holm S, Sørensen TIA, Christensen U . Risk of early death in extremely overweight young men. Br Med J 1983; 287: 795–797.

    Article  CAS  Google Scholar 

  24. Schnohr P, Jensen G, Nyboe J, Eybjaerg HA . [The Copenhagen City Heart Study. A prospective cardiovascular population study of 20 000 men and women]. Ugeskr Laeger 1977; 139: 1921–1923.

    CAS  PubMed  Google Scholar 

  25. Pedersen CB, Gotzsche H, Moller JO, Mortensen PB . The Danish Civil Registration System. A cohort of eight million persons. Dan Med Bull 2006; 53: 441–449.

    Google Scholar 

  26. Juel K, Helweg-Larsen K . The Danish registers of causes of death. Dan Med Bull 1999; 46: 354–357.

    CAS  PubMed  Google Scholar 

  27. Andersen PK, Borgan Ø, Gill RD, Keiding N . Statistical Models Based on Counting Processes 1993. Springer-Verlag: New York, 767 p.

    Book  Google Scholar 

  28. Greenland S . Dose-response and trend analysis in epidemiology: alternatives to categorical analysis. Epidemiology 1995; 6: 356–365.

    Article  CAS  Google Scholar 

  29. Harrel FE . Relaxing linearity assumption for continuous predictors. In: Harrel FE (ed). Regression Modeling Strategies: With Applications To Linear Models, Logistic Regression, And Survival Analyses. Springer: New York, 2002, pp. 16–26.

    Google Scholar 

  30. Andersen TF, Madsen M, Jorgensen J, Mellemkjoer L, Olsen JH . The Danish National Hospital Register. A valuable source of data for modern health sciences. Dan Med Bull 1999; 46: 263–268.

    CAS  Google Scholar 

  31. Schoenfeld D . Chi-squared gooness of fit tests for the proporional hazards regression model. Biometrica 1980; 67: 145–153.

    Article  Google Scholar 

  32. Sonne-Holm S, Sørensen TIA, Jensen G, Schnohr P . Influence of fatness, intelligence, education and sociodemographic factors on response rate in a health survey. J Epidemiol Community Health 1989; 43: 369–374.

    Article  CAS  Google Scholar 

  33. Fontaine KR, Allison DB . Does intentional weight loss affect mortality rate? Eat Behav 2001; 2: 87–95.

    Article  CAS  Google Scholar 

  34. Wannamethee SG, Shaper AG, Whincup PH, Walker M . Characteristics of older men who lose weight intentionally or unintentionally. Am J Epidemiol 2000; 151: 667–675.

    Article  CAS  Google Scholar 

  35. Williamson DF, Thompson TJ, Thun M, Flanders D, Pamuk E, Byers T . Intentional weight loss and mortality among overweight individuals with diabetes. Diabetes Care 2000; 23: 1499–1504.

    Article  CAS  Google Scholar 

  36. Sørensen TIA . Weight loss causes increased mortality: pros. Obes Rev 2003; 4: 3–7.

    Article  Google Scholar 

  37. Falkstedt D, Hemmingsson T, Rasmussen F, Lundberg I . Body mass index in late adolescence and its association with coronary heart disease and stroke in middle age among Swedish men. Int J Obes 2007; 31: 777–783.

    Article  CAS  Google Scholar 

  38. World Cancer Research Fund, American Institute for Cancer Research [AICR]. 2007 Food, Nutrition Physical Activity, and the Prevention of Cancer: a Global Perspective. AICR: Washington DC, 537 p.

  39. Juonala M, Magnussen CG, Berenson GS, Venn A, Burns TL, Sabin MA et al. Childhood adiposity, adult adiposity, and cardiovascular risk factors. N Engl J Med 2011; 365: 1876–1885.

    Article  CAS  Google Scholar 

  40. Tsiros MD, Olds T, Buckley JD, Grimshaw P, Brennan L, Walkley J et al. Health-related quality of life in obese children and adolescents. Int J Obes 2009; 33: 387–400.

    Article  CAS  Google Scholar 

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Acknowledgements

The work was supported by grants from the Cluster for Endocrinology and Metabolism, University of Copenhagen, Denmark. This work is also part of the research activities in the Danish Obesity Research Centre (DanORC, see http://www.danorc.dk/), supported by the Danish Council for Strategic Research.

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Authors and Affiliations

  1. Institute of Preventive Medicine, Copenhagen University Hospitals, Frederiksberg Hospital, Frederiksberg, Denmark

    E Zimmermann, T L Berentzen, L Ängquist, C Holst & T I A Sørensen

  2. Institute of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark

    E Zimmermann

  3. Faculty of Health and Medical Sciences, Novo Nordisk Foundation Centre for Basic Metabolic Research, Section on Metabolic Genetics, University of Copenhagen, Copenhagen, Denmark

    T I A Sørensen

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Correspondence to E Zimmermann.

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Competing interests

Thorkild I.A. Sørensen has various industrial collaborations on obesity research as indicated on the website http://www.ipm.hosp.dk/person/tias/Disclosures.html. The remaining authors declare no conflict of interest.

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Zimmermann, E., Berentzen, T., Ängquist, L. et al. Long-term weight changes in obese young adult men and subsequent all-cause mortality. Int J Obes 37, 1020–1025 (2013). https://doi.org/10.1038/ijo.2012.176

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