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Epidemiology

Association between weight cycling and risk of colorectal cancer: a prospective cohort study

British Journal of Cancer volume 130, pages 496–503 (2024)Cite this article

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Abstract

Background

Weight cycling is the repeated episodes manifesting intentional weight loss and subsequent unintentional weight gain. Whether the frequency and magnitude of weight cycling is associated with colorectal cancer risk independent of body mass index (BMI) remains unknown.

Methods

Two prospective cohort studies, Nurses’ Health Study I and Health Professionals Follow-up Study, followed 85,562 participants from 1992 to 2014. Participants completed a questionnaire regarding the frequency and magnitude of intentional weight loss in the past 4 years at the baseline. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox proportional hazard model.

Results

We identified 1626 colorectal cancer cases during up to 22 years of follow-up. In the pooled analysis of HPFS and NHS, compared to non-weight cycling, moderate weight cycling (≥3 times of intentional weight loss of ≥2.3–4.4 kg) was associated with a reduced risk of colorectal cancer after adjustment for confounders, including attained BMI after weight cycling (HR = 0.82, 95% CI 0.69, 0.97). However, no significant association was observed in mild weight cyclers and in severe weight cyclers.

Conclusions

Moderate weight cycling was associated with a lower risk of colorectal cancer independent of BMI. This finding needs further studies for replication and putative biological mechanisms.

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Data availability

The data underlying this article cannot be shared for the privacy of individuals who participated in Nurses’ Health Study I and Health Professionals Follow-up study.

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Codes are not shared.

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Acknowledgements

The authors would like to acknowledge the contribution to this study from the Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and central cancer registries supported through the Centers for Disease Control and Prevention’s National Program of Cancer Registries (NPCR) and/or the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) Program. Central registries may also be supported by state agencies, universities, and cancer centres. Participating central cancer registries include the following: Alabama, Alaska, Arizona, Arkansas, California, Colorado, Connecticut, Delaware, Florida, Georgia, Hawaii, Idaho, Indiana, Iowa, Kentucky, Louisiana, Massachusetts, Maine, Maryland, Michigan, Mississippi, Montana, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, Puerto Rico, Rhode Island, Seattle SEER Registry, South Carolina, Tennessee, Texas, Utah, Virginia, West Virginia, Wyoming.

Funding

The Nurses’ Health Study I was funded by the National Cancer Institute, National Institutes of Health (UM1 CA176726, P01 CA87969) Health Professionals Follow-up Study was funded by the National Cancer Institute, National Institutes of Health (U01 CA167552). This work was funded by the National Institutes of Health (R03 CA204825) and the Yonsei University Research Grant of 2023-22-0351.

Author information

Author notes

  1. These authors contributed equally: Suryun Kim, Dong Hoon Lee.

  2. These authors jointly supervised this work: Edward L. Giovannucci, NaNa Keum.

Authors and Affiliations

  1. Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA

    Suryun Kim

  2. Department of Sports Industry Studies, Yonsei University, Seoul, Republic of Korea

    Dong Hoon Lee

  3. Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA

    Dong Hoon Lee, Edward L. Giovannucci & NaNa Keum

  4. Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA

    Edward L. Giovannucci

  5. Department of Food Science and Biotechnology, Dongguk University, Goyang, Republic of Korea

    NaNa Keum

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Contributions

DHL, NK and ELG conceived and designed the study. DHL conducted data analyses. SK prepared the first draft. DHL, NK and ELG aided in interpreting the results. All authors contributed to the critical revision of the manuscript for important intellectual content. All authors approved the final version of the manuscript.

Corresponding author

Correspondence to NaNa Keum.

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Competing interests

The authors declare no competing interests.

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The protocol of this study was approved by the institutional review boards of Harvard T.H. Chan School of Public Health, the Brigham and Women’s Hospital, Boston, USA, and those of participating registries according to need. Completion of the questionnaire was considered to imply informed consent.

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Kim, S., Lee, D.H., Giovannucci, E.L. et al. Association between weight cycling and risk of colorectal cancer: a prospective cohort study. Br J Cancer 130, 496–503 (2024). https://doi.org/10.1038/s41416-023-02529-y

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