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The enigma of increased non-cancer mortality after weight loss in healthy men who are overweight or obese.

Nilsson, Peter LU ; Nilsson, Jan-Åke LU ; Hedblad, Bo LU ; Berglund, Göran LU and Lindgärde, Folke LU (2002) In Journal of Internal Medicine1989-01-01+01:00 252(1). p.70-78
Abstract
Objective. To study effects on non-cancer mortality of observational weight loss in middle-aged men stratified for body mass index (BMI), taking a wide range of possible confounders into account.



Design. Prospective, population based study.



Setting. Male population of Malmö, Sweden.



Participants. In all 5722 men were screened twice with a mean time interval of 6 years in Malmö, southern Sweden. They were classified according to BMI category at baseline (<21, 22-25, overweight: 26-30, and obesity: 30+ kg m-2) and weight change category until second screening (weight stable men defined as having a baseline BMI ± 0.1 kg m-2 year-1 at follow-up re-screening).



Main... (More)
Objective. To study effects on non-cancer mortality of observational weight loss in middle-aged men stratified for body mass index (BMI), taking a wide range of possible confounders into account.



Design. Prospective, population based study.



Setting. Male population of Malmö, Sweden.



Participants. In all 5722 men were screened twice with a mean time interval of 6 years in Malmö, southern Sweden. They were classified according to BMI category at baseline (<21, 22-25, overweight: 26-30, and obesity: 30+ kg m-2) and weight change category until second screening (weight stable men defined as having a baseline BMI ± 0.1 kg m-2 year-1 at follow-up re-screening).



Main outcome measures. Non-cancer mortality calculated from national registers during 16 years of follow-up after the second screening. Data from the first year of follow-up were excluded to avoid bias by mortality caused by subclinical disease at re-screening.



Results. The relative risk (RR; 95% CI) for non-cancer mortality during follow-up was higher in men with decreasing BMI in all subgroups: RR 2.64 (1.46-4.71, baseline BMI <21 kg m-2), 1.39 (0.98-1.95, baseline BMI 22-25 kg m-2), and 1.71 (1.18-2.47, baseline BMI 26+ kg m-2), using BMI-stable men as reference group. Correspondingly, the non-cancer mortality was also higher in men with increasing BMI, but only in the obese group (baseline BMI 26+ kg m-2) with RR 1.86 (1.31-2.65). In a subanalysis, nonsmoking obese (30+ kg m-2) men with decreased BMI had an increased non-cancer mortality compared with BMI-stable obese men (Fischer's test: P=0.001). The mortality risk for nonsmoking overweight men who increased their BMI compared with BMI-stable men was also significant (P=0.006), but not in corresponding obese men (P=0.094).



Conclusions. Weight loss in self-reported healthy but overweight middle-aged men, without serious disease, is associated with an increased non-cancer mortality, which seems even more pronounced in obese, nonsmoking men, as compared with corresponding but weight-stable men. The explanation for these observational findings is still enigmatic but could hypothetically be because of premature ageing effects causing so-called weight loss of involution. (Less)
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organization
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type
Contribution to journal
publication status
published
subject
keywords
Population Surveillance, Obesity, Middle Age, Male, Life Style, Non-U.S. Gov't, Human, Cause of Death, Body Mass Index, Sweden, Weight Loss, Prospective Studies, Questionnaires, Registries, Risk Factors, Smoking: adverse effects, Support
in
Journal of Internal Medicine1989-01-01+01:00
volume
252
issue
1
pages
70 - 78
publisher
Wiley-Blackwell Publishing Ltd
external identifiers
  • wos:000176336400010
  • pmid:12074741
  • scopus:0036309010
ISSN
1365-2796
DOI
10.1046/j.1365-2796.2002.01010.x
language
English
LU publication?
yes
id
b5e62af0-493a-4632-9840-a99bab006116 (old id 115218)
date added to LUP
2007-07-26 15:54:49
date last changed
2017-04-30 14:58:45
@article{b5e62af0-493a-4632-9840-a99bab006116,
  abstract     = {Objective. To study effects on non-cancer mortality of observational weight loss in middle-aged men stratified for body mass index (BMI), taking a wide range of possible confounders into account.<br/><br>
<br/><br>
Design. Prospective, population based study.<br/><br>
<br/><br>
Setting. Male population of Malmö, Sweden.<br/><br>
<br/><br>
Participants. In all 5722 men were screened twice with a mean time interval of 6 years in Malmö, southern Sweden. They were classified according to BMI category at baseline (&lt;21, 22-25, overweight: 26-30, and obesity: 30+ kg m-2) and weight change category until second screening (weight stable men defined as having a baseline BMI ± 0.1 kg m-2 year-1 at follow-up re-screening).<br/><br>
<br/><br>
Main outcome measures. Non-cancer mortality calculated from national registers during 16 years of follow-up after the second screening. Data from the first year of follow-up were excluded to avoid bias by mortality caused by subclinical disease at re-screening.<br/><br>
<br/><br>
Results. The relative risk (RR; 95% CI) for non-cancer mortality during follow-up was higher in men with decreasing BMI in all subgroups: RR 2.64 (1.46-4.71, baseline BMI &lt;21 kg m-2), 1.39 (0.98-1.95, baseline BMI 22-25 kg m-2), and 1.71 (1.18-2.47, baseline BMI 26+ kg m-2), using BMI-stable men as reference group. Correspondingly, the non-cancer mortality was also higher in men with increasing BMI, but only in the obese group (baseline BMI 26+ kg m-2) with RR 1.86 (1.31-2.65). In a subanalysis, nonsmoking obese (30+ kg m-2) men with decreased BMI had an increased non-cancer mortality compared with BMI-stable obese men (Fischer's test: P=0.001). The mortality risk for nonsmoking overweight men who increased their BMI compared with BMI-stable men was also significant (P=0.006), but not in corresponding obese men (P=0.094).<br/><br>
<br/><br>
Conclusions. Weight loss in self-reported healthy but overweight middle-aged men, without serious disease, is associated with an increased non-cancer mortality, which seems even more pronounced in obese, nonsmoking men, as compared with corresponding but weight-stable men. The explanation for these observational findings is still enigmatic but could hypothetically be because of premature ageing effects causing so-called weight loss of involution.},
  author       = {Nilsson, Peter and Nilsson, Jan-Åke and Hedblad, Bo and Berglund, Göran and Lindgärde, Folke},
  issn         = {1365-2796},
  keyword      = {Population Surveillance,Obesity,Middle Age,Male,Life Style,Non-U.S. Gov't,Human,Cause of Death,Body Mass Index,Sweden,Weight Loss,Prospective Studies,Questionnaires,Registries,Risk Factors,Smoking: adverse effects,Support},
  language     = {eng},
  number       = {1},
  pages        = {70--78},
  publisher    = {Wiley-Blackwell Publishing Ltd},
  series       = {Journal of Internal Medicine1989-01-01+01:00},
  title        = {The enigma of increased non-cancer mortality after weight loss in healthy men who are overweight or obese.},
  url          = {http://dx.doi.org/10.1046/j.1365-2796.2002.01010.x},
  volume       = {252},
  year         = {2002},
}