0

The full content of Annals is available to subscribers

Subscribe/Learn More  >
Conferences |

Weight Loss and Subsequent Death in a Cohort of U.S. Adults

Elsie R. Pamuk, PhD; David F. Williamson, PhD; Mary K. Serdula, MD; Jennifer Madans, PhD; and Tim E. Byers, MD
[+] Article and Author Information

From the Centers for Disease Control and Prevention, Atlanta, Georgia, and Hyattsville, Maryland. Requests for Reprints: Elsie R. Pamuk, PhD, Division of Nutrition (K-26), Centers for Disease Control and Prevention, 1600 Clifton Road, N.E., Atlanta, GA 30333.


Copyright 2004 by the American College of Physicians


Ann Intern Med. 1993;119(7_Part_2):744-748. doi:10.7326/0003-4819-119-7_Part_2-199310011-00023
Text Size: A A A

Objective: Because we previously found that weight loss was associated with increased risk for death in all but very overweight men in a cohort of U.S. adults, we undertook a new analysis to determine whether inadequate control for preexisting illness or cigarette smoking contributed to this association.

Design: Cohort study.

Setting: The first National Health and Nutrition Examination Survey (NHANES I, 1971 to 1975) collected information on maximum lifetime weight and measured current weight on a probability sample of U.S. adults. The NHANES I Epidemiologic Follow-up Study determined the vital status of participants through 1987.

Participants: Men (n = 2453) and women (n = 2739) who were 45 to 74 years old at the time of the NHANES I examination.

Results: The effect of excluding persons who died within the first 5 and first 8 years after baseline was examined to limit the influence of weight loss due to preexisting illness. For women, extension of the exclusionary period weakened the association between weight loss and increased risk for death from noncardiovascular disease. However, excluding death for as much as 8 years after baseline did not affect the strong association between weight loss and increased risk for death from cardiovascular disease among men and women with maximum body mass indexes between 26 and 29 (relative risks of up to 2.1 and 3.6 for men and women, respectively, after excluding deaths in the first 8 years). Results were not substantially altered by limiting the analysis to persons who never smoked.

Conclusions: Preexisting illness may influence the association between weight loss and death principally through deaths from noncardiovascular disease. For some persons, weight loss is associated with an increased risk for death, even after excluding deaths occurring in the first 8 years.

Figures

Grahic Jump Location
Figure 1.
Relative risk for death among men who never smoked, by maximum body mass index and percentage of maximum weight lost.

Deaths in the first 5 years after baseline were excluded. ( ) 95% CI.

Grahic Jump Location
Grahic Jump Location
Figure 2.
Relative risk for death among women who never smoked, by maximum body mass index and percentage of maximum weight lost.

Deaths in the first 8 years after baseline were excluded. ( ) 95% CI.

Grahic Jump Location

Tables

References

Letters

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Comments

Submit a Comment
Submit a Comment

Summary for Patients

Clinical Slide Sets

Terms of Use

The In the Clinic® slide sets are owned and copyrighted by the American College of Physicians (ACP). All text, graphics, trademarks, and other intellectual property incorporated into the slide sets remain the sole and exclusive property of the ACP. The slide sets may be used only by the person who downloads or purchases them and only for the purpose of presenting them during not-for-profit educational activities. Users may incorporate the entire slide set or selected individual slides into their own teaching presentations but may not alter the content of the slides in any way or remove the ACP copyright notice. Users may make print copies for use as hand-outs for the audience the user is personally addressing but may not otherwise reproduce or distribute the slides by any means or media, including but not limited to sending them as e-mail attachments, posting them on Internet or Intranet sites, publishing them in meeting proceedings, or making them available for sale or distribution in any unauthorized form, without the express written permission of the ACP. Unauthorized use of the In the Clinic slide sets will constitute copyright infringement.

Toolkit

Buy Now

to gain full access to the content and tools.

Want to Subscribe?

Learn more about subscription options

Advertisement
Related Articles
Related Point of Care
Topic Collections
PubMed Articles
Forgot your password?
Enter your username and email address. We'll send you a reminder to the email address on record.
(Required)
(Required)