Nina Roswall1,2, Yingjun Li1,3,4, Sven Sandin1, Peter Ström1, Hans-Olov Adami1,5,6, Elisabete Weiderpass1,7,8,9. 1. Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden. 2. Department of Diet, Genes and Environment, Danish Cancer Society Research Center, Copenhagen, Denmark. 3. Department of Epidemiology and Health Statistics, Zhejiang University School of Public Health, Hangzhou, China. 4. Department of Public Health, Hangzhou Medical School, Hangzhou, China. 5. Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, USA. 6. Institute of Health and Society, University of Oslo, Oslo, Norway. 7. Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, The Arctic University of Norway, Tromsø, Norway. 8. Genetic Epidemiology Group, Folkhälsan Research Center, Helsinki, Finland. 9. The Cancer Registry of Norway, Institute of Population Based Cancer Research, Oslo, Norway.
Abstract
OBJECTIVE: Most studies on obesity and mortality use a single anthropometric measure. Less is known about the effects of weight change on mortality. This study examined changes in body mass index (ΔBMI) and waist circumference (ΔWC) and subsequent all-cause and cause-specific mortality. METHODS: The study was conducted in the Women's Lifestyle and Health cohort, using self-reported anthropometric measures from 1991 to 1992 and 2003. Hazard ratios of mortality and 95% confidence intervals were calculated using Cox proportional hazards models. ΔBMI and ΔWC were examined in quartiles of absolute and relative change, with the second quartile (moderate gain) as the reference. RESULTS: There was a higher risk of death in the first quartile of relative ΔBMI: HR 1.28 (1.04-1.56). Absolute ΔBMI suggested the same pattern, but the result was nonsignificant. ΔWC was not associated with mortality. In cause-specific analyses, the association remained significant for cancer mortality only. In sensitivity analyses excluding the first 5 years of follow-up, the association was, however, attenuated. CONCLUSIONS: This study found a higher risk of death among women in the first quartile of relative ΔBMI compared with the second. It was driven by cancer mortality but may be ascribed to reverse causality. ΔWC was not associated with mortality.
OBJECTIVE: Most studies on obesity and mortality use a single anthropometric measure. Less is known about the effects of weight change on mortality. This study examined changes in body mass index (ΔBMI) and waist circumference (ΔWC) and subsequent all-cause and cause-specific mortality. METHODS: The study was conducted in the Women's Lifestyle and Health cohort, using self-reported anthropometric measures from 1991 to 1992 and 2003. Hazard ratios of mortality and 95% confidence intervals were calculated using Cox proportional hazards models. ΔBMI and ΔWC were examined in quartiles of absolute and relative change, with the second quartile (moderate gain) as the reference. RESULTS: There was a higher risk of death in the first quartile of relative ΔBMI: HR 1.28 (1.04-1.56). Absolute ΔBMI suggested the same pattern, but the result was nonsignificant. ΔWC was not associated with mortality. In cause-specific analyses, the association remained significant for cancer mortality only. In sensitivity analyses excluding the first 5 years of follow-up, the association was, however, attenuated. CONCLUSIONS: This study found a higher risk of death among women in the first quartile of relative ΔBMI compared with the second. It was driven by cancer mortality but may be ascribed to reverse causality. ΔWC was not associated with mortality.
Authors: Jaime da Silva Fernandes; Fabiana Schuelter-Trevisol; Ana Carolina Lobor Cancelier; Helena Caetano Gonçalves E Silva; Daiana Gomes de Sousa; Richard L Atkinson; Daisson José Trevisol Journal: Int J Obes (Lond) Date: 2021-03-22 Impact factor: 5.095
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