Abstract
Background:
It is unclear whether weight change during adulthood influences subsequent mortality in Asian populations, who have a relatively lean body mass.
Objective:
To assess the relation of weight change over 5 years to all-cause, cancer and cardiovascular disease mortality among Japanese men and women.
Design:
Subjects were 36 220 men and 44 091 women aged between 45 and 75 years without a history of serious disease at baseline. Weight change was calculated as the difference of body weight between two surveys with a 5-year interval.
Results:
During 699 963 person-years of follow-up, we identified 4232 deaths of all-cause, 1872 cancer deaths and 1021 cardiovascular deaths. The relation between weight change and all-cause mortality was reverse J-shaped. Multivariate hazard ratios (95% confidence interval) for weight loss of 5 kg or more versus weight change of less than 2.5 kg were 1.62 (1.45–1.81) in men and 1.76 (1.51–2.05) in women, whereas those for weight gain of 5 kg or more were 1.40 (1.22–1.59) in men and 1.25 (1.02–1.54) in women. These associations remained statistically significant even after the exclusion of deaths in the first 3 years of follow-up. The weight change–mortality association was pronounced in underweight persons or in nonsmoking men. The risk of cancer mortality increased in both men and women who lost weight by 5 kg or more. With regard to cardiovascular disease, mortality risk tended to increase with weight loss both in men and women, whereas its increase with weight gain was observed only in women.
Conclusions:
A large weight change, both loss and gain, was associated with an increased risk of mortality. Weight loss and gain may be predictors of early death in apparently healthy adult Japanese.
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Acknowledgements
We thank Drs Yumi Matsushita, Kyoko Kirii (both International Medical Center of Japan) and Masayuki Kato (Japan Foundation for the Promotion of International Medical Research Cooperation) for their helpful discussions. This work was supported by Grants-in-Aid for Cancer Research (19shi-2) and a Health Sciences Research Grant (Research on Comprehensive Research on Cardiovascular Diseases H19-016) from the Ministry of Health, Labour and Welfare of Japan.
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Study group members
Members of the Japan Public Health Center-Based Prospective Study (JPHC Study) Group are: S Tsugane (principal investigator), M Inoue, T Sobue and T Hanaoka, National Cancer Center, Tokyo, Japan; J Ogata, S Baba, T Mannami, A Okayama and Y Kokubo, National Cardiovascular Center, Osaka, Japan; K Miyakawa, F Saito, A Koizumi, Y Sano, I Hashimoto, T Ikuta and Y Tanaba, Iwate Prefectural Ninohe Public Health Center, Iwate, Japan; Y Miyajima, N Suzuki, S Nagasawa, Y Furusugi and N Nagai, Akita Prefectural Yokote Public Health Center, Akita, Japan; H Sanada, Y Hatayama, F Kobayashi, H Uchino, Y Shirai, T Kondo, R Sasaki, Y Watanabe, Y Miyagawa and Y Kobayashi, Nagano Prefectural Saku Public Health Center, Nagano, Japan; Y Kishimoto, E Takara, T Fukuyama, M Kinjo, M Irei and H Sakiyama, Okinawa Prefectural Chubu Public Health Center, Okinawa, Japan; K Imoto, H Yazawa, T Seo, A Seiko, F Ito, F Shoji and R Saito, Katsushika Public Health Center, Tokyo, Japan; A Murata, K Minato, K Motegi and T Fujieda, Ibaraki Prefectural Mito Public Health Center, Ibaraki, Japan; K Matsui, T Abe, M Katagiri and M Suzuki, Niigata Prefectural Kashiwazaki and Nagaoka Public Health Center, Niigata, Japan; M Doi, A Terao, Y Ishikawa and T Tagami, Kochi Prefectural Chuo-higashi Public Health Center, Kochi, Japan; H Sueta, H Doi, M Urata, N Okamoto and F Ide, Nagasaki Prefectural Kamigoto Public Health Center, Nagasaki, Japan; H Sakiyama, N Onga, H Takaesu and M Uehara, Okinawa Prefectural Miyako Public Health Center, Okinawa, Japan; F Horii, I Asano, H Yamaguchi, K Aoki, S Maruyama, M Ichii and M Takano, Osaka Prefectural Suita Public Health Center, Osaka, Japan; Y Tsubono, Tohoku University, Miyagi, Japan; K Suzuki, Research Institute for Brain and Blood Vessels Akita, Akita, Japan; Y Honda, K Yamagishi, S Sakurai and N Tsuchiya, Tsukuba University, Ibaraki, Japan; M Kabuto, National Institute for Environmental Studies, Ibaraki, Japan; M Yamaguchi, Y Matsumura, S Sasaki and S Watanabe, National Institute of Health and Nutrition, Tokyo, Japan; M Akabane, Tokyo University of Agriculture, Tokyo, Japan; T Kadowaki, Tokyo University, Tokyo, Japan; M Noda and T Mizoue, International Medical Center of Japan, Tokyo, Japan; Y Kawaguchi, Tokyo Medical and Dental University, Tokyo, Japan; Y Takashima and M Yoshida, Kyorin University, Tokyo, Japan; K Nakamura, Niigata University, Niigata, Japan; S Matsushima and S Natsukawa, Saku General Hospital, Nagano, Japan; H Shimizu, Sakihae Institute, Gifu, Japan; H Sugimura, Hamamatsu University, Shizuoka, Japan; S Tominaga, Aichi Cancer Center Research Institute, Aichi, Japan; H Iso, Osaka University, Osaka, Japan; M Iida, W Ajiki and A Ioka, Osaka Medical Center for Cancer and Cardiovascular Disease, Osaka, Japan; S Sato, Chiba Prefectural Institute of Public Health, Chiba, Japan; E Maruyama, Kobe University, Hyogo, Japan; M Konishi, K Okada and I Saito, Ehime University, Ehime, Japan; N Yasuda, Kochi University, Kochi, Japan; and S Kono, Kyushu University, Fukuoka, Japan.
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Nanri, A., Mizoue, T., Takahashi, Y. et al. Weight change and all-cause, cancer and cardiovascular disease mortality in Japanese men and women: the Japan Public Health Center-Based Prospective Study. Int J Obes 34, 348–356 (2010). https://doi.org/10.1038/ijo.2009.234
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DOI: https://doi.org/10.1038/ijo.2009.234
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