Weight change and all-cause, cancer and cardiovascular disease mortality in Japanese men and women: the Japan Public Health Center-Based Prospective Study.
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.


METHODS
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.
Nanri
A
A
Department of Epidemiology and International Health, Research Institute, International Medical Center of Japan, Shinjuku-ku, Tokyo, Japan.
Mizoue
T
T
Takahashi
Y
Y
Noda
M
M
Inoue
M
M
Tsugane
S
S
D000368:Aged; D044466:Asian People; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000401:mortality* / Q000503:physiopathology; D002423:Cause of Death; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000401:mortality* / Q000503:physiopathology; D009765:Obesity / Q000401:mortality* / Q000503:physiopathology; D011446:Prospective Studies; D012307:Risk Factors; D015430:Weight Gain / Q000502:physiology*; D015431:Weight Loss / Q000502:physiology*