Weight loss and premature death: the 1946 British birth cohort study.
OBJECTIVE
The relationship between weight loss and mortality has important clinical and public health significance but has proved to be complex. Evidence is mixed and particularly limited on the association between weight loss in mid-life and premature death (i.e. before 65 years of age), a small albeit important segment of total mortality. We aimed to study the association between midlife weight change and mortality accounting for health and lifestyle characteristics, and also considering potential bias due to preexisting chronic diseases and smoking status.


METHODS
Longitudinal, population-based, 'the 1946 British' birth cohort study.


METHODS
In 2750 men and women, mortality from age 53 through 65 years was analyzed according to categories of measured 10 year weight change between 43 and 53 years. Cox's hazard ratios (HR) were progressively adjusted for socio-demographic, lifestyle and health characteristics.


RESULTS
Nearly 20% of participants lost weight and over 50% gained 5 kg or more in midlife. There were 164 deaths. Compared to those who gained between 2 and 5 kg, those who lost 5 kg or more had an increased risk of premature death independently of midlife physical activity, socio-economic circumstances and educational attainment. This association was unaltered when highest weight loss (lost more than 15 Kg) (p = 0.04) and early deaths were excluded (p<0.001), but was no longer significant after adjustment for cardiovascular risk factors and health status (HR = 1.8; 95% CI: 0.9 to 3.5).


CONCLUSIONS
The inverse association between weight loss in midlife and higher risk of premature death may be explained by vascular risk factors and ill health. In consideration of the burden of premature death, closer monitoring of weight loss in mid-life is warranted.
Laboratory of Population Science, National Institute on Aging, Bethesda, Maryland, United States of America.
Emiliano
E
Albanese
Norwegian Institute of Public Health, Oslo, Norway.
Bjørn Heine
BH
Strand
University of Maryland School of Medicine, Baltimore, Maryland, United States of America.
Jack M
JM
Guralnik
Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, Washington, United States of America.
Kushang V
KV
Patel
MRC Unit for Lifelong Health and Ageing at UCL, London, United Kingdom.
Diana
D
Kuh
MRC Unit for Lifelong Health and Ageing at UCL, London, United Kingdom.
Rebecca
R
Hardy
D000368:Aged; D002423:Cause of Death; D002908:Chronic Disease / Q000401:mortality; D005260:Female; D006801:Humans; D008019:Life Style; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D061213:Mortality, Premature; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects / Q000401:mortality; D015431:Weight Loss / Q000502:physiology*