Weight change, weight cycling and mortality in the ERFORT Male Cohort Study
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Objective To investigate the effect of weight change and weight fluctuations on all-cause-mortality in men. Methods Within a prospective population-based cohort of 1160 men aged 40–59 years at recruitment, complete weight change patterns from baseline and three follow-up examinations during a period of 15 years of follow-up was used to categorize the 505 men into stable obese, stable non-obese, weight gain, weight loss and weight fluctuation groups. For these men (age range: 55–74 years at start time of survival analysis) further survival was analyzed during the subsequent 15 years. Results Overall, 183 deaths were observed among the 505 men. Only weight fluctuations had a clear significant impact on all-cause mortality. Adjusted hazard rate ratio (HRR (95%-CI)) was 1.86 (1.31–2.66) after adjustment for age group, pre-existing cardiovascular disease or diabetes mellitus, smoking and socio-economic status. The risk rate due to weight loss was borderline significant (HRR = 1.81 (0.99–3.31)). Risk of death due to weight gain (HRR = 1.15 (0.70–1.88)) or stable obesity (HRR = 1.16 (0.69–1.94)), however, were not significantly increased compared to men staying non-obese for the first 15 years after cohort recruitment. Conclusion Weight fluctuations are a major risk factor for all-cause mortality in middle aged men. Moreover, stable obesity does not increase further mortality in men aged 55–74 years in long-term follow-up.
KeywordsGender Cohort study Mortality Obesity Weight change Weight cycling
Body mass index
- ERFORT study
Erfurt Male Cohort Study
Hazard rate ratio
The professional fieldwork of this study is deeply acknowledged. The representatives of the study physicians are the PD Dr. Hartmut Holtz and PD Dr. Klaus-Dieter Dück, who examined together with the PI (G. S.) of the study a large fraction of the study populations and who were involved also in the follow-up programs. The blood tests were conducted by supervision of Prof. Dr. Peter Koehler. The program on psychosocial factors were supervised and conducted by Prof. Dr. M. Geyer, Dr. E. Kunzendorff, Edeltraud Bartel, Klaus Andrzejak, Dr. Katja Limpert, Dr. Günter Stübe, and Helma Bürger. Furthermore, we thank the study nurses Margrit Ullmann, Margot Langelotz, Anke Binding, and Siglinde Litzrodt as well as the team assistant Margret Remke and data manager Elke Siegemund, Hubert Schneller and Claudia Greschik for their extremely cautious work. The authors acknowledge the institutional support of the directors of the department of the Erfurt Medical School, Department for Preventive Cardiology, Prof. Dr. Joachim Knappe, and of the GSF-Institute of Epidemiology, Prof. Dr. Dr. H.-Erich Wichmann.
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