Weight loss increases and fat loss decreases all-cause mortality rate

Results from two independent cohort studies

D. B. Allison, R. Zannolli, M. S. Faith, Moonseong Heo, A. Pictrobelli, T. B. Vanitallie, F. X. Pi-Sunyer, S. B. Heymsfield

Research output: Contribution to journalArticle

174 Citations (Scopus)

Abstract

OBJECTIVE: In epidemiological studies, weight loss is usually associated with increased mortality rate. Contrarily, among obese people, weight loss reduces other risk factors for disease and death. We hypothesised that this paradox could exist because weight is used as an implicit adiposity index. No study has considered the independent effects of weight loss and fat loss on mortality rate. We studied mortality rate as a function of weight loss and fat loss. DESIGN: Analysis of 'time to death' in two prospective population-based cohort studies, the Tecumseh Community Health Study (1890 subjects; 321 deaths within 16 y of follow-up) and the Framingham Heart Study (2731 subjects; 507 deaths within 8 y of follow-up), in which weight and fat (via skinfolds) loss were assessable. RESULTS: In both studies, regardless of the statistical approach, weight loss was associated with an increased, and fat loss with a decreased, mortality rate (P < 0.05). Each standard deviation (s.d.) of weight loss (4.6 kg in Tecumseh, 6.7 kg in Framingham) was estimated to increase the hazard rate by 29% (95% confidence interval CI), (14%, 47%, respectively) and 39% (95% CI, 25%, 54% respectively), in the two samples. Contrarily, each s.d. of fat loss (10.0 mm in Tecumseh, 4.8 mm in Framingham) was estimated to reduce the hazard rate 15% (95% CI, 4%, 25%) and 17% (95% CI, 8%, 25%) in Tecumseh and Framingham, respectively. Generalisability of these results to severely (that is, body mass index BMI ≥ 34) obese individuals is unclear. CONCLUSIONS: Among individuals that are not severely obese, weight loss is associated with increased mortality rate and fat loss with decreased mortality rate.

Original languageEnglish (US)
Pages (from-to)603-611
Number of pages9
JournalInternational Journal of Obesity
Volume23
Issue number6
StatePublished - 1999
Externally publishedYes

Fingerprint

cohort studies
Weight Loss
Cohort Studies
weight loss
Fats
Mortality
lipids
death
community health
Weights and Measures
Adiposity
adiposity
epidemiological studies
body mass index
Epidemiologic Studies
confidence interval
Body Mass Index
risk factors
heart
Confidence Intervals

Keywords

  • Body mass index
  • Fat loss
  • Longevity
  • Mortality
  • Obesity
  • Weight loss

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Public Health, Environmental and Occupational Health
  • Endocrinology
  • Food Science
  • Endocrinology, Diabetes and Metabolism

Cite this

Allison, D. B., Zannolli, R., Faith, M. S., Heo, M., Pictrobelli, A., Vanitallie, T. B., ... Heymsfield, S. B. (1999). Weight loss increases and fat loss decreases all-cause mortality rate: Results from two independent cohort studies. International Journal of Obesity, 23(6), 603-611.

Weight loss increases and fat loss decreases all-cause mortality rate : Results from two independent cohort studies. / Allison, D. B.; Zannolli, R.; Faith, M. S.; Heo, Moonseong; Pictrobelli, A.; Vanitallie, T. B.; Pi-Sunyer, F. X.; Heymsfield, S. B.

In: International Journal of Obesity, Vol. 23, No. 6, 1999, p. 603-611.

Research output: Contribution to journalArticle

Allison, DB, Zannolli, R, Faith, MS, Heo, M, Pictrobelli, A, Vanitallie, TB, Pi-Sunyer, FX & Heymsfield, SB 1999, 'Weight loss increases and fat loss decreases all-cause mortality rate: Results from two independent cohort studies', International Journal of Obesity, vol. 23, no. 6, pp. 603-611.
Allison, D. B. ; Zannolli, R. ; Faith, M. S. ; Heo, Moonseong ; Pictrobelli, A. ; Vanitallie, T. B. ; Pi-Sunyer, F. X. ; Heymsfield, S. B. / Weight loss increases and fat loss decreases all-cause mortality rate : Results from two independent cohort studies. In: International Journal of Obesity. 1999 ; Vol. 23, No. 6. pp. 603-611.
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AU - Faith, M. S.

AU - Heo, Moonseong

AU - Pictrobelli, A.

AU - Vanitallie, T. B.

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AB - OBJECTIVE: In epidemiological studies, weight loss is usually associated with increased mortality rate. Contrarily, among obese people, weight loss reduces other risk factors for disease and death. We hypothesised that this paradox could exist because weight is used as an implicit adiposity index. No study has considered the independent effects of weight loss and fat loss on mortality rate. We studied mortality rate as a function of weight loss and fat loss. DESIGN: Analysis of 'time to death' in two prospective population-based cohort studies, the Tecumseh Community Health Study (1890 subjects; 321 deaths within 16 y of follow-up) and the Framingham Heart Study (2731 subjects; 507 deaths within 8 y of follow-up), in which weight and fat (via skinfolds) loss were assessable. RESULTS: In both studies, regardless of the statistical approach, weight loss was associated with an increased, and fat loss with a decreased, mortality rate (P < 0.05). Each standard deviation (s.d.) of weight loss (4.6 kg in Tecumseh, 6.7 kg in Framingham) was estimated to increase the hazard rate by 29% (95% confidence interval CI), (14%, 47%, respectively) and 39% (95% CI, 25%, 54% respectively), in the two samples. Contrarily, each s.d. of fat loss (10.0 mm in Tecumseh, 4.8 mm in Framingham) was estimated to reduce the hazard rate 15% (95% CI, 4%, 25%) and 17% (95% CI, 8%, 25%) in Tecumseh and Framingham, respectively. Generalisability of these results to severely (that is, body mass index BMI ≥ 34) obese individuals is unclear. CONCLUSIONS: Among individuals that are not severely obese, weight loss is associated with increased mortality rate and fat loss with decreased mortality rate.

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KW - Longevity

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KW - Obesity

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