VARIABILITY OF BODY-WEIGHT AND HEALTH OUTCOMES IN THE FRAMINGHAM POPULATION

被引:551
作者
LISSNER, L
ODELL, PM
DAGOSTINO, RB
STOKES, J
KREGER, BE
BELANGER, AJ
BROWNELL, KD
机构
[1] YALE UNIV, DEPT PSYCHOL, 2 HILLHOUSE AVE, BOX 11A, NEW HAVEN, CT 06520 USA
[2] BRYANT COLL, DEPT MATH, SMITHFIELD, RI 02917 USA
[3] BOSTON UNIV, DEPT MATH, BOSTON, MA 02215 USA
[4] DEPT PRIMARY HLTH CARE, GOTHENBURG, SWEDEN
[5] BOSTON UNIV, MED CTR, DEPT PREVENT MED & EPIDEMIOL, BOSTON, MA 02215 USA
关键词
D O I
10.1056/NEJM199106273242602
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background. Fluctuation in body weight is a common phenomenon, due in part to the high prevalence of dieting. In this study we examined the associations between variability in body weight and health end points in subjects participating in the Framingham Heart Study, which involves follow-up examinations every two years after entry. Methods. The degree of variability of body weight was expressed as the coefficient of variation of each subject's measured body-mass-index values at the first eight biennial examinations during the study and on their recalled weight at 25 years of age. Using the 32-year follow-up data, we analyzed total mortality, mortality from coronary heart disease, and morbidity due to coronary heart disease and cancer in relation to intraindividual variation in body weight, including only end points that occurred after the 10th biennial examination. We used age-adjusted proportional-hazards regression for the data analysis. Results. Subjects with highly variable body weights had increased total mortality (P = 0.005 for men, P = 0.01 for women), mortality from coronary heart disease (P = 0.009 for men, P = 0.009 for women), and morbidity due to coronary heart disease (P = 0.0009 for men, P = 0.006 for women). Using a multivariate analysis that also controlled for obesity, trends in weight over time, and five indicators of cardiovascular risk, we found that the positive associations between fluctuations in body weight and end points related to mortality and coronary heart disease could not be attributed to these potential confounding factors. The relative risks of these end points in subjects whose weight varied substantially, as compared with those whose weight was relatively stable, ranged from 1.27 to 1.93. Conclusions. Fluctuations in body weight may have negative health consequences, independent of obesity and the trend of body weight over time.
引用
收藏
页码:1839 / 1844
页数:6
相关论文
共 16 条
[1]  
[Anonymous], 1976, INT CLASSIFICATION D
[2]   RELATION OF WEIGHT CHANGE TO CHANGES IN ATHEROGENIC TRAITS - FRAMINGHAM STUDY [J].
ASHLEY, FW ;
KANNEL, WB .
JOURNAL OF CHRONIC DISEASES, 1974, 27 (03) :103-114
[3]   UNDERSTANDING AND PREVENTING RELAPSE [J].
BROWNELL, KD ;
MARLATT, GA ;
LICHTENSTEIN, E ;
WILSON, GT .
AMERICAN PSYCHOLOGIST, 1986, 41 (07) :765-782
[4]  
Dawber T. R., 1980, FRAMINGHAM STUDY EPI
[5]  
DAWBER TR, 1951, AM J PUBLIC HEALTH, V41, P279
[6]   LARGE FLUCTUATIONS IN BODY-WEIGHT DURING YOUNG ADULTHOOD AND 25-YEAR RISK OF CORONARY DEATH IN MEN [J].
HAMM, P ;
SHEKELLE, RB ;
STAMLER, J .
AMERICAN JOURNAL OF EPIDEMIOLOGY, 1989, 129 (02) :312-318
[7]   OBESITY AS AN INDEPENDENT RISK FACTOR FOR CARDIOVASCULAR-DISEASE - A 26-YEAR FOLLOW-UP OF PARTICIPANTS IN THE FRAMINGHAM HEART-STUDY [J].
HUBERT, HB ;
FEINLEIB, M ;
MCNAMARA, PM ;
CASTELLI, WP .
CIRCULATION, 1983, 67 (05) :968-977
[8]  
Lissner L., 1989, Obesity in Europe 88. Proceedings of the 1st European Congress on Obesity, 5-6 June, 1988, Stockholm, Sweden., P55
[9]  
LISSNER L, 1990, INT J OBESITY, V14, P373
[10]  
MARLATT GA, 1985, RELAPSE PREVENTION