Simonsen, M. K. et al. Intentional weight loss and mortality among initially healthy men and women. Nutr. Rev. 66, 375-386

Research Unit for Dietary Studies, Institute of Preventive Medicine, Center for Health and Society, Copenhagen, Denmark.
Nutrition Reviews (Impact Factor: 6.08). 08/2008; 66(7):375-86. DOI: 10.1111/j.1753-4887.2008.00047.x
Source: PubMed


Most prospective observational studies suggest that weight loss increases the risk of premature death among obese individuals. This is surprising because clinical studies show that weight loss generally leads to overall improvements in cardiovascular risk factors. It is sometimes argued that the increased mortality observed with weight loss must depend on confounding or poor study designs. This review was conducted to summarize results from studies on intentional weight loss and mortality among healthy individuals, while carefully considering the designs and problems in these studies. Evaluation criteria with a rating scale were developed. Of the studies evaluated, two found decreased mortality with intentional weight loss, three found increased mortality, and four found no significant associations between intentional weight loss and total mortality. Thus, it is still not possible for health authorities to make secure recommendations on intentional weight loss. More studies designed to specifically address this issue are warranted.

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    • "e l s e v i e r . c o m / l o c a t e / y g y n o individuals is now also beginning to emerge [14]. In a recent review Wolin et al. suggested that obesity causes a substantial proportion of all cancers, and emerging evidence suggests that adult weight loss reduces cancer risk [5]. "
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    ABSTRACT: Obesity is a major risk factor for the development of endometrial cancer (EC). An improved understanding of biologic mechanisms associated with weight loss, including alteration in inflammation, hormonal balance, and cancer antigens expression may lead to the development of effective cancer prevention strategies. The goal of this study was to explore longitudinal biomarker changes in obese women who underwent weight loss intervention, testing the hypothesis biomarker levels can be altered through intentional weight loss. Serum samples from 89 participants with Class II and Class III obesity and 43 non morbidly obese comparisons were obtained in Re-Energize with Nutrition, Exercise and Weight Loss (RENEW) study as previously reported. Twenty-one bead-based xMAP immunoassays were utilized, including cancer-associated antigens, cytokines, chemokines, and hormones. One-way repeated measures ANOVA was used to examine the association between changes in biomarker expression levels over time (baseline, 6 months and 12 months). Linear mixed effects models were used to examine longitudinal relationships between biomarker expression levels. Mean levels of VEGF, soluble E-selectin, GH, adiponectin, IL-6, IL-7, CA-125, and IGFBP-1 significantly differed between time periods. In adjusted mixed linear models, decreasing BMI was significantly associated with lower levels of soluble E-selectin and IL-6 and increases in GH, adiponectin, and IGFBP-1. This is one of the first efforts to explore changes in cancer-associated biomarkers in a cohort of weight loss research participants at high risk for EC development. Our findings demonstrate that changes in the expression of markers can be achieved with weight loss intervention.
    Gynecologic Oncology 12/2011; 125(1):114-9. DOI:10.1016/j.ygyno.2011.12.439 · 3.77 Impact Factor
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    • "Evidence: Most prospective observational studies suggest that weight loss increases the risk of premature death among obese individuals, even when the weight loss is intentional and the studies are well controlled with regard to known confounding factors, including hazardous behavior and underlying diseases [91-96]. Recent review of NHANES, for example, a nationally representative sample of ethnically diverse people over the age of fifty, shows that mortality increased among those who lost weight [97]. "
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    ABSTRACT: Current guidelines recommend that "overweight" and "obese" individuals lose weight through engaging in lifestyle modification involving diet, exercise and other behavior change. This approach reliably induces short term weight loss, but the majority of individuals are unable to maintain weight loss over the long term and do not achieve the putative benefits of improved morbidity and mortality. Concern has arisen that this weight focus is not only ineffective at producing thinner, healthier bodies, but may also have unintended consequences, contributing to food and body preoccupation, repeated cycles of weight loss and regain, distraction from other personal health goals and wider health determinants, reduced self-esteem, eating disorders, other health decrement, and weight stigmatization and discrimination. This concern has drawn increased attention to the ethical implications of recommending treatment that may be ineffective or damaging. A growing trans-disciplinary movement called Health at Every Size (HAES) challenges the value of promoting weight loss and dieting behavior and argues for a shift in focus to weight-neutral outcomes. Randomized controlled clinical trials indicate that a HAES approach is associated with statistically and clinically relevant improvements in physiological measures (e.g., blood pressure, blood lipids), health behaviors (e.g., eating and activity habits, dietary quality), and psychosocial outcomes (such as self-esteem and body image), and that HAES achieves these health outcomes more successfully than weight loss treatment and without the contraindications associated with a weight focus. This paper evaluates the evidence and rationale that justifies shifting the health care paradigm from a conventional weight focus to HAES.
    Nutrition Journal 01/2011; 10(1):9. DOI:10.1186/1475-2891-10-9 · 2.60 Impact Factor
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    • "os basados en ocho estudios, publicados de 1993 al 2005. Los resultados más importantes son las diferencias en la mortalidad dependiendo del género, de la enfermedad coexistente y de la intencionalidad de la pérdida de peso. En mujeres y en las personas con sobrepeso y diabetes, disminuyó el riesgo de mortalidad por la pérdida de peso intencional. Simonsen y cols. (2008) 25 , realizaron una revision de estudios prospectivos publicados de 1995 al 2005, en la que analizaron la asociación de la pérdida de peso intencional sobre la mortalidad en individuos sanos. Desarrollaron un instrumento para evaluar la calidad metodológica de los estudios, en el cual tomaron en cuenta 10 criterios seleccionados por los"
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    ABSTRACT: The beneficial effect of intentional weight loss on mortality is controversial. The purpose of this study was to conduct a systematic review and analyze the quality of prospective studies that assess weight loss on mortality. An electronic search at MEDLINE/PubMed, SciELO, and EBSCO data base, of studies with a follow-up of five or more years, published from January, 2000 to October, 2009, was conducted. Quality of the studies was assessed by Simonsen's criteria. Twenty studies were analyzed. At the beginning of the studies, the age of the subjects ranged from 20 to 101 years. Nine studies included those who intended to loose weight. The quality of the studies ranged from 8 to 17 points (out of 20). Weight loss increased the mortality rate in 15 studies and decreased it in 5. Seven of the studies assessing intention to loose weight showed that weight loss increased the mortality rate, whereas in two the mortality rate decreased. In three out of the four studies that assessed weight fluctuation, the mortality rate increased. These results underline the importance of preventing weight increase, as well as the need to avoid gaining or loosing weight more than 4%.
    Nutricion hospitalaria: organo oficial de la Sociedad Espanola de Nutricion Parenteral y Enteral 10/2010; 25(5):718-24. DOI:10.3305/nh.2010.25.5.4722 · 1.04 Impact Factor
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