Intentional weight loss and mortality among initially healthy men and women

Research Unit for Dietary Studies, Institute of Preventive Medicine, Center for Health and Society, Copenhagen, Denmark.
Nutrition Reviews (Impact Factor: 5.54). 08/2008; 66(7):375-86. DOI: 10.1111/j.1753-4887.2008.00047.x
Source: PubMed

ABSTRACT 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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    ABSTRACT: Introduction: Fruit and vegetable consumption is an important determinant of health and life expectancy. Past research shows that Slovenian adolescents do not consume sufficient amounts of fruit and vegetable. The aim of this study was to analyse the frequency and to examine socio-demographic and socio-economic differences in fruit and vegetable consumption using a nationally representative sample of youth in Slovenia aged 16–27 years. Method: We analysed survey data from the FES-CEPYUS Slovenian Youth 2013 Study (N = 907; Mage = 21.9; 48.3 % women). Two indicators of dietary habits were analysed: the number of fruit servings and the number of vegetable servings consumed daily (1 = “do not eat fruit/vegetable”; 8 = “6 or more servings daily”). Results: A relative majority of young people reported consuming only one serving of fruit daily (28.8 %) and one serving of vegetable daily (32.3 %). On average, respondents consumed 3.62 servings of combined fruit and vegetable daily and only 33 % consumed 5 or more servings daily. Chi-square tests indicated that fruit and vegetable intake was higher among women (compared to men) and among youth from high-status families (compared to low- and middle-status families), while other socio-demographic and socio-economic differences were not statistically significant. Discussion: Two thirds of young people in Slovenia do not consume the recommended daily amounts of fruit and vegetable. The results of this study provide a basis for programmes and measures for raising fruit and vegetable consumption among young people, which should especially focus on young men and youth from low-status families, also by emphasizing the beneficial health effects of fruit and vegetable consumption. Izhodišča: Uživanje sadja in zelenjave je pomemben dejavnik zdravja in pričakovane življenjske dobe. Pretekle raziskave kažejo, da slovenski adolescenti ne uživajo zadostnih količin sadja in zelenjave. Namen pričujoče raziskave je bil analizirati pogostost in razlike v uživanja sadja in zelenjave na reprezentativnem vzorcu mladih v Sloveniji, starih med 16 in 27 let. Metode: Uporabljeni so bili podatki anketne raziskave slovenske mladine Youth 2013 (N = 907; N = 907; Mstarost = 21,9; 48,3 % žensk). Analizirali smo dva indikatorja prehranjevalnih navad, in sicer število enot zaužitega sadja in zaužite zelenjave dnevno (1 = »ne jem sadja/zelenjave«; 8 = »6 ali več enot dnevno«). Rezultati: Največji delež mladih dnevno zaužije le eno enoto sadja (28,8 %) in eno enoto zelenjave (32,3 %). Mladi dnevno v povprečju zaužijejo 3,62 enot sadja in zelenjave, le 33 % pa jih zaužije pet ali več enot dnevno. Hi-kvadrat testi so pokazali, da sadje in zelenjavo v večji meri uživajo ženske ter mladostniki iz družin z višjim materialnim statusom. Ostali sociodemografski in socioekonomski dejavniki niso bili statistično značilni. Razprava: Dve tretjini mladih v Sloveniji ne uživa priporočenih dnevnih količin sadja in zelenjave. Rezultati pričujoče študije lahko predstavljajo podlago za programe in ukrepe na področju zviševanja uživanja sadja in zelenjave med mladimi, ki bi morali biti usmerjeni še posebej na mlade moške in mlade iz socioekonomsko depriviligiranih družin, med drugim tudi s poudarjanjem pozitivnih zdravstvenih učinkov uživanja sadja in zelenjave.
    Second scientific conference with international participation »Slovenian day of dietitians and nutritionists", Izola, Slovenia; 09/2014
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    ABSTRACT: The overall objective of this thesis was to study genetic mechanisms of body weight regulation. Two genome-wide approaches to identify chromosomal regions/candidate genes/genetic variants involved in body weight regulation were applied. Saar et al. (2003) presented the first genome-wide linkage scan for early onset obesity and detected suggestive evidence for linkage. In contrast, the first genome-wide association study for early onset obesity presented in Hinney et al. (2007) led to the re-identification of FTO, the currently best supported candidate gene for obesity. Thus, our investigation underlines two things: first, GWAs are in principle suitable to detect genes with small to modest genetic effect sizes, and second, with our relatively small but well defined sample of cases and controls it is possible to detect the same effects which required genotyping of several thousand population based unselected probands for body weight. Moreover, this thesis comprised the examination of three candidate genes for obesity (BDNF, GLUT4 and DGAT). Additionally, we observed that carriers of functionally relevant MC4R mutations are able to reduce their body weight, but that they seem to have difficulties to sustain this weight loss over time. Common obesity is caused by a complex interplay of genetic background and environmental factors. While monogenic forms of obesity are well understood, GWAs now seem to offer the option to detect oligo- and polygenes. As these genes are typically characterized by small to modest genetic effect sizes but are more common they might be more important than monogenes with regard to clinical implications. In sum, this work is part of a puzzle that might lead to evidence-based, personalized medicine which will be based on a solid scientific base by investigating the molecular genetic mechanisms of body weight regulation with regard to confirmed findings in independent large samples and by more carefully addressing methodological flaws.
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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; 10:9. DOI:10.1186/1475-2891-10-9 · 2.64 Impact Factor

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