Dataset Information

Adiposity change and mortality in middle-aged to older Chinese: an 8-year follow-up of the Guangzhou Biobank Cohort Study.

ABSTRACT: Objective: To examine the associations of change in body mass index (BMI) and waist circumference (WC) over an average of 4 years with subsequent mortality risk in middle-aged to older Chinese.

Design: Prospective cohort study based on the Guangzhou Biobank Cohort Study.

Setting: Community-based sample.

Participants: 17 773 participants (12 956 women and 4817 men) aged 50+ years.

Primary and secondary outcome measures: Primary outcome measure was all-cause mortality. Secondary outcome measures were cardiovascular disease (CVD) and cancer mortality. Causes of death were obtained via record linkage, and coded according to the International Classification of Diseases (tenth revision).

Results: 1424 deaths (53.4% women) occurred in the 17 773 participants (mean age 61.2, SD 6.8 years) during an average follow-up of 7.8 (SD=1.5) years, and 97.7% of participants did not have an intention of weight loss . Compared with participants with stable BMI, participants with BMI loss (>5%), but not gain, had a higher risk of all-cause mortality (HR=1.49, 95%?CI 1.31 to 1.71), which was greatest in those who were underweight (HR=2.45, 95%?CI 1.31 to 4.59). Similar patterns were found for WC. In contrast, for participants with a BMI of ?27.5?kg/m², BMI gain, versus stable BMI, was associated with 89% higher risk of all-cause mortality (HR=1.89, 95%?CI 1.25 to 2.88), 72% higher risk of CVD mortality (HR=1.72, 95%?CI 0.80 to 3.72) and 2.27-fold risk of cancer mortality (HR=2.27, 95%?CI 1.26 to 4.10).

Conclusion: In older people, unintentional BMI/WC loss, especially in those who were underweight was associated with higher mortality risk. However, BMI gain in those with obesity showed excess risks of all-cause and cancer mortality, but not CVD mortality. Frequent monitoring of changes in body size can be used as an early warning for timely clinical investigations and interventions and is important to inform appropriate health management in older Chinese.

SUBMITTER: Huang YY

PROVIDER: S-EPMC7722382 | biostudies-literature | 2020 Dec

REPOSITORIES: biostudies-literature

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Publications

Adiposity change and mortality in middle-aged to older Chinese: an 8-year follow-up of the Guangzhou Biobank Cohort Study.

Huang Ying Yue YY Jiang Chao Qiang CQ Xu Lin L Zhang Wei Sen WS Zhu Feng F Jin Ya Li YL Thomas G Neil GN Cheng Kar Keung KK Lam Tai Hing TH

BMJ open 20201204 12

<h4>Objective</h4>To examine the associations of change in body mass index (BMI) and waist circumference (WC) over an average of 4 years with subsequent mortality risk in middle-aged to older Chinese.<h4>Design</h4>Prospective cohort study based on the Guangzhou Biobank Cohort Study.<h4>Setting</h4>Community-based sample.<h4>Participants</h4>17 773 participants (12 956 women and 4817 men) aged 50+ years.<h4>Primary and secondary outcome measures</h4>Primary outcome measure was all-cause mortalit ...[more]

PMID: 33277280

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Project description:BackgroundPhysical activity (PA) is generally encouraged. Studies from developed countries in the West have shown that maintenance of adequate PA or increasing PA are associated with lower mortality risk. It is unclear whether these associations apply to an older Chinese population. Hence, we examined the changes in PA prospectively among a middle-aged and older Chinese population over an average of 4 years and explored their subsequent mortality risks.MethodsMetabolic equivalent scores of PA among participants in the Guangzhou Biobank Cohort Study were calculated. Participants were divided into 3 groups related to PA level, and changes in PA were classified into 9 categories. Information on vital status and causes of death from March 2008 to December 2012 (the first repeated examination) until December 31, 2017, was obtained via record linkage with the Death Registry.ResultsOf 18,104 participants aged 61.21 ± 6.85 years (mean ± SD), 1461 deaths occurred within 141,417 person-years. Compared to participants who maintained moderate PA, those who decreased PA from moderate or high levels to a low level had increased risks for all-cause mortality (hazard ratio (HR) = 1.47, 95% confidence interval (95%CI): 1.11-1.96). Participants who maintained a high level of PA (HR = 0.83, 95%CI: 0.70-0.98) or increased PA from low to high levels (HR = 0.71, 95%CI: 0.52-0.97) showed lower all-cause mortality risks. Those who maintained low PA levels showed a higher all-cause mortality risk, whereas those who increased their PA levels showed a non-significantly lower risk. Similar results were found for cardiovascular disease risk.ConclusionEven at an older age, maintaining a high PA level or increasing PA from low to high levels results in lower mortality risks, suggesting that substantial health benefits might be achieved by maintaining or increasing engagement in adequate levels of PA. The increased risk of maintaining a low PA level or decreasing PA to a low level warrants the attention of public health officials and clinicians.

Project description:ObjectiveAs overall spread of obesity in populations is generally acknowledged to result from unhealthy lifestyles rather than individual genetic makeup, this study aimed to gain specific insights into its determinants through assessing the prevalent associations between individual socioeconomic status (SES) and weight loss in overweight and obese men and women.MethodsA prospective, 2-year follow-up study covered 3362 (38.0% men) respondents, aged 43-64 years, body mass index ≥25 kg/m2. Changes in body weight were estimated as a percentage of initial weight. Three categories of changes were defined: gained ≥3%, stable (gained <3% or lost <3%), lost ≥3%. Body weight loss was determined against three categories: lost ≥3 to <5%, lost ≥5 to <10%, lost ≥10%. Select SES variables (ie, gender, age, education, marital status, occupational activity and income) were determined in line with the Health Status Questionnaire. The associations between SES and body weight changes were analysed with the aid of logistic regression models. The results were presented as ORs with 95% CIs.ResultsOnly 18% of the respondents had complied with the medical recommendations on weight loss. Significant differences were encountered between the gender, age and occupational activity variables and the weight loss one. Multifactorial models were used to determine the following gender-specific associations between SES and weight loss. Men with moderate income had significantly higher odds for weight loss (≈75%), as compared with the higher earners, whereas women with low income, occupationally inactive, had significantly higher odds (≈30% and ≈50%, respectively), as compared with the high earners and occupationally active ones.ConclusionsLower education, male gender, lower income per household, older age and unemployment status were the established factors predisposing to obesity. While aiming to ensure effectiveness of the measures specifically aimed at preventing obesity, population groups deemed most at risk of potential weight gain must prior be identified.

Dataset Information

Adiposity change and mortality in middle-aged to older Chinese: an 8-year follow-up of the Guangzhou Biobank Cohort Study.

Publications

Adiposity change and mortality in middle-aged to older Chinese: an 8-year follow-up of the Guangzhou Biobank Cohort Study.

Similar Datasets

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