Habitual consumption of long-chain n–3 PUFAs and fish attenuates genetically associated long-term weight gain

ABSTRACT Background A growing amount of data suggests that n–3 (ω-3) polyunsaturated fatty acid (PUFA) intake may modify the genetic association with weight change. Objectives We aimed to prospectively test interactions of habitual consumption of n–3 PUFAs or fish, the major food source, with overall genetic susceptibility on long-term weight change. Design Gene–diet interactions were examined in 11,330 women from the Nurses’ Health Study (NHS), 6773 men from the Health Professionals Follow-Up Study (HPFS), and 6254 women from the Women's Health Initiative (WHI). Results In the NHS and HPFS cohorts, food-sourced long-chain n–3 PUFA intake showed directionally consistent interactions with genetic risk score on long-term changes in BMI (P-interaction = 0.01 in the HPFS, 0.15 in the NHS, and 0.01 in both cohorts combined). Such interactions were successfully replicated in the WHI, an independent cohort (P-interaction = 0.02 in the WHI and 0.01 in the combined 3 cohorts). The genetic associations with changes in BMI (in kg/m2) consistently decreased (0.15, 0.10, 0.07, and −0.14 per 10 BMI-increasing alleles) across the quartiles of long-chain n–3 PUFAs in the combined cohorts. In addition, high fish intake also attenuated the genetic associations with long-term changes in BMI in the HPFS (P-interaction = 0.01), NHS (P-interaction = 0.03), WHI (P-interaction = 0.10), and the combined cohorts (P-interaction = 0.01); and the differences in BMI changes per 10 BMI-increasing alleles were 0.16, 0.06, −0.08, and −0.18, respectively, across the categories (≤1, 1∼4, 4∼6, and ≥7 servings/wk) of total fish intake. Similar interactions on body weight were observed for fish intake (P-interaction = 0.003) and long-chain n–3 PUFA intake (P-interaction = 0.12). Conclusion Our study provides replicable evidence to show that high intakes of fish and long-chain n–3 PUFAs are associated with an attenuation of the genetic association with long-term weight gain based on results from 3 prospective cohorts of Caucasians.

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Fish and marine fatty acids intakes, theFADSgenotypes and long-term weight gain: a prospective cohort study

BMJ Open ◽

10.1136/bmjopen-2018-022877 ◽

2019 ◽

Vol 9 (7) ◽

pp. e022877

Author(s):

Tao Huang ◽

Tiange Wang ◽

Yoriko Heianza ◽

Janey Wiggs ◽

Dianjianyi Sun ◽

...

Keyword(s):

Fatty Acids ◽

Body Weight ◽

Weight Gain ◽

Prospective Cohort ◽

Fish Intake ◽

Health Study ◽

Genetic Associations ◽

Long Term Changes ◽

Long Chain

ObjectiveWe tested whether genetic variants near fatty acid desaturases gene (FADS) cluster, which were recently identified to be signatures of adaptation to fish-rich and n-3 polyunsaturated fatty acids (PUFAs)-rich diet, interacted with these dietary factors on change in body mass index (BMI).DesignThreeFADSvariants were examined for gene-diet interactions on long-term (~10 years) changes in BMI and body weight in four prospective cohort studies.SettingPopulation based study.Participants11 323 women from the Nurses’ Health Study (NHS), 6833 men from the Health Professionals Follow-up Study (HPFS) and replicated in 6254 women from the Women’s Health Initiative (WHI) and 5 264 Chinese from the Singapore Chinese Health Study (SCHS).Main outcomesLong-term (~10 years) changes in BMI and body weight.ResultsIn the NHS and HPFS cohorts, food-sourced n-3 PUFAs intake showed interactions with theFADSrs174570 on changes of BMI (P for interaction=0.02 in NHS, 0.05 in HPFS and 0.007 in combined). Such interactions were replicated in two independent cohorts WHI and SCHS (P for interaction=0.04 in WHI, 0.02 in SCHS and 0.001 in combined). The genetic associations of theFADSrs174570 with changes in BMI increased across the tertiles of n-3 PUFAs in all the cohorts. Fish intake also accentuated the genetic associations of theFADSrs174570 with long-term changes in BMI (pooled P for interaction=0.006). Viewed differently, long chain n-3 PUFAs intake showed stronger association with long-term changes in BMI among the rs174570 T carriers (beta=0.79 kg/m2per g, p=3×10−5) than the rs174570 non-T carriers (beta=0.16 kg/m2per g, p=0.08). Similar results were observed for fish intake.ConclusionsOur hypothesis-driven analyses provide replicable evidence that long chain n-3 PUFAs and fish intakes may interact with theFADSvariant on long-term weight gain. Further investigation is needed to confirm our findings in other cohorts.

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Abstract P051: Lifestyle Change In Mid-life And Long-term Weight Gain In Women With And Without History Of Gestational Diabetes Mellitus

Circulation ◽

10.1161/circ.143.suppl_1.p051 ◽

2021 ◽

Vol 143 (Suppl_1) ◽

Author(s):

Jiaxi Yang ◽

Janet Rich-Edwards ◽

Molin Wang ◽

Wafaie W Fawzi ◽

Cuilin Zhang ◽

...

Keyword(s):

Physical Activity ◽

Diabetes Mellitus ◽

Body Weight ◽

Weight Gain ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Weight Change ◽

Lifestyle Change ◽

History Of

Introduction: Identifying strategies to mitigate gradual long-term weight gain is critical for preventing obesity and its related chronic diseases, particularly for persons at high risk, such as women with a history of gestational diabetes mellitus (GDM). We prospectively examined the independent associations between lifestyle changes in mid-life with long-term weight change among women with and without a history of GDM. Hypothesis: We hypothesized that favorable improvements in lifestyle would be associated with less long-term weight gain, particularly among women with a history of GDM. Methods: We used data from the longitudinal Nurses’ Health Study II, with self-reported lifestyle, diet via food frequency questionnaire, and body weight updated every 2-4 years. We analyzed repeated 4-year changes of the following lifestyle factors among parous women after age 40: adherence to a healthy dietary pattern (Alternate Healthy Eating Index score [AHEI]), physical activity (MET-hrs/wk), moderate alcohol intake (servings/d), and non-smoking, in relation to concurrent 4-year change in body weight (lb). We used multivariable generalized estimating equation models to estimate the least-squares mean of 4-year weight change and 95% confidence interval (CI) for each lifestyle change category (e.g., decrease, remain stable, and increase). Results: Our analysis included 61,637 women, of which 3,444 (5.6%) had a history of GDM. Mean of repeated 4-year weight change after age 40 was 3.0 lb (SD=14.3). Improving diet was associated with favorable 4-year weight change, particularly among women with a history of GDM vs. without GDM (AHEI score change from low to high: -6.3 lb [CI: -9.3, -3.4] vs. -2.7 lb [CI: -3.2, -2.2], respectively; p-interaction=0.04). Increasing physical activity was associated with weight maintenance for GDM women only (MET-hrs/wk change from low to high: 0.6 lb [95% CI: -0.6, 1.7] vs. 2.0 lb [95% CI: 1.8, 2.2] for GDM vs. non-GDM, respectively; p-interaction=0.01). Reducing alcohol (decreased servings/d: 1.9 lb [95% CI: 1.2, 2.6] and 2.8 lb [95% CI: 2.6, 2.9] for GDM vs. non-GDM, respectively) and smoking cessation (recent quitter: 9.8 lb [95% CI: 7.1, 12.5] and 8.5 lb [95% CI: 8.0, 9.1] for GDM vs. non-GDM, respectively) were associated with similar patterns in weight change for women with and without prior GDM. Further, the joint association of improving both diet and physical activity from low to high was related to -12.3 lb (95% CI: -19.5, -5.0) and -6.1 lb (95% CI: -8.0, -4.2) of weight loss for GDM vs. non-GDM women, respectively. Conclusions: We observed that attainable improvements in diet quality and physical activity were associated with weight gain prevention. These findings support continued efforts to improve lifestyle as a beneficial strategy to prevent long-term weight gain, particularly among women with a history of GDM.

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High Intake of Free Sugars, Fructose, and Sucrose Is Associated with Weight Gain in Japanese Men

Journal of Nutrition ◽

10.1093/jn/nxz227 ◽

2019 ◽

Author(s):

Michiyo Yamakawa ◽

Keiko Wada ◽

Sachi Koda ◽

Fumi Mizuta ◽

Takahiro Uji ◽

...

Keyword(s):

Body Weight ◽

Weight Gain ◽

Weight Change ◽

Free Sugar ◽

Linear Regression Models ◽

Japanese Men ◽

Free Sugars ◽

Sugar Intake ◽

Artery Disease

ABSTRACT Background Available evidence for associations between sugar intake and body weight is largely from short-term controlled trials and studies focusing on sugar-sweetened beverages. Studies on long-term weight change related to the intake of types of sugar are thus needed. Objective We examined the associations between weight change and the intake of various types of carbohydrates, including starch, total sugars, and free or naturally occurring sugars and saccharides (i.e., glucose, fructose, sucrose, and lactose), among Japanese men and women. Methods This prospective cohort study included 14,971 residents of Takayama City in Japan who were aged 35–69 y at the first survey in 1992 and responded to a self-administrated questionnaire at the second survey in 2002. We excluded those with cancer, coronary artery disease, stroke, or diabetes on the first survey and those with missing information about body weight on both surveys, leaving 13,229 participants for analysis (5879 men and 7350 women). Mean (95% CI) values of 10-y weight change according to types of carbohydrates were estimated using linear regression models with adjustment for total energy intake and other dietary and lifestyle factors. Dietary intake was assessed at the first survey using a validated FFQ. Results Among men, free sugar intake was associated with weight gain and the estimated means (95% CIs) of weight change were −0.60 (−0.67, −0.54), −0.31 (−0.38, −0.24), −0.12 (−0.19, −0.05), and 0.20 (0.13, 0.27) kg from the first to fourth quartiles (P-trend = 0.002). Moreover, high intakes of sucrose and fructose were associated with weight gain (P-trend: 0.018 for sucrose and 0.001 for fructose). Among women, the intake of any type of carbohydrate was not significantly associated with weight change. Conclusions These results suggested that high intakes of free sugars, sucrose, and fructose were associated with long-term weight gain among Japanese men.

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The weight change impact on metabolic syndrome: a 17-year follow-up study

Open Medicine ◽

10.2478/s11536-011-0093-2 ◽

2011 ◽

Vol 6 (6) ◽

pp. 788-794 ◽

Cited By ~ 1

Author(s):

Magdalena Kwaśniewska ◽

Dorota Kaleta ◽

Anna Jegier ◽

Tomasz Kostka ◽

Elżbieta Dziankowska-Zaborszczyk ◽

...

Keyword(s):

Metabolic Syndrome ◽

Weight Loss ◽

Weight Gain ◽

Weight Change ◽

Metabolic Risk ◽

Adjusted Relative Risk ◽

Prospective Longitudinal ◽

The Impact

AbstractIntroduction: Data on long-term patterns of weight change in relation to the development of metabolic syndrome (MetS) are scarce. The aim of the study was to evaluate the impact of weight change on the risk of MetS in men. Material and Methods: Prospective longitudinal observation (17.9 ± 8.1 years) of apparently healthy 324 men aged 18–64 years. Metabolic risk was assessed in weight gain (⩾ 2.5 kg), stable weight (> −2.5 kg and < 2.5 kg) and weight loss (⩽ −2.5 kg) groups. Adjusted relative risk (RR) of MetS was analyzed using multivariate logistic regression. Results: The prevalence of MetS over follow-up was 22.5%. There was a strong relationship between weight gain and worsening of MetS components among baseline overweight men. Long-term increase in weight was most strongly related with the risk of abdominal obesity (RR=7.26; 95% CI 2.98–18.98), regardless of baseline body mass index (BMI). Weight loss was protective against most metabolic disorders. Leisure-time physical activity (LTPA) with energy expenditure > 2000 metabolic equivalent/min/week was associated with a significantly lower risk of MetS. Conclusions: Reducing weight among overweight and maintaining stable weight among normal-weight men lower the risk of MetS. High LTPA level may additionally decrease the metabolic risk regardless of BMI.

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Change in Body Weight and Long-Term Risk of Stroke and Death in Healthy Men

Stroke ◽

10.1161/strokeaha.119.027233 ◽

2020 ◽

Vol 51 (5) ◽

pp. 1435-1441 ◽

Cited By ~ 2

Author(s):

Erik Prestgaard ◽

Julian Mariampillai ◽

Kristian Engeseth ◽

Jan Erikssen ◽

Johan Bodegård ◽

...

Keyword(s):

Weight Loss ◽

Weight Gain ◽

Weight Change ◽

Early Life ◽

Cox Regression ◽

Weight Increase ◽

Healthy Men ◽

Measured Weight ◽

Long Term Follow Up

Background and Purpose— The importance of weight change for the risk of stroke is not well known. We examined the associations between early- and mid-life weight change and risks of stroke and death during long-term follow-up of healthy men. Methods— We recruited healthy men aged between 40 and 59 years and performed a cardiovascular examination at baseline and again at 7 years. We collected data on weight change since the age of 25 (early-life weight change) and measured weight change from baseline to the visit at 7 years (mid-life weight change). For both weight change periods, participants were divided into the following categories: weight loss, weight gain 0 to 4.9 kg, weight gain 5 to 9.9 kg, and weight gain ≥10 kg. Data on stroke and death were collected up to 35 years, from study visits, hospital records, and the National Cause of Death Registry. We used Cox regression to analyze the associations between weight change during early-life and mid-life and risks of stroke and death. Results— Of the 2014 participants, 2014 (100%) had data on early-life weight change and were followed for a median of 30.1 years, while 1403 had data on mid-life weight change and were followed for a median of 24.6 years. During early-life, compared with those who had weight gain 0 to 4.9 kg, hazard ratio for stroke was 1.46 (95% CI, 1.09–1.95) among those with weight gain 5 to 9.9 kg, 1.39 (95% CI, 1.03–1.87) for those with weight gain ≥10 kg, and 1.46 (95% CI, 0.99–2.11) among those with weight loss. For all-cause death, the hazard ratios were 1.08 (95% CI, 0.92–1.23), 1.14 (95% CI, 0.98–1.33), and 1.29 (95% CI, 1.06–1.56), respectively. During mid-life, there were no significant differences in risk of stroke or death between the groups. Conclusions— Weight increase during early-life, but not mid-life, seems to be associated with increased long-term risk of stroke in healthy men. If these findings can be confirmed, efforts to prevent weight increase should target the younger population.

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Changes in nut consumption influence long-term weight change in US men and women

BMJ Nutrition, Prevention & Health ◽

10.1136/bmjnph-2019-000034 ◽

2019 ◽

Vol 2 (2) ◽

pp. 90-99 ◽

Cited By ~ 3

Author(s):

Xiaoran Liu ◽

Yanping Li ◽

Marta Guasch-Ferré ◽

Walter C Willett ◽

Jean-Philippe Drouin-Chartier ◽

...

Keyword(s):

Weight Gain ◽

Weight Change ◽

Health Professionals ◽

Lower Risk ◽

Health Study ◽

Total Consumption ◽

Tree Nuts ◽

The Us

BackgroundNut consumption has increased in the US but little evidence exists on the association between changes in nut consumption and weight change. We aimed to evaluate the association between changes in total consumption of nuts and intakes of different nuts (including peanuts) and long-term weight change, in three independent cohort studies.Methods and findingsData collected in three prospective, longitudinal cohorts among health professionals in the US were analysed. We included 27 521 men (Health Professionals Follow-up Study, 1986 to 2010), 61 680 women (Nurses’ Health Study, 1986 to 2010), and 55 684 younger women (Nurses’ Health Study II, 1991 to 2011) who were free of chronic disease at baseline in the analyses. We investigated the association between changes in nut consumption over 4-year intervals and concurrent weight change over 20–24 years of follow-up using multivariate linear models with an unstructured correlation matrix to account for within-individual repeated measures. 21 322 individuals attained a body mass index classification of obesity (BMI ≥30 kg/m2) at the end of follow-up.Average weight gain across the three cohorts was 0.32 kg each year. Increases in nut consumption, per 0.5 servings/day (14 g), was significantly associated with less weight gain per 4-year interval (p<0.01 for all): −0.19 kg (95% CI -0.21 to -0.17) for total consumption of nuts, -0.37 kg (95% CI -0.45 to -0.30) for walnuts, -0.36 kg (95% CI -0.40 to -0.31) for other tree nuts, and -0.15 kg (95% CI -0.19 to -0.11) for peanuts.Increasing intakes of nuts, walnuts, and other tree nuts by 0.5 servings/day was associated with a lower risk of obesity. The multivariable adjusted RR for total nuts, walnuts, and other tree nuts was 0.97 (95% CI 0.96 to 0.99, p=0.0036), 0.85 (95% CI 0.81 to 0.89, p=0.0002), and 0.89 (95% CI 0.87 to 0.91, p<0.0001), respectively. Increasing nut consumption was also associated with a lower risk of gaining ≥2 kg or ≥5 kg (RR 0.89–0.98, p<0.01 for all).In substitution analyses, substituting 0.5 servings/day of nuts for red meat, processed meat, French fries, desserts, or potato, chips (crisps) was associated with less weight gain (p<0.05 for all).Our cohorts were largely composed of Caucasian health professionals with relatively higher socioeconomic status; thus the results may not be generalisable to other populations.ConclusionIncreasing daily consumption of nuts is associated with less long-term weight gain and a lower risk of obesity in adults. Replacing 0.5 servings/day of less healthful foods with nuts may be a simple strategy to help prevent gradual long-term weight gain and obesity.

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Abstract P091: A Comparison of Analytical Methods to Evaluate the Association Between Diet and Long-Term Weight Gain in Three Prospective Cohorts

Circulation ◽

10.1161/circ.127.suppl_12.ap091 ◽

2013 ◽

Vol 127 (suppl_12) ◽

Author(s):

Jessica D Smith ◽

Tao Hou ◽

Frank Hu ◽

Eric B Rimm ◽

Donna Spiegelman ◽

...

Keyword(s):

Weight Gain ◽

Weight Change ◽

Dietary Habits ◽

Dietary Change ◽

Health Study ◽

Biologically Relevant ◽

Prospective Cohorts ◽

Comparison Of Analytical Methods

Background: Because long-term weight gain typically occurs insidiously (~1 lb/y) it is very difficult to study in RCTs and prospective cohorts provide crucial evidence on its key contributors. Most prior studies have evaluated how baseline diet, rather than change in diet that may be more physiologically relevant, relates to future weight gain. Aim: To evaluate and compare different methodological approaches for investigating how diet relates to long-term weight gain. Methods: Participants from 3 separate cohorts, the Nurses Health Study (NHS, n=50,422), Nurses Health Study II (NHS II, n=47,898), and the Health Professionals Follow-up Study (HPFS, n=22,557), free of obesity and chronic diseases at baseline, were included and followed for up to 20 y. Lifestyle, health status, and weight were assessed by questionnaires every 2 y, and diet by validated FFQ every 4 y. We assessed 3 different analytic approaches, including relations of 1) baseline diet at the start of each 4 y with weight change in the next 4 y; 2) 4-y change in diet with weight change in the same 4 y; and 3) 4-y change in diet with lagged weight change in the next 4 y. We compared these approaches evaluating consistency across cohorts, magnitudes of associations, and biological plausibility of findings. Results: Across the three methods, consistent, robust, and biologically plausible associations were only seen between changes in diet and changes in weight in the same 4 y (Figure). Findings evaluating baseline diet and lagged dietary change were less consistent across cohorts, far smaller in magnitude, and often not biologically plausible, suggesting presence of both bias and misclassification of the true relevant dietary metric. Conclusions: The methods used to analyze dietary habits and long-term weight gain are crucial. The most robust, biologically relevant, and consistent findings are seen when evaluating dietary change and weight change in discrete periods.

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Weight change with atypical antipsychotics in the treatment of schizophrenia

Journal of Psychopharmacology ◽

10.1177/0269881105058378 ◽

2005 ◽

Vol 19 (6_suppl) ◽

pp. 16-27 ◽

Cited By ~ 82

Author(s):

Peter Haddad

Keyword(s):

Weight Gain ◽

Weight Change ◽

First Year ◽

Antipsychotic Treatment ◽

Short Term ◽

Management Interventions ◽

First Onset ◽

Risk Patients ◽

Randomised Controlled

Weight gain is a common complication of antipsychotic treatment. Its consequences include decreased self-esteem, reduced quality of life, reduced adherence with medication and increased morbidity and mortality. Most studies that assess weight change are short term. Among the atypicals mean weight gain is greatest with olanzapine and clozapine and least with aripiprazole and ziprasidone. Mean weight change obscures the marked individual variation in weight change that occurs during antipsychotic treatment i.e. irrespective of the antipsychotic, some subjects lose weight, some maintain their weight and some gain weight. In several long-term naturalistic studies (>6 months) mean weight gain is less marked than in randomised controlled trials of a shorter or comparable duration. This may reflect selective prescribing, the effect of weight management interventions and differences in the statistical analysis employed. With most antipsychotics weight stabilizes in the short to medium term but with clozapine it may continue beyond the first year. With some drugs clinical improvement is associated with short-term weight gain. Predictors of long-term weight gain include lower body mass index, increased appetite and rapid initial weight increase. Weight gain is greater in first onset patients due to the lack of prior antipsychotic exposure and associated weight gain. The potential for weight gain should be discussed with patients before starting antipsychotic treatment and weight monitored regularly during treatment. It may be possible to predict weight gain before an antipsychotic is started or early on in treatment enabling high-risk patients to receive more intensive strategies to reduce weight gain.

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Treatment-Related Weight Change and Overall Survival in United States Veterans with Follicular Lymphoma

Blood ◽

10.1182/blood.v126.23.2088.2088 ◽

2015 ◽

Vol 126 (23) ◽

pp. 2088-2088

Author(s):

Daphne Y Xiao ◽

Katiuscia O'Brian ◽

Suhong Luo ◽

Kenneth R Carson

Keyword(s):

Overall Survival ◽

Weight Loss ◽

Weight Gain ◽

Weight Change ◽

Treatment Initiation ◽

Disease Specific Survival ◽

Baseline Weight ◽

Cox Analysis ◽

Disease Specific

Abstract Introduction Weight loss during chemotherapy has been associated with decreased overall survival (OS) in various solid tumors. While weight loss >10% in the 6 months leading up to diagnosis is a known adverse prognostic factor for non-Hodgkin's lymphoma (one of the B symptoms), the association between weight loss during chemotherapy and survival in follicular lymphoma (FL) patients is not well understood. Few studies have looked at long-term weight change patterns following chemotherapy treatment in this patient population. We investigated short and long-term weight change trends, predictors, and association with OS and disease-specific survival (DSS) in a cohort of FL patients. Methods FL patients diagnosed and treated with CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisone) +/- rituximab, CVP (cyclophosphamide, vincristine, and prednisone) +/- rituximab, or rituximab monotherapy regimens between 1998 and 2010 were identified in the Veterans Health Administration database. Data on weight 1 year prior to treatment, at time of first treatment (baseline), and up to 5 years after treatment initiation was obtained. Additional data on height, age, stage, race, comorbidities, date of diagnosis, LDH, and B-symptoms was obtained. Body Mass Index (BMI) at diagnosis was categorized according to World Health Organization criteria. Weight change during treatment is calculated as difference between baseline weight and 3 months after start of treatment. Long-term weight change is calculated as difference between baseline weight and 24 months after start of treatment. Logistic regression identified factors associated with long-term weight gain. Landmark Cox analysis evaluated prognostic significance of weight loss during treatment among patients who survived at least 6 months after treatment initiation. Results 1022 patients met inclusion criteria out of 2235. Mean and median age at diagnosis was 63.6 and 63.0 years respectively, 95.9% were men, and 72.7% had Stage III/IV disease. The mean Charlson co-morbidity score was 2.3. B symptoms were present in 37.9% and LDH was elevated in 26.8%. Mean and median weight change during treatment was -1.4kg (-1.5%) and -0.4kg (-0.6%), with a majority of patients losing weight (56%) and 23% of patients losing >5% of their baseline weight. In contrast, mean and median weight change at 24 months after treatment initiation was +1.2kg (+1.6%) and +1.3kg (+1.6%), with a majority of patients (57%) gaining weight and 14% of patients gaining >10% of their baseline weight after treatment completion. Logistic regression analysis identified factors associated with increased risk of weight gain >10% at 24 months after treatment initiation. These included: weight loss >5% in the year prior to treatment (Odds Ratio (OR) 6.82, 95% Confidence Interval (CI) 3.09-15.05), weight gain between 0-5% during treatment (OR 2.53, 95% CI 1.21-5.27), and weight gain >5% during treatment (OR 9.43, 95% CI 3.85-23.14). Kaplan-Meier survival analysis showed that weight loss >5% during treatment was associated with decreased OS (p<0.0001) and disease specific survival (DSS) (p=0.0027) compared to weight loss <5% or weight gain. A landmark Cox analysis controlling for age, disease stage, comorbidities, elevated LDH, B symptoms, BMI at diagnosis, and treatment type showed that weight loss >5% during treatment was independently associated with worse OS (Hazard Ratio (HR) 1.71, 95% CI 1.32-2.22) and DSS (HR 1.61, 95% CI 1.11-2.34). Conclusions In patients with FL, weight loss >5% during treatment is independently predictive of worse overall survival and disease-specific survival. Weight loss could be considered in conjunction with other dynamic variables (such as PET positivity and nodal size) to assess prognosis at the end of therapy. 14% of patients experience long-term weight gain >10% of baseline. Patients who gained 5% or more during treatment are at highest risk (OR=9.4) for long-term weight gain-this subset of patients could be targeted for weight loss interventions to prevent future obesity-related comorbidities. Disclosures No relevant conflicts of interest to declare.

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Intensive nutritional counselling obviates a weight gain in kidney transplant recipients with long-term graft survival in Estonia

F1000Research ◽

10.12688/f1000research.10035.1 ◽

2016 ◽

Vol 5 ◽

pp. 2658

Author(s):

Liidia Kiisk ◽

Mai Ots-Rosenberg

Keyword(s):

Kidney Transplantation ◽

Weight Gain ◽

Kidney Transplant ◽

Graft Survival ◽

Weight Change ◽

Standard Care ◽

Care Group ◽

Nutritional Counselling ◽

Males And Females

Background. After kidney transplantation body weight gain (WG) in patients generally increases and this can be influenced by improved appetite and reversal of the uremic state. Because of a lack of evidence for effective interventions that prevent body WG after kidney transplantation, Ryan et al. recently published a randomized controlled trial design in BMC Nephrology to assess the effects of intensive nutrition interventions on WG and metabolic parameters. Here we are demonstrating a part of a study performed at our transplantation centre where we also performed an intensive nutritional counselling intervention on kidney recipients. We hypothesised that kidney transplant (KTx) patients who received intensive counselling may have better long-term weight control compared with patients who did not receive such counselling. Methods. During intensive counselling the dietician took into consideration the results of anthropometry, densitometry, biochemistry, food frequency questionnaire and an analysis of 3-day dietary records. Anthropometrical measurements were assessed at 18 months, 36 months, and, finally, 10 years after the kidney transplantation. Results. We noticed WG in all KTx patients (n=56) both in males and females, as follows: in the standard care group the mean WG in males (N=21) was 6.4 kg, females (N=15) 7.0 kg and among intensively counselled males (N=9) 4.6 kg, females (N=11) 1.1 kg. Statistically non-significant weight change was found among counselled living KTx patients with long-term graft survival both in males (p=0.0680) and females ( p=0.3166) which was registered 10 years after the KTx compared with the first measurement mean weight. Among standard care control KTx patients, weight change was statistically significant in both males and females (males: p=0.0016; females: p=0.0040) 10 years after the KTx. Conclusions. The long-term WG data clearly showed that in our population of KT patients, the patients who received intensive individual dietary counselling had much more educated behaviour in the long-term, thereby preventing WG which is a well-known risk factor for long-term graft failure as well as for cardiovascular complications and mortality.

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