REPORTED WEIGHT CHANGE IN OLDER ADULTS AND PRESENCE OF FRAILTY

Objective: A 5% change in weight is a significant predictor for frailty and obesity. We ascertained how self-reported weight change over the lifespan impacts rates of frailty in older adults. Methods: We identified 4,984 subjects ≥60 years with body composition measures from the National Health and Nutrition Examination Survey. An adapted version of Fried’s frailty criteria was used as the primary outcome. Self-reported weight was assessed at time current,1 and 10 years earlier and at age 25. Weight changes between each time point were categorized as ≥ 5%, ≤5% or neutral. Logistic regression assessed the impact of weight change on the outcome of frailty. Results: Among 4,984 participants, 56.5% were female, mean age was 71.1 years, and mean BMI was 28.2kg/m2. A weight loss of ≥ 5% had a higher association with frailty compared to current weight, age 25 (OR 2.94 [1.72,5.02]), 10 years ago (OR 1.68 [1.05,2.69]), and 1 year ago (OR 1.55 [1.02,2.36]). Weight gain in the last year was associated with increased rate of frailty (1.59 [1.09,2.32]). Conclusion: There is an association between frailty and reported weight loss over time while only weight gain in the last year has an association with frailty.

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Waitlist Weight Changes Impact Survival Following Heart Transplantation

10.22541/au.161152066.63991526/v1 ◽

2021 ◽

Author(s):

Nicholas Hess ◽

Ryan Tedford ◽

Brian Houston ◽

Nicolas Pope ◽

Lucas Witer ◽

...

Keyword(s):

Weight Loss ◽

Weight Gain ◽

Heart Transplantation ◽

Weight Change ◽

Secondary Analysis ◽

Orthotopic Heart Transplantation ◽

Weight Changes ◽

One Year ◽

The Impact ◽

United Network

Background: This study investigated the impact of weight change in waitlisted candidates on posttransplant outcomes following orthotopic heart transplantation (OHT). Methods: The United Network for Organ Sharing database was queried to identify adult patients undergoing isolated, primary OHT from 1/1/2010 to 3/20/2020. Patients were stratified into 3 cohorts based on percent weight change from listing to OHT. The primary outcome was one-year survival, and multivariable modeling was used for risk-adjustment. A secondary analysis compared outcomes of recipients waitlisted ≥90 days. Results: A total of 22,360 patients were included, 18,826 (84.2%) with stable weight, 1,672 (7.5%) with ≥5% weight loss, and 1,862 (8.3%) with ≥5% weight gain. Median age was similar across cohorts. Waitlist time was longest in patients with weight gain and shortest in those with stable weight (417 vs 74 days, P<0.001). The weight loss cohort had higher rates of dialysis dependency, pacemaker, and drug-treated acute rejection at one year (all P<0.05). Ninety-day and one-year posttransplant survival was lowest in the weight loss cohort. Multivariable modeling identified both ≥5% weight loss (HR 1.26, 95% CI 1.07-1.48) and decreasing weight (per 1%, HR 1.02, 95% CI 1.01-1.03) as risk-adjusted predictors of one-year mortality. In sub-analysis of recipients waitlisted ≥90 days, ≥5% weight loss and decreasing weight remained significant independent predictors for mortality. Conclusion: Waitlisted OHT candidates with ≥5% weight loss comprised a small, but higher-risk population with increased rates of postoperative complications and decreased survival. Efforts focused on nutritional optimization and preventing weight loss while awaiting OHT appear warranted.

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The association of weight change and all-cause mortality in older adults: a systematic review and meta-analysis

Age and Ageing ◽

10.1093/ageing/afaa231 ◽

2020 ◽

Author(s):

Tagrid A Alharbi ◽

Susan Paudel ◽

Danijela Gasevic ◽

Joanne Ryan ◽

Rosanne Freak-Poli ◽

...

Keyword(s):

Older Adults ◽

Weight Loss ◽

Weight Gain ◽

Mortality Risk ◽

Weight Change ◽

Meta Analysis ◽

Community Dwelling ◽

Weight Fluctuation ◽

All Cause Mortality ◽

The Impact

Abstract Objective there may be age-related differences in the impact of weight change on health. This study systematically reviewed the evidence on the relationship between weight change and all-cause mortality in adults aged 65 years and older. Methods MEDLINE, EMBASE and CINAHL were searched from inception to 11 June 2020, PROSPERO CRD 42019142268. We included observational studies reporting on the association between weight change and all-cause mortality in older community-dwelling adults. A random-effects meta-analysis was performed to calculate pooled hazard ratios and scored based on the Agency for Healthcare Research and Quality guidelines. Results a total of 30 studies, including 1,219,279 participants with 69,255 deaths, demonstrated that weight loss was associated with a 59% increase in mortality risk (hazard ratio (HR): 1.59; 95% confidence interval (CI): 1.45–1.74; P < 0.001). Twenty-seven studies that reported outcomes for weight gain (1,210,116 participants with 65,481 deaths) indicated that weight gain was associated with a 10% increase in all-cause mortality (HR: 1.10; 95%CI: 1.02, 1.17; P = 0.01). Four studies investigated weight fluctuation (2,283 events among 6,901 participants), which was associated with a 63% increased mortality risk (HR: 1.66; 95%CI: 1.28, 2.15). No evidence of publication bias was observed (all P > 0.05). Conclusion for community-dwelling older adults, weight changes (weight loss, gain or weight fluctuation) are associated with an increased risk of all-cause mortality risk relative to stable weight. Further research is needed to determine whether these associations vary depending upon initial weight, and whether or not the weight loss/gain was intentional.

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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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Association of weight change with telotristat ethyl in the treatment of carcinoid syndrome.

Journal of Clinical Oncology ◽

10.1200/jco.2017.35.15_suppl.e15692 ◽

2017 ◽

Vol 35 (15_suppl) ◽

pp. e15692-e15692

Author(s):

Martin O Weickert ◽

Gregory Kaltsas ◽

Dieter Hörsch ◽

Pablo Lapuerta ◽

Marianne Pavel ◽

...

Keyword(s):

Weight Loss ◽

Weight Gain ◽

Weight Change ◽

Carcinoid Syndrome ◽

Tryptophan Hydroxylase ◽

Performance Status ◽

Statistical Analysis Plan ◽

Weight Changes ◽

Double Blind ◽

And Performance

e15692 Background: In the Phase 3 TELESTAR study, the oral tryptophan hydroxylase inhibitor telotristat ethyl (TE) significantly reduced bowel movement (BM) frequency compared with placebo (pbo) over a 12-week Double-blind Treatment (DBT) period in patients with carcinoid syndrome (CS). Weight loss has previously been associated with uncontrolled CS and may result in reduced survival, so it is important to examine weight changes in patients with neuroendocrine tumors (NETs). Methods: We conducted an analysis, prespecified in the statistical analysis plan, of the incidence of weight change of ≥3% at Week 12 in TELESTAR. Patients with metastatic NETs, CS, and ≥4 BMs per day were randomly assigned to receive pbo, TE 250 mg 3x/day (tid), or TE 500 mg tid for 12 weeks, in addition to somatostatin analog therapy. Results: There were 45 patients in each group. Mean baseline age was 63.5 years, with 5.8 BMs/day and mean body mass index 24.87 kg/m2. Weight gain ≥3% at Week 12 was observed in 2/39 (5.1%), 7/41 (17.1%), and 13/40 (32.5%) patients on pbo, TE 250 tid, and TE 500 mg tid, respectively. The Cochrane–Armitage test for trend in weight gain incidence across groups yielded p = 0.0017. Among the 20 patients with a ≥3% weight gain on TE, 10 patients experienced a reduction of at least 30% in BM frequency at Week 12 (maximum reduction 75%). Weight loss ≥3% at Week 12 was observed in 5 (12.8%), 4 (9.8%), and 6 (15.0%) patients on pbo, TE 250 tid, and TE 500 mg tid. Adverse events of vomiting, decreased appetite, cachexia, and performance status decreased were reported during the DBT period among those with weight loss but not those with weight gain. Conclusions: The incidence of weight gain was dose-related on TE and was greater than that on pbo. It was possibly related to a reduction in diarrhea severity, and it may be a relevant aspect of TE efficacy among patients with functioning metastatic NETs. Clinical trial information: NCT01677910.

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Changes and variations of body weight as risk factors for coronary heart disease

Medicinski pregled ◽

10.2298/mpns0806274j ◽

2008 ◽

Vol 61 (5-6) ◽

pp. 274-280 ◽

Cited By ~ 1

Author(s):

Dragana Jovanovic ◽

Branko Jakovljevic ◽

Katarina Paunovic ◽

Dusan Grubor ◽

Aleksandar Milovanovic

Keyword(s):

Risk Factors ◽

Blood Pressure ◽

Coronary Heart Disease ◽

Weight Loss ◽

Body Weight ◽

Heart Disease ◽

Weight Gain ◽

Weight Change ◽

Healthy Controls ◽

Weight Changes

Introduction Weight variations are a common phenomenon. Therefore, concern has been raised about the association between weight changes and weight variations and coronary heart disease (CHD). The aim of this study was to estimate the influence of weight change and weight variations as risk factors for coronary heart disease. Materials and methods The investigation was conducted as an observational cross-sectional study, including 102 participants of both genders: 61 patients with CHD and 41 healthy controls. All participants underwent anthropometric measurements and completed a questionnaire that included 1) weight changes in adulthood (maximum and minimum weight), 2) presence and number of weight variations in the 10 years prior to the onset of disease and 3) the size of weight change (weight gain or weight loss in kg). One weight variation was defined as weight loss followed by weight gain for more than 10% of body weight, or about 7 kg. Multivariant logistic regression was used for the estimation of significant predictors for the occurrence of coronary heart disease. Results Participants with CHD had higher values of body weight in adulthood compared to healthy controls, larger number of weight variations in the last 10 years, and more frequently reported weight gain and weight loss for more than 10 kg. The highest risk for the occurrence of coronary heart disease was observed for participants who had more than 3 weight variations for 10% (OR=2.13; 95%CI=0.98-5.48), those with weight loss over 10 kg (OR=2.16; 95%CI=1.71-2.72) and those with weight gain over 10 kg (OR=2.71; 95%CI=1.08-6.83), regardless of gender, age, smoking, body mass index and blood pressure. Discussion Several mechanisms are suggested to explain the relationship between weight changes and variations and coronary heart disease, including changes in plasma lipid levels, insulin levels, decrease of HDL cholesterol, increase of C-reactive protein and increase of blood pressure. Conclusion This study suggests that frequent and very intense weight changes can be considered important predictors for the occurrence of coronary heart disease.

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Experience from the selection and nutritional preparation for Expedition ICE MAIDEN: the first successful all-female unassisted Antarctic traverse

Journal of the Royal Army Medical Corps ◽

10.1136/jramc-2019-001175 ◽

2019 ◽

pp. jramc-2019-001175 ◽

Cited By ~ 1

Author(s):

Natalie Taylor ◽

R M Gifford ◽

R Cobb ◽

S L Wardle ◽

S Jones ◽

...

Keyword(s):

Weight Loss ◽

Body Composition ◽

Weight Gain ◽

Lean Mass ◽

Weight Change ◽

Weight Changes ◽

Before And After ◽

Successful Women ◽

Composition Changes ◽

And Training

IntroductionExpedition ICE MAIDEN (Ex IM) was the first all-female unsupported crossing of Antarctica. We describe the prerequisite selection and training, comparing those who formed the final team with other participants, and discuss how the expedition diet was established.MethodsAll women serving in the British Army were invited to participate. Following initial assessments, successful women completed three training/selection ski expeditions. Between expeditions 1 and 2, participants completed 6 months rigorous UK-based training. Weight was measured before and after the 6 months UK-based training, expeditions 2 and 3, and body composition by skinfold before and after expedition 2. Participant feedback, body composition and weight changes were applied to modify the expedition diet and provide weight gain targets prior to Ex IM.ResultsFollowing 250 applications, 50 women were assessed and 22, 12 and seven women attended training expeditions 1, 2 and 3, respectively. The final team of six women lost more weight than other participants during UK-based training (mean (SD) change −1.3 (1.5) kg vs −0.5 (1.6) kg, respectively, p=0.046) and during training expedition 2 (−2.8 (0.8) kg vs −1.7 (0.4) kg, respectively, p=0.048), when they also gained more lean mass (+2.1 (0.8) kg vs +0.4 (0.7) kg, respectively, p=0.004). The Ex IM diet provided 5000 kCal/day, comprising approximately 45% carbohydrate, 45% fat and 10% protein. Median (range) weight change between expedition 3 and Ex IM was +8.7 (−1.9 to +14.3) kg.ConclusionsThe selected Ex IM team demonstrated favourable training-associated body composition changes. Training-associated weight loss informed the expeditionary diet design.

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Dietary Restraint as a Predictor of Reported Weight Loss and Affect

Psychological Reports ◽

10.2466/pr0.1994.75.3f.1679 ◽

1994 ◽

Vol 75 (3_suppl) ◽

pp. 1679-1682 ◽

Cited By ~ 20

Author(s):

Marika Tiggemann

Keyword(s):

Weight Loss ◽

Weight Gain ◽

Weight Change ◽

Dietary Restraint ◽

Restrained Eaters ◽

Weight Changes ◽

Permanent Change ◽

Chronic Dieting ◽

Unrestrained Eaters

This study investigated dietary restraint as a predictor of subsequent reported weight loss. Neither chronic dieters nor nondieters reported actually losing weight over a 7-mo. period. With respect to recent weight change, restrained eaters reported both more recent weight loss and more recent weight gain than unrestrained eaters. Further, such weight changes had a much larger influence on their affect. It was concluded that chronic dieting is likely to produce temporary swings in both weight and mood but no permanent change. As such, chronic dieters might best be advised to abandon their dieting attempts.

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Age-Related Difference in Weight Change and All-Cause Mortality in Middle-Aged and Older Korean Populations: Korean Longitudinal Study of Aging

Korean Journal of Family Medicine ◽

10.4082/kjfm.20.0170 ◽

2021 ◽

Vol 42 (4) ◽

pp. 297-302

Author(s):

Jungki Suh ◽

Yoon Jeong Cho ◽

Hyun Ji Kim ◽

Seong Soo Choi

Keyword(s):

Older Adults ◽

Weight Loss ◽

Weight Gain ◽

Longitudinal Study ◽

Weight Change ◽

Significant Risk ◽

Middle Aged ◽

Weight Losses ◽

Age Related ◽

All Cause Mortality

Background: Obesity is associated with increased mortality as a significant risk factor for chronic diseases, including cardiovascular diseases and cancer. Several people believe that weight gain is harmful, and weight loss helps maintain health. However, some studies have shown that weight loss, particularly among older adults, is more likely to increase the risk of mortality than weight gain.Methods: We used data for the cohort of the Korean Longitudinal Study of Aging, which is a nationwide stratified multi-stage sample of adults aged 45 years. The all-cause mortality risk was assessed using the survival status and the number of months of survival calculated from 2006 (baseline year) to 2016. Cox proportional hazard regression were used to study the causal link between weight change and all-cause mortality risk.Results: The results showed interactive associations between weight loss and mortality among middle-aged and older adults. The hazard ratio was 1.62 (95% confidence interval [CI], 1.10–2.40) for the participants aged 45–65 years with weight losses greater than 5 kg and 1.56 (95% CI, 1.29–1.89) for those older than 65 years with weight losses greater than 5 kg. The results for the group with weight gain above 5 kg were not significant. Middle-aged and older men showed an increase in all-cause mortality associated with weight loss of more than 5 kg, but only the older women showed significant results.Conclusion: This large-scale cohort study in Korea showed a relationship between weight loss and all-cause mortality in middle-aged and older individuals.

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Association Between Weight Change and Leukocyte Telomere Length in U.S. Adults

Frontiers in Endocrinology ◽

10.3389/fendo.2021.650988 ◽

2021 ◽

Vol 12 ◽

Author(s):

Yiling Zhang ◽

Ziye Xu ◽

Yiling Yang ◽

Shanshan Cao ◽

Sali Lyu ◽

...

Keyword(s):

Weight Gain ◽

Telomere Length ◽

Weight Change ◽

Reference Group ◽

Normal Weight ◽

Leukocyte Telomere Length ◽

Weight Changes ◽

Health And Nutrition ◽

Race Ethnicity ◽

Stratified Analysis

ObjectiveTo investigate the association of dynamic weight change in adulthood with leukocyte telomere length among U.S. adults.MethodsThis study included 3,886 subjects aged 36-75 years from the National Health and Nutrition Examination Survey (NHANES) 1999-2002 cycle. Survey-weighted multivariable linear regression with adjustments for potential confounders was utilized.Results3,386 individuals were finally included. People with stable obesity had a 0.130 kbp (95% CI: 0.061-0.198, P=1.97E-04) shorter leukocyte telomere length than those with stable normal weight (reference group) during the 10-year period, corresponding to approximately 8.7 years of aging. Weight gain from non-obesity to obesity shortened the leukocyte telomere length by 0.094 kbp (95% CI: 0.012-0.177, P=0.026), while normal weight to overweight or remaining overweight shortened the leukocyte telomere length by 0.074 kbp (95% CI: 0.014-0.134, P=0.016). The leukocyte telomere length has 0.003 kbp attrition on average for every 1 kg increase in weight from a mean age of 41 years to 51 years. Further stratified analysis showed that the associations generally varied across sex and race/ethnicity.ConclusionsThis study found that weight changes during a 10-year period was associated with leukocyte telomere length and supports the theory that weight gain promotes aging across adulthood.

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Abstract 13752: Impact of Pre-ablation Weight Changes on Freedom From Atrial Fibrillation

Circulation ◽

10.1161/circ.142.suppl_3.13752 ◽

2020 ◽

Vol 142 (Suppl_3) ◽

Author(s):

Graham Peigh ◽

Kelly Vogel ◽

Rachel M Kaplan ◽

Jeremiah Wasserlauf ◽

Anna Pfenniger ◽

...

Keyword(s):

Atrial Fibrillation ◽

Weight Loss ◽

Weight Gain ◽

Healthy Lifestyle ◽

Obese Patients ◽

Inclusion Criteria ◽

Weight Changes ◽

Af Ablation ◽

Recurrent Atrial Fibrillation ◽

The Impact

Introduction: Obesity is an established risk factor for recurrent atrial fibrillation (AF) after ablation. The impact of pre-procedure weight changes on freedom from AF (FFAF) post-ablation in both obese and non-obese patients is unknown. Hypothesis: Weight gain over the year prior to AF ablation is associated with reduced FFAF. Methods: A single-center retrospective cohort study of patients undergoing AF ablation using cryoballoon (CBA) was performed. Prior to ablation, all candidates were encouraged to adopt healthy lifestyle habits according to AHA guidelines, including weight loss, by their treating physician. Inclusion criteria included availability of weight measurements 1-year prior to and at the time of CBA, and post-CBA follow up > 90 days. The primary endpoint was FFAF through 1-year after the 3-month blanking period. Results: Among 747 CBA performed from 2011-2017, 720 patients (49% male; average age 61.3 ± 10.3 years) met inclusion criteria. Of these, 241 patients (33.5%) were obese (body mass index ≥ 30) and 337 (46.8%) had non-paroxysmal AF. There were 9.5 ± 2.8 freezes per patient and 99 patients had additional ablation lesion sets delivered. Overall, FFAF was observed in 506 (70.3%) patients at 15 months. Multivariate analysis revealed that weight loss (p<0.001), paroxysmal AF (p=0.036), shorter duration of AF diagnosis (p=0.022) and absence of AF during the 90-day blanking period (p<0.001) were associated with FFAF. Kaplan-Meier estimates of FFAF by pre-ablation weight changes in obese and non-obese patients are shown in Figure 1a-b. In obese and non-obese patients, weight loss was associated with FFAF in a dose- dependent and binary manner, respectively. Conclusions: Weight gain in the year prior to AF ablation was associated with lower rates of FFAF regardless of baseline BMI. Patient directed weight loss should be encouraged prior to AF ablation.

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