Weight change in middle-aged and elderly Singaporean Chinese linked to increased mortality risk

Both moderate-to-large weight gain and weight loss, defined as a change of 10% or more in weight, among middle-aged and elderly Chinese Singaporeans are linked to increased risk of death, particularly from cardiovascular disease, and between them, weight loss was associated with higher risk than weight gain. Furthermore, excessive weight loss increased risk among participants who were overweight or obese to start with, and excessive weight gain might increase risk even among participants with low or normal body mass index at baseline.

Nested in the Singapore Chinese Health Study, the researchers used data from 36,338 middle-aged and elderly participants who were able to report weight and height during interviews at both recruitment (1993-1998) and follow-up 1 (1999-2004) surveys, and who had no history of cancer or cardiovascular disease. Weight change was computed as the difference between weights at baseline and the follow-up 1 surveys, after an average of 6 years, and classified as moderate-to-large weight loss (≥10%), small weight loss (5.1-9.9%), stable weight (±5%), small weight gain (5.1-9.9%) and moderate-to-large weight gain (≥10%). The participants were followed for mortality through linkage with the Singapore Birth and Death Registry.

“This first study on a large population-based cohort of Singaporean Chinese aligns with findings from similar studies conducted among European, Japanese and Korean populations,” stated Prof Koh Woon Puay, Principal Investigator of the Singapore Chinese Health Study, and Professor at Duke-NUS Medical School and Saw Swee Hock School of Public Health. “The findings suggest that moderate-to-large weight change in mid-life and older age should be monitored closely by health practitioners, and weight loss, especially, should be considered critically in elderly individuals as it may be related to loss of muscle mass, frailty and poor control of chronic diseases.”

The researchers urge caution in the interpretation of the study results, highlighting that information regarding whether the weight loss was intentional and if the weight loss was due to loss of fat or lean mass was not examined in this study. Nevertheless, findings from this Singapore study and studies in other populations suggest that it is prudent to maintain stability in body weight within the non-obese range for middle-aged and elderly populations to reduce risk of mortality.

“The observational nature of our study means we cannot generalise our findings to potential interventions at this point,” said Prof Koh. “Further studies are needed to understand the mechanisms underlying the association between weight change and mortality.”

At a recent conference on ageing, longevity and health, co-organised by Duke-NUS’ Centre for Ageing Research and Education (CARE), Prof Koh presented similar findings on weight change and cognitive impairment within the same study population.

Commenting on Prof Koh’s study, Assoc Prof Angelique Chan, Executive Director of CARE, noted, “Singapore is among the world’s fastest ageing societies, therefore it is critical to build on studies such as these so the government can develop appropriate policies and programmes to guide future health outcomes.”

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Type 2 diabetes linked to colorectal cancer risk in men

(HealthDay)—Type 2 diabetes (T2D) is associated with an increased risk for colorectal cancer (CRC), with the association significant for men only, according to a study published online Nov. 7 in the British Journal of Cancer.

Yanan Ma, from China Medical University in Shenyang, and colleagues followed 87,523 women from the Nurses’ Health Study and 47,240 men from the Health Professionals Follow-up Study to examine the correlation of T2D and its duration with the risk for incident CRC.

The researchers documented 3,000 cases of CRC during a follow-up of 32 years. Among men, the risk for CRC was increased for those with versus those without T2D (hazard ratio, 1.42; 95 percent confidence interval, 1.12 to 1.81). The positive association remained in sensitivity analyses excluding CRC identified within one year of diabetes diagnosis and excluding patients with T2D using hypoglycemic medications. Among women, there was a positive but not statistically significant association between T2D and CRC risk (hazard ratio, 1.17; 95 percent confidence interval, 0.98 to 1.39).

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Maternal stress at conception linked to children’s stress response at age 11

A new study published in the Journal of Developmental Origins of Health and Disease finds that mothers’ stress levels at the moment they conceive their children are linked to the way children respond to life challenges at age 11. SFU health sciences professor Pablo Nepomnaschy led an interdisciplinary research team on this first cohort study.

Researchers measured cortisol levels from mothers-to-be starting before pregnancy and continuing through the first eight weeks of gestation, and then years later from their children. Their goal is to understand the associations between maternal biological stress around the time of conception and the development of their children’s stress physiology.

Using urine samples to measure reproductive hormones, the researchers identified the day children were conceived, as well as the moms’ cortisol levels, a biomarker of physiological stress, during the first eight weeks after conception.

Twelve years later, they studied how these children reacted to the start of a new school year (a well known “natural” stressor) and to a public-speaking challenge (a frequently used “experimental” stressor).

Maternal cortisol following conception was associated with different facets of the children’s cortisol responses to those challenges, and many of these associations differed between boys and girls.

Study lead author Cindy Barha, who worked under Nepomnaschy as a doctoral student, reports that sons of mothers who had higher cortisol in gestational week two had higher cortisol reactions to the experimental public-speaking challenge, but this association was not observed in daughters. In contrast, mothers with higher cortisol in gestational week five had daughters with higher ‘basal’ cortisol before the start of a new school term, but not sons.

However, both sons and daughters had higher cortisol responses to the start of a new school term, and in response to the experimental public speaking challenge, if their mothers had higher cortisol during gestational week five. The biological mechanisms mediating these associations are not yet known, but are likely to involve genetics and epigenetics as well as environmental and cultural factors shared by moms and their children.

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