Body weight change, all-cause mortality, and cause-specific mortality in the Multiple Risk Factor Intervention Trial

To evaluate the relation between weight variability and death in high-risk, middle-aged men participating in the Multiple Risk Factor Intervention Trial (MRFIT).

Cohort study with 3.8 years of follow-up.

Multicenter, collaborative, primary prevention trial conducted at 22 clinical centers in the United States.

Men (n = 10,529) who were 35 to 57 years old at baseline and who were in the upper 10% to 15% of risk for coronary heart disease because of smoking, high blood pressure, and elevated cholesterol level. Participants were seen at least annually for 6 to 7 years for medical evaluations in study clinical centers.

Death from cardiovascular disease (228 deaths) and from all causes (380 deaths).

The primary measure of weight variability was the intrapersonal standard deviation of weight (ISD), which was calculated from measured weights obtained at clinic visits during a 6- to 7-year period. All-cause death rates per 1000 person-years of follow-up across ISD quartiles were 8.28, 8.25, 10.57, and 11.07 from the first to fourth quartiles, respectively. After adjusting for baseline risk factors associated with weight change, the relative risk for all-cause mortality in the fourth compared with the first quartile was 1.64 (95% CI, 1.21 to 2.23). Cardiovascular death and ISD showed a similar pattern. The association between weight change and death was not observed in the heaviest men.

Greater weight variability was associated with a greater risk for cardiovascular disease and all-cause mortality in some types of high-risk men.