Weight loss linked to higher risk of death than weight gain among middle-aged and older Chinese Singaporeans

Singapore Press Holdings

You could be putting your life on the line if you are experiencing a drastic weight change – especially if you are losing weight, a study has found.

The Singapore Chinese Health Study – led by Professor Koh Woon Puay of Duke-NUS Medical School and the National University of Singapore’s (NUS’) Saw Swee Hock School of Public Health – has found a link between weight change and increased risk of death, particularly from cardiovascular disease, among middle-aged and elderly Chinese Singaporeans.

Weight loss, in particular, was associated with a higher risk than weight gain.

The team of researchers discovered that Chinese Singaporeans aged 45 to 74 – who lost 10 per cent or more of their weight over approximately five or six years – had an alarming 39 per cent higher risk of death from all causes compared to those who maintained their weight.

The risk is even higher among previously overweight or obese participants who had experienced excessive weight loss.

When it comes to weight gain though, those who gained 10 per cent or more were found to have a smaller (13 per cent) increased risk of death. In addition, excessive weight gain might increase risk even among participants with low or normal body mass index at baseline.

A small weight loss of between 5 to 10 per cent was associated with about the same percentage risk increase.

However, risk was again different for overweight Chinese Singaporeans with a body mass index higher than 23. In fact, for this group, a small weight loss or gain did not increase their risk of dying.

Findings in line with similar studies conducted with other racial groups

Although only Chinese Singaporeans participated in the study, the findings could potentially apply to other races as well.

“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,” the researchers said.

Moderate-to-large weight change in mid-life and older age should be monitored closely by health practitioners, they added. Weight loss, in particular, could be related to loss of muscle mass, frailty and poor control of chronic diseases in elderly folk.

As part of the study, researchers collected the height and weight data of more than 60,000 participants – who belonged to one of the two major dialect groups (Hokkien or Cantonese) – between 1993 and 1998. About six years after the first survey, a follow-up survey was conducted.

The top causes of death among the study’s participants were cancer and cardiovascular diseases, consistent with national averages. Over one-third died from cancer while 16.7 per cent died from heart disease and 8 per cent died from stroke.

Weight changes did not affect the rate of cancer deaths significantly.

The study also found that women were more likely to gain weight than men, while older people were more likely to lose weight than younger people.

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