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Epidemiology/Health services research
Intentional weight loss as a predictor of type 2 diabetes occurrence in a general adult population
  1. Laura Sares-Jäske1,2,
  2. Paul Knekt1,
  3. Antti Eranti3,
  4. Niina E Kaartinen1,
  5. Markku Heliövaara1,
  6. Satu Männistö1
  1. 1Department of Public Health Solutions, Finnish Institute for Health and Welfare, Helsinki, Finland
  2. 2Department of Public Health, University of Helsinki, Helsinki, Finland
  3. 3Department of Internal Medicine, Paijat-Hame Central Hospital, Lahti, Finland
  1. Correspondence to Dr Laura Sares-Jäske; laura.sares-jaske{at}thl.fi

Abstract

Introduction Observational and intervention studies have verified that weight loss predicts a reduced type 2 diabetes (T2D) risk. At the population level, knowledge on the prediction of self-report intentional weight loss (IWL) on T2D incidence is, however, sparse. We studied the prediction of self-report IWL on T2D incidence during a 15-year follow-up in a general adult population.

Research design and methods The study sample from the representative Finnish Health 2000 Survey comprised 4270 individuals, aged 30–69 years. IWL was determined with questions concerning dieting attempts and weight loss during the year prior to baseline. Incident T2D cases during a 15-year follow-up were drawn from national health registers. The strength of the association between IWL and T2D incidence was estimated with the Cox model.

Results During the follow-up, 417 incident cases of T2D occurred. IWL predicted an increased risk of T2D incidence (HR 1.44; 95% CI 1.11 to 1.87, p=0.008) in a multivariable model. In interaction analyses comparing individuals with and without IWL, a suggestively elevated risk emerged in men, the younger age group, among less-educated people and in individuals with unfavorable values in several lifestyle factors.

Conclusions Self-report IWL may predict an increased risk of T2D in long-term, probably due to self-implemented IWL tending to fail. The initial prevention of weight gain and support for weight maintenance after weight loss deserve greater emphasis in order to prevent T2D.

  • weight loss
  • diabetes mellitus, type 2
  • cohort studies
  • obesity
http://creativecommons.org/licenses/by-nc/4.0/

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

https://doi.org/10.1136/bmjdrc-2020-001560

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    Footnotes

    • Contributors LS-J, PK and SM designed the research. LS-J conducted the research, analyzed the data and wrote the first draft of the manuscript. LS-J, PK, AE, NEK, MH and SM participated in the interpretation of the results and commented the manuscript. All authors read and approved the final manuscript. LS-J and PK are the guarantors of this work.

    • Funding This study was funded by The Doctoral Programme in Population Health, University of Helsinki (LS-J) and by The Juho Vainio Foundation (LS-J).

    • Disclaimer The funders had no role in the design, analysis or writing of the article.

    • Competing interests None declared.

    • Patient consent for publication Not required.

    • Ethics approval The study was performed in accordance with the ethical standards of the 1983 Helsinki Declaration and its later amendments. The survey was approved by the Ethics Committee of the Hospital District of Helsinki and Uusimaa (register number 3/9/310500). All participants gave their written informed consent.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data availability statement Data may be obtained from a third party and are not publicly available. No data are available as the individual-level data are sensitive data. However, access to the data can be requested with a study proposal from THL Biobank at: https://thl.fi/en/web/thl-biobank/for-researchers.