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Body mass index, weight change and risk of stroke and stroke subtypes: the Japan Public Health Center-based prospective (JPHC) study

International Journal of Obesity volume 35, pages 283–291 (2011)Cite this article

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Abstract

Objective:

The Japan Public Health Center-based prospective Study examined the association of body mass index (BMI) and weight change with incident stroke in Japanese individuals, for whom BMI levels are generally low.

Methods:

We used initial data from 1990 to 1994 and 5-year follow-up surveys from 1995 to 1999. We calculated weight change over a 5-year period for 32 847 men and 38 875 women, aged 45–74 years, with no history of cardiovascular disease or cancer. Subjects were followed from the 1995–1999 survey to the end of 2005, and hazard ratios of self-reported BMI levels and weight change for incident stroke were estimated using Cox's proportional hazard models adjusted for potential confounders.

Results:

During the follow-up period (median 7.9 years) there were 2019 incident strokes, including subtypes. Multivariable-adjusted hazard ratios for all stroke events by BMI levels of 27.0–29.9 and ⩾30 kg m–2 versus 23.0–24.9 kg m–2 were 1.09 (95% confidence interval 0.88, 1.36) and 1.25 (0.86, 1.84) in men (P for trend=0.22), and 1.29 (1.01, 1.65) and 2.16 (1.60, 2.93) in women (P for trend <0.001), respectively. A weight change of ⩾10% in the previous 5 years was associated with total strokes and ischemic strokes in women.

Conclusion:

Higher BMI levels and a weight gain of ⩾10% over 5 years were associated with an increased risk of stroke in women, whereas this association was weak in men.

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Acknowledgements

We thank all staff members in each study area and in the central offices for their cooperation and technical assistance during the study (Appendix). This study was supported by grants-in-aid for Cancer Research and the 3rd Term Comprehensive 10-Year-Strategy for Cancer Control from the Ministry of Health, Labour and Welfare, Japan.

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Authors and Affiliations

  1. Department of Public Health, Social Medicine and Medical Informatics, Ehime University Graduate School of Medicine, Toon, Japan

    I Saito

  2. Department of Social and Environmental Medicine, Division of Preventive and Environmental Medicine, Graduate School of Medicine, Osaka University, Suita, Japan

    H Iso

  3. Department of Preventive Cardiology, National Cerebral and Cardiovascular Center, Suita, Japan

    Y Kokubo

  4. Epidemiology and Prevention Division, Research Center for Cancer Prevention and Screening, National Cancer Center, Chuo-ku, Japan

    M Inoue & S Tsugane

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  1. I Saito
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Corresponding author

Correspondence to I Saito.

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Appendix

Appendix

Members of the JPHC Study Group (principal investigator: S Tsugane): S Tsugane, M Inoue, T Sobue and T Hanaoka, Research Center for Cancer Prevention and Screening, National Cancer Center, Tokyo; J Ogata, S Baba, T Mannami, A Okayama and Y Kokubo, National Cardiovascular Center, Suita; K Miyakawa, F Saito, A Koizumi, Y Sano, I Hashimoto and T Ikuta, Iwate Prefectural Ninohe Public Health Center, Ninohe; Y Miyajima, N Suzuki, S Nagasawa, Y Furusugi and N Nagai, Akita Prefectural Yokote Public Health Center, Yokote; H Sanada, Y Hatayama, F Kobayashi, H Uchino, Y Shirai, T Kondo, R Sasaki, Y Watanabe, Y Miyagawa and Y Kobayashi, Nagano Prefectural Saku Public Health Center, Saku; Y Kishimoto, E Takara, T Fukuyama, M Kinjo, M Irei and H Sakiyama, Okinawa Prefectural Chubu Public Health Center, Okinawa; K Imoto, H Yazawa, T Seo, A Seiko, F Ito and F Shoji, Katsushika Public Health Center, Tokyo; A Murata, K Minato, K Motegi and T Fujieda, Ibaraki Prefectural Mito Public Health Center, Mito; T Abe, M Katagiri, M Suzuki and K Matsui, Niigata Prefectural Kashiwazaki and Nagaoka Public Health Center, Kashiwazaki and Nagaoka; M Doi, A Terao, Y Ishikawa and T Tagami, Kochi Prefectural Chuo-higashi Public Health Center, Tosayamada; H Doi, M Urata, N Okamoto, F Ide and H Sueta, Nagasaki Prefectural Kamigoto Public Health Center, Arikawa; H Sakiyama, N Onga, H Takaesu and M Uehara, Okinawa Prefectural Miyako Public Health Center, Hirara; F Horii, I Asano, H Yamaguchi, K Aoki, S Maruyama, M Ichii and M Takano, Osaka Prefectural Suita Public Health Center, Suita; S Matsushima and S Natsukawa, Saku General Hospital, Usuda; M Akabane, Tokyo University of Agriculture, Tokyo; I Saito, Ehime University, Toon; H Iso, Osaka University, Suita; Y Honda and K Yamagishi, Tsukuba University, Tsukuba; H Sugimura, Hamamatsu University, Hamamatsu; Y Tsubono, Tohoku University, Sendai; M Kabuto, National Institute for Environmental Studies, Tsukuba; S Tominaga, Aichi Cancer Center Research Institute, Nagoya; M Iida, W Ajiki and A Ioka, Osaka Medical Center for Cancer and Cardiovascular Disease, Osaka; S Sato, Osaka Medical Center for Health Science and Promotion, Osaka; N Yasuda, Kochi University, Nankoku; K Nakamura, Niigata University, Niigata; S Kono, Kyushu University, Fukuoka; K Suzuki, Research Institute for Brain and Blood Vessels Akita, Akita; Y Takashima, Kyorin University, Mitaka; E Maruyama, Kobe University, Kobe; M Yamaguchi, Y Matsumura, S Sasaki and S Watanabe, National Institute of Health and Nutrition, Tokyo; T Kadowaki, Tokyo University, Tokyo; M Noda, International Medical Center of Japan, Tokyo; Y Kawaguchi, Tokyo Medical and Dental University, Tokyo; and H Shimizu, Sakihae Institute, Gifu.

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Saito, I., Iso, H., Kokubo, Y. et al. Body mass index, weight change and risk of stroke and stroke subtypes: the Japan Public Health Center-based prospective (JPHC) study. Int J Obes 35, 283–291 (2011). https://doi.org/10.1038/ijo.2010.131

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