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Weight cycling and the subsequent onset of type 2 diabetes mellitus: 10-year cohort studies in urban and rural Japan
  1. Hiroshi Yokomichi1,
  2. Sachiko Ohde2,
  3. Osamu Takahashi2,
  4. Mie Mochizuki3,
  5. Atsunori Takahashi1,
  6. Yoshioki Yoda4,
  7. Masahiro Tsuji4,
  8. Yuka Akiyama1,
  9. Zentaro Yamagata1
  1. 1Department of Health Sciences, University of Yamanashi, Chuo City, Yamanashi, Japan
  2. 2Center for Clinical Epidemiology, St. Luke's International University, Chuo Ward, Tokyo, Japan
  3. 3Department of Pediatrics, University of Yamanashi, Chuo City, Yamanashi, Japan
  4. 4Yamanashi Koseiren Health Care Center, Kofu City, Yamanashi, Japan
  1. Correspondence to Dr. Hiroshi Yokomichi; hyokomichi{at}


Objective To investigate how weight cycling (gaining and losing weight) affects the risk of diabetes.

Design Cohort studies.

Setting Primary healthcare in urban and rural Japan.

Participants 20 708 urban and 9670 rural residents.

Primary outcome measures ORs for diabetes in those with weight loss, weight loss-gain, stable weight, weight gain-loss and weight gain over 10 years. Weight gain and loss were defined as a change of more than ±4% from baseline weight.

Results In the urban region, the ORs relative to the stable group for the loss-gain and gain-loss groups were 0.63 (95% CI 0.45 to 0.89) and 0.51 (95% CI 0.32 to 0.82) for men and 0.72 (95% CI 0.39 to 1.34) and 1.05 (95% CI 0.57 to 1.95) for women. In the rural region, they were 1.58 (95% CI 0.78 to 3.17) and 0.44 (95% CI 0.15 to 1.29) in men and 0.41 (95% CI 0.12 to 1.44) and 0.77 (95% CI 0.28 to 2.14) in women. The ORs for an increase in weight between 5 and 10 kg from the age of 20 years were 1.54 (95% CI 1.03 to 2.30) in men and 0.96 (95% CI 0.55 to 1.65) in women.

Conclusions In Japan, weight cycling was associated with a significant reduction in the risk of diabetes for men from urban regions. The associations were unclear for women from urban regions and both men and women from rural regions. These results differ from those in Western studies, probably because of differences in diet, insulin secretion and sensitivity and weight-consciousness.

  • body weight changes
  • type 2 diabetes
  • body mass index
  • Asian
  • sarcopenia

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  • Contributors ZY, YY, MT and OT: setting up the study and data collection. HY, ZY, MM and AT: designing the study. HY and AT: data analysis. HY: writing and revising the draft. ZY, SO, MM, YA and HY: development of the discussion section. All authors read and approved the final manuscript.

  • Funding This work was supported by theMinistry of Education, Culture, Sports, Science and Technology of Japan (MEXT) (KAKENHI grant number: JP15K08730 and JP15K15221). The funder had no role in study design, analysis, decision topublish or preparation of the manuscript.

  • Competing interests None declared.

  • Ethics approval The ethics committee of the School of Medicine, University of Yamanashi (approval number: H27-1417)

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

  • Data sharing statement No additional data are available.

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