scholarly journals Association of Weight Loss from Early to Middle Adulthood and Incident Hypertension Risk Later in Life

Nutrients ◽  
2020 ◽  
Vol 12 (9) ◽  
pp. 2622
Author(s):  
Yunping Zhou ◽  
Tao Wang ◽  
Xin Yin ◽  
Yun Sun ◽  
Wei Jie Seow

Background: The effect of obesity in early adulthood and weight loss on incident hypertension in older age has not been well characterized. This study aimed to examine the association of weight loss from young adulthood to midlife with risk of incident hypertension later in life. Methods: We performed a retrospective cohort study using data from the National Health and Nutrition Examination Survey (NHANES). Five weight change groups were categorized: stable normal, weight loss, weight gain, maximum overweight and stable obese. The hazard ratios (HRs) and 95% confidence intervals (CIs) of the association between weight change and risk of hypertension in later life were estimated using Cox regression models. Results: Compared with participants who maintained normal weight, the stable obese, weight gain, maximum overweight and weight loss groups exhibited significantly higher risks of incident hypertension, with HR of 3.28 (95% CI = 2.71 to 3.96), 2.93 (95% CI = 2.62 to 3.28), 1.76 (95% CI = 1.55 to 2.00) and 1.97 (95% CI = 1.17 to 3.31), respectively. We also observed a lower risk among those in the weight loss group (HR = 0.60, 95% CI = 0.35 to 1.02) compared with those who were stable obese. Conclusions: Weight loss from early to middle adulthood was associated with lower risk of incident hypertension as compared to those who stayed obese and higher risk of incident hypertension as compared to those who maintained normal weight. Thus, maintaining normal weight throughout adulthood may be important for the primary prevention of hypertension.

Author(s):  
Mengyi Liu ◽  
Zhuxian Zhang ◽  
Chun Zhou ◽  
Panpan He ◽  
Yuanyuan Zhang ◽  
...  

Abstract Context The effect of weight change patterns on cardiovascular diseases (CVD) remains uncertain. Objective We aim to examine the relation of weight change patterns and absolute weight change from young adulthood to midlife with incident CVD. Design Retrospective cohort study. Setting National Health and Nutrition Examination Survey 1999-2016. Participants A total of 20 715 US adults aged 40 through 79 with recalled weight at young adulthood (25 years) and midlife (10 years before baseline). Main Outcome Measure CVD status was determined by self-report of a prior diagnosis, and age at diagnosis was used to establish time of CVD onset. CVD events was defined as the first occurrence of a congestive heart failure, coronary heart disease, angina pectoris, heart attack, or stroke. Results After 9.76 years of follow-up, compared with participants who remained at normal weight, those in maximum overweight, changing from nonobese to obese, changing from obese to nonobese, maintaining obesity between young and middle adulthood had a 39% (hazard ratio [HR], 1.39; 95% confidence interval [CI], 1.19-1.62), 93% (HR, 1.93; 95% CI, 1.64-2.28), 125% (HR, 2.25; 95% CI, 1.29-3.94), and 132% (HR, 2.32; 95% CI, 1.68-3.20) higher risk of CVD, respectively. In addition, compared with weight change within 2.5 kg, weight gain ≥ 10.0 kg was associated with higher risk of CVD. Conclusions Both nonobese to obese, obese to nonobese, and stable obese from young to middle adulthood were associated with increased risks of CVD. The findings emphasize the importance of maintaining normal weight throughout the adulthood for preventing CVD in later life.


Stroke ◽  
2020 ◽  
Vol 51 (5) ◽  
pp. 1435-1441 ◽  
Author(s):  
Erik Prestgaard ◽  
Julian Mariampillai ◽  
Kristian Engeseth ◽  
Jan Erikssen ◽  
Johan Bodegård ◽  
...  

Background and Purpose— The importance of weight change for the risk of stroke is not well known. We examined the associations between early- and mid-life weight change and risks of stroke and death during long-term follow-up of healthy men. Methods— We recruited healthy men aged between 40 and 59 years and performed a cardiovascular examination at baseline and again at 7 years. We collected data on weight change since the age of 25 (early-life weight change) and measured weight change from baseline to the visit at 7 years (mid-life weight change). For both weight change periods, participants were divided into the following categories: weight loss, weight gain 0 to 4.9 kg, weight gain 5 to 9.9 kg, and weight gain ≥10 kg. Data on stroke and death were collected up to 35 years, from study visits, hospital records, and the National Cause of Death Registry. We used Cox regression to analyze the associations between weight change during early-life and mid-life and risks of stroke and death. Results— Of the 2014 participants, 2014 (100%) had data on early-life weight change and were followed for a median of 30.1 years, while 1403 had data on mid-life weight change and were followed for a median of 24.6 years. During early-life, compared with those who had weight gain 0 to 4.9 kg, hazard ratio for stroke was 1.46 (95% CI, 1.09–1.95) among those with weight gain 5 to 9.9 kg, 1.39 (95% CI, 1.03–1.87) for those with weight gain ≥10 kg, and 1.46 (95% CI, 0.99–2.11) among those with weight loss. For all-cause death, the hazard ratios were 1.08 (95% CI, 0.92–1.23), 1.14 (95% CI, 0.98–1.33), and 1.29 (95% CI, 1.06–1.56), respectively. During mid-life, there were no significant differences in risk of stroke or death between the groups. Conclusions— Weight increase during early-life, but not mid-life, seems to be associated with increased long-term risk of stroke in healthy men. If these findings can be confirmed, efforts to prevent weight increase should target the younger population.


2020 ◽  
Author(s):  
Tao Wang ◽  
Yunping Zhou ◽  
Nan Kong ◽  
Jianzhong Zhang ◽  
Guo Cheng ◽  
...  

Abstract Background: Data describing the effects of weight change across adulthood on asthma are important for the prevention of asthma. This study aimed to investigate the association between weight change from early to middle adulthood and risk of incident asthma.Methods: Using data from the National Health and Nutrition Examination Survey (NHANES), we performed a nationally retrospective cohort study of the U.S. general population. A total of 20 771 people aged 40-74 years with recalled weight at young and middle adulthood were included in the cohort. Hazard ratios relating weight change to incident asthma over 10 years of follow-up were calculated using Cox models adjusting for covariates.Results: Compared with participants with stable non-obesity between young and middle adulthood, the hazard ratios of incident asthma were 1.63 (95% confidence interval 1.29 to 2.07) for weight gain (non-obesity to obesity), 1.41 (0.97 to 2.05) for stable obesity, and 1.21 (0.41 to 3.62) for weight loss (obesity to non-obesity). In addition, participants who gained more than 20 kg had a hazard ratio of 1.53 (1.15 to 2.03), compared with those whose weight had remained stable. When stratified by sex, the association between weight gain and incident asthma was seen only in females. Population attributable fraction calculations estimated that 10.2% of adult-onset asthma could be averted, if all those who were non-obesity at early adulthood could prevent weight gain by midlife. Conclusion: The findings implied that maintaining normal weight across adulthood, especially preventing weight gain in early adulthood, was important for preventing adult-onset asthma.


2020 ◽  
Author(s):  
Michail Katsoulis ◽  
Bianca DeStavola ◽  
Karla Diaz-Ordaz ◽  
Manuel Gomes ◽  
Alvina Lai ◽  
...  

Background: Cross sectional measures of body mass index (BMI) are associated with cardiovascular disease (CVD) incidence, but less is known about whether weight change affects the risk of CVD. Methods: We estimated the effect of 2 year weight change interventions on 7 year risk of CVD, by emulating hypothetical target trials using electronic health records. We identified 138.567 individuals in England between 1998 and 2016, aged 45-69 years old, free of chronic diseases at baseline. We performed pooled logistic regression, using inverse-probability weighting to adjust for baseline and time-varying variables. Each individual was classified into a weight loss, maintenance, or gain group. Findings: In the normal weight, both weight loss and gain were associated with increased risk for CVD [HR vs weight maintenance=1.53 (1.18 to 1.98) and 1.43 (1.19 to 1.71 respectively)]. Among overweight individuals, both weight loss and gain groups, compared to weight maintenance, had a moderately higher risk of CVD [HR=1.20 (0.99 to 1.44) and 1.17 (0.99 to 1.38), respectively]. In the obese, weight loss had a lower risk lower risk of CHD [HR =0.66 (0.49 to 0.89)] and a moderately lower risk of CVD [HR =0.90 (0.72 to 1.13)]. When we assumed that a chronic disease occurred 1-3 years before the recorded date, estimates for weight loss and gain were attenuated among overweight individuals and estimates for weight loss were stronger among individuals with obesity. Interpretation: Among individuals with obesity, the weight loss group had a lower risk of CHD and moderately lower risk of CVD. Weight gain increased the risk of CVD across BMI groups.


Author(s):  
Maya Tabet ◽  
Soumya Banna ◽  
Lan Luong ◽  
Russell Kirby ◽  
Jen Jen Chang

Objective This study aimed to examine the effects of interpregnancy weight change on pregnancy outcomes, including recurrent preeclampsia, preterm birth, small-for-gestational age (SGA), large-for-gestational age (LGA), and cesarean delivery, among women with a history of preeclampsia. We also evaluated whether these associations were modified by prepregnancy body mass index (BMI) category in the first pregnancy (BMI < 25 vs. ≥25 kg/m2) and if associations were present among women who maintained a healthy BMI category in both pregnancies. Study Design We conducted a population-based retrospective cohort study including 15,108 women who delivered their first two nonanomalous singleton live births in Missouri (1989–2005) and experienced preeclampsia in the first pregnancy. We performed Poisson regression with robust error variance to estimate relative risks and 95% confidence intervals for outcomes of interest after controlling for potential confounders. Results Interpregnancy weight gain was associated with increased risk of recurrent preeclampsia, LGA, and cesarean delivery. These risks increased in a “dose–response” manner with increasing magnitude of interpregnancy weight gain and were generally more pronounced among women who were underweight or normal weight in the first pregnancy. Interpregnancy weight loss exceeding 1 BMI unit was associated with increased risk of SGA among underweight and normal weight women, while interpregnancy weight loss exceeding 2 BMI units was associated with reduced risk of recurrent preeclampsia among overweight and obese women. Conclusion Even small changes in interpregnancy weight may significantly affect pregnancy outcomes among formerly preeclamptic women. Appropriate weight management between pregnancies has the potential to attenuate such risks. Key Points


2020 ◽  
Author(s):  
Qing-Song Xia ◽  
Fan Wu ◽  
Ming-Ming Gong ◽  
Yan Zhao ◽  
Ding-Kun Wang ◽  
...  

Abstract Objective: The observational study was intended to explore the weight changes and risk factors of weight gain during the self-quarantine and find available methods to lose weight.Method: This was an online retrospective observational study investigating the weight changes before and after home confinement. A total of 530 participants completed the online questionnaire. diet, sleep, self-reported depression, disease history and exercise information possibly relating to weight changes were incorporated into the questionnaire. The differences among four groups (underweight, normal weight, overweight and obesity) in BMI change and weight change were compared, and the risk factors of weight gain was also analyzed by multiple linear regression analysis. Result: Participants were mostly between 21-50 years old, getting an average weight change of 0.82±3.31kg, and an average BMI change of 0.35 [-0.37, 1.00]. 43.77% of them gained weight by 2.99±2.29kg averagely. People with normal weight were easier to gain weight than obese group (p=0.001). There were differences in food intake (p<0.001), eating habits(p<0.001), taste preference (p=0.047), daily exercise step change(p=0.007), exercise (p=0.02) between non-weight gain group and weight gain group. The multiple linear regression revealed that weight gains were associated with sex (p=0.002), food intake (p=0.004), current daily exercise step (p=0.009) and self-reported depression (p=0.002) and weight loss was related to food intake (p=0.004) and pre-BMI (p=0.001).Conclusion: Eating irregularly, increasing food intake, self-reported depression and decreased daily steps were risk factors of weight gain, yet weight loss was related to decreased food intake and pre-BMI.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Eva Graham ◽  
Tristan Watson ◽  
Sonya S. Deschênes ◽  
Kristian B. Filion ◽  
Mélanie Henderson ◽  
...  

AbstractThis cohort study aimed to compare the incidence of type 2 diabetes in adults with depression-related weight gain, depression-related weight loss, depression with no weight change, and no depression. The study sample included 59,315 community-dwelling adults in Ontario, Canada. Depression-related weight change in the past 12 months was measured using the Composite International Diagnostic Interview—Short Form. Participants were followed for up to 20 years using administrative health data. Cox proportional hazards models compared the incidence of type 2 diabetes in adults with depression-related weight change and in adults with no depression. Adults with depression-related weight gain had an increased risk of type 2 diabetes compared to adults no depression (HR 1.70, 95% CI 1.32–2.20), adults with depression-related weight loss (HR 1.62, 95% CI 1.09–2.42), and adults with depression with no weight change (HR 1.39, 95% CI 1.03–1.86). Adults with depression with no weight change also had an increased risk of type 2 diabetes compared to those with no depression (HR 1.23, 95% CI 1.04–1.45). Associations were stronger among women and persisted after adjusting for attained overweight and obesity. Identifying symptoms of weight change in depression may aid in identifying adults at higher risk of type 2 diabetes and in developing tailored prevention strategies.


Stroke ◽  
2021 ◽  
Vol 52 (Suppl_1) ◽  
Author(s):  
Maria D Zambrano Espinoza ◽  
Emma Kersey ◽  
Amelia K Boehme ◽  
Joshua Willey ◽  
Eliza C Miller

Background: Obesity is an independent risk factor for stroke. Weight gain has been associated with a higher risk of cardiovascular diseases in postmenopausal women. It is unclear, however, if weight changes before menopause have similar effects. We hypothesized that clinically meaningful premenopausal weight gain, defined as Body Mass Index (BMI) change >5%, would be associated with a higher stroke risk later in life. Methods: Using data from the California Teachers Study, we identified women aged < 55 with no history of stroke. We used weight changes between 1995-2006 as proxy for premenopausal weight gain. We defined weight change as modest or moderate using BMI changes of 5-10% and >10% respectively. Stroke outcomes were obtained from linkage to California hospitalization records. We used Cox regression models to calculate hazard ratios with 95% confidence intervals for the association of weight change and future stroke, adjusting for vascular risk factors. Results: Of 17,295 women included in the study, 113 had a stroke. In comparison to women who maintained a stable weight, women with moderate weight gain during premenopausal years had 2.0 times the risk of stroke. In the adjusted analysis, women with moderate weight gain had 89.6% higher risk of stroke, compared to the reference group. We found no significant association with stroke in women who had modest weight changes. Conclusion: Moderate premenopausal weight gain significantly increased stroke risk in women. Younger women should be educated about the effects of weight gain on future brain health. Count: 1836/1950


Circulation ◽  
2015 ◽  
Vol 131 (suppl_1) ◽  
Author(s):  
Zhaohui Cui ◽  
Kimberly P Truesdale ◽  
Patrick T Bradshaw ◽  
Jianwen Cai ◽  
June Stevens

Introduction: The 2013 AHA/ACC/TOS Guideline for the Management of Overweight and Obesity in Adults recommended weight loss for obese adults in order to reduce their cardiovascular disease (CVD) risk. However, not all obese adults develop CVD and approximately 17% of obese Americans in the 1999-2004 NHANES were metabolically healthy. The absence of abnormal CVD risk factors in this subgroup of obese adults indicates that some individuals are resistant to excess adiposity and positive energy balance, and raises the question of whether all obese adults should be recommended for weight loss treatment. We know of no study that has examined whether metabolically healthy obese (MHO) adults respond to weight changes the same way as metabolically healthy normal weight adults (MHNW). Also, no study has compared the effects of weight loss, weight maintenance and weight gain on CVD risk factors in MHO adults. Hypothesis: We hypothesized that the effects of weight change would be different in MHNW and MHO adults, with MHO adults having less stable risk factors, and that weight loss has a protective effect on CVD risk factors in the MHO compared to weight maintenance and weight gain. Methods: Data were from 2,710 MHO and MHNW participants in the Atherosclerosis Risk in Communities (ARIC) study. Four examinations yielded 4,541 observations over sequential 3-year intervals. Metabolically healthy was defined as absence of all components of metabolic syndrome, excluding waist circumference, at the beginning of a 3-year interval. Mixed effect models were applied to individually compare changes in five CVD risk factors (systolic blood pressure, diastolic blood pressure, triglycerides, high-density lipoprotein cholesterol and glucose) in MHO and MHNW adults within 3 weight change categories (<3% weight loss, weight maintenance (±3%) and >3% weight gain). Results: Weight loss was associated with small or no changes in the five CVD risk factors in both MHO and MHNW adults. Weight maintenance was associated with larger increases in MHO compared to MHNW adults in triglycerides (mean ± standard error: 10.0±1.7 vs. 6.5±1.0 mg/dL) and glucose (1.7±0.4 vs. 0.9±0.2 mg/dL). Weight gain was associated with larger increases in systolic (8.6±0.6 vs. 6.2±0.4 mmHg) and diastolic (3.9±0.4 vs. 2.5±0.3 mmHg) blood pressure, triglycerides (22.0±1.8 vs. 16.0±1.1 mg/dL) and glucose (4.9±0.4 vs. 1.9±0.3 mg/dL) among the MHO compared to the MHNW. MHO weight losers experienced more favorable changes in the five CVD risk factors compared to MHO weight maintainers (p<0.04) or gainers (p<0.0001). Conclusions: We showed that compared to MHNW, MHO adults experienced similar changes in CVD risk factors with weight loss and larger increases with weight maintenance and gain. Our study supports the 2013 Guideline that primary health care providers should recommend weight loss treatment for MHO patients.


2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Zewei Shen ◽  
◽  
Canqing Yu ◽  
Yu Guo ◽  
Zheng Bian ◽  
...  

Abstract Summary In a Chinese population from both urban and rural areas, weight loss of ≥ 5 kg from early adulthood to midlife was associated with a higher risk of hip fracture and lower BMD in later life. Introduction This study investigates the association of the long-term weight loss from young adulthood through the middle ages with the subsequent 10-year risk of hospitalized fracture and calcaneus bone mineral density (BMD). Methods China Kadoorie Biobank (CKB) was established during 2004–2008 in ten areas across China. Weight at age 25 years was self-reported at baseline, and weight at baseline and resurvey was measured by the calibrated equipment. Outcomes were hospitalized fracture during follow-up and calcaneus BMD measured at resurvey. Analysis for fracture risk included 411,812 participants who were free of fracture in the last 5 years before baseline, cancer, or stroke at any time before baseline. Analysis for BMD included 21,453 participants who participated in the resurvey of 2013–2014 with the same exclusion criteria as above. Results The mean age was 50.8 at baseline and 58.4 at resurvey. Median weight change from age 25 to baseline was 4.4 kg, with 20.7% losing weight and 58.5% gaining weight. During a median follow-up of 10.1 years, we documented 13,065 cases of first diagnosed fracture hospitalizations, including 1222 hip fracture. Compared with participants whose weight was stable (± 2.4 kg), the adjusted hazard ratios (95% CIs) for those with weight loss of ≥ 5.0 kg from age 25 to baseline was 1.39 (1.17 to 1.66) for hip fracture. Weight loss was not associated with fracture risk at other sites. Those with weight loss from age 25 to resurvey had the lowest BMD measures, with β (95% CIs) of − 4.52 (− 5.08 to − 3.96) for broadband ultrasound attenuation (BUA), − 4.83 (− 6.98, − 2.67) for speed of sound (SOS), and − 4.36 (− 5.22, − 3.49) for stiffness index (SI). Conclusions Weight loss from early adulthood to midlife was associated with a higher risk of hip fracture and lower BMD in later life.


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