BACKGROUND AND PURPOSE:

• Many previous studies did not look at weight change across specific age ranges, especially from early to middle adulthood, when most weight gain occurs
  • Focus on BMI rather than weight change
• Zheng et al. (JAMA, 2017) examined the association of weight gain from early to middle adulthood and adverse health outcomes later in life

METHODS:

• Cohort analyses using Nurses’ Health Study (1976-June 30, 2012) and US men from the Health Professionals Follow-Up Study (1986-January 31, 2012)
• Participants recalled weight during early adulthood (18 y/o for women and 21 y/o for men) and reported current weight in middle adulthood (55 y/o)
• Primary outcomes included type 2 diabetes, hypertension, cardiovascular disease, obesity-related cancer, cholelithiasis, clinically severe osteoarthritis, cataract extraction, death, the composite healthy aging outcome, and a composite measure of major chronic diseases
• Secondary outcomes included cardiovascular disease subtypes (ie, CHD and stroke), overall cancer, and mortality caused by cardiovascular disease or cancer
• Composite healthy aging outcome was defined as being free of 11 chronic diseases and major cognitive or physical impairment
• Stable weight was defined as weight loss ≤2.5 kg or gain <2.5 kg
• Moderate weight gain was defined as weight gain ≥2.5-<10.0 kg
• Obesity-related cancers included esophagus (adenocarcinoma), colon and rectum, pancreas, breast (after menopause), endometrium, ovaries, kidney, liver and gallbladder

RESULTS:

• 92,837 women with an 18 year follow up and 25,303 men with a 15 year follow-up
• Weight change from early to middle adulthood was associated with development of type 2 diabetes, hypertension, cardiovascular disease, cataracts, cholelithiasis, severe osteoarthritis, and mortality
  • P < .001 for trend for all comparisons except for severe osteoarthritis in men, which had P = .003
• From early to middle adulthood
  • Women during 37 years gained a mean of 12.6 kg
  • Men gained a mean of 9.7 kg during 34 years
• Women who gained moderate weight during adulthood compared to stable weight
  • Higher incidence of Type 2 diabetes (207 vs 110)
  • Higher incidence of hypertension (3425 vs 2754)
  • Higher incidence of Cardiovascular disease (309 vs 248)
  • Higher incidence of obesity-related cancer (452 vs 415)
    • No associations with overall cancer
  • Lower composite healthy aging outcome (24% vs 27%)
• Men who gained weight during young adulthood:
  • Had higher incidence of Type 2 diabetes (258 vs 147),
  • Hypertension (2861 vs 2366)
  • Cardiovascular disease (383 vs 340)
  • Obesity-related cancer (208 vs 165)
    • No associations with overall cancer
  • Lower composite healthy aging outcome (37% vs 39%)

** rates are per 100,000 person-years

CONCLUSION:

• Weight gain as little as 5 kg was linked to higher rates of chronic diseases and decreased odds of healthy aging
• Weight gain risk was independent of initial early weight

Learn More – Primary Sources:

Associations of Weight Gain From Early to Middle Adulthood With Major Health Outcomes Later in Life

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