#Grand Rounds

What are the long-term consequences of early adult weight gain?

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

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

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

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

< Previous

Next >