Marte Karoline Råberg Kjøllesdal1,2, Inger Ariansen3, Øyvind Erik Næss4,3. 1. Institute of Health and Society, University of Oslo, PB 1130 Blindern, 0318, Oslo, Norway. MarteKarolineRaberg.Kjollesdal@fhi.no. 2. Norwegian Institute of Public Health, Health Services Research, PB 222 Skøyen, 0213, Oslo, Norway. MarteKarolineRaberg.Kjollesdal@fhi.no. 3. Domain of Mental and Physical Health, Norwegian Institute of Public Health, PB 4404 Nydalen, 0403, Oslo, Norway. 4. Institute of Health and Society, University of Oslo, PB 1130 Blindern, 0318, Oslo, Norway.
Abstract
BACKGROUND: The time between early adulthood and midlife is important for obesity development. There is paucity of studies using objectively measured body mass index (BMI) at both time points with full range of midlife cardiovascular risk factors. We aimed to investigate the risk of cardiovascular disease (CVD) mortality associated with different levels of objectively measured change in body weight from early adulthood to midlife, and to assess whether risk is primarily explained by midlife cardiovascular risk factors. METHODS: Pooled data from Norwegian health surveys (1985-2003), Tuberculosis screenings, Conscript data and the Norwegian Educational database were linked to the Cause of Death Registry. Health survey participants with data on objectively measured weight and height in both early adulthood (18-20 years) and midlife (40-50 years) were included, n = 148,021. Cox regression models were used to assess associations between weight change and CVD mortality. RESULTS: Total analysis time included 2,841,174 person years. Mean follow-up was 19 (standard deviation 4) years. Participants being normal weight in early adulthood and obese in midlife had a hazard ratio (HR) of CVD mortality of 2.09 (95% CI 1.74-2.50) relative to those who were normal weight at both times. The corresponding HR of those being obese at both times was 5.15 (3.61-7.36). Adjustment for CVD risk factors attenuated these associations. Gaining ≥15 kg between early adulthood and midlife was associated with higher CVD mortality after adjustment for early adulthood weight (HR 1.51 (1.20-1.89)), and for smoking and education (HR 1.63 (1.30-2.04)), however not after adjustment for mediating CVD risk factors. CONCLUSIONS: Obesity both in early adulthood and in midlife was associated with CVD mortality. Weight gain of ≥15 kg from early adulthood to midlife was also associated with CVD mortality, but not after adjustment for mediating CVD risk factors.
BACKGROUND: The time between early adulthood and midlife is important for obesity development. There is paucity of studies using objectively measured body mass index (BMI) at both time points with full range of midlife cardiovascular risk factors. We aimed to investigate the risk of cardiovascular disease (CVD) mortality associated with different levels of objectively measured change in body weight from early adulthood to midlife, and to assess whether risk is primarily explained by midlife cardiovascular risk factors. METHODS: Pooled data from Norwegian health surveys (1985-2003), Tuberculosis screenings, Conscript data and the Norwegian Educational database were linked to the Cause of Death Registry. Health survey participants with data on objectively measured weight and height in both early adulthood (18-20 years) and midlife (40-50 years) were included, n = 148,021. Cox regression models were used to assess associations between weight change and CVDmortality. RESULTS: Total analysis time included 2,841,174 person years. Mean follow-up was 19 (standard deviation 4) years. Participants being normal weight in early adulthood and obese in midlife had a hazard ratio (HR) of CVDmortality of 2.09 (95% CI 1.74-2.50) relative to those who were normal weight at both times. The corresponding HR of those being obese at both times was 5.15 (3.61-7.36). Adjustment for CVD risk factors attenuated these associations. Gaining ≥15 kg between early adulthood and midlife was associated with higher CVDmortality after adjustment for early adulthood weight (HR 1.51 (1.20-1.89)), and for smoking and education (HR 1.63 (1.30-2.04)), however not after adjustment for mediating CVD risk factors. CONCLUSIONS:Obesity both in early adulthood and in midlife was associated with CVDmortality. Weight gain of ≥15 kg from early adulthood to midlife was also associated with CVDmortality, but not after adjustment for mediating CVD risk factors.
Authors: Lindsay Fernández-Rhodes; Nicole M Butera; Evans K Lodge; Nora Franceschini; Maria M Llabre; Elva M Arredondo; Linda C Gallo; William Arguelles; Frank J Penedo; Martha L Daviglus; Carmen R Isasi; Paul Smokowski; Penny Gordon-Larsen; Allison E Aiello; Krista M Perreira; Daniela Sotres-Alvarez; Kari E North Journal: BMC Public Health Date: 2021-11-10 Impact factor: 3.295