Body weight and coronary disease risk: patterns of risk factor change associated with long-term weight change. The Normative Aging Study.

Previous studies have suggested that excess body weight increases coronary disease risk by modification of the levels of other risk factors and in addition may contribute to overall risk independently. Few studies, however, have systematically characterized long-term change in risk factors with specific changes in overall weight while they have controlled for the effects of multiple potential confounders. Also, very little information is available on the differential impact of weight change on risk factor changes with advancing age. The present investigation used 15 years of longitudinal data collected on 1,396 men participating in the Veterans Administration Normative Aging Study in Boston, Massachusetts. Multiple regression analysis was used to predict change in each of eight putative coronary disease risk factors from change in weight and the interaction between weight change and age. These included blood pressure, serum cholesterol, triglycerides, fasting and two-hour postprandial blood glucose, uric acid, and forced vital capacity of the lungs. After controlling for initial levels of the risk factor, weight, age, and smoking status, change in weight remained a significant predictor of long-term change in each of the risk factors studied. In addition, the interaction between weight change and age was significant for fasting glucose, uric acid, and forced vital capacity, indicating that the effect of weight gain on uric acid and forced vital capacity was greater in younger men whereas the effect of weight gain on fasting glucose was greater in older men.