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

Zheng, Yan; Manson, JoAnn E.; Yuan, Changzheng; Liang, Matthew H.; Grodstein, Francine; Stampfer, Meir J.; Willett, Walter C.; Hu, Frank B.

doi:10.1001/jama.2017.7092

Cited by 425 publications

(377 citation statements)

References 34 publications

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“…33 A study from the USA reported that each 5-kg increase in bodyweight during early and middle adulthood was associated with a 30% increased risk of type 2 diabetes and a 14% increased risk of hypertension. 34 Thus, the potential significance of the effect of Atole on fatness, especially abdominal fatness, should not be understated.…”

Section: Discussionmentioning

confidence: 99%

Exposure to improved nutrition from conception to age 2 years and adult cardiometabolic disease risk: a modelling study

Ford

Behrman

Hoddinott

et al. 2018

The Lancet Global Health

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Background Low-income and middle-income countries with populations that are chronically undernourished in early life are undergoing a nutrition transition and are experiencing an epidemic of cardiometabolic disease. These dual burdens are thought to be causally related; therefore, the extent to which improvements in early-life nutrition can offset adult-onset disease is important. The aim of this study was to examine whether improvement of protein-energy nutrition from conception to age 2 years can attenuate the risk of cardiometabolic disease. Methods We followed up a cohort of 2392 individuals born between Jan 1, 1962, and Feb 28, 1977, in four villages in Guatemala who had participated in a cluster-randomised protein-energy nutritional supplementation (Atole) trial. Of 1661 participants available for follow-up from Feb 26, 2015, to April 29, 2017, we studied 684 women and 455 men. We assessed cardiometabolic disease risk at ages 37–54 years using anthropometry, fasting and post-challenge glucose, fasting lipid concentrations, and blood pressure. We used generalised linear and logistic regression modelling to estimate the effect of Atole from conception to age 2 years (the first 1000 days) on cardiometabolic disease risk. Findings Exposure to Atole from conception to age 2 years was associated with increased fatness (body-mass index [1·29 kg/m², 95% CI 0·08 to 2·50], body fat [1·73%, 0·20 to 3·26], and obesity [odds ratio 1·94, 1·11 to 3·40]), diastolic blood pressure (1·59 mm Hg, –0·74 to 3·92), and blood lipids (total cholesterol [10·10 mg/dL, 0·80 to 19·40] and non-HDL cholesterol [10·41 mg/dL, 1·51 to 19·31]), reduced post-challenge glucose (–5·84 mg/dL, –12·51 to 0·83), and reduced odds of diabetes (odds ratio 0·46, 0·21 to 0·97). We found stratum heterogeneity by sex in pooled models for non-HDL cholesterol (4·34 mg/dL, 95% CI –6·86 to 15·55 for women vs 19·84 mg/dL, 5·86 to 33·82 for men) and post-challenge glucose (–0·19 mg/dL, –8·63 to 8·24 for women vs –13·10 mg/dL, –23·64 to –2·56 for men). p values for interaction of sex and exposure to Atole from conception to age 2 years were 0·09 and 0·04, respectively. Interpretation Improved protein-energy nutrition from conception to the 2nd birthday reduced the odds of diabetes at ages 37–54 years; however, this protein-energy supplementation also increased the risk of obesity and several obesity-related conditions. Our findings suggest a mixed ability of protein-energy nutritional supplementation in early life to prevent adult cardiometabolic disease incidence in the context of high childhood stunting and high adult overweight and obesity.

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Section: Discussionmentioning

confidence: 99%

Exposure to improved nutrition from conception to age 2 years and adult cardiometabolic disease risk: a modelling study

Ford

Behrman

Hoddinott

et al. 2018

The Lancet Global Health

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“…Insurance companies may need to evaluate their approaches to coverage accordingly. Prevention is key as noted from two long-term cohort studies which found that “weight gain from early to middle adulthood was associated with increased risk of morbidity and mortality, and decreased odds of achieving the composite healthy aging outcome among women and men…weight gain as little as 5 kg was associated with significantly elevated incidence of a composite measure of major chronic diseases, consisting of type 2 diabetes, cardiovascular disease, cancer, and nontraumatic death.” 122 …”

Section: Resultsmentioning

confidence: 99%

Obesity in the Workplace

Yarborough

Brethauer

Burton

et al. 2018

Journal of Occupational &Amp; Environmental Medicine

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Objective To conduct a comprehensive literature review to develop recommendations for managing obesity among workers to improve health outcomes and to explore the impact of obesity on health costs to determine if a case can be made for surgical interventions and insurance coverage. Methods We searched PubMed from 2011–2016, and CINAHL, Scopus, and Cochrane Registry of Clinical Trials for interventions addressing obesity in the workplace. Results A total of 1,419 articles were screened, resulting in 275 articles being included. Several areas were identified that require more research and investigation. Conclusions Our findings support the use of both lifestyle modification and bariatric surgery to assist appropriate patients in losing weight.

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“…1 An 18-year follow-up of almost 93 000 women in the Nurses’ Health Study revealed a dose-response association of weight gain and obesity with several cancers. 2 …”

mentioning

confidence: 99%

“…Furthermore, the sequelae of these diseases are related to the severity of obesity in a dose-response fashion. 2 It is therefore not surprising that obesity accounts for a significant portion of health care costs.…”

mentioning

confidence: 99%

Excessive Weight Gain, Obesity, and Cancer

Massetti

Dietz

Richardson

2017

JAMA

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Even though the effects of overweight and obesity on diabetes, cardiovascular disease, allcause mortality, and other health outcomes are widely known, there is less awareness that overweight, obesity, and weight gain are associated with an increased risk of certain cancers. A recent review of more than 1000 studies concluded that sufficient evidence existed to link weight gain, overweight, and obesity with 13 cancers, including adenocarcinoma of the esophagus; cancers of the gastric cardia, colon and rectum, liver, gallbladder, pancreas, corpus uteri, ovary, kidney, and thyroid; postmenopausal female breast cancer; meningioma; and multiple myeloma. 1 An 18-year follow-up of almost 93 000 women in the Nurses' Health Study revealed a dose-response association of weight gain and obesity with several cancers. 2 The prevalence of obesity in the United States has been increasing for almost 50 years. Currently, more than two-thirds of adults and almost one-third of children and adolescents are overweight or obese. Youths who are obese are more likely to be obese as adults, compounding their risk for health consequences such as cardiovascular disease, diabetes, and cancer. Trends in many of the health consequences of overweight and obesity (such as type 2 diabetes and coronary heart disease) also are increasing, coinciding with prior trends in rates of obesity. Furthermore, the sequelae of these diseases are related to the severity of obesity in a dose-response fashion. 2 It is therefore not surprising that obesity accounts for a significant portion of health care costs.

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

Abstract: In these cohorts of health professionals, weight gain during adulthood was associated with significantly increased risk of major chronic diseases and decreased odds of healthy aging. These findings may help counsel patients regarding the risks of weight gain.

Cited by 425 publications

References 34 publications

Exposure to improved nutrition from conception to age 2 years and adult cardiometabolic disease risk: a modelling study

Exposure to improved nutrition from conception to age 2 years and adult cardiometabolic disease risk: a modelling study

Obesity in the Workplace

Excessive Weight Gain, Obesity, and Cancer

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