Body mass index and weight change since 20 years of age and risk of coronary heart disease among Japanese: the Japan Public Health Center-Based Study

Abstract

Background: Obesity and weight gain are associated with increased risk of coronary heart disease in Western countries. However, their impact is not well elucidated in Asia, where body mass index (BMI) levels are generally lower than in Western countries. We examined associations of BMI (kg/m 2 ) and weight change with risk of coronary heart disease in Japanese people. Methods and results: A total of 43 235 men and 47 444 women aged 40-69 years living in communities were followed up from 1990 to 2001 in the Japan Public Health Center-based (JPHC) prospective study . During 879 619 person-years of follow-up, we documented 399 cases of coronary heart disease (334 myocardial infarction and 65 sudden cardiac death) for men and 119 (95 myocardial infarction and 24 sudden cardiac death) for women. Compared with persons with BMI 23.0-24.9, men, but not women, with BMI X30.0 had higher risk of coronary heart disease and myocardial infarction; the multivariable relative risks for men were 1.8 (1.1-3.0) and 1.9 (1.1-3.2), respectively. When weight change was examined according to BMI at age 20 years, men with initial BMI o21.7 who gained more than 10 kg compared with men of no weight change had a twofold higher risk of coronary heart disease. Both men and women with initial BMI X21.7 showed no association between weight loss and the risk. Conclusions: High BMI was associated with increased risk of coronary heart disease among men. Also, weight gain was associated with increased risk among lean men.

Associations between weight change since 20 years of age and sleep-disordered breathing among male truck drivers

“…A recent 10-year follow-up study of Japanese subjects reported that weight gain of X10 kg among men with BMI o21.7 at age 20 was associated with a doubling of the risk of coronary heart disease but that no excessive risk was established for men with BMI X21.7. 19 We also found that the prevalence of excessive daytime sleepiness was elevated for BMI X30 and for BMI gain of X3 Abbreviations: BMI, body mass index; OR, odds ratio; RDI, respiratory disturbance index. Multivariable adjustment variables are shown in Table 2 and further for BMI (kg m À2 ) at 20 years of age.…”

The impact of the metabolic syndrome and its components on the incidence of ischemic heart disease and stroke: the Japan public health center-based study

“…19 It is of value to examine the criteria of the metabolic syndrome that effectively predict the risk of cardiovascular disease among lessobese populations, such as the Japanese. 20 We examined the contribution of the metabolic syndrome and its components to the incidence of ischemic heart disease and stroke among Japanese men and women, among whom there is a low prevalence of obesity.…”

Association Between Weight Change Since 20 Years of Age With Mortality From Myocardial Infarction and Chronic Heart Failure in the Japan Collaborative Cohort (JACC) Study

“…5,6 A 10-year follow-up study of Japanese subjects reported that men who have weight gain since the age of 20 have a 1.4-fold higher risk of CAD than those with no weight change. 4 In contrast, several clinical studies showed that patients with cardiovascular disease or overweight with coronary risk factors who lost weight intentionally had decreased risk of CAD: the HRs were 0.57 (0.39-0.84) and 0.62 (0.42-0.92). 19,20 No previous prospective studies, however, have examined the association between weight change and risk of HF in the general population.…”