Metabolically healthy obesity is not a stable or reliable indicator of future risk for CVD. Weight loss and lifestyle management for CVD risk factors should be recommended to all individuals with obesity.

Abstract-This study prospectively investigates the contribution of pregnancy complications and other reproductive age risk factors on the risk of subsequent cardiovascular disease death. Participants were 14 403 women in the Child Health and Development Studies pregnancy cohort drawn from the Kaiser Permanente Health Plan in California. Only women with nonmissing parity and no previously diagnosed heart conditions were included. A total of 481 had observed preeclampsia, and 266 died from cardiovascular disease. The median age at enrollment was 26 years, and the median follow-up time was 37 years. 3,4 and that PE is one indicator of this health burden. 5 Following from the idea of pregnancy as a stress test, there is continuing debate around whether PE is only an indication of pre-existing risk factors or is itself an independent factor on the causal pathway to CVD. 4 -7 Complicating this debate, PE is a complex syndrome that has yet to be homogeneously diagnosed or defined. 8 Many researchers consider early or severe PE to be a different diagnosis than late PE that occurs near or at delivery and is usually milder. 9 -12 This is borne out by observations that early PE is linked with decreased gestational age and birth weight, as well as intrauterine growth restriction (IUGR) more generally, whereas late PE is characterized by a disproportionate number of high birth weight infants. 13,14 The problem of overlapping risk factors (exemplified by the strong association between PE and IUGR) is ubiquitous in investigations of the association between PE and CVD. Traditional risk factors for CVD, such as increased body mass index and pre-existing hypertension, are also known to be associated with increased risk of PE. Such overlapping risk factors continue to provoke a multitude of questions about independence and confounding.This study investigates the predictors of PE to establish the sequence of maternal markers. Then the separate and combined effects of PE and other CVD risk factors are examined in an attempt to unravel their relationship with the causes of CVD death. This study further investigates the varying effects of PE on CVD death by gestational timing to clarify the spectrum of PE and its impact on subsequent CVD. Methods Study PopulationThe subjects in this study were women enrolled in the original Child Health and Development Studies (CHDS) cohort. 15 They were members of the Kaiser Permanente Health Plan in the East Bay Area

Background Risk for coronary heart disease (CHD) differs by sex, and accumulating evidence suggests sex differences in the effect of coronary risk factors on vascular risk. To date, the existence of a sex difference in the relationship between body mass index (BMI) with CHD has yet to be systematically examined. As sexual dimorphisms in body composition exist, we hypothesized that the relationship between body mass index (BMI) and CHD would differ in women and men. Methods From systematic searches of PubMed and EMBASE up to February 2015, we identified 32 published studies of the longitudinal association between BMI and CHD in women and men from population-based cohorts. We also included individual participant data from four large studies. Study results were pooled using random effect models with inverse variance weighting. Findings Data from 95 cohorts, 1,219,187 participants, and 37,488 incident cases of CHD were included. Higher BMI was significantly associated with age-adjusted incident CHD: hazard ratios (95% confidence interval) in women and men were 1.04 (1.03–1.05) and 1.05 (1.04–1.07) for one unit BMI, 1.25(1.05–1.49), 1.09(0.91–1.23) for underweight, 1.20 (1.12–1.29), 1.22 (1.12–1.32) for overweight, 1.61 (1.42–1.82) and 1.60 (1.43–1.79) for obesity, respectively). Overall, there was no sex difference in these associations. The women-to-men ratio of the hazard ratios were 0.99 (0.98–1.00) for one unit BMI; 1.08 (0.89–1.31) for underweight; 1.00(0.92–1.07) for overweight; and, 1.05(0.94–1.17) for obesity. Similar results were obtained after multiple-adjustment and in a range of sensitivity analyses. Interpretation Higher BMI, measured continuously and categorically, has the same deleterious effects on risk of incident CHD in women and men across diverse populations.

Both duration and severity of obesity are positively associated with incident metabolic syndrome, suggesting that metabolically healthy obesity is a transient state in the pathway to cardiometabolic disease. Weight loss should be recommended to all individuals with obesity, including those who are currently defined as metabolically healthy.

Sex hormones are significantly associated with adiposity, and the associations of androgens differ qualitatively by sex. This heterogeneity may help explain the complexity of the contribution of sex hormones to sex differences in cardiovascular disease.

Background The relationship between body weight and cardiometabolic disease may vary substantially by race/ethnicity. Objective To determine the prevalence and correlates of the phenotype of metabolic abnormality but normal weight (MAN) for 5 racial/ethnic groups. Design Cross-sectional analysis. Setting 2 community-based cohorts. Participants 2622 white, 803 Chinese American, 1893 African American, and 1496 Hispanic persons from MESA (Multi-Ethnic Study of Atherosclerosis) and 803 South Asian participants in the MASALA (Mediators of Atherosclerosis in South Asians Living in America) study. Measurements Prevalence of 2 or more cardiometabolic abnormalities (high fasting glucose, low high-density lipoprotein cholesterol, and high triglyceride levels and hypertension) among normal-weight participants was estimated. Correlates of MAN were assessed by using log-binomial models. Results Among normal-weight participants (n = 846 whites, 323 Chinese Americans, 334 African Americans, 252 Hispanics, and 195 South Asians), the prevalence of MAN was 21.0% (95% CI, 18.4% to 23.9%) in whites, 32.2% (CI, 27.3% to 37.4%) in Chinese Americans, 31.1% (CI, 26.3% to 36.3%) in African Americans, 38.5% (CI, 32.6% to 44.6%) in Hispanics, and 43.6% (CI, 36.8% to 50.6%) in South Asians. Adjustment for demographic, behavioral, and ectopic body fat measures did not explain racial/ethnic differences. After adjustment for age, sex, and race/ethnicity–body mass index (BMI) interaction, for the equivalent MAN prevalence at a BMI of 25.0 kg/m2 in whites, the corresponding BMI values were 22.9 kg/m2 (CI, 19.5 to 26.3 kg/m2) in African Americans, 21.5 kg/m2 (CI, 18.5 to 24.5 kg/m2) in Hispanics, 20.9 kg/m2 (CI, 19.7 to 22.1 kg/m2) in Chinese Americans, and 19.6 kg/m2 (CI, 17.2 to 22.0 kg/m2) in South Asians. Limitation Cross-sectional study design and lack of harmonized dietary data between studies. Conclusion Compared with whites, all racial/ethnic minority groups had a statistically significantly higher prevalence of MAN, which was not explained by demographic, behavioral, or ectopic fat measures. Using a BMI criterion for overweight to screen for cardiometabolic risk may result in a large proportion of racial/ethnic minority groups being overlooked. Primary Funding Source National Institutes of Health.

A multifactorial behavioral intervention emphasizing spices and herbs significantly reduced sodium intake. Because of the ubiquity of sodium in the US food supply, multilevel strategies addressing individual behaviors and the food supply are needed to improve adherence to recommendations. This trial was registered at clinicaltrials.gov as NCT01615159.

The Child Health and Development Studies is a > or =40-year follow-up of 20,754 pregnancies occurring between 1959 and 1967 in California. There were 84 cases of undescended testes at birth persisting to at least age 2 years among 7,574 liveborn sons whose mothers were interviewed in early pregnancy. Cases were matched to three controls on birth year and race. Compared with mothers of controls, mothers of cryptorchid boys consumed more caffeine during pregnancy (odds ratio = 1.4, 95% confidence interval: 1.1, 1.9 for an interquartile range equivalent to three cups of coffee per day) but were not more likely to smoke or drink alcohol when all behaviors were considered together. Other maternal and perinatal risk factors were not significantly associated with persistent cryptorchidism and did not confound the association with caffeine.