Predictors of increased body weight and waist circumference for middle-aged adults

Abstract

Objective: To identify predictors of increased adiposity for different measures of adiposity. Design: Prospective cohort study, the Melbourne Collaborative Cohort Study (MCCS), with data at baseline (1990)(1991)(1992)(1993)(1994) and wave 2 (2003-2007). Setting: Participants recruited from the community. Subjects: Australian-born participants (n 5879) aged 40 to 69 years who were not current smokers and who were free from common chronic diseases at recruitment. At baseline and at wave 2, weight and waist circumference were measured; while demographic and lifestyle variables were obtained at baseline via structured interviews. Results: Participants who reported any recreational physical activity at baseline had lower weight and smaller waist circumference at wave 2 than those who did not, particularly for younger participants and for vigorous physical activity. Walking for leisure was not associated, and greater physical activity at work was associated, with greater adiposity measures at wave 2. A diet low in carbohydrates and fibre, but high in fat and protein, predicted greater weight and waist circumference at wave 2. Participants were less likely to have elevated weight or waist circumference at wave 2 if they consumed low to moderate amounts of alcohol. Conclusions: Our findings indicate that promoting vigorous physical activity, encouraging a diet high in carbohydrate and fibre but low in fat and protein, and limiting alcohol intake could be promising approaches for preventing obesity in middle-aged adults. Similar interventions should successfully address the management of both weight and waist circumference, as they were predicted by similar factors. Keywords Weight Waist circumference Obesity Predictors Physical activityUnderstanding the individual-level predictors of weight and waist circumference gain is critical, both to identify individuals most at risk and to allow targeting of the behavioural risk factors likely to contribute the most to overweight and obesity. While consensus is forming around the role of specific dietary elements and markers of physical activity and inactivity associated with increased weight gain (1)(2)(3) , few studies have analysed predictors of increasing waist circumference (4)(5)(6)(7) and the majority of these have focused solely on dietary factors.Waist circumference is a better indicator of excess visceral adiposity (8) , which tends to be more closely associated with metabolic abnormalities and some cancers than overall adiposity as assessed by BMI (3) . Further, there is evidence that waist circumference is increasing at a faster rate than BMI (7,9)

Associations of fat and carbohydrate intake with becoming overweight and obese: an 11-year longitudinal cohort study

“…A previous systematic review of RCT also found that a small reduction in weight (1•5 kg, 95 % CI −2•0, −1•1 kg) could be reflected in a reduction of BMI (−0•50 kg/m 2 , 95 % CI −0•74, −0•26 kg/m 2 ) in adults by consuming less fat (33) . This study revealed that higher fat intake could lead to a larger risk of obesity, which is in accordance with some previous cohort research (24,34,35) . Additionally, one cohort research found that greater total fat intake was related to greater gain in weight more strongly in females than in males (18) .…”

“…A prospective study in the USA showed an inverse relationship between increased grain consumption and weight gain (47) . Some cohort studies stated that weight gain was related to younger women only and not older female or male with fat (35,48) , which was similar to our findings. In addition, several studies have demonstrated stronger associations between dietary carbohydrate intake and metabolic diseases in women than in men (49) .…”

“…In the sensitivity analyses, total fat was related to a higher risk of overweight/obesity, whereas high carbohydrate intake was related to a lower risk of overweight/ obesity in women, meaning that the higher level of total fat intake and lower level of carbohydrate intake were related to the higher risk of overweight/obesity in women. A prospective cohort study indicated that encouraging a low-fat, highcarbohydrate diet could be a promising approach for obesity prevention (35) , which was consistent with our findings. Further research is needed to evaluate how subdivisions of energy, fat, carbohydrate and protein intakes are associated with obesity.…”

Early-life social origins of later-life body weight: The role of socioeconomic status and health behaviors over the life course

“…With respect to alcohol use, some studies report no association between alcohol intake and BMI (Fortier, Katzmarzyk, and Bouchard, 2002; Sammel et al, 2003). Others studies show that heavy drinking increases the likelihood of obesity, whereas moderate alcohol intake is associated with lower weight and waist circumference compared to abstaining and heavy drinking (MacInnis et al, 2013; Wannamethee et al, 2004). Moderate drinking can reduce weight by increasing resting energy expenditure (Klesges, Mealer, and Klesges, 1994) and heat release associated with basic metabolism (Westerterp, 2004).…”

Effect of weight and body composition changes on waist measurement of severely obese women receiving carbohydrate-restricted diet

“…These identify excess body fat, its distribution, especially abdominal obesity, strongly related with the onset of cardiovascular diseases 2,3,18 and allow one to know the effects of diet composition on body changes. Therefore, the objective of this study was to assess the effect of weight and body composition changes on the abdominal measurements of severely obese women receiving a short-term low carbohydrate diet.…”