Steeper change in body mass across four decades predicts poorer cardiometabolic outcomes at midlife

Abstract

Objective We examined patterns of change in adiposity across four decades starting in young adulthood and their relationships with midlife cardiometabolic outcomes. Methods BMI was assessed at average age 20, 40, 56 and 62 years in 977 male veterans from the Vietnam Era Twin Study of Aging. Age 62 (range 56–66) cardiometabolic outcomes included hypertension, diabetes, dyslipidemia, inflammation, and ischemic heart disease. Analyses included latent growth modeling (LGM), latent class growth modeling (LCGM), and logistic regression models. Results Linear BMI slope was associated with all outcomes. Accelerated (quadratic) BMI slope was significantly associated with greater risk for hypertension, diabetes, dyslipidemia, and inflammation; odds ratios ranged from 1.93 (diabetes) to 3.15 (dyslipidemia). Initial BMI did not predict later outcomes. Linear slope contributed significant unique variance for diabetes and dyslipidemia even controlling for age 62 BMI. LCGM revealed three trajectories. Men with the relatively stable, lower BMI trajectory had significantly better outcomes than those with trajectories with accelerated increases, especially those including obesity. Conclusions How individuals reach late midlife BMI is important. Steepness of BMI change across 40 years from young adulthood to late midlife, in addition to late midlife BMI itself, was robustly associated with greater risk for poor cardiometabolic outcomes.

BMI Trajectories from Birth to 23 Years by Cardiometabolic Risks in Young Adulthood

“…Recently, BMI growth trajectories have been examined in relation to cardiovascular health. These studies generally have linked specific BMI growth patterns to later CM risks or evaluated how age‐specific changes in BMI relate to cardiovascular disease . However, longitudinal studies in which both BMI growth patterns and adult CM disease are known can also be useful for understanding how growth patterns differ according to the presence or absence of CM risks.…”

“…Although such studies have adopted an interesting approach of contrasting growth patterns by known CM risk, neither study compared the rate of BMI change or possible BMI growth acceleration or deceleration by subsequent CM risk. Yet larger and faster BMI increases have been associated with poorer CM outcomes . Thus, comparing BMI growth, as well as BMI at various ages, by subsequent CM risk allows one to not only determine whether distinct growth patterns precede CM risk, but also to quantify how such growth patterns might diverge.…”

Distinct developmental trajectories of body mass index and diabetes risk: A 5‐year longitudinal study of Chinese adults

“…In the past years, this method has been successfully used to examine the association between BMI trajectories and the risk of hypertension, cancer and all‐cause mortality. However, to date, just a few studies have explored the association between BMI trajectories identified by GBTM and diabetes risk. Whether distinct BMI trajectories would be predictive of diabetes risk in general Chinese adults is still unknown.…”

Long-term Body Mass Index Changes in obese Adults and the Risk of Heart Failure, Cardiovascular Disease and Mortality: A Longitudinal Study of 260,000 Adults

“…Few studies have explored how BMI in overweight or obese individuals may change over time, and any cardiovascular impact this may have. No existing research on BMI trajectories over time [11][12][13][14][15] has focused entirely on obese and overweight adult populations, so the BMI course of these individuals is unknown. This aim of this study was rstly to examine BMI trajectories in the general population of adults who were overweight or obese adults; and secondly to explore the risk of heart failure, cardiovascular disease (CVD), CVD-related mortality and all-cause mortality, associated with different BMI trajectories.…”