Weight change across adulthood in relation to all cause and cause specific mortality: prospective cohort study

Abstract

ObjectiveTo investigate the association between weight changes across adulthood and mortality.DesignProspective cohort study.SettingUS National Health and Nutrition Examination Survey (NHANES) 1988-94 and 1999-2014.Participants36 051 people aged 40 years or over with measured body weight and height at baseline and recalled weight at young adulthood (25 years old) and middle adulthood (10 years before baseline).Main outcome measuresAll cause and cause specific mortality from baseline until 31 December 2015.ResultsDuring a mean follow-up of 12.3 years, 10 500 deaths occurred. Compared with participants who remained at normal weight, those moving from the non-obese to obese category between young and middle adulthood had a 22% (hazard ratio 1.22, 95% confidence interval 1.11 to 1.33) and 49% (1.49, 1.21 to 1.83) higher risk of all cause mortality and heart disease mortality, respectively. Changing from obese to non-obese body mass index over this period was not significantly associated with mortality risk. An obese to non-obese weight change pattern from middle to late adulthood was associated with increased risk of all cause mortality (1.30, 1.16 to 1.45) and heart disease mortality (1.48, 1.14 to 1.92), whereas moving from the non-obese to obese category over this period was not significantly associated with mortality risk. Maintaining obesity across adulthood was consistently associated with increased risk of all cause mortality; the hazard ratio was 1.72 (1.52 to 1.95) from young to middle adulthood, 1.61 (1.41 to 1.84) from young to late adulthood, and 1.20 (1.09 to 1.32) from middle to late adulthood. Maximum overweight had a very modest or null association with mortality across adulthood. No significant associations were found between various weight change patterns and cancer mortality.ConclusionsStable obesity across adulthood, weight gain from young to middle adulthood, and weight loss from middle to late adulthood were associated with increased risks of mortality. The findings imply that maintaining normal weight across adulthood, especially preventing weight gain in early adulthood, is important for preventing premature deaths in later life.

Prevalence and changes of BMI categories in China and related chronic diseases: Cross-sectional National Health Service Surveys (NHSSs) from 2013 to 2018

“…Obesity is a major risk factor for various chronic diseases. To make matters worse, excessive weight gain from young to middle adulthood was associated with increased risks of all-cause mortality [30] . Indeed, adiposity has long term harmful consequences, which predicts sharp growth of chronic disease burden and premature death in the future in China.…”

Association of Weight Loss from Early to Middle Adulthood and Incident Hypertension Risk Later in Life

“…The study design is shown in Figure S1. The NHANES study design has been described in detail previously [12,15].…”

Association of childhood obesity with risk of early all-cause and cause-specific mortality: A Swedish prospective cohort study

“…Due to the relatively limited number of deaths occurring in early adulthood, we were not able to examine the effect of obesity treatment response on risk of mortality. However, it is well-established that weight loss has positive long-term health benefits [4,17,46], and has in adults been shown to reduce the risk of premature mortality [25]. Future research should investigate whether successful obesity treatment can lead to a reduction in the risk of early mortality.…”

“…While 1 study found a correlation between adolescent BMI and mortality risk before the age of 30 years [19], 2 of the studies did not find such an association [20,22]. High BMI in young adulthood has been associated with a higher risk of premature death later in life, largely driven by cardiovascular disease and other noncancer diseases [23][24][25]. To our knowledge, there are no current studies on risk of mortality in young adulthood in relation to measured height and weight in childhood.…”