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Wang L, Deng YY, Yu T, Lao XQ, Wong MCS. Associations of short-term changes in obesity indices with all-cause mortality and cardiovascular disease. Obesity (Silver Spring) 2024; 32:1568-1584. [PMID: 38924337 DOI: 10.1002/oby.24062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Revised: 04/23/2024] [Accepted: 04/23/2024] [Indexed: 06/28/2024]
Abstract
OBJECTIVE This study aimed to investigate how short-term changes (1-, 3-, and 5-year) in obesity measures affect mortality and cardiovascular disease (CVD) risk. METHODS We analyzed longitudinal data from the MJ Health Centre (n = 43,304 for the 1-year study; 24,295 for the 3-year study; 16,138 for the 5-year study) with median follow-up periods of 15.8, 13.9, and 12.3 years, respectively. Associations of short-term obesity indices changes with mortality and Framingham Risk Score changes were explored using time-dependent coefficient Cox regression models, restricted cubic splines, and multivariable linear regression models. RESULTS All-cause mortality was negatively associated with short-term weight and BMI changes, with greater reductions causing poorer outcomes. Compared with stable groups, short-term reduced weight and BMI were associated with greater risks of all-cause mortality and CVD-specific mortality (5-year study only). Also, either 1- and 3-year reduced or 3-year increased waist circumference and waist to height ratio were related to higher all-cause and CVD deaths than stable groups, respectively. Nonlinear relationships indicated lower cutoff values for short-term changes in obesity indices in predicting all-cause mortality. Decreased obesity indices significantly improved CVD profiles. CONCLUSIONS Short-term changes in obesity indices show complex mortality risks, urging personalized approaches beyond a simple weight loss focus.
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Affiliation(s)
- Lyu Wang
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Yun-Yang Deng
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China
| | - Tsung Yu
- Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Xiang-Qian Lao
- Department of Biomedical Science, City University of Hong Kong, Hong Kong, China
- School of Public Health, Zhengzhou University, Zhengzhou, China
| | - Martin C S Wong
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
- School of Public Health, The Chinese Academy of Medical Sciences and the Peking Union Medical College, Beijing, China
- School of Public Health, Peking University, Beijing, China
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da Silva M, Fritz J, Mboya IB, Sun M, Wahlström J, van Guelpen B, Michaëlsson K, Magnusson PKE, Melander O, Sandin S, Yin W, Trolle Lagerros Y, Nwaru B, Leppert J, Chabok A, Pedersen NL, Elmståhl S, Isaksson K, Ingvar C, Hedman L, Backman H, Häggström C, Stocks T. Cohort profile: The Obesity and Disease Development Sweden (ODDS) study, a pooled cohort. BMJ Open 2024; 14:e084836. [PMID: 39013647 PMCID: PMC11253753 DOI: 10.1136/bmjopen-2024-084836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Accepted: 06/21/2024] [Indexed: 07/18/2024] Open
Abstract
PURPOSE The Obesity and Disease Development Sweden (ODDS) study was designed to create a large cohort to study body mass index (BMI), waist circumference (WC) and changes in weight and WC, in relation to morbidity and mortality. PARTICIPANTS ODDS includes 4 295 859 individuals, 2 165 048 men and 2 130 811 women, in Swedish cohorts and national registers with information on weight assessed once (2 555 098 individuals) or more (1 740 761 individuals), in total constituting 7 733 901 weight assessments at the age of 17-103 years in 1963-2020 (recalled weight as of 1911). Information on WC is available in 152 089 men and 212 658 women, out of whom 108 795 have repeated information on WC (in total 512 273 assessments). Information on morbidity and mortality was retrieved from national registers, with follow-up until the end of 2019-2021, varying between the registers. FINDINGS TO DATE Among all weight assessments (of which 85% are objectively measured), the median year, age and BMI (IQR) is 1985 (1977-1994) in men and 2001 (1991-2010) in women, age 19 (18-40) years in men and 30 (26-36) years in women and BMI 22.9 (20.9-25.4) kg/m2 in men and 23.2 (21.2-26.1) kg/m2 in women. Normal weight (BMI 18.5-24.9 kg/m2) is present in 67% of assessments in men and 64% in women and obesity (BMI≥30 kg/m2) in 5% of assessments in men and 10% in women. The median (IQR) follow-up time from the first objectively measured or self-reported current weight assessment until emigration, death or end of follow-up is 31.4 (21.8-40.8) years in men and 19.6 (9.3-29.0) years in women. During follow-up, 283 244 men and 123 457 women died. FUTURE PLANS The large sample size and long follow-up of the ODDS Study will provide robust results on anthropometric measures in relation to risk of common diseases and causes of deaths, and novel findings in subgroups and rarer outcomes.
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Affiliation(s)
- Marisa da Silva
- Department of Translational Medicine, Lund University, Malmö, Sweden
| | - Josef Fritz
- Department of Translational Medicine, Lund University, Malmö, Sweden
- Institute of Medical Statistics and Informatics, Medical University of Innsbruck, Innsbruck, Austria
| | - Innocent B Mboya
- Department of Translational Medicine, Lund University, Malmö, Sweden
| | - Ming Sun
- Department of Translational Medicine, Lund University, Malmö, Sweden
| | - Jens Wahlström
- Section of Sustainable Health, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | | | - Karl Michaëlsson
- Department of Surgical Sciences, Medical Epidemiology, Uppsala University, Uppsala, Sweden
| | - Patrik K E Magnusson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Olle Melander
- Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden
| | - Sven Sandin
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Weiyao Yin
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Ylva Trolle Lagerros
- Division of Clinical Epidemiology, Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden
- Center for Obesity, Academic Specialist Center, Stockholm Health Services, Stockholm, Sweden
| | - Bright Nwaru
- Krefting Research Centre, University of Gothenburg, Gothenburg, Sweden
- Wallenberg Centre for Molecular and Translational Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Jerzy Leppert
- Center for Clinical Research, Uppsala University, Västmanland Hospital, Västerås, Sweden
| | - Abbas Chabok
- Center for Clinical Research, Uppsala University, Västmanland Hospital, Västerås, Sweden
| | - Nancy L Pedersen
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Sölve Elmståhl
- Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden
| | - Karolin Isaksson
- Department of Clinical Sciences Lund, Lund University, Lund, Sweden
- Department of Surgery, Kristianstad Hospital, Kristianstad, Sweden
| | - Christian Ingvar
- Department of Clinical Sciences Lund, Lund University, Lund, Sweden
| | - Linnea Hedman
- Section of Sustainable Health, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Helena Backman
- Section of Sustainable Health, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Christel Häggström
- Northern Registry Centre, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Tanja Stocks
- Department of Translational Medicine, Lund University, Malmö, Sweden
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Kino S, Tamada Y, Takeuchi K, Nakagomi A, Shiba K, Kusama T, Yamamoto T, Aida J. Exploring the relationship between oral health and multiple health conditions: An outcome-wide approach. J Prosthodont Res 2024; 68:415-424. [PMID: 37574274 DOI: 10.2186/jpr.jpr_d_23_00091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/15/2023]
Abstract
PURPOSE A growing body of evidence suggests that oral health is associated with a wide range of health outcomes; however, opinions tend to vary because of inconsistent findings. This study aimed to simultaneously examine the association between oral health status and multiple health and well-being indicators using outcome-wide epidemiology. METHODS Data were obtained from the Japan Gerontological Evaluation Study. Oral health status was categorized as: ≥20 teeth, 10-19 teeth with dental prosthesis, 0-9 teeth with prosthesis, 10-19 teeth without prosthesis, and 0-9 teeth without prosthesis. We examined the associations between oral health status in 2013 and 35 health and well-being outcomes in 2019, including physical/cognitive health, psychological distress, subjective health, social well-being, prosocial/altruistic behaviors, and health behaviors, using two databases (n=32,827 and 15,905). RESULTS Compared to individuals with ≥20 teeth, those with <20 teeth had a 10-33% higher risk of mortality and a 6-14% higher risk of functional disability six years later. Additionally, individuals with fewer than 20 teeth tended to go out less frequently and eat fewer vegetables and fruits. Furthermore, individuals with 0-9 teeth without a prosthesis were more likely to have severe functional disability (risk ratio (RR):1.17, 95% confidence interval (CI):1.05-1.31), engage in fewer intellectual activities (standardized difference: 0.17, 95% CI: 0.10-0.24), and feel more hopeless (RR: 1.21, 95% CI: 1.04-1.41). CONCLUSIONS The prevention of tooth loss and prosthodontic treatment may be associated with reduced mortality and functional disability, as well as maintenance of intellectual ability, frequency of going out, and improvements in dietary lifestyle.
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Affiliation(s)
- Shiho Kino
- Department of Oral Health Promotion, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yudai Tamada
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - Kenji Takeuchi
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai, Japan
- Division of Statistics and Data Science, Liaison Center for Innovative Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - Atsushi Nakagomi
- Department of Social Preventive Medical Sciences, Center for Preventive Medical Sciences, Chiba University, Chiba, Japan
| | - Koichiro Shiba
- Department of Epidemiology, Boston University School of Public Health, Boston, the United States
| | - Taro Kusama
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai, Japan
- Division of Statistics and Data Science, Liaison Center for Innovative Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - Takafumi Yamamoto
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai, Japan
- Department of Health Promotion, National Institute of Public Health, Saitama, Japan
| | - Jun Aida
- Department of Oral Health Promotion, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
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Gong HJ, Tang X, Zhou JB. The association between weight change patterns and obesity-related complex multimorbidity: evidence from NHANES. Front Endocrinol (Lausanne) 2024; 15:1400204. [PMID: 38974571 PMCID: PMC11224475 DOI: 10.3389/fendo.2024.1400204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2024] [Accepted: 05/31/2024] [Indexed: 07/09/2024] Open
Abstract
Objective Obesity is a major risk factor for non-communicable diseases (NCDs), which has been the leading cause of death nowadays. The aim of this study is to examine the association between total changes in body mass index (BMI) across adulthood and the risk of obesity-related complex multimorbidity in elderly, characterizing the capacity of BMI waves in predicting major chronic diseases. Methods In this retrospective study, 15,520 participants were analyzed from the National Health and Nutrition Examination Survey (NHANES) from 1999 and 2018. BMI was categorized as obesity (≥30.0 kg/m²), overweight (25.0-29.9 kg/m²), normal weight (18.5-24.9 kg/m²), and underweight (<18.5 kg/m²). Odds ratios (ORs) with 95% confidence interval (CIs) for the relationship between BMI change patterns and major health outcomes included hypertension, cancer, chronic obstructive pulmonary disease, cardiovascular disease, and diabetes, and population attributable fractions (PAFs) of BMI were evaluated. Results In comparison with participants who remained non-obese, those who are stable obese showed the highest risks of developing at least one chronic disease in later life, with odds ratios of 2.76 (95% CI: 2.20 to 3.45) from age 25 years to 10 years before baseline, 2.90 (2.28 to 3.68) from age 25 years to baseline, and 2.49 (2.11 to 2.95) in the 10-year period before baseline. Moving from non-obese to obese weight-change pattern in all periods (from age 25 years to 10 years before baseline: OR = 1.82; 95% CI, 1.57 to 2.11; from age 25 years to baseline: OR = 1.87; 95% CI, 1.59 to 2.19; from 10 years before baseline to baseline: OR = 1.62; 95% CI, 1.26 to 2.08) and moving from obese to non-obese, the 10-year period before baseline (OR = 1.89; 95% CI, 1.39 to 2.57) was associated with increased risk of chronic diseases. Midlife obesity status can explain the 8.6% risk of occurrence of the chronic diseases in elderly. Conclusions Maintaining a stable healthy weight and losing weight in early adulthood and midlife are important for better life quality during the aging process. More effective strategies and policies to reduce the prevalence of obesity are needed.
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Affiliation(s)
- Hong-Jian Gong
- Department of Endocrinology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Xingyao Tang
- Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Jian-Bo Zhou
- Department of Endocrinology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
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Grubic N, Khattar J, De Rubeis V, Banack HR, Dabravolskaj J, Maximova K. The Weight of Trauma: Navigating Collider Stratification Bias in the Association Between Childhood Maltreatment and Adult Body Mass Index. CJC PEDIATRIC AND CONGENITAL HEART DISEASE 2024; 3:98-101. [PMID: 39070954 PMCID: PMC11282882 DOI: 10.1016/j.cjcpc.2024.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/23/2024] [Accepted: 05/02/2024] [Indexed: 07/30/2024]
Affiliation(s)
- Nicholas Grubic
- Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Jayati Khattar
- Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Vanessa De Rubeis
- Department of Psychiatry & Behavioural Neurosciences, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Hailey R. Banack
- Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Julia Dabravolskaj
- MAP Centre for Urban Health Solutions, St. Michael’s Hospital, Toronto, Ontario, Canada
| | - Katerina Maximova
- Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- MAP Centre for Urban Health Solutions, St. Michael’s Hospital, Toronto, Ontario, Canada
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6
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Yang H, Wang J, Wang X, Sun W, Tong C, Fan J, Qiao Y, Abnet CC. Weight change and all-cause and cause-specific mortality: A 25-year follow-up study. Chin Med J (Engl) 2024; 137:1169-1178. [PMID: 38282387 PMCID: PMC11101236 DOI: 10.1097/cm9.0000000000002970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Indexed: 01/30/2024] Open
Abstract
BACKGROUND Whether the dynamic weight change is an independent risk factor for mortality remains controversial. This study aimed to examine the association between weight change and risk of all-cause and cause-specific mortality based on the Linxian Nutrition Intervention Trial (NIT) cohort. METHODS Body weight of 21,028 healthy residents of Linxian, Henan province, aged 40-69 years was measured two times from 1986 to 1991. Outcome events were prospectively collected up to 2016. Weight maintenance group (weight change <2 kg) or stable normal weight group was treated as the reference. Cox proportional hazard model was performed to calculate hazard ratios (HRs) and 95% confidence intervals (95% CIs) to estimate the risk of mortality. RESULTS A total of 21,028 subjects were included in the final analysis. Compared with the weight maintenance group, subjects with weight loss ≥2 kg had an increased risk of death from all-cause (HR All-cause = 1.14, 95% CI: 1.09-1.19, P <0.001), cancer (HR Cancer = 1.12, 95% CI: 1.03-1.21, P = 0.009), and heart disease (HR Heart diseases = 1.21, 95% CI: 1.11-1.31, P <0.001), whereas subjects with weight gain ≥5 kg had 11% (HR Cancer = 0.89, 95% CI: 0.79-0.99, P = 0.033) lower risk of cancer mortality and 23% higher risk of stroke mortality (HR Stroke = 1.23,95% CI: 1.12-1.34, P <0.001). For the change of weight status, both going from overweight to normal weight and becoming underweight within 5 years could increase the risk of total death (HR Overweight to normal = 1.18, 95% CI: 1.09-1.27; HR Becoming underweight = 1.35, 95% CI: 1.25-1.46) and cancer death (HR Overweight to normal = 1.20, 95% CI: 1.04-1.39; HR Becoming underweight = 1.44, 95% CI: 1.24-1.67), while stable overweight could increase the risk of total death (HR Stable overweight = 1.11, 95% CI: 1.05-1.17) and death from stroke (HR Stable overweight = 1.44, 95% CI: 1.33-1.56). Interaction effects were observed between age and weight change on cancer mortality, as well as between baseline BMI and weight change on all-cause, heart disease, and stroke mortality (all Pinteraction <0.01). CONCLUSIONS Weight loss was associated with an increased risk of all-cause, cancer, and heart disease mortality, whereas excessive weight gain and stable overweight were associated with a higher risk of stroke mortality. Efforts of weight management should be taken to improve health status. TRIAL REGISTRATION https://classic.clinicaltrials.gov/ , NCT00342654.
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Affiliation(s)
- Huan Yang
- Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Jianbing Wang
- Department of Public Health, Zhejiang University School of Medicine, National Clinical Research Center for Children’s Health, Hangzhou, Zhejiang 310058, China
| | - Xiaokun Wang
- Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Wanyi Sun
- Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Chenyunhao Tong
- Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Jinhu Fan
- Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Youlin Qiao
- Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Christian C. Abnet
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD 20850, USA
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Henney AE, Wilding JPH, Alam U, Cuthbertson DJ. Obesity pharmacotherapy in older adults: a narrative review of evidence. Int J Obes (Lond) 2024:10.1038/s41366-024-01529-z. [PMID: 38710803 DOI: 10.1038/s41366-024-01529-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Revised: 04/22/2024] [Accepted: 04/24/2024] [Indexed: 05/08/2024]
Abstract
The prevalence of obesity in older adults (people aged >60 years) is increasing in line with the demographic shift in global populations. Despite knowledge of obesity-related complications in younger adults (increased risk of type 2 diabetes, liver and cardiovascular disease and malignancy), these considerations may be outweighed, in older adults, by concerns regarding weight-loss induced reduction in skeletal muscle and bone mass, and the awareness of the 'obesity paradox'. Obesity in the elderly contributes to various obesity-related complications from cardiometabolic disease and cancer, to functional decline, worsening cognition, and quality of life, that will have already suffered an age-related decline. Lifestyle interventions remain the cornerstone of obesity management in older adults, with emphasis on resistance training for muscle strength and bone mineral density preservation. However, in older adults with obesity refractory to lifestyle strategies, pharmacotherapy, using anti-obesity medicines (AOMs), can be a useful adjunct. Recent evidence suggests that intentional weight loss in older adults with overweight and obesity is effective and safe, hence a diminishing reluctance to use AOMs in this more vulnerable population. Despite nine AOMs being currently approved for the treatment of obesity, limited clinical trial evidence in older adults predominantly focuses on incretin therapy with glucagon-like peptide-1 receptor agonists (liraglutide, semaglutide, and tirzepatide). AOMs enhance weight loss and reduce cardiometabolic events, while maintaining muscle mass. Future randomised controlled trials should specifically evaluate the effectiveness of novel AOMs for long-term weight management in older adults with obesity, carefully considering the impact on body composition and functional ability, as well as health economics.
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Affiliation(s)
- Alex E Henney
- Department of Cardiovascular & Metabolic Medicine, University of Liverpool, Liverpool, UK.
- Metabolism & Nutrition Research Group, Liverpool University Hospitals NHS Foundation Trust, Liverpool, Merseyside, UK.
- Liverpool Centre for Cardiovascular Sciences, University of Liverpool and Liverpool University Hospitals NHS Foundation Trust, Liverpool, Merseyside, UK.
| | - John P H Wilding
- Department of Cardiovascular & Metabolic Medicine, University of Liverpool, Liverpool, UK
- Metabolism & Nutrition Research Group, Liverpool University Hospitals NHS Foundation Trust, Liverpool, Merseyside, UK
- Liverpool Centre for Cardiovascular Sciences, University of Liverpool and Liverpool University Hospitals NHS Foundation Trust, Liverpool, Merseyside, UK
| | - Uazman Alam
- Department of Cardiovascular & Metabolic Medicine, University of Liverpool, Liverpool, UK
- Metabolism & Nutrition Research Group, Liverpool University Hospitals NHS Foundation Trust, Liverpool, Merseyside, UK
- Liverpool Centre for Cardiovascular Sciences, University of Liverpool and Liverpool University Hospitals NHS Foundation Trust, Liverpool, Merseyside, UK
| | - Daniel J Cuthbertson
- Department of Cardiovascular & Metabolic Medicine, University of Liverpool, Liverpool, UK
- Metabolism & Nutrition Research Group, Liverpool University Hospitals NHS Foundation Trust, Liverpool, Merseyside, UK
- Liverpool Centre for Cardiovascular Sciences, University of Liverpool and Liverpool University Hospitals NHS Foundation Trust, Liverpool, Merseyside, UK
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Wang L, Ding H, Deng Y, Huang J, Lao X, Wong MCS. Associations of obesity indices change with cardiovascular outcomes: a dose-response meta-analysis. Int J Obes (Lond) 2024; 48:635-645. [PMID: 38336864 DOI: 10.1038/s41366-024-01485-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Revised: 01/22/2024] [Accepted: 01/25/2024] [Indexed: 02/12/2024]
Abstract
BACKGROUND Little is known about the degrees and shapes of associations of changes in obesity indices with cardiovascular disease (CVD) and mortality risks. We aimed to conduct a dose-response meta-analysis for the associations of changes in weight, body mass index (BMI), waist circumference (WC), waist-to-hip ratio, and waist-to-height ratio with CVD events, CVD-specific deaths, and all-cause mortality. METHODS We searched MEDLINE via OvidSP, Embase via OvidSP, Web of Science, CINAHL, and Scopus for articles published before January 8th, 2023. Dose-response relationships were modeled using the one-stage mixed-effects meta-analysis. Random-effects models were used to pool the relative risk (RR) and 95% confidence interval (CI). RESULTS We included 122 articles. Weight change was negatively associated with deaths from CVD and any cause, while WC change elevated CVD-specific mortality. Non-linear relationships also confirmed the adverse effects of increased WC on CVD-specific mortality. Additionally, gains of 5 kg in weight and 1 kg/m2 in BMI or more were associated with elevated CVD events, especially among young adults and individuals without CVD. Conversely, reductions of 5 kg in weight and 1 kg/m2 in BMI or more were associated with higher CVD-specific and all-cause deaths than increased counterparts, particularly among old adults and individuals with CVD. Similar non-linear relationships between relative changes in weight and BMI and deaths from CVD and any cause were observed. CONCLUSIONS The effects of changes in weight and BMI on CVD outcomes were affected by age and cardiovascular health. Tailored weight management and avoidance of increased WC should be recommended.
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Affiliation(s)
- Lyu Wang
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, the Chinese University of Hong Kong, Hong Kong SAR, China
| | - Hanyue Ding
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yunyang Deng
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, the Chinese University of Hong Kong, Hong Kong SAR, China
| | - Junjie Huang
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, the Chinese University of Hong Kong, Hong Kong SAR, China
- Centre for Health Education and Health Promotion, Faculty of Medicine, the Chinese University of Hong Kong, Hong Kong SAR, China
| | - Xiangqian Lao
- Department of Biomedical Science, City University of Hong Kong, Hong Kong SAR, China
- School of Public Health, Zhengzhou University, Zhengzhou, China
| | - Martin C S Wong
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, the Chinese University of Hong Kong, Hong Kong SAR, China.
- School of Public Health, Peking University, Beijing, China.
- Centre for Health Education and Health Promotion, Faculty of Medicine, the Chinese University of Hong Kong, Hong Kong SAR, China.
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Kohansal K, Afaghi S, Khalili D, Molavizadeh D, Hadaegh F. Gender differences in midlife to later-life cumulative burden and variability of obesity measures and risk of all-cause and cause-specific mortality. Int J Obes (Lond) 2024; 48:495-502. [PMID: 38114811 DOI: 10.1038/s41366-023-01440-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Revised: 11/22/2023] [Accepted: 12/01/2023] [Indexed: 12/21/2023]
Abstract
BACKGROUND/OBJECTIVES Previous studies have reported the gender-specific association between general and central obesity measures, using snapshot assessments, and mortality events. This study seeks to further explore this link by examining how the longitudinal cumulative burden and variability of obesity measures from midlife to later-life impact mortality events in the Atherosclerosis Risk in Communities (ARIC) study population, specifically in relation to gender differences. SUBJECTS/METHODS Using data from the ARIC study, a total of 7615 (4360 women) participants free of cardiovascular disease, cancer, and early mortality events were included in the data analysis. Longitudinal cumulative burden (estimated by the area under the curve (AUC) using a quadratic mixed-effects method) and variability (calculated according to average successive variability (ASV)) were considered as exposures, separately and all together. Cox proportional hazard regression models were used to estimate multivariable-adjusted standardized hazard ratios. RESULTS The mean age was 62.4 and the median follow-up was 16.9 years. In men, AUCs of waist-related obesity measures, and also ASVs of all obesity measures were associated with increased all-cause mortality risk. In women, waist circumference and waist-to-height ratio AUCs were associated with increased all-cause mortality risk. Regarding cardiovascular mortality, all adiposity measures ASVs in both genders and waist-related obesity measures AUCs in men were associated with increased risk. Significant gender differences were found for the associations between cumulative and variability of waist-to-hip ratio for all-cause mortality and all adiposity measures ASVs for cardiovascular mortality risk with higher impact among men. CONCLUSIONS Cumulative burden and variability in general and central obesity measures were associated with higher all-cause and cardiovascular mortalities among men. In women, general obesity measures variability, as well as cumulative and variability of central adiposity measure, increased all-cause mortality risk.
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Affiliation(s)
- Karim Kohansal
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Department of Epidemiology and Biostatistics, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Siamak Afaghi
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Davood Khalili
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Department of Epidemiology and Biostatistics, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Danial Molavizadeh
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farzad Hadaegh
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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Dos Santos Pereira DB, Dos Santos IKS, Vieira Pastorello CC, da Silva Mazzeti CM, Queiroz Pereira MH, Amorim Sena Pereira ML, de Oliveira MH, Lisboa Conde W. Risk assessment of obesity-related noncommunicable diseases through body mass index trajectories in adulthood: NHANES 2007-2018. Am J Hum Biol 2024; 36:e24000. [PMID: 37830763 DOI: 10.1002/ajhb.24000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 09/26/2023] [Accepted: 09/27/2023] [Indexed: 10/14/2023] Open
Abstract
AIM To assess the impact of adult body mass index (BMI) trajectories on the risk of obesity-related noncommunicable diseases (NCDs) in the U.S. adults after adjustment for sociodemographic and lifestyle factors. METHODS Data were extracted from the National Health and Nutrition Examination Survey conducted from 2007 to 2018, including male and female participants aged 29-59 years. Rao-Scott adjusted chi-square was employed to detect associations between categorical variables in descriptive analyses. Cox proportional hazards models estimated hazard ratios (HR) and 95% confidence intervals (CI) for NCDs and BMI trajectories, adjusted for sociodemographic and lifestyle factors. Kaplan-Meier curves illustrated the cumulative incidence over time. RESULTS Analyses were carried out on 15 721 participants and revealing significant differences among BMI trajectories in terms of demographic, lifestyle, and health characteristics. The overall prevalence of NCDs was 28.0% (95%CI:26.6-28.9). The cumulative incidence over time was higher in the high increase, moderate increase, and mixed trajectory groups, with a correspondingly higher cumulative risk (p < 0.001). Non-overweight trajectory was considered reference category in Cox models. The BMI trajectories were independently associated with an increased risk of NCDs, even after adjusting for potential confounders (HR: 1.7; 95%CI: 1.4-1.9 for moderate increase; HR: 3.6; 95%CI: 3.2-4.1 for high increase; and HR: 2.4; 95%CI: 2.1-2.7, for mixed). Furthermore, differences between males and females were also observed. CONCLUSION The transition to and persistence of obesity into adulthood increases the risk of NCDs. The implementation of targeted interventions with long-term monitoring of BMI may be beneficial in the prevention of future obesity-related NCDs.
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Affiliation(s)
- Débora Borges Dos Santos Pereira
- School of Public Health. Department of Nutrition, Graduate Program in Nutrition in Public Health, University of São Paulo, São Paulo, Brazil
| | - Iolanda Karla Santana Dos Santos
- School of Public Health. Department of Nutrition, Graduate Program in Nutrition in Public Health, University of São Paulo, São Paulo, Brazil
- Foundation Federal University of ABC, São Paulo, Brazil
| | - Cláudia Cristina Vieira Pastorello
- School of Public Health. Department of Nutrition, Graduate Program in Nutrition in Public Health, University of São Paulo, São Paulo, Brazil
| | | | | | | | - Mariane Helen de Oliveira
- School of Public Health. Department of Nutrition, Graduate Program in Nutrition in Public Health, University of São Paulo, São Paulo, Brazil
| | - Wolney Lisboa Conde
- School of Public Health. Department of Nutrition, Graduate Program in Nutrition in Public Health, University of São Paulo, São Paulo, Brazil
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11
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Riviati N, Legiran, Indrajaya T, Saleh I, Ali Z, Irfannuddin, Probosuseno, Indra B. Serum Albumin as Prognostic Marker for Older Adults in Hospital and Community Settings. Gerontol Geriatr Med 2024; 10:23337214241249914. [PMID: 38720941 PMCID: PMC11078084 DOI: 10.1177/23337214241249914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2024] [Revised: 04/06/2024] [Accepted: 04/10/2024] [Indexed: 05/12/2024] Open
Abstract
Serum albumin, known for its multifaceted role in health, is hypothesized to serve as a prognostic marker for older adults, both in hospital and community settings. Nine studies were included in the review, revealing consistent associations between low serum albumin levels and increased mortality risk in hospitalized older individuals. In community settings, low serum albumin levels were linked to higher mortality rates compared to those with normal levels. The synthesis of evidence underscores the potential of serum albumin as a prognostic marker for older adults, offering valuable insights for risk stratification and targeted interventions. While robust evidence supports its utility in hospital settings, further research is warranted in community settings to address current limitations and enhance the applicability of serum albumin as a prognostic tool. This review merges existing knowledge of the prognostic significance of serum albumin in older adults across hospital and community settings. The findings emphasize the importance of serum albumin as a potential prognostic marker, urging continued research efforts to refine its application in diverse healthcare contexts and improve outcomes for the aging population.
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Affiliation(s)
- Nur Riviati
- University of Sriwijaya, Palembang, Indonesia
| | - Legiran
- University of Sriwijaya, Palembang, Indonesia
| | | | - Irsan Saleh
- University of Sriwijaya, Palembang, Indonesia
| | | | - Irfannuddin
- University of Sriwijaya, Palembang, Indonesia
| | - Probosuseno
- University of Sriwijaya, Palembang, Indonesia
| | - Bima Indra
- University of Sriwijaya, Palembang, Indonesia
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12
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Kazibwe R, Singleton MJ, Ahmad MI, Kaze AD, Chevli PA, Namutebi JH, Kasozi RN, Asiimwe DD, Kazibwe J, Shapiro MD, Yeboah J. Association between weight variability, weight change and clinical outcomes in hypertension. Am J Prev Cardiol 2023; 16:100610. [PMID: 37942025 PMCID: PMC10630599 DOI: 10.1016/j.ajpc.2023.100610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 08/30/2023] [Accepted: 10/08/2023] [Indexed: 11/10/2023] Open
Abstract
Objective The effect of body weight variability (BWV) and body weight change (BWC) in high-risk individuals with hypertension, but without diabetes mellitus (DM) remains unclear. We examined the effect of BWV and BWC on the primary outcome [the composite of myocardial infarction (MI), other acute coronary syndromes, stroke, acute decompensated heart failure (HF), or cardiovascular (CV) death] and all-cause mortality in the Systolic Blood Pressure Intervention Trial (SPRINT). Methods In this post-hoc analysis, we used multivariate Cox regression models to examine the risk associated with BWV and BWC for the primary outcome in SPRINT. BWV was defined as the intra-individual average successive variability (ASV). BWC was defined as baseline weight minus final weight. Results A total of 8714 SPRINT participants (mean age 67.8 ± 9.4 years, 35.1 % women, 58.9 % Whites) with available data on body weight were included. The median follow-up was about 3.9 years (IQR, 3.3-4.4). In multivariable-adjusted Cox models, each 1 unit standard deviation (SD) of BWV was significantly associated with a higher risk for the primary outcome, all-cause mortality, HF, MI, and stroke [HR(95 % CI)]: 1.13 (1.07-1.19; p < 0.0001), 1.22 (1.14-1.30; p < 0.0001), 1.16 (1.07-1.26; p < 0.001), 1.10 (1.00-1.20; p = 0.047), and 1.15 (1.05-1.27; p = 0.005), respectively. Similarly, each 1 unit SD of BWC was significantly associated with a higher risk of the primary outcome, all-cause mortality, MI, and HF: 1.11(1.02-1.21; p = 0.017), 1.44 (1.26-1.65; p < 0.0001), 1.16 (1.01-1.32; p = 0.041) and 1.19 (1.02-1.40; p = 0.031) respectively. However, there was no significant association with CV death (for both BWV and BWC) or stroke (BWC). Conclusion In high-risk hypertension, BWV and BWC were both associated with higher risk of the primary outcome and all-cause mortality. These results further stress the clinical importance of sustained weight loss and minimizing fluctuations in weight in hypertension.
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Affiliation(s)
- Richard Kazibwe
- Department of Medicine, Section on Hospital Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Matthew J. Singleton
- Department of Medicine, Section on Cardiovascular Medicine, WellSpan Health, York, PA, USA
| | - Muhammad Imtiaz Ahmad
- Department of Internal Medicine, Section on Hospital Medicine, Medical College of Wisconsin, Wauwatosa, Wisconsin, USA
| | | | - Parag A. Chevli
- Department of Medicine, Section on Hospital Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | | | - Ramla N. Kasozi
- Department of Family Medicine, Mayo Clinic, Jacksonville, FL, USA
| | | | - Joseph Kazibwe
- Department of Cardiology, Sheffield Teaching Hospital, Sheffield, UK
| | - Michael D. Shapiro
- Center for the Prevention of Cardiovascular Disease Section on Cardiovascular Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Joseph Yeboah
- Department of Medicine, Section of Cardiovascular Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, USA
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13
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Katsoulis M, Lai AG, Kipourou DK, Gomes M, Banerjee A, Denaxas S, Lumbers RT, Tsilidis K, Kostara M, Belot A, Dale C, Sofat R, Leyrat C, Hemingway H, Diaz-Ordaz K. On the estimation of the effect of weight change on a health outcome using observational data, by utilising the target trial emulation framework. Int J Obes (Lond) 2023; 47:1309-1317. [PMID: 37884665 PMCID: PMC10663146 DOI: 10.1038/s41366-023-01396-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 09/17/2023] [Accepted: 10/10/2023] [Indexed: 10/28/2023]
Abstract
BACKGROUND/OBJECTIVES When studying the effect of weight change between two time points on a health outcome using observational data, two main problems arise initially (i) 'when is time zero?' and (ii) 'which confounders should we account for?' From the baseline date or the 1st follow-up (when the weight change can be measured)? Different methods have been previously used in the literature that carry different sources of bias and hence produce different results. METHODS We utilised the target trial emulation framework and considered weight change as a hypothetical intervention. First, we used a simplified example from a hypothetical randomised trial where no modelling is required. Then we simulated data from an observational study where modelling is needed. We demonstrate the problems of each of these methods and suggest a strategy. INTERVENTIONS weight loss/gain vs maintenance. RESULTS The recommended method defines time-zero at enrolment, but adjustment for confounders (or exclusion of individuals based on levels of confounders) should be performed both at enrolment and the 1st follow-up. CONCLUSIONS The implementation of our suggested method [adjusting for (or excluding based on) confounders measured both at baseline and the 1st follow-up] can help researchers attenuate bias by avoiding some common pitfalls. Other methods that have been widely used in the past to estimate the effect of weight change on a health outcome are more biased. However, two issues remain (i) the exposure is not well-defined as there are different ways of changing weight (however we tried to reduce this problem by excluding individuals who develop a chronic disease); and (ii) immortal time bias, which may be small if the time to first follow up is short.
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Affiliation(s)
- M Katsoulis
- MRC Unit for Lifelong Health and Ageing, Institute of Cardiovascular Science, University College London, London, UK.
| | - A G Lai
- Institute of Health Informatics, University College London, London, UK
| | - D K Kipourou
- Inequalities in Cancer Outcomes Network, Department of Non-communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
- AstraZeneca, London, UK
| | - M Gomes
- Department of Applied Health Research, University College London, London, UK
| | - A Banerjee
- Institute of Health Informatics, University College London, London, UK
- University College London Hospitals NHS Trust, London, UK
- Barts Health NHS Trust, The Royal London Hospital, London, UK
| | - S Denaxas
- Institute of Health Informatics, University College London, London, UK
- Alan Turing Institute, London, UK
| | - R T Lumbers
- Institute of Health Informatics, University College London, London, UK
| | - K Tsilidis
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
- Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece
| | - Maria Kostara
- Department of Pediatrics, University Hospital of Ioannina, Ioannina, Greece
| | - A Belot
- Inequalities in Cancer Outcomes Network, Department of Non-communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
| | - C Dale
- Department of Pharmacology and Therapeutics, University of Liverpool, Liverpool, UK
| | - R Sofat
- Department of Pharmacology and Therapeutics, University of Liverpool, Liverpool, UK
| | - C Leyrat
- Department of Medical Statistics, London School of Hygiene and Tropical Medicine, London, UK
| | - H Hemingway
- Institute of Health Informatics, University College London, London, UK
| | - K Diaz-Ordaz
- Dept of Statistical Science, Faculty of Maths & Physical Sciences, University College London, London, UK
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14
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Shadyab AH, Manson JE, Allison MA, Laddu D, Wassertheil-Smoller S, Van Horn L, Wild RA, Banack HR, Tabung FK, Haring B, Sun Y, LeBlanc ES, Wactawski-Wende J, LeBoff MS, Naughton MJ, Luo J, Schnatz PF, Natale G, Ostfeld RJ, LaCroix AZ. Association of Later-Life Weight Changes With Survival to Ages 90, 95, and 100: The Women's Health Initiative. J Gerontol A Biol Sci Med Sci 2023; 78:2264-2273. [PMID: 37642339 PMCID: PMC10692416 DOI: 10.1093/gerona/glad177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Indexed: 08/31/2023] Open
Abstract
BACKGROUND Associations of weight changes and intentionality of weight loss with longevity are not well described. METHODS Using longitudinal data from the Women's Health Initiative (N = 54 437; 61-81 years), we examined associations of weight changes and intentionality of weight loss with survival to ages 90, 95, and 100. Weight was measured at baseline, year 3, and year 10, and participants were classified as having weight loss (≥5% decrease from baseline), weight gain (≥5% increase from baseline), or stable weight (<5% change from baseline). Participants reported intentionality of weight loss at year 3. RESULTS A total of 30 647 (56.3%) women survived to ≥90 years. After adjustment for relevant covariates, 3-year weight loss of ≥5% vs stable weight was associated with lower odds of survival to ages 90 (OR, 0.67; 95% CI, 0.64-0.71), 95 (OR, 0.65; 95% CI, 0.60-0.71), and 100 (OR, 0.62; 95% CI, 0.49-0.78). Compared to intentional weight loss, unintentional weight loss was more strongly associated with lower odds of survival to age 90 (OR, 0.83; 95% CI, 0.74-0.94 and OR, 0.49; 95% CI, 0.44-0.55, respectively). Three-year weight gain of ≥5% vs stable weight was not associated with survival to age 90, 95, or 100. The pattern of results was similar among normal weight, overweight, and obese women in body mass index (BMI)-stratified analyses. CONCLUSIONS Weight loss of ≥5% vs stable weight was associated with lower odds of longevity, more strongly for unintentional weight loss than for intentional weight loss. Potential inaccuracy of self-reported intentionality of weight loss and residual confounding were limitations.
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Affiliation(s)
- Aladdin H Shadyab
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, La Jolla, California, USA
| | - JoAnn E Manson
- Division of Preventive Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Matthew A Allison
- Department of Family Medicine, School of Medicine, University of California, San Diego, La Jolla, California, USA
| | - Deepika Laddu
- Department of Physical Therapy, College of Applied Science, University of Illinois Chicago, Chicago, Illinois, USA
| | - Sylvia Wassertheil-Smoller
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Linda Van Horn
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Robert A Wild
- Division of Reproductive Endocrinology and Infertility, Departments of Obstetrics and Gynecology, and Biostatistics and Epidemiology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - Hailey R Banack
- Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Fred K Tabung
- Division of Medical Oncology, Department of Internal Medicine, College of Medicine and Comprehensive Cancer Center, The Ohio State University, Columbus, Ohio, USA
| | - Bernhard Haring
- Department of Medicine III, Saarland University Hospital, Homburg, Saarland, Germany
- Department of Medicine I, University of Wurzburg, Wurzburg, Germany
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Yangbo Sun
- Department of Preventive Medicine, College of Medicine, The University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | - Erin S LeBlanc
- Kaiser Permanente, Center for Health Research, Portland, Oregon, USA
| | - Jean Wactawski-Wende
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo – SUNY, Buffalo, New York, USA
| | - Meryl S LeBoff
- Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Michelle J Naughton
- Division of Cancer Prevention and Control, Department of Internal Medicine, The Ohio State University, Columbus, Ohio, USA
| | - Juhua Luo
- Department of Epidemiology and Biostatistics, School of Public Health, Indiana University Bloomington, Bloomington, Indiana, USA
| | - Peter F Schnatz
- Department of Obstetrics/Gynecology and Internal Medicine, Reading Hospital/Tower Health, West Reading, Pennsylvania, USA
| | - Ginny Natale
- Department of Family, Population, and Preventive Medicine, Program in Public Health, Stony Brook University, Stony Brook, New York, USA
| | - Robert J Ostfeld
- Division of Cardiology, Montefiore Health System, Bronx, New York, USA
| | - Andrea Z LaCroix
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, La Jolla, California, USA
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15
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Tazzeo C, Zucchelli A, Vetrano DL, Demurtas J, Smith L, Schoene D, Sanchez-Rodriguez D, Onder G, Balci C, Bonetti S, Grande G, Torbahn G, Veronese N, Marengoni A. Risk factors for multimorbidity in adulthood: A systematic review. Ageing Res Rev 2023; 91:102039. [PMID: 37647994 DOI: 10.1016/j.arr.2023.102039] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 07/25/2023] [Accepted: 08/18/2023] [Indexed: 09/01/2023]
Abstract
BACKGROUND Multimorbidity, the coexistence of multiple chronic diseases in an individual, is highly prevalent and challenging for healthcare systems. However, its risk factors remain poorly understood. OBJECTIVE To systematically review studies reporting multimorbidity risk factors. METHODS A PRISMA-compliant systematic review was conducted, searching electronic databases (MEDLINE, EMBASE, Web of Science, Scopus). Inclusion criteria were studies addressing multimorbidity transitions, trajectories, continuous disease counts, and specific patterns. Non-human studies and participants under 18 were excluded. Associations between risk factors and multimorbidity onset were reported. RESULTS Of 20,806 identified studies, 68 were included, with participants aged 18-105 from 23 countries. Nine risk factor categories were identified, including demographic, socioeconomic, and behavioral factors. Older age, low education, obesity, hypertension, depression, low pysical function were generally positively associated with multimorbidity. Results for factors like smoking, alcohol consumption, and dietary patterns were inconsistent. Study quality was moderate, with 16.2% having low risk of bias. CONCLUSIONS Several risk factors seem to be consistently associated with an increased risk of accumulating chronic diseases over time. However, heterogeneity in settings, exposure and outcome, and baseline health of participants hampers robust conclusions.
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Affiliation(s)
- Clare Tazzeo
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
| | - Alberto Zucchelli
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden; Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.
| | - Davide Liborio Vetrano
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
| | - Jacopo Demurtas
- Primary Care Department USL Toscana Sud Est, AFT Orbetello, Italy
| | - Lee Smith
- Centre for Health, Performance and Wellbeing, Anglia Ruskin University, Cambridge, UK
| | - Daniel Schoene
- Friedrich-Alexander University Erlangen-Nürnberg, Institute of Medical Physics, Erlangen, Germany; Leipzig University, Institute of Exercise and Public Health, Leipzig, Germany; Robert-Bosch-Hospital, Department of Clinical Gerontology, Stuttgart, Germany
| | - Dolores Sanchez-Rodriguez
- Geriatrics Department, Brugmann university hospital, Université Libre de Bruxelles, Brussels, Belgium; WHO Collaborating Centre for Public Health Aspects of Musculo-Skeletal Health and Ageing, Division of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium; Geriatrics Department, Parc Salut Mar, Rehabilitation Research Group, Hospital Del Mar Medical Research Institute (IMIM), Barcelona, Spain
| | - Graziano Onder
- Department of Geriatric and Orthopedic sciences, Università Cattolica del Sacro Cuore, Roma, Italy
| | - Cafer Balci
- Hacettepe University Faculty of Medicine Division of Geriatric Medicine, Turkey
| | - Silvia Bonetti
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Giulia Grande
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
| | - Gabriel Torbahn
- Department of Pediatrics, Paracelsus Medical University, Klinikum Nürnberg, Universitätsklinik der Paracelsus Medizinischen Privatuniversität Nürnberg, Nuremberg, Germany; Department of Pediatrics, Paracelsus Medical University, Salzburg, Austria; Institute for Biomedicine of Aging, Friedrich-Alexander-Universität Erlangen-Nürnberg, Nuremberg, Germany
| | - Nicola Veronese
- Department of Internal Medicine, Geriatrics Section, University of Palermo, Palermo, Italy
| | - Alessandra Marengoni
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden; Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
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16
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Peng Y, Li H, Liao F, Lu J, Yang W, Tan L, Lu A, Wei Y, Long L, Qu H, Fu C. Association between weight change and the predicted 10-year risk for atherosclerosis cardiovascular disease among U.S. older adults: data from National Health and Nutrition Examination Survey 1999-2018. Front Public Health 2023; 11:1183200. [PMID: 37908690 PMCID: PMC10614635 DOI: 10.3389/fpubh.2023.1183200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 09/19/2023] [Indexed: 11/02/2023] Open
Abstract
Background It remains controversial regarding the association between weight change and cardiovascular disease risk in older adults (aged ≥60 years). This study aimed to evaluate the association between weight change and the predicted 10-year atherosclerotic cardiovascular disease (ASCVD) risks in older adults. Methods This study used data from the National Health and Nutrition Examination Survey (NHANES). Older adults aged 60-79 years who were free of self-reported ASCVD at the time of the NHANES interview were included. Data were collected from January 1999 to December 2018 and analyzed in March 2022. We focused on the associations between weight change and the 10-year ASCVD risks with the percentage change in weight during short-term (1 year) and long-term (10 years), which categorized as moderate to high weight loss (≥10%), small weight loss (5.1-9.9%), stable weight (±5%), small weight gain (5.1-9.9%), and moderate to high weight gain (≥10%). Results The number of participants was 1,867 (mean age 67.49 years; 42.10% female) for the long-term interval (10 years) in our analysis, and 1894 for the short-term interval (1 years). We only observed an inverse association between long-term weight loss and the 10-year ASCVD risk in fully adjusted model (loss ≥ 10%: β = 2.52, 95%CI = 0.98, 4.05; loss 5.1% ~ 9.9%: β = 2.99, 95% CI = 1.30, 4.68), but all intervals of weight gain ≥5% were not significant associated with higher risk than stable weight. However, in the subgroup analyses, the association between long-term weight loss and the 10-year ASCVD risk was not significant in old-old (aged 75-79), obesity (BMI ≥ 35 kg/m2), intentional weight loss, moderate physical activity and diabetics. Conclusion Older adults (aged 60-79 years) with weight loss >5% over the past 10 years have excess predicted 10-year ASCVD risk. Our study supports the benefits of stable weight in promoting cardiovascular health in older adults.
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Affiliation(s)
- Yuxuan Peng
- Xiyuan Hospital of China Academy of Chinese Medical Sciences, Beijing, China
- National Clinical Research Center for Cardiovascular Diseases of Traditional Chinese Medicine, Beijing, China
- Beijing University of Chinese Medicine, Beijing, China
| | - Hongzheng Li
- Xiyuan Hospital of China Academy of Chinese Medical Sciences, Beijing, China
- National Clinical Research Center for Cardiovascular Diseases of Traditional Chinese Medicine, Beijing, China
- Beijing University of Chinese Medicine, Beijing, China
| | - Feifei Liao
- Xiyuan Hospital of China Academy of Chinese Medical Sciences, Beijing, China
- National Clinical Research Center for Cardiovascular Diseases of Traditional Chinese Medicine, Beijing, China
- Beijing University of Chinese Medicine, Beijing, China
| | - Jieming Lu
- Xiyuan Hospital of China Academy of Chinese Medical Sciences, Beijing, China
- National Clinical Research Center for Cardiovascular Diseases of Traditional Chinese Medicine, Beijing, China
- Beijing University of Chinese Medicine, Beijing, China
| | - Wenwen Yang
- Xiyuan Hospital of China Academy of Chinese Medical Sciences, Beijing, China
- National Clinical Research Center for Cardiovascular Diseases of Traditional Chinese Medicine, Beijing, China
- Beijing University of Chinese Medicine, Beijing, China
| | - Ling Tan
- Xiyuan Hospital of China Academy of Chinese Medical Sciences, Beijing, China
- National Clinical Research Center for Cardiovascular Diseases of Traditional Chinese Medicine, Beijing, China
- Beijing University of Chinese Medicine, Beijing, China
| | - Aimei Lu
- Xiyuan Hospital of China Academy of Chinese Medical Sciences, Beijing, China
- National Clinical Research Center for Cardiovascular Diseases of Traditional Chinese Medicine, Beijing, China
- Beijing University of Chinese Medicine, Beijing, China
| | - Yue Wei
- Xiyuan Hospital of China Academy of Chinese Medical Sciences, Beijing, China
- National Clinical Research Center for Cardiovascular Diseases of Traditional Chinese Medicine, Beijing, China
- Beijing University of Chinese Medicine, Beijing, China
| | - Linzi Long
- Xiyuan Hospital of China Academy of Chinese Medical Sciences, Beijing, China
- National Clinical Research Center for Cardiovascular Diseases of Traditional Chinese Medicine, Beijing, China
| | - Hua Qu
- Xiyuan Hospital of China Academy of Chinese Medical Sciences, Beijing, China
- National Clinical Research Center for Cardiovascular Diseases of Traditional Chinese Medicine, Beijing, China
| | - Changgeng Fu
- Xiyuan Hospital of China Academy of Chinese Medical Sciences, Beijing, China
- National Clinical Research Center for Cardiovascular Diseases of Traditional Chinese Medicine, Beijing, China
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17
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Shiota C, Kusama T, Takeuchi K, Kiuchi S, Osaka K. Oral Hypofunction and Risk of Weight Change among Independent Older Adults. Nutrients 2023; 15:4370. [PMID: 37892444 PMCID: PMC10610140 DOI: 10.3390/nu15204370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 10/11/2023] [Accepted: 10/13/2023] [Indexed: 10/29/2023] Open
Abstract
Oral health is essential for nutritional status; however, little is known about its association with weight change. This study aimed to investigate whether the risk of weight change differs according to the presence of each important component of oral hypofunction (fewer remaining teeth, low chewing efficiency, swallowing problems, and xerostomia) among independent older adults. This was a three-year follow-up cohort study based on self-reported questionnaires. The participants were independent older adults aged ≥65 from the Japan Gerontological Evaluation Study (JAGES). We used >5% weight loss/gain during follow-up as the outcome variables, and the number of remaining teeth (≥20/10-19/0-9), the presence of chewing difficulty, swallowing problems, and xerostomia (yes/no) as the exposure variables. We fitted the Poisson regression model, including possible confounders to estimate the risk ratios (RRs) and 95% confidence intervals (CIs). For weight loss, RRs were significantly higher among those with 0-9 remaining teeth (RR = 1.17; 95% CI = 1.11-1.23), chewing difficulty (RR = 1.12; 95% CI = 1.07-1.16), and xerostomia (RR = 1.11; 95% CI = 1.06-1.16), but there was no significant association with swallowing problems (RR = 1.01; 95% CI = 0.97-1.06). For weight gain, we also found similar associations with oral hypofunction. Oral hypofunction among older adults could have non-negligible health impacts on nutritional status.
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Grants
- 15H01972, 19H03861, 22K17265, 22H03299 Japan Society for the Promotion of Science
- H28-Choju-Ippan-002, 23FA1022 Health Labour Sciences Research Grant
- JP18dk0110027, JP18ls0110002, JP18le0110009, JP20dk0110034, JP21lk0310073, JP21dk0110037, JP22lk0310087, JP22rea522107 Japan Agency for Medical Research and Development
- OPERA, JPMJOP1831 Open Innovation Platform with Enterprises, Research Institute and Academia
- 1-4 a grant from Innovative Research Program on Suicide Countermeasures
- adopted number: 19-2-06 a grant from Sasakawa Sports Foundation, a grant from Japan Health Promotion & Fitness Foundation, a grant from Chiba Foundation for Health Promotion & Disease Prevention, the 8020 Research Grant for fiscal 2019 from the 8020 Promotion Foundation
- 29-42, 30-22,20-19, 21-20 grants from Meiji Yasuda Life Foundation of Health and Welfare and the Research Funding for Longevity Sciences from National Center for Geriatrics and Gerontology
- JPMJSP2114 JST SPRING
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Affiliation(s)
- Chihiro Shiota
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai 980-8575, Japan; (C.S.); (T.K.)
| | - Taro Kusama
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai 980-8575, Japan; (C.S.); (T.K.)
- Division of Statistics and Data Science, Liaison Center for Innovative Dentistry, Tohoku University Graduate School of Dentistry, Sendai 980-8575, Japan
| | - Kenji Takeuchi
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai 980-8575, Japan; (C.S.); (T.K.)
- Division of Statistics and Data Science, Liaison Center for Innovative Dentistry, Tohoku University Graduate School of Dentistry, Sendai 980-8575, Japan
| | - Sakura Kiuchi
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai 980-8575, Japan; (C.S.); (T.K.)
- Frontier Research Institute for Interdisciplinary Sciences, Tohoku University, Sendai 980-8578, Japan
| | - Ken Osaka
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai 980-8575, Japan; (C.S.); (T.K.)
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18
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Kolberg M, Paur I, Sun YQ, Gjøra L, Skjellegrind HK, Thingstad P, Strand BH, Selbæk G, Fagerhaug TN, Thoresen L. Prevalence of malnutrition among older adults in a population-based study - the HUNT Study. Clin Nutr ESPEN 2023; 57:711-717. [PMID: 37739727 DOI: 10.1016/j.clnesp.2023.08.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 08/16/2023] [Indexed: 09/24/2023]
Abstract
BACKGROUND Malnutrition is common in older adults and is associated with increased morbidity and mortality rates. AIM The aim of the study is to describe the prevalence of malnutrition based on low BMI, involuntary weight loss, and reduced food intake, in a Norwegian population of community-dwelling older adults and older adults living in nursing homes. METHODS This population-based study is part of the fourth wave of the Trøndelag Health Study (HUNT4) and includes participants ≥70 years from the HUNT4 70+ cohort. The HUNT4 70+ cohort consist of 9930 (response rate 51.2%) participants. In the current study 8127 older people had complete dataset for inclusion in the analyses. Participants completed a self-report questionnaire and standardised interviews and clinical assessments at field stations, in participants' homes or at nursing homes. Malnutrition was defined using the following criteria: low BMI, involuntary weight loss and severely reduced food intake. The standardised prevalence of malnutrition was estimated using inverse probability weighting (IPW) with weights for sex, age and education of the total population in the catchment area of HUNT. RESULTS Of the 8127 included participants, 7671 (94.4%) met at field stations, 356 (4.4%) were examined in their home, and 100 (1.2%) in nursing homes. In total, 14.3% of the population were malnourished based on either low BMI, weight loss, or reduced food intake, of which low BMI was the most frequently fulfilled criterion. The prevalence of malnutrition was less common among men than among women (10.1 vs 18.0%, p < 0.001), also after adjustment for age (OR 0.53, 95% confidence interval (CI) 0.46-0.61). The prevalence increased gradually with increasing age and the regression analysis adjusted for sex showed that for each year increase in age the prevalence of malnutrition increased with 4.0% (OR 1.04, 95% CI 1.03-1.05). The prevalence was higher both among older adults examined in their homes (26.4%) and residents in nursing home (23.6%), as compared to community-dwelling older adults who met at field stations (13.5%). CONCLUSION The prevalence of malnutrition is high in the older population. Special attention on prevention and treatment of malnutrition should be given to older women, the oldest age groups, and care-dependent community-dwelling older adults and nursing home residents.
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Affiliation(s)
- Marit Kolberg
- Center for Oral Health Services and Research, Mid-Norway (TkMidt), Trondheim, Norway.
| | - Ingvild Paur
- Norwegian Advisory Unit on Disease-related Undernutrition, Oslo, Norway; Section for Clinical Nutrition, Department of Clinical Services, Division of Cancer Medicine, Oslo University Hospital, Norway; Department of Clinical Medicine, Clinical Nutrition Research Group, UiT The Arctic University of Norway, Tromsø, Norway
| | - Yi-Qian Sun
- Center for Oral Health Services and Research, Mid-Norway (TkMidt), Trondheim, Norway; Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Linda Gjøra
- The Norwegian National Centre for Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway; Department of Psychiatry, Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway
| | - Håvard Kjesbu Skjellegrind
- HUNT Research Centre, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Levanger, Norway; Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway
| | - Pernille Thingstad
- Department of Neuromedicine and Movement Science (INB), Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway; Department of Health and Welfare, Trondheim Municipality, Trondheim, Norway
| | - Bjørn Heine Strand
- The Norwegian National Centre for Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway; Department of Physical Health and Ageing, Norwegian Institute of Public Health, Oslo, Norway; Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway
| | - Geir Selbæk
- The Norwegian National Centre for Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway; Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway; Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Tone Natland Fagerhaug
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Lene Thoresen
- Oncology Clinic, Trondheim University Hospital, Trondheim, Norway
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19
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Li SY, Leung JCS, Lu ZH, Kwok TCY. Quantity and Variety of Fruit and Vegetable Intake with Changes in Measures of Adiposity among Community-Dwelling Chinese Older Adults. Nutrients 2023; 15:4096. [PMID: 37836380 PMCID: PMC10574446 DOI: 10.3390/nu15194096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 09/17/2023] [Accepted: 09/20/2023] [Indexed: 10/15/2023] Open
Abstract
BACKGROUND The association between fruit and vegetable intake, considering both quantity and variety, and weight change among older adults remains controversial. We aimed to investigate the association between fruit and vegetable intake, variety, and changes in adiposity measures among community-dwelling Chinese older adults. METHODS A total of 2944 participants aged ≥65 years from Hong Kong communities were included. Fruit and vegetable intake was estimated by a locally validated food frequency questionnaire. Adiposity measures (weight, body mass index (BMI), waist circumference, fat and lean mass) were assessed at baseline and the year four follow-up. Restricted cubic spline and logistic models were performed to estimate the associations between fruit and vegetable intake, variety, and changes in adiposity measures. RESULTS A nonlinear association between vegetable intake and weight change was found, following a J-shape curve. Increased vegetable intake was associated with less increases in weight, BMI, and fat mass among those below median intakes. However, these associations became insignificant at higher intakes (all P-nonlinearity < 0.05). The ORs (95% CIs) for weight gain across the quartiles of vegetable intake were as follows: 1.00 (reference), 0.81 (0.56, 1.17), 0.55 (0.36, 0.83), and 0.88 (0.58, 1.33). Similar patterns were observed in overweight and normal weight participants, but not in those with low body weight. No associations with weight change were found for fruit intake or fruit and vegetable variety. CONCLUSIONS Moderate vegetable intake was associated with less weight gain among community-dwelling Chinese older adults, but not in those with low body weight. No association was observed between fruit intake or variety with weight change.
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Affiliation(s)
- Shu-Yi Li
- Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China
| | - Jason C. S. Leung
- Jockey Club Centre for Osteoporosis Care and Control, The Chinese University of Hong Kong, Hong Kong, China
| | - Zhi-Hui Lu
- Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China
| | - Timothy C. Y. Kwok
- Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China
- Jockey Club Centre for Osteoporosis Care and Control, The Chinese University of Hong Kong, Hong Kong, China
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20
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Harada T, Nagai K, Mase K, Tsunoda R, Iseki K, Moriyama T, Tsuruya K, Fujimoto S, Narita I, Konta T, Kondo M, Kasahara M, Shibagaki Y, Asahi K, Watanabe T, Yamagata K. Elevated Crude Mortality in Obese Chronic Kidney Disease Patients with Loss of Exercise Habit: A Cohort Study of the Japanese General Population. Intern Med 2023; 62:2171-2179. [PMID: 36543210 PMCID: PMC10465275 DOI: 10.2169/internalmedicine.0803-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Accepted: 11/15/2022] [Indexed: 12/24/2022] Open
Abstract
Objective The relationship between obesity and risk of death in chronic kidney disease (CKD) patients remains controversial. In addition, no clear evidence has been accumulated regarding whether or not exercise improves mortality in CKD patients. Methods The original cohort was based on a Japanese general population of 685,889 people from 40 to 74 years old who had undergone annual specific health checkups. The number of all-cause deaths during follow-up (mean, 4.7 years) in this study was 1,490. Information on walking and exercise habits was obtained by questionnaires. The study population was divided into 4 categories by the combination of CKD and obesity [body mass index (BMI) ≥25.0 kg/m2]. Changes in the BMI and walking and exercise habits were determined by results for the first year and following year. Results Obese CKD patients with weight gain (BMI increase by more than +1.0 kg/m2/year) showed a higher crude mortality (1.32%) than those with a stable BMI (within ±1.0 kg/m2/year; 0.69%). In the obese CKD population, mortality was higher with loss of exercise habits (0.96%) than in those continuously maintaining exercise habits (0.52%). The age- and sex-adjusted hazard ratio for all-cause death was 2.23 in the group with weight gain compared to the group with stable weight (p<0.01) and 2.08 in the group with loss of exercise habits compared to those who maintained exercise habits (p<0.01). Conclusion This observational cohort study suggested that loss of exercise habits as well as weight gain of more than 1 kg/m2/year might worsen all-cause mortality in the obese CKD population.
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Affiliation(s)
- Takuya Harada
- Department of Nephrology, Faculty of Medicine, University of Tsukuba, Japan
| | - Kei Nagai
- Department of Nephrology, Faculty of Medicine, University of Tsukuba, Japan
| | - Kaori Mase
- Department of Nephrology, Faculty of Medicine, University of Tsukuba, Japan
| | - Ryoya Tsunoda
- Department of Nephrology, Faculty of Medicine, University of Tsukuba, Japan
| | - Kunitoshi Iseki
- The Japan Specific Health Checkups Study (J-SHC Study) Group, Japan
| | - Toshiki Moriyama
- The Japan Specific Health Checkups Study (J-SHC Study) Group, Japan
| | - Kazuhiko Tsuruya
- The Japan Specific Health Checkups Study (J-SHC Study) Group, Japan
| | | | - Ichiei Narita
- The Japan Specific Health Checkups Study (J-SHC Study) Group, Japan
| | - Tsuneo Konta
- The Japan Specific Health Checkups Study (J-SHC Study) Group, Japan
| | - Masahide Kondo
- The Japan Specific Health Checkups Study (J-SHC Study) Group, Japan
| | - Masato Kasahara
- The Japan Specific Health Checkups Study (J-SHC Study) Group, Japan
| | - Yugo Shibagaki
- The Japan Specific Health Checkups Study (J-SHC Study) Group, Japan
| | - Koichi Asahi
- The Japan Specific Health Checkups Study (J-SHC Study) Group, Japan
| | | | - Kunihiro Yamagata
- Department of Nephrology, Faculty of Medicine, University of Tsukuba, Japan
- The Japan Specific Health Checkups Study (J-SHC Study) Group, Japan
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21
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Cogan B, Pearson RC, Jenkins NT, Paton CM, Cooper JA. A pecan-enriched diet reduced postprandial appetite intensity and enhanced peptide YY secretion: A randomized control trial. Clin Nutr ESPEN 2023; 56:25-35. [PMID: 37344080 DOI: 10.1016/j.clnesp.2023.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 04/25/2023] [Accepted: 05/01/2023] [Indexed: 06/23/2023]
Abstract
BACKGROUND & AIMS Tree nuts have been shown to have satiating qualities; however, little is known concerning the effect of pecans on measures of appetite. The purpose of this study was to examine the impact of a pecan-enriched diet on subjective, physiological, and direct measures of appetite in older adults. METHODS This was a randomized, controlled trial in which healthy older adults (50-75 y) were randomized to either consume 68 g of pecans/day (pecan; n = 21) or avoid all nuts (control; n = 23) for 4 weeks. At pre- (V1) and post-diet (V2) visits body weight (BW) and body fat percentage (BF) were assessed and actual change in these outcomes for pecan were compared to theoretical changes if pecans were consumed without compensation. Subjective appetite was measured using visual analog scale (VAS), and blood was collected to assess changes in physiological appetite before and every 30 min for 4 h following a high-fat meal. Energy intake (EI) at a buffet meal was then assessed in the laboratory ("in-lab"). VAS assessments continued hourly for the next 7 h and EI ("at-home") was self-reported. RESULTS BW and BF did not change for pecan or control across the intervention and theoretical change in BW (theoretical: 2.2 ± 0.1 vs. actual: 0.4 ± 0.2 kg; p < 0.0001) and BF (theoretical: 0.4 ± 0.04 vs. actual: 0.2 ± 0.2%; p < 0.0001) was significantly greater than actual change for pecan. From V1 to V2, there was an increase in fasting (pecan: 77.0 ± 4.6 to 93.5 ± 6.1 vs control: 76.0 ± 5.0 to 72.5 ± 5.0 pg/mL; p = 0.01) and postprandial peptide YY for pecan vs. control (p = 0.04); however, fasting and postprandial cholecystokinin and ghrelin did not differ (p > 0.05). There were no differences in the change in subjective appetite ratings at fasting, following the high-fat meal (in-lab), at-home, or across the full day between groups (p > 0.05 for all). However, there was a significant suppression of peak desire to eat ratings for pecan vs. control (pecan: 67.9 ± 4.6 to 57.1 ± 5.2 vs. control: 61.9 ± 4.2 to 60.6 ± 4.3 mm; p = 0.04). Combined, buffet meal, and at-home EI did not differ significantly within pecan and control; however, there was a trend (p = 0.11) for a between group difference in buffet meal EI driven by increased EI for control (+137 ± 86 kcal) vs. decreased EI for pecan (-45 ± 77 kcal). CONCLUSION A 4-week pecan-enriched diet led to enhanced satietogenic metrics compared to a diet void of all nuts. As weight remained stable during the intervention, adding pecans to the daily diet may be beneficial to appetite control and weight maintenance in a healthy older population. TRIAL REGISTRATION INFORMATION ClinicalTrials.gov: NCT04385537.
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Affiliation(s)
- Betsy Cogan
- Department of Nutritional Sciences, University of Georgia, Athens, GA, USA
| | - Regis C Pearson
- Department of Kinesiology, University of Georgia, Athens, GA, USA
| | - Nathan T Jenkins
- Department of Kinesiology, University of Georgia, Athens, GA, USA
| | - Chad M Paton
- Department of Nutritional Sciences, University of Georgia, Athens, GA, USA; Department of Food Science and Technology, University of Georgia, Athens, GA, USA
| | - Jamie A Cooper
- Department of Nutritional Sciences, University of Georgia, Athens, GA, USA.
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Li Y, Xia PF, Geng TT, Tu ZZ, Zhang YB, Yu HC, Zhang JJ, Guo K, Yang K, Liu G, Shan Z, Pan A. Trends in Self-Reported Adherence to Healthy Lifestyle Behaviors Among US Adults, 1999 to March 2020. JAMA Netw Open 2023; 6:e2323584. [PMID: 37450300 PMCID: PMC10349344 DOI: 10.1001/jamanetworkopen.2023.23584] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 05/28/2023] [Indexed: 07/15/2023] Open
Abstract
Importance Adherence to a healthy lifestyle is associated with lower risks of adverse outcomes. However, trends in multiple lifestyle factors and overall healthy lifestyle status among US adults in recent years are unknown. Objective To examine trends in multiple lifestyle factors and overall healthy lifestyle among US adults. Design, Setting, and Participants This serial cross-sectional study used nationally representative data from 10 National Health and Nutrition Examination Survey (NHANES) cycles (nine 2-year cycles from 1999 to 2016 and 1 combined cycle from 2017 to March 2020) among adults 20 years or older. Data were analyzed from December 10, 2021, to January 11, 2023. Exposure Survey cycle. Main Outcomes and Measures Five healthy lifestyle factors: never smoking, moderate or lighter alcohol consumption (for women: ≤7 drinks/wk; for men: ≤14 drinks/wk), healthy diet (Healthy Eating Index-2015 scores ≥60.0), sufficient physical activity (≥150 min/wk of equivalent moderate physical activity), and healthy weight (body mass index [calculated as weight in kilograms divided by height in meters squared] 18.5-24.9). Results A total of 47 852 adults were included in this study. The weighted mean [SE] age was 47.3 [0.2] years; 24 539 (weighted proportion, 51.5%) were women. From the 1999-2000 cycle to the 2017 to March 2020 cycle, the estimated prevalence of the 5 lifestyle factors showed divergent trends, with increasing prevalence of never smoking (from 49.4% [95% CI, 46.4%-52.4%] to 57.7% [95% CI, 55.5%-59.9%]; difference, 8.2% [95% CI, 4.5%-12.0%]), healthy diet (from 19.3% [95% CI, 16.0%-22.6%] to 24.5% [95% CI, 21.5%-27.5%]; difference, 5.2% [95% CI, 0.8%-9.7%]), and sufficient physical activity (from 55.7% [95% CI, 51.8%-59.6%] to 69.1% [95% CI, 67.2%-71.1%]; difference, 13.4% [95% CI, 9.0%-17.8%]), while prevalence of healthy weight decreased from 33.1% (95% CI, 30.5%-35.6%) to 24.6% (95% CI, 22.6%-26.7%; difference, -8.4% [95% CI, -11.8% to -5.1%]) (all P < .001 for trend). Meanwhile, there was no significant trend in moderate or lighter alcohol consumption. Overall, the estimated prevalence of at least 4 healthy lifestyle factors increased from 15.7% (95% CI, 12.8%-18.7%) to 20.3% (95% CI, 17.8%-22.7%; difference, 4.5% [95% CI, 0.7%-8.4%]; P < .001 for trend). Disparities in healthy lifestyle were widened by age group, with little improvement among adults 65 years and older (difference, 0.04% [95% CI, -4.28% to 4.35%]). There were persistent disparities in healthy lifestyle by race and ethnicity, educational level, and income level. Conclusions and Relevance The findings of this cross-sectional study of NHANES data over a 22-year period suggest diverse change patterns across 5 healthy lifestyle factors and a modest improvement in overall lifestyle existed among US adults, with worsening or persistent disparities in lifestyle.
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Affiliation(s)
- Yue Li
- Department of Epidemiology and Biostatistics, Ministry of Education Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Peng-Fei Xia
- Department of Epidemiology and Biostatistics, Ministry of Education Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Ting-Ting Geng
- Department of Epidemiology and Biostatistics, Ministry of Education Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Department of Nutrition and Food Hygiene, School of Public Health, Institute of Nutrition, Fudan University, Shanghai, China
| | - Zhou-Zheng Tu
- Department of Epidemiology and Biostatistics, Ministry of Education Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yan-Bo Zhang
- Department of Epidemiology and Biostatistics, Ministry of Education Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Han-Cheng Yu
- Department of Epidemiology and Biostatistics, Ministry of Education Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Ji-Juan Zhang
- Department of Epidemiology and Biostatistics, Ministry of Education Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Kunquan Guo
- Department of Endocrinology, Affiliated Dongfeng Hospital, Hubei University of Medicine, Shiyan, China
| | - Kun Yang
- Department of Endocrinology, Affiliated Dongfeng Hospital, Hubei University of Medicine, Shiyan, China
| | - Gang Liu
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zhilei Shan
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - An Pan
- Department of Epidemiology and Biostatistics, Ministry of Education Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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23
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Alharbi TA, Owen AJ, Ryan J, Gasevic D, McNeil JJ, Woods RL, Nelson MR, Freak-Poli R. Socio-Demographic, Lifestyle, and Clinical Characteristics of Early and Later Weight Status in Older Adults: Secondary Analysis of the ASPREE Trial and ALSOP Sub-Study. Geriatrics (Basel) 2023; 8:71. [PMID: 37489319 PMCID: PMC10366913 DOI: 10.3390/geriatrics8040071] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 04/10/2023] [Accepted: 06/21/2023] [Indexed: 07/26/2023] Open
Abstract
OBJECTIVE To identify the socio-demographic, lifestyle, and clinical characteristics associated with self-reported weight status in early (age 18 years) and late (age ≥ 70 years) adulthood. METHODS The number of participants was 11,288, who were relatively healthy community-dwelling Australian adults aged ≥70 years (mean age 75.1 ± 4.2 years) in the Aspirin in Reducing Events in the Elderly (ASPREE) Longitudinal Study of Older Persons (ALSOP) sub-study. Self-reported weight at the study baseline (age ≥ 70 years) and recalled weight at age 18 years were collected. Height measured at baseline was used to calculate the BMI at both time points. Individuals were categorised into one of five 'lifetime' weight status groups: healthy weight (at both age 18 year and ≥70 years), overweight (at either or both times), non-obese (age 18 year) to obesity (age ≥70 years), obesity (age 18 years) to non-obese (age ≥ 70 years), and early and later life obesity (at age 18 years and ≥70 years). RESULTS Participants who experienced obesity in early and/or late adulthood were at a higher risk of adverse clinical characteristics. Obesity in late adulthood (regardless of early adulthood weight status) was associated with high proportions of hypertension, diabetes, and dyslipidaemia, whereas obesity in early adulthood (regardless of late adulthood weight status) was associated with lower cognitive scores (on all four measures). DISCUSSION/CONCLUSION Healthy or overweight weight status in early and later adulthood was associated with more favourable socioeconomic, lifestyle, and clinical measures. Obesity in early adulthood was associated with lower cognitive function in later adulthood, whereas obesity in later adulthood was associated with hypertension, diabetes, and dyslipidaemia.
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Affiliation(s)
- Tagrid A. Alharbi
- School of Public Health and Preventive Medicine, Monash University, 553 St. Kilda Rd, Melbourne, VIC 3004, Australia
| | - Alice J. Owen
- School of Public Health and Preventive Medicine, Monash University, 553 St. Kilda Rd, Melbourne, VIC 3004, Australia
| | - Joanne Ryan
- School of Public Health and Preventive Medicine, Monash University, 553 St. Kilda Rd, Melbourne, VIC 3004, Australia
| | - Danijela Gasevic
- School of Public Health and Preventive Medicine, Monash University, 553 St. Kilda Rd, Melbourne, VIC 3004, Australia
- Usher Institute, University of Edinburgh, Teviot Place, Edinburgh EH8 9AG, UK
| | - John J. McNeil
- School of Public Health and Preventive Medicine, Monash University, 553 St. Kilda Rd, Melbourne, VIC 3004, Australia
| | - Robyn L. Woods
- School of Public Health and Preventive Medicine, Monash University, 553 St. Kilda Rd, Melbourne, VIC 3004, Australia
| | - Mark R. Nelson
- School of Public Health and Preventive Medicine, Monash University, 553 St. Kilda Rd, Melbourne, VIC 3004, Australia
- Menzies Institute for Medical Research, University of Tasmania, 17 Liverpool St, Hobart, TAS 7001, Australia
| | - Rosanne Freak-Poli
- School of Public Health and Preventive Medicine, Monash University, 553 St. Kilda Rd, Melbourne, VIC 3004, Australia
- School of Clinical Sciences at Monash Health, Monash University, 27-31 Wright Street, Melbourne, VIC 3004, Australia
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Kwon SY, Kim G, Lee J, Park J, Lee YB, Jin SM, Hur KY, Kim JH. Association of body weight change with all-cause and cause-specific mortality: A nationwide population-based study. Diabetes Res Clin Pract 2023; 199:110666. [PMID: 37031890 DOI: 10.1016/j.diabres.2023.110666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 03/09/2023] [Accepted: 04/04/2023] [Indexed: 04/11/2023]
Abstract
AIMS Weight gain and loss increase the risk of all-cause mortality. This study explored the association of short-term weight change with all-cause and cause-specific mortality in middle-aged to older people. METHODS This was a 8.4-year retrospective cohort study of 645,260 adults aged 40 to 80 who underwent health checkups twice within a 2-year interval between January 2009 and December 2012. Cox analyses were used to analyze the association between short-term weight change and all-cause and cause-specific mortality. RESULTS Weight gain and loss were associated with an increased risk of all-cause mortality: the hazard ratios were 2.05 (95% confidence interval [CI], 1.93-2.16), 1.21 (95% CI, 1.16-1.25), 1.12 (95% CI 1.08-1.17), and 1.60 (95% CI, 1.49-1.70) for the severe weight loss, moderate weight loss, moderate weight gain, and severe weight gain groups, respectively. This U-shaped association was also seen between weight change and cause-specific mortality. Within the weight loss group, those who regained weight after two years had a reduced mortality risk. CONCLUSIONS In a middle-aged and elderly population, weight gain or loss of more than 3% during a 2-year interval was related to an elevated risk of all-cause and cause-specific mortality.
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Affiliation(s)
- So Yoon Kwon
- Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Gangnam‑gu, Seoul, Korea
| | - Gyuri Kim
- Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Gangnam‑gu, Seoul, Korea
| | - Jungkuk Lee
- Data Science Team, Hanmi Pharm. Co., Ltd., Seoul, Korea
| | - Jiyun Park
- Division of Endocrine and Metabolism, Department of Internal Medicine, CHA Bundang Medical Center, CHA University School of Medicine, Bundang-gu, Seongnam, Gyeonggi-do, Korea
| | - You-Bin Lee
- Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Gangnam‑gu, Seoul, Korea
| | - Sang-Man Jin
- Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Gangnam‑gu, Seoul, Korea
| | - Kyu Yeon Hur
- Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Gangnam‑gu, Seoul, Korea
| | - Jae Hyeon Kim
- Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Gangnam‑gu, Seoul, Korea; Department of Clinical Research Design and Evaluation, Samsung Advanced Institute for Health Sciences and Technology, Sungkyunkwan University School of Medicine, Gangnam-gu, Seoul, Korea.
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Hussain SM, Newman AB, Beilin LJ, Tonkin AM, Woods RL, Neumann JT, Nelson M, Carr PR, Reid CM, Owen A, Ball J, Cicuttini FM, Tran C, Wang Y, Ernst ME, McNeil JJ. Associations of Change in Body Size With All-Cause and Cause-Specific Mortality Among Healthy Older Adults. JAMA Netw Open 2023; 6:e237482. [PMID: 37036703 PMCID: PMC10087052 DOI: 10.1001/jamanetworkopen.2023.7482] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 02/25/2023] [Indexed: 04/11/2023] Open
Abstract
Importance The association between weight change and subsequent cause-specific mortality among older adults is not well described. The significance of changes in waist circumference (WC) has also not been compared with weight change for this purpose. Objective To examine the associations of changes in body weight and WC with all-cause and cause-specific mortality. Design, Setting, and Participants This cohort study is a post hoc analysis of data from the Aspirin in Reducing Events in the Elderly (ASPREE) randomized clinical trial, which recruited participants between March 1, 2010, and December 31, 2014. The study included community-based older adults (16 703 Australian participants aged ≥70 years and 2411 US participants aged ≥65 years) without evident cardiovascular disease (CVD), dementia, physical disability, or life-limiting chronic illness. Data analysis was performed from April to September 2022. Exposures Body weight and WC were measured at baseline and at annual visit 2. Analysis models were adjusted for baseline body mass index because height and weight were measured at baseline, allowing for calculation of body mass index and other variables. Both body weight and WC changes were categorized as change within 5% (stable), decrease by 5% to 10%, decrease by more than 10%, increase by 5% to 10%, and increase by more than 10%. Main Outcomes and Measures All-cause, cancer-specific, CVD-specific, and noncancer non-CVD-specific mortality. Mortality events were adjudicated by an expert review panel. Cox proportional hazards regression and competing risk analyses were used to calculate hazard ratios (HRs) and 95% CIs. Results Among 16 523 participants (mean [SD] age, 75.0 [4.3] years; 9193 women [55.6%]), 1256 deaths were observed over a mean (SD) of 4.4 (1.7) years. Compared with men with stable weight, those with a 5% to 10% weight loss had a 33% higher (HR, 1.33; 95% CI, 1.07-1.66) risk of all-cause mortality, and those with more than a 10% decrease in body weight had a 289% higher (HR, 3.89; 95% CI, 2.93-5.18) risk. Compared with women with stable weight, those with a 5% to 10% weight loss had a 26% higher (HR, 1.26; 95% CI, 1.00-1.60) risk of all-cause mortality, and those with more than a 10% decrease in body weight had a 114% higher (HR, 2.14; 95% CI, 1.58-2.91) risk. Weight loss was associated with a higher cancer-specific mortality (>10% decrease among men: HR, 3.49; 95% CI, 2.26-5.40; 5%-10% decrease among women: HR, 1.44; 95% CI, 1.46-2.04; >10% decrease among women: HR, 2.78; 95% CI, 1.82-4.26), CVD-specific mortality (>10% decrease among men: HR, 3.14; 95% CI, 1.63-6.04; >10% decrease among women: HR, 1.92; 95% CI, 1.05-3.51), and noncancer non-CVD-specific mortality (>10% decrease among men: HR, 4.98; 95% CI, 3.14-7.91). A decrease in WC was also associated with mortality. Conclusions and Relevance This cohort study of healthy older adults suggests that weight loss was associated with an increase in all-cause and cause-specific mortality, including an increased risk of cancer, CVD, and other life-limiting conditions. Physicians should be aware of the significance of weight loss, especially among older men.
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Affiliation(s)
- Sultana Monira Hussain
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- Department of Medical Education, Melbourne Medical School, The University of Melbourne, Melbourne, Victoria, Australia
| | - Anne B. Newman
- Center for Aging and Population Health, Department of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Lawrence J. Beilin
- Medical School, Royal Perth Hospital, University of Western Australia, Perth, Western Australia, Australia
| | - Andrew M. Tonkin
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Robyn L. Woods
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Johannes T. Neumann
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- Department of Cardiology, University Heart & Vascular Center Hamburg, Hamburg, Germany
- German Center for Cardiovascular Research, Partner Site Hamburg/Kiel/Lübeck, Hamburg, Germany
| | - Mark Nelson
- Discipline of General Practice, University of Tasmania, Hobart, Australia
| | - Prudence R. Carr
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Christopher M. Reid
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Alice Owen
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Jocasta Ball
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Flavia M. Cicuttini
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Cammie Tran
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Yuanyuan Wang
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Michael E. Ernst
- Department of Pharmacy Practice and Science, College of Pharmacy, The University of Iowa, Iowa City
- Department of Family Medicine, Carver College of Medicine, The University of Iowa, Iowa City
| | - John J. McNeil
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
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26
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Kusama T, Takeuchi K, Kiuchi S, Aida J, Kondo K, Osaka K. Weight Loss Mediated the Relationship between Tooth Loss and Mortality Risk. J Dent Res 2023; 102:45-52. [PMID: 36068707 DOI: 10.1177/00220345221120642] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Tooth loss is a risk factor for increased mortality; however, the underlying mechanism remains unclear. This study aimed to evaluate the mediating effect of weight change on the relationship between tooth loss and mortality risk. This was a 10-y follow-up prospective cohort study using the data from the Japan Gerontological Evaluation Study (JAGES). The participants were independent older adults aged ≥65 y at baseline and were followed up from 2010 to 2020. The incidence of death in 2013 and 2020, incidence of >5% weight loss/gain in 2010 and 2013, and the number of remaining teeth in 2010 were used as the outcome, mediator, and explanatory variables, respectively. We conducted causal mediation analysis by fitting the Cox proportional hazard model, including possible confounders. Hazard ratios (HRs) and 95% confidence intervals (95% CIs) of the total effect (TE), natural indirect effect (NIE), and proportion mediated (PM) were estimated. Among the 34,510 participants, the mean age was 72.6 (SD = 5.4) y, and 47.6% were men. From 2013 to 2020, 14.0% of the participants (n = 4,825) died, 60.5% (n = 20,871) had 0 to 19 remaining teeth, and 17.2% (n = 5,927) and 8.4% (n = 2,907) experienced >5% weight loss and gain, respectively. The mortality rate was 0.016 per person-year among those with ≥20 remaining teeth and 0.027 per person-year among those with 0 to 19 remaining teeth. Weight loss of >5% significantly mediated the association between tooth loss and higher mortality risk (TE: HR, 1.28 [95% CI, 1.16 to 1.40]; NIE: HR, 1.03 [95% CI, 1.02 to 1.04]; PM, 13.1%); however, we observed a slight mediating effect for >5% weight gain (NIE: HR, 1.003 [95%CI, 1.0001 to 1.01]; PM, 1.3%). The present study suggests that a clinically meaningful level of weight loss mediated the association between tooth loss and increased risk of mortality among independent older adults.
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Affiliation(s)
- T Kusama
- Division for Regional Community Development, Liaison Center for Innovative Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Miyagi, Japan.,Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai, Miyagi, Japan
| | - K Takeuchi
- Division for Regional Community Development, Liaison Center for Innovative Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Miyagi, Japan.,Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai, Miyagi, Japan
| | - S Kiuchi
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai, Miyagi, Japan
| | - J Aida
- Department of Oral Health Promotion, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo, Japan
| | - K Kondo
- Department of Social Preventive Medical Sciences, Center for Preventive Medical Sciences, Chiba University, Chiba, Chiba, Japan.,Department of Gerontological Evaluation, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan
| | - K Osaka
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai, Miyagi, Japan
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27
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Cao X, Yang G, Li X, Fu J, Mohedaner M, Danzengzhuoga, Høj Jørgensen TS, Agogo GO, Wang L, Zhang X, Zhang T, Han L, Gao X, Liu Z. Weight change across adulthood and accelerated biological aging in middle-aged and older adults. Am J Clin Nutr 2023; 117:1-11. [PMID: 36789928 DOI: 10.1016/j.ajcnut.2022.10.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Revised: 10/21/2022] [Accepted: 10/28/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Little is known regarding the association between weight change and accelerated aging. OBJECTIVES This study aimed to estimate the influence of weight change across adulthood on biological aging acceleration in middle-aged and older adults in the United States. METHODS We used data of 5553 adults (40-84 y) from the National Health and Nutrition Examination Survey 1999-2010. Weight change patterns (i.e., stable normal, maximal overweight, obese to nonobese, nonobese to obese, and stable obese) and absolute weight change groups across adulthood (i.e., from young to middle adulthood, young to late adulthood, and middle to late adulthood) were defined. A biological aging measure (i.e., phenotypic age acceleration [PhenoAgeAccel]) at late adulthood was calculated. Survey analysis procedures with the survey weights were performed. RESULTS Across adulthood, maximal overweight, nonobese to obese, and stable obesity were consistently associated with higher PhenoAgeAccel. For instance, from young to middle adulthood, compared with participants who had stable normal weight, participants experiencing maximal overweight, moving from the nonobese to obese, and maintaining obesity had 1.71 (standard error [SE], 0.21; P < 0.001), 3.62 (SE, 0.28; P < 0.001), and 6.61 (SE, 0.58; P < 0.001) higher PhenoAgeAccel values, respectively. From young to middle adulthood, relative to absolute weight loss or gain of <2.5 kg, weight loss of ≥2.5 kg was marginally associated with lower PhenoAgeAccel (P = 0.054), whereas an obese to nonobese pattern from middle to late adulthood was associated with higher PhenoAgeAccel (P < 0.001). CONCLUSIONS Maximal overweight, nonobese to obese, and stable obesity across adulthood, as well as an obese to nonobese pattern from middle to late adulthood, were associated with accelerated biological aging. In contrast, weight loss from young to middle adulthood was associated with decelerated biological aging. The findings highlight the potential role of weight management across adulthood for aging. Monitoring weight fluctuation may help identify the population at high risk of accelerated aging.
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Affiliation(s)
- Xingqi Cao
- Center for Clinical Big Data and Analytics of the Second Affiliated Hospital and Department of Big Data in Health Science School of Public Health, The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of Medicine, Zhejiang, China
| | - Gan Yang
- Center for Clinical Big Data and Analytics of the Second Affiliated Hospital and Department of Big Data in Health Science School of Public Health, The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of Medicine, Zhejiang, China
| | - Xueqin Li
- Center for Clinical Big Data and Analytics of the Second Affiliated Hospital and Department of Big Data in Health Science School of Public Health, The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of Medicine, Zhejiang, China
| | - Jinjing Fu
- Center for Clinical Big Data and Analytics of the Second Affiliated Hospital and Department of Big Data in Health Science School of Public Health, The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of Medicine, Zhejiang, China
| | - Mayila Mohedaner
- Center for Clinical Big Data and Analytics of the Second Affiliated Hospital and Department of Big Data in Health Science School of Public Health, The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of Medicine, Zhejiang, China
| | - Danzengzhuoga
- Center for Clinical Big Data and Analytics of the Second Affiliated Hospital and Department of Big Data in Health Science School of Public Health, The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of Medicine, Zhejiang, China
| | - Terese Sara Høj Jørgensen
- Section of Social Medicine, Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | | | - Liang Wang
- Department of Public Health, Robbins College of Human Health and Sciences, Baylor University, Waco, TX, USA
| | - Xuehong Zhang
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Tao Zhang
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Shandong, China
| | - Liyuan Han
- Department of Global Health, Ningbo Institute of Life and Health Industry, University of Chinese Academy of Sciences, Zhejiang, China; Hwa Mei Hospital, University of Chinese Academy of Sciences, Zhejiang, China
| | - Xiang Gao
- Department of Nutrition and Food Hygiene, School of Public Health, Fudan University, Shanghai, China
| | - Zuyun Liu
- Center for Clinical Big Data and Analytics of the Second Affiliated Hospital and Department of Big Data in Health Science School of Public Health, The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of Medicine, Zhejiang, China.
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28
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Alharbi TA, Ryan J, Freak-Poli R, Gasevic D, McNeil J, Woods RL, Britt C, Nelson MR, Owen AJ. Self-Reported Early and Later Life Weight and the Risk of All-Cause Mortality in Older Adults. J Nutr Health Aging 2023; 27:301-308. [PMID: 37170438 PMCID: PMC10353754 DOI: 10.1007/s12603-023-1907-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 01/25/2023] [Indexed: 05/13/2023]
Abstract
OBJECTIVES The extent to which body weight in early adulthood is associated with late-life mortality risk is unclear. This study aimed to determine the association between body mass index (BMI) in early adulthood (at 18 years of age) and older age (70 years and over), and the risk of mortality in later life. DESIGN Secondary analysis of the ASPREE Longitudinal Study of Older Persons (ALSOP). SETTING, PARTICIPANTS Data were from 14,853 relatively healthy community-dwelling Australians aged ≥ 70 years when enrolled in the study. MEASUREMENTS Self-reported weight at age ≥ 70 years and recalled weight at age 18 years were collected at ALSOP study baseline. Height was measured with a stadiometer and was used for calculation of BMI at both timepoints. BMI at each timepoint was defined as: underweight, normal weight, overweight and obese. Individuals were categorised into one of five 'lifetime' BMI groups: normal weight (BMI between 18.5 and 24.9 at both times), overweight (25.0-29.9 at either or both times), obesity to non-obese (≥30.0 at age 18 and <30.0 ≥ 70 years), non-obese to obesity (<30.0 at age 18 and ≥30.0 at age ≥ 70 years), and early and later life obesity (≥30.0 at both times). RESULTS During a median 4.7 years follow-up, 715 deaths occurred. Obesity at 18 years, but not in older age (p=0.44), was significantly associated with the risk of mortality in later life, even after accounting for current health status (HR: 2.35, 95% CI: 1.53-3.58, p<0.001). Compared with participants with normal BMI at both time points, being obese at both time points was associated with increased mortality risk (HR=1.99, 95% CI: 1.04-3.81, p=0.03), and the risk was even greater for individuals who were obese at 18 years but were no longer obese in older age (HR=2.92, 95% CI: 1.65-5.16, p<0.001), in fully adjusted models. Participants who were normal weight at 18 years and were obese in later life, did not have an increased mortality risk (p=0.78). CONCLUSIONS Obesity in early adulthood, and obesity in both early and later life, were associated with increased mortality risk in later life. This highlights the importance of preventing obesity in early adulthood and maintaining a normal weight over an adult lifespan.
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Affiliation(s)
- T A Alharbi
- Dr Alice J. Owen, Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, 553 St. Kilda Rd., Level 4, Melbourne VIC 3004, Australia, Tel: +61 3 9903 0416,
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Deravi N, Moazzeni SS, Hasheminia M, Hizomi Arani R, Azizi F, Hadaegh F. Three-year weight change and risk of all-cause, cardiovascular, and cancer mortality among Iranian adults: over a decade of follow-up in the Tehran Lipid and Glucose Study. BMC Public Health 2022; 22:1762. [PMID: 36114528 PMCID: PMC9482273 DOI: 10.1186/s12889-022-14126-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Accepted: 09/06/2022] [Indexed: 12/03/2022] Open
Abstract
Background We investigated the impact of weight change on mortality in a population-based cohort setting. Methods We conducted two weight measurements for 5436 participants aged ≥ 30 years with an approximate 3-year interval. Based on their weight change, we categorized participants to: > 5% weight loss, 3–5% weight loss, stable weight (± < 3%), 3–5% weight gain, > 5% weight gain. We followed participants for mortality annually up to March 20th 2018. We applied the multivariable Cox proportional hazard models to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) of weight change categories for all-cause, cardiovascular (CV), and cancer mortality, considering stable weight as reference. The Cox models was adjusted for age, sex, educational level, body mass index, smoking status, hypertension, hypercholesterolemia, diabetes, and cardiovascular disease (CVD) at baseline. Results During a median follow-up of 14.4 years, 629 deaths (247 CV and 126 cancer deaths) have occurred. Over 5% weight loss and gain were associated with increased risk of all-cause mortality in multivariable analysis with HRs of 1.47 [95% CI: 1.17–1.85] and 1.27 [1.02–1.57], respectively; however, a 3–5% loss or gain did not alter the risk of all-cause mortality significantly. These significant risks for wight change > 5% were not modified by the presence of diabetes, obesity, and smoking status; however, the unfavorable impact of weight change on mortality events was more prominent in those older than > 65 years (P-value for interaction: 0.042). After excluding those with history of CVD, diabetes, and cancer during the weight measurements period, these associations significantly attenuated (HR: 1.29 [0.89–1.87] for > 5% weight loss and 1.12 [0.84–1.50] for > 5% weight gain). Additionally, a > 5% weight loss was also associated with about 60% higher risk for CV mortality (HR: 1.62 [1.15–2.28]), and a 3–5% weight loss was associated with about 95% higher risk of cancer mortality (HR: 1.95 [1.13–3.38]). Conclusions Our findings showed a U-shaped association across weight change categories for all-cause mortality risk with over 5% weight gain and loss causing higher risk. Moreover, weight loss can have adverse impact on CV and cancer mortality events. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-14126-4.
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Xu J, Johnson JS, Signer R, Birgegård A, Jordan J, Kennedy MA, Landén M, Maguire SL, Martin NG, Mortensen PB, Petersen LV, Thornton LM, Bulik CM, Huckins LM. Exploring the clinical and genetic associations of adult weight trajectories using electronic health records in a racially diverse biobank: a phenome-wide and polygenic risk study. Lancet Digit Health 2022; 4:e604-e614. [PMID: 35780037 PMCID: PMC9612590 DOI: 10.1016/s2589-7500(22)00099-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Revised: 04/19/2022] [Accepted: 05/06/2022] [Indexed: 11/10/2022]
Abstract
BACKGROUND Weight trajectories might reflect individual health status. In this study, we aimed to examine the clinical and genetic associations of adult weight trajectories using electronic health records (EHRs) in the BioMe Biobank. METHODS We constructed four weight trajectories based on a-priori definitions of weight changes (5% or 10%) using annual weight in EHRs (stable weight, weight gain, weight loss, and weight cycle); the final weight dataset included 21 487 participants with 162 783 annual weight measures. To confirm accurate assignment of weight trajectories, we manually reviewed weight trajectory plots for 100 random individuals. We then did a hypothesis-free phenome-wide association study (PheWAS) to identify diseases associated with each weight trajectory. Next, we estimated the single-nucleotide polymorphism-based heritability (hSNP2) of weight trajectories using GCTA-GREML, and we did a hypothesis-driven analysis of anorexia nervosa and depression polygenic risk scores (PRS) on these weight trajectories, given both diseases are associated with weight changes. We extended our analyses to the UK Biobank to replicate findings from a patient population to a generally healthy population. FINDINGS We found high concordance between manually assigned weight trajectories and those assigned by the algorithm (accuracy ≥98%). Stable weight was consistently associated with lower disease risks among those passing Bonferroni-corrected p value in our PheWAS (p≤4·4 × 10-5). Additionally, we identified an association between depression and weight cycle (odds ratio [OR] 1·42, 95% CI 1·31-1·55, p≤7·7 × 10-16). The adult weight trajectories were heritable (using 5% weight change as the cutoff: hSNP2 of 2·1%, 95% CI 0·9-3·3, for stable weight; 4·1%, 1·4-6·8, for weight gain; 5·5%, 2·8-8·2, for weight loss; and 4·7%, 2·3-7·1%, for weight cycle). Anorexia nervosa PRS was positively associated with weight loss trajectory among individuals without eating disorder diagnoses (OR1SD 1·16, 95% CI 1·07-1·26, per 1 SD higher PRS, p=0·011), and the association was not attenuated by obesity PRS. No association was found between depression PRS and weight trajectories after permutation tests. All main findings were replicated in the UK Biobank (p<0·05). INTERPRETATION Our findings suggest the importance of considering weight from a longitudinal aspect for its association with health and highlight a crucial role of weight management during disease development and progression. FUNDING Klarman Family Foundation, US National Institute of Mental Health (NIMH).
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Affiliation(s)
- Jiayi Xu
- Pamela Sklar Division of Psychiatric Genomics, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Jessica S Johnson
- Pamela Sklar Division of Psychiatric Genomics, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Rebecca Signer
- Pamela Sklar Division of Psychiatric Genomics, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Andreas Birgegård
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Jennifer Jordan
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand; Canterbury District Health Board, Christchurch, New Zealand
| | - Martin A Kennedy
- Department of Pathology and Biomedical Science, University of Otago, Christchurch, New Zealand
| | - Mikael Landén
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
| | - Sarah L Maguire
- InsideOut Institute, Charles Perkins Centre, The University of Sydney, Camperdown, Sydney, NSW, Australia
| | - Nicholas G Martin
- Genetics & Computational Biology Department, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - Preben Bo Mortensen
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark; National Centre for Register-Based Research, Aarhus BSS, and Centre for Integrated Register-based Research, Aarhus University, Aarhus, Denmark
| | - Liselotte V Petersen
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark; National Centre for Register-Based Research, Aarhus BSS, and Centre for Integrated Register-based Research, Aarhus University, Aarhus, Denmark
| | - Laura M Thornton
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Cynthia M Bulik
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Laura M Huckins
- Pamela Sklar Division of Psychiatric Genomics, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Icahn Institute for Genomics and Multiscale Biology, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Mental Illness Research, Education and Clinical Centers, James J Peters Department of Veterans Affairs Medical Center, Bronx, NY, USA.
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Objectively Assessed Weight Change and All-Cause Mortality among Community-Dwelling Older People. Nutrients 2022; 14:nu14142983. [PMID: 35889940 PMCID: PMC9320907 DOI: 10.3390/nu14142983] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 07/18/2022] [Accepted: 07/18/2022] [Indexed: 02/01/2023] Open
Abstract
Later life changes in body weight may be associated with an increased risk of mortality in older adults. The objective of this study was to examine whether weight change over four years was associated with a 17-year mortality risk in older adults. Participants were 1664 community-dwelling adults aged ≥65 years in the longitudinal Enquete de Sante’ Psychologique-Risques, Incidence et Traitement (ESPRIT) study. Outcomes were all-cause mortality, cardiovascular disease (CVD) and cancer mortality. Weight change was defined as difference between weight at baseline and 4 years, categorised into: weight stable (±<5% weight change), weight loss (≥5%) and weight gain (≥5%). Association between weight change and mortality risk was evaluated using Cox proportional hazards models. Over 17 years of follow-up (median 15 years), 565 participants died. Compared to stable weight participants, those with ≥ 5% weight loss had an increased risk of all-cause mortality (HR: 1.24, 95% CI: 1.00−1.56, p = 0.05) and CVD mortality (HR: 1.53, 95% CI: 1.10−2.14, p = 0.01), but not cancer mortality (HR: 0.83, 95% CI: 0.50−1.39, p = 0.49). Weight gain of ≥5% was not associated with increased mortality (HR: 1.05, 95% CI: 0.76−1.45, p = 0.74). Weight monitoring in older adults could help identify weight loss at its early stages to better target interventions to maintain nutritional reserve and prevent premature mortality.
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Kubo Y, Noguchi T, Hayashi T, Tomiyama N, Ochi A, Hayashi H. Eating alone and weight change in community-dwelling older adults during the coronavirus pandemic: A longitudinal study. Nutrition 2022; 102:111697. [PMID: 35816810 PMCID: PMC9093156 DOI: 10.1016/j.nut.2022.111697] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 04/05/2022] [Accepted: 04/10/2022] [Indexed: 11/18/2022]
Abstract
Objectives It is likely that the number of older adults who eat alone has increased during the COVID-19 pandemic. Older adults who eat alone tend to experience weight fluctuations. Weight loss and underweight in older adults cause health problems. The study objective was to longitudinally investigate the association between changes in eating alone or with others and body weight status in older adults. Methods This longitudinal cohort study was conducted in March and October 2020 in Minokamo City, Gifu Prefecture, Japan. Questionnaire data for 1071 community-dwelling older adults were analyzed. Multinomial logistic regression analysis was performed using changes in eating alone or with others as the independent variable and body weight status as the dependent variable. The analysis was adjusted for age, sex, living arrangements, educational level, diseases receiving medical treatment, cognitive status, depression, and instrumental activities of daily living. Missing data were imputed using multiple imputation. Results The average age of participants was 81.1 y (SD, 4.9 y). Individuals who reported eating alone in both surveys were more likely to report weight loss than those who reported eating with others in both surveys (adjusted model: odds ratio, 2.25; 95% confidence interval, 1.06–4.78; P = 0.04). Conclusions These findings suggest that measures to prevent weight loss in older adults who eat alone are particularly important during the COVID-19 pandemic.
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Affiliation(s)
- Yuta Kubo
- Division of Occupational Therapy, Faculty of Rehabilitation and Care, Seijoh University, Tokai, Japan.
| | - Taiji Noguchi
- Department of Social Science, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Japan; Department of Public Health, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Takahiro Hayashi
- Division of Physical Therapy, Faculty of Rehabilitation and Care, Seijoh University, Tokai, Japan
| | - Naoki Tomiyama
- Division of Occupational Therapy, Faculty of Rehabilitation and Care, Seijoh University, Tokai, Japan
| | - Akira Ochi
- Division of Physical Therapy, Faculty of Rehabilitation and Care, Seijoh University, Tokai, Japan
| | - Hiroyuki Hayashi
- Division of Occupational Therapy, Faculty of Rehabilitation and Care, Seijoh University, Tokai, Japan
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Yuan Y, Lin S, Lin W, Huang F, Zhu P. Modifiable predictive factors and all-cause mortality in the non-hospitalized elderly population: An umbrella review of meta-analyses. Exp Gerontol 2022; 163:111792. [PMID: 35367595 DOI: 10.1016/j.exger.2022.111792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Revised: 03/20/2022] [Accepted: 03/28/2022] [Indexed: 11/04/2022]
Abstract
OBJECTIVE This umbrella review aimed to summarize the association between modifiable predictive factors and all-cause mortality in the non-hospitalized elderly population, and estimated the credibility and strength of the current evidence. METHODS PubMed, Embase, Web of science, and EBSCOhost were searched up to February 28, 2022. Random-effect summary effect sizes and 95% confidence intervals (CIs), heterogeneity, small-study effect, excess significance bias, as well as 95% prediction intervals (PIs) were calculated. Methodological quality was assessed with the Assessment of Multiple Systematic Reviews 2 (AMSTAR-2) tool. The credibility of the included meta-analyses was graded from convincing to weak using established criteria. This umbrella review was registered with PROSPERO, CRD 42021282183. RESULTS In total, 32 predictive factors involving 49 associations extracted from 35 meta-analyses were analyzed. Forty-three of the 49 (87.8%) associations presented nominal significant effects by the random-effect model (P < 0.05), of which 34 had harmful associations and nine had beneficial associations with all-cause mortality. Frailty (FRAIL scale), low short physical performance battery (SPPB) score, and fewer daily steps carried a more than three-fold risk for all-cause mortality. Convincing evidence showed that weight fluctuation, prefrailty and frailty status, sarcopenia, low SPPB score, fewer daily steps, and fatigue increased the risk of all-cause mortality, while daily moderate-to-vigorous physical activity (MVPA) duration and total physical activity participation reduced the risk of death. There were twenty, nine, five, and six associations that yielded highly suggestive, suggestive, weak, and non-significant grades of evidence. Thirty-four (69.4%) of the associations exhibited significant heterogeneity. Twenty-two associations presented 95% PIs excluding the null value, two indicated small-study effects, and three had evidence for excess significance bias, respectively. The methodological quality of most meta-analyses was rated as low (37.1%) or critically low (42.9%). CONCLUSIONS A summary of the currently available meta-analyses suggests that a broad range of modifiable predictive factors are significantly associated with all-cause mortality risk in the non-hospitalized elderly population. The most credible evidence indicates that physical function represented by frailty and sarcopenia, as well as physical activity, are significant predictors for all-cause mortality. This umbrella review may provide prognostic information to direct appropriate diagnostic evaluation and treatment goals in the future. More solid evidence is still needed coming from moderate-to-high quality meta-analyses.
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Affiliation(s)
- Yin Yuan
- Department of Geriatric Medicine, Fujian Provincial Hospital, Fuzhou, China; Shengli Clinical Medical College, Fujian Medical University, Fuzhou, China; Fujian Provincial Institute of Clinical Geriatrics, Fuzhou, China; Fujian Provincial Center of Geriatrics, Fuzhou, China; Fujian Provincial Key Laboratory of Geriatrics, Fuzhou, China
| | - Siyang Lin
- Department of Geriatric Medicine, Fujian Provincial Hospital, Fuzhou, China; Shengli Clinical Medical College, Fujian Medical University, Fuzhou, China; Fujian Provincial Institute of Clinical Geriatrics, Fuzhou, China; Fujian Provincial Center of Geriatrics, Fuzhou, China; Fujian Provincial Key Laboratory of Geriatrics, Fuzhou, China
| | - Wenwen Lin
- Department of Geriatric Medicine, Fujian Provincial Hospital, Fuzhou, China; Shengli Clinical Medical College, Fujian Medical University, Fuzhou, China; Fujian Provincial Institute of Clinical Geriatrics, Fuzhou, China; Fujian Provincial Center of Geriatrics, Fuzhou, China; Fujian Provincial Key Laboratory of Geriatrics, Fuzhou, China
| | - Feng Huang
- Department of Geriatric Medicine, Fujian Provincial Hospital, Fuzhou, China; Shengli Clinical Medical College, Fujian Medical University, Fuzhou, China; Fujian Provincial Institute of Clinical Geriatrics, Fuzhou, China; Fujian Provincial Center of Geriatrics, Fuzhou, China; Fujian Provincial Key Laboratory of Geriatrics, Fuzhou, China.
| | - Pengli Zhu
- Department of Geriatric Medicine, Fujian Provincial Hospital, Fuzhou, China; Shengli Clinical Medical College, Fujian Medical University, Fuzhou, China; Fujian Provincial Institute of Clinical Geriatrics, Fuzhou, China; Fujian Provincial Center of Geriatrics, Fuzhou, China; Fujian Provincial Key Laboratory of Geriatrics, Fuzhou, China.
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Murayama H, Liang J, Shaw BA, Botoseneanu A, Kobayashi E, Fukaya T, Shinkai S. Short-, Medium-, and Long-term Weight Changes and All-Cause Mortality in Old Age: Findings From the National Survey of the Japanese Elderly. J Gerontol A Biol Sci Med Sci 2021; 76:2039-2046. [PMID: 33626135 DOI: 10.1093/gerona/glab052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2020] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Recent studies, predominantly in Western populations, suggest that both weight loss and weight gain are associated with an increased mortality risk in old age. However, evidence of this association in older Asian populations remains sparse. This study aimed to examine the association between weight change and all-cause mortality in a nationally representative sample of community-dwelling older Japanese people. METHODS Data were obtained from the National Survey of the Japanese Elderly, which included 4869 adults aged ≥60 years. Participants were followed for up to 30 years. We considered 3 indicators of weight change according to the follow-up interval: short-term (3 years), medium-term (6-7 years), and long-term (12-13 years). Weight change was classified as loss ≥ 5%, loss 2.5%-4.9%, stable (±2.4%), gain 2.5%-4.9%, and gain ≥ 5%. Cox proportional hazards models were used to calculate the relative mortality risk of each weight change category. RESULTS Weight loss ≥ 5% for all intervals was associated with higher mortality than stable weight and the effects were largely similar across all 3 intervals (hazard ratio [95% confidence interval]: 1.36 [1.22-1.51] for short-term, 1.36 [1.22-1.51] for medium-term, and 1.31 [1.11-1.54] for long-term). A similar pattern of results was observed among the young-old and old-old, and among men and women. The effect of weight loss on higher mortality was greater among those with a lower body mass index at baseline. CONCLUSIONS These findings could inform clinical and public health approaches to body-weight management aimed at improving the health and survival of older adults, particularly in Asian populations.
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Affiliation(s)
- Hiroshi Murayama
- Tokyo Metropolitan Institute of Gerontology, Itabashi-ku, Tokyo, Japan
| | - Jersey Liang
- Department of Health Management and Policy, University of Michigan School of Public Health, Ann Arbor, USA
| | - Benjamin A Shaw
- Department of Health Policy, Management and Behavior, School of Public Health, State University of New York at Albany, Rensselaer, USA
| | - Anda Botoseneanu
- Department of Health and Human Services, University of Michigan-Dearborn, USA
| | - Erika Kobayashi
- Tokyo Metropolitan Institute of Gerontology, Itabashi-ku, Tokyo, Japan
| | - Taro Fukaya
- Tokyo Metropolitan Institute of Gerontology, Itabashi-ku, Tokyo, Japan
| | - Shoji Shinkai
- Tokyo Metropolitan Institute of Gerontology, Itabashi-ku, Tokyo, Japan
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Buch A, Marcus Y, Shefer G, Zimmet P, Stern N. Approach to Obesity in the Older Population. J Clin Endocrinol Metab 2021; 106:2788-2805. [PMID: 34406394 DOI: 10.1210/clinem/dgab359] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Indexed: 12/14/2022]
Abstract
Until recently, weight loss in older obese people was feared because of ensuing muscle loss and frailty. Facing overall increasing longevity, high rates of obesity in older individuals (age ≥ 65 years) and a growing recognition of the health and functional cost of the number of obesity years, abetted by evidence that intentional weight loss in older obese people is safe, this approach is gradually, but not unanimously, being replaced by more active principles. Lifestyle interventions that include reduced but sufficient energy intake, age-adequate protein and micronutrient intake, coupled with aerobic and resistance exercise tailored to personal limitations, can induce weight loss with improvement in frailty indices. Sustained weight loss at this age can prevent or ameliorate diabetes. More active steps are controversial. The use of weight loss medications, particularly glucagon-like peptide-1 analogs (liraglutide as the first example), provides an additional treatment tier. Its safety and cardiovascular health benefits have been convincingly shown in older obese patients with type 2 diabetes mellitus. In our opinion, this option should not be denied to obese individuals with prediabetes or other obesity-related comorbidities based on age. Finally, many reports now provide evidence that bariatric surgery can be safely performed in older people as the last treatment tier. Risk-benefit issues should be considered with extreme care and disclosed to candidates. The selection process requires good presurgical functional status, individualized consideration of the sequels of obesity, and reliance on centers that are highly experienced in the surgical procedure as well as short-term and long-term subsequent comprehensive care and support.
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Affiliation(s)
- Assaf Buch
- The Sagol Center for Epigenetics of Aging and Metabolism, Tel Aviv-Sourasky Medical Center, Tel Aviv 6423906, Israel
- The Institute of Endocrinology, Metabolism and Hypertension, Tel Aviv-Sourasky Medical Center, Tel Aviv 6423906, Israel
| | - Yonit Marcus
- The Sagol Center for Epigenetics of Aging and Metabolism, Tel Aviv-Sourasky Medical Center, Tel Aviv 6423906, Israel
- The Institute of Endocrinology, Metabolism and Hypertension, Tel Aviv-Sourasky Medical Center, Tel Aviv 6423906, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel
| | - Gabi Shefer
- The Sagol Center for Epigenetics of Aging and Metabolism, Tel Aviv-Sourasky Medical Center, Tel Aviv 6423906, Israel
- The Institute of Endocrinology, Metabolism and Hypertension, Tel Aviv-Sourasky Medical Center, Tel Aviv 6423906, Israel
| | - Paul Zimmet
- The Sagol Center for Epigenetics of Aging and Metabolism, Tel Aviv-Sourasky Medical Center, Tel Aviv 6423906, Israel
- Department of Diabetes, Central Clinical School, Monash University, Melbourne, Victoria 3004, Australia
| | - Naftali Stern
- The Sagol Center for Epigenetics of Aging and Metabolism, Tel Aviv-Sourasky Medical Center, Tel Aviv 6423906, Israel
- The Institute of Endocrinology, Metabolism and Hypertension, Tel Aviv-Sourasky Medical Center, Tel Aviv 6423906, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel
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