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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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Kim T, Shin SH, Kim H, Im Y, Cho J, Kang D, Park HY. Longitudinal BMI change and outcomes in Chronic Obstructive Pulmonary Disease: a nationwide population-based cohort study. Respir Res 2024; 25:150. [PMID: 38555459 PMCID: PMC10981805 DOI: 10.1186/s12931-024-02788-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 03/25/2024] [Indexed: 04/02/2024] Open
Abstract
BACKGROUND The association between longitudinal body mass index (BMI) change and clinical outcomes in patients with chronic obstructive pulmonary disease (COPD) has not fully investigated. METHODS This retrospective cohort study included 116,463 COPD patients aged ≥ 40, with at least two health examinations, one within 2 years before and another within 3 years after COPD diagnosis (January 1, 2014, to December 31, 2019). Associations between BMI percentage change with all-cause mortality, primary endpoint, and initial severe exacerbation were assessed. RESULTS BMI decreased > 5% in 14,728 (12.6%), while maintained in 80,689 (69.2%), and increased > 5% in 21,046 (18.1%) after COPD diagnosis. Compared to maintenance group, adjusted hazard ratio (aHR) for all-cause mortality was 1.70 in BMI decrease group (95% CI:1.61, 1.79) and 1.13 in BMI increase group (95% CI:1.07, 1.20). In subgroup analysis, decrease in BMI showed a stronger effect on mortality as baseline BMI was lower, while an increase in BMI was related to an increase in mortality only in obese COPD patients with aHRs of 1.18 (95% CI: 1.03, 1.36). The aHRs for the risk of severe exacerbation (BMI decrease group and increase group vs. maintenance group) were 1.30 (95% CI:1.24, 1.35) and 1.12 (95% CI:1.07, 1.16), respectively. CONCLUSIONS A decrease in BMI was associated with an increased risk of all-cause mortality in a dose-dependent manner in patients with COPD. This was most significant in underweight patients. Regular monitoring for weight loss might be an important component for COPD management.
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Affiliation(s)
- Taeyun Kim
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kosin University Gospel Hospital, Kosin University College of Medicine, Busan, Republic of Korea
| | - Sun Hye Shin
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Seoul, 06351, Republic of Korea
| | - Hyunsoo Kim
- Center for Clinical Epidemiology, Samsung Medical Center, Seoul, Republic of Korea
| | - Yunjoo Im
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Seoul, 06351, Republic of Korea
| | - Juhee Cho
- Center for Clinical Epidemiology, Samsung Medical Center, Seoul, Republic of Korea
- Department of Clinical Research Design and Evaluation, SAIHST, Sungkyunkwan University, 115 Irwon-ro, Seoul, 06335, South Korea
| | - Danbee Kang
- Center for Clinical Epidemiology, Samsung Medical Center, Seoul, Republic of Korea.
- Department of Clinical Research Design and Evaluation, SAIHST, Sungkyunkwan University, 115 Irwon-ro, Seoul, 06335, South Korea.
| | - Hye Yun Park
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Seoul, 06351, Republic of Korea.
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Almuwaqqat Z, Hui Q, Liu C, Zhou JJ, Voight BF, Ho YL, Posner DC, Vassy JL, Gaziano JM, Cho K, Wilson PWF, Sun YV. Long-Term Body Mass Index Variability and Adverse Cardiovascular Outcomes. JAMA Netw Open 2024; 7:e243062. [PMID: 38512255 PMCID: PMC10958234 DOI: 10.1001/jamanetworkopen.2024.3062] [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: 10/09/2023] [Accepted: 01/23/2024] [Indexed: 03/22/2024] Open
Abstract
Importance Body mass index (BMI; calculated as weight in kilograms divided by height in meters squared) is a commonly used estimate of obesity, which is a complex trait affected by genetic and lifestyle factors. Marked weight gain and loss could be associated with adverse biological processes. Objective To evaluate the association between BMI variability and incident cardiovascular disease (CVD) events in 2 distinct cohorts. Design, Setting, and Participants This cohort study used data from the Million Veteran Program (MVP) between 2011 and 2018 and participants in the UK Biobank (UKB) enrolled between 2006 and 2010. Participants were followed up for a median of 3.8 (5th-95th percentile, 3.5) years. Participants with baseline CVD or cancer were excluded. Data were analyzed from September 2022 and September 2023. Exposure BMI variability was calculated by the retrospective SD and coefficient of variation (CV) using multiple clinical BMI measurements up to the baseline. Main Outcomes and Measures The main outcome was incident composite CVD events (incident nonfatal myocardial infarction, acute ischemic stroke, and cardiovascular death), assessed using Cox proportional hazards modeling after adjustment for CVD risk factors, including age, sex, mean BMI, systolic blood pressure, total cholesterol, high-density lipoprotein cholesterol, smoking status, diabetes status, and statin use. Secondary analysis assessed whether associations were dependent on the polygenic score of BMI. Results Among 92 363 US veterans in the MVP cohort (81 675 [88%] male; mean [SD] age, 56.7 [14.1] years), there were 9695 Hispanic participants, 22 488 non-Hispanic Black participants, and 60 180 non-Hispanic White participants. A total of 4811 composite CVD events were observed from 2011 to 2018. The CV of BMI was associated with 16% higher risk for composite CVD across all groups (hazard ratio [HR], 1.16; 95% CI, 1.13-1.19). These associations were unchanged among subgroups and after adjustment for the polygenic score of BMI. The UKB cohort included 65 047 individuals (mean [SD] age, 57.30 (7.77) years; 38 065 [59%] female) and had 6934 composite CVD events. Each 1-SD increase in BMI variability in the UKB cohort was associated with 8% increased risk of cardiovascular death (HR, 1.08; 95% CI, 1.04-1.11). Conclusions and Relevance This cohort study found that among US veterans, higher BMI variability was a significant risk marker associated with adverse cardiovascular events independent of mean BMI across major racial and ethnic groups. Results were consistent in the UKB for the cardiovascular death end point. Further studies should investigate the phenotype of high BMI variability.
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Affiliation(s)
- Zakaria Almuwaqqat
- Veterans Affairs Atlanta Healthcare System, Decatur, Georgia
- Division of Cardiology, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia
| | - Qin Hui
- Veterans Affairs Atlanta Healthcare System, Decatur, Georgia
- Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, Georgia
| | - Chang Liu
- Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, Georgia
| | - Jin J. Zhou
- Department of Medicine and Biostatistics, University of California, Los Angeles
- Veterans Affairs Phoenix Healthcare System, Phoenix, Arizona
| | - Benjamin F. Voight
- Corporal Michael J. Crescenz VA Medical Center, Philadelphia, Pennsylvania
- Department of Systems Pharmacology and Translational Therapeutics, Department of Genetics, University of Pennsylvania, Philadelphia\
| | - Yuk-Lam Ho
- Massachusetts Veterans Epidemiology Research and Information Center, VA Boston Healthcare System, Boston
| | - Daniel C. Posner
- Massachusetts Veterans Epidemiology Research and Information Center, VA Boston Healthcare System, Boston
| | - Jason L. Vassy
- Massachusetts Veterans Epidemiology Research and Information Center, VA Boston Healthcare System, Boston
- Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
| | - J. Michael Gaziano
- Massachusetts Veterans Epidemiology Research and Information Center, VA Boston Healthcare System, Boston
- Division of Aging, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
| | - Kelly Cho
- Massachusetts Veterans Epidemiology Research and Information Center, VA Boston Healthcare System, Boston
- Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
| | - Peter W. F. Wilson
- Veterans Affairs Atlanta Healthcare System, Decatur, Georgia
- Division of Cardiology, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia
| | - Yan V. Sun
- Veterans Affairs Atlanta Healthcare System, Decatur, Georgia
- Division of Cardiology, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia
- Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, Georgia
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Verdu-Rotellar JM, Calero E, Duran J, Navas E, Alonso S, Argemí N, Casademunt M, Furió P, Casajuana E, Vinyoles E, Muñoz MA. Impact of malnutrition on the quality of life in older patients with advanced heart failure: a cohort study. Rev Clin Esp 2024; 224:105-113. [PMID: 38280424 DOI: 10.1016/j.rceng.2024.01.005] [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: 01/29/2024]
Abstract
OBJECTIVES The aim of this study was to assess the prevalence of malnutrition, the clinical characteristics associated with malnutrition and the impact of nutritional status on mortality, quality of life, self-care abilities, and activities of daily living in the older patients with advanced heart failure. METHODS A prospective multicentre cohort study including 260 community-dwelling elderly patients with advanced HF was conducted between June 2017 and December 2019. The study was carried out in 22 primary healthcare centres, three university hospitals, one acute-care hospital, and one geriatric rehabilitation unit in the city of Barcelona (Spain). Nutritional status was assessed at baseline using the Mini Nutritional Assessment questionnaire. Patient-reported outcome measures included quality of life (EQ-5D-3L), self-care behaviour (European Heart Failure Self-care Behaviour Scale) and impact on activities of daily living (Barthel Index). RESULTS Using the MNA-SF, 126 (48.5%) patients were identified as being at risk of malnutrition and 33 (12.7%) patients as having confirmed malnutrition. Compared to HF patients with normal nutritional status, patients with confirmed malnutrition were significantly older, with a lower BMI, and with reduced haemoglobin levels. During follow-up (median 14.9 months, Interquartile Range; 4.9-26.9), 133 (51.2%) of the included participants died, and mortality was significantly higher among patients identified as having malnutrition (p < 0.001). Better Barthel index and quality of life scores were inversely related to the risk of malnutrition, [Odds Ratio (OR) 0.97 (95% Confidence interval 0.96; 0.98) and OR 0.98 (95% Confidence interval, 0.96; 0.99)], respectively. Higher scores in the European Heart Failure Self-care Behaviour Scale, which implies worse self care, were related to higher malnutrition risk, OR 1.05 (95% Confidence interval, 1.02; 1.09. Adjusted multivariate logistic model found that malnutrition was significantly associated with poor quality of life, and adverse impacts on daily activities and self-care. CONCLUSIONS In community-dwelling older patients with advanced HF, malnutrition was associated with worse patient reported outcome measures related to poor quality of life, and adverse impacts on self-care and daily activities. Nutritional status must be systematically addressed by primary care nurses and family doctors to improve survival rates in these patients. It would be helpful the incorporation of expert professionals in nutrition in the primary health care centres.
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Affiliation(s)
- J-M Verdu-Rotellar
- Gerencia Territorial de Barcelona (Primary Healthcare), Institut Català de la Salut, Barcelona, Spain; Departament de Ciències Experimentals i de la Salut, School of Medicine, Universitat Pompeu Fabra, Barcelona, Spain; Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Barcelona, Spain
| | - E Calero
- Bellvitge University Hospital, Institut Català de la Salut, Barcelona, Spain
| | - J Duran
- Clinica Sant Antoni (Institut Medic i de Rehabilitació), Barcelona, Spain
| | - E Navas
- Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Barcelona, Spain
| | - S Alonso
- Gerencia Territorial de Barcelona (Primary Healthcare), Institut Català de la Salut, Barcelona, Spain
| | - N Argemí
- Gerencia Territorial de Barcelona (Primary Healthcare), Institut Català de la Salut, Barcelona, Spain
| | - M Casademunt
- Gerencia Territorial de Barcelona (Primary Healthcare), Institut Català de la Salut, Barcelona, Spain
| | - P Furió
- Gerencia Territorial de Barcelona (Primary Healthcare), Institut Català de la Salut, Barcelona, Spain
| | - E Casajuana
- Gerencia Territorial de Barcelona (Primary Healthcare), Institut Català de la Salut, Barcelona, Spain
| | - E Vinyoles
- Gerencia Territorial de Barcelona (Primary Healthcare), Institut Català de la Salut, Barcelona, Spain; Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Barcelona, Spain; Departament de Medicina (School of Medicine, Universitat de Barcelona), Barcelona, Spain
| | - M A Muñoz
- Gerencia Territorial de Barcelona (Primary Healthcare), Institut Català de la Salut, Barcelona, Spain; Departament de Ciències Experimentals i de la Salut, School of Medicine, Universitat Pompeu Fabra, Barcelona, Spain; Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Barcelona, Spain.
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5
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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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Tsubota-Utsugi M, Tanno K, Takahashi N, Onoda T, Yonekura Y, Ohsawa M, Takahashi S, Kuribayashi T, Itabashi R, Tanaka F, Asahi K, Omama S, Ogasawara K, Ishigaki Y, Takahashi F, Soma A, Takanashi N, Sakata K, Ohkubo T, Okayama A. Rapid weight change as a predictor of disability among community-dwelling Japanese older adults. Geriatr Gerontol Int 2023; 23:809-816. [PMID: 37770036 DOI: 10.1111/ggi.14687] [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: 06/22/2023] [Revised: 08/21/2023] [Accepted: 09/11/2023] [Indexed: 10/03/2023]
Abstract
AIM To fill the knowledge gap regarding weight change and the onset of disability in community-dwelling Japanese older adults, we investigated the potential effects of rapid weight change on disability risk as defined by Japan's long-term care insurance (LTCI) system. METHODS We analyzed data from a longitudinal study of 10 375 community-dwelling older Japanese adults (≥65 years) who were not LTCI needs certified at baseline and joined the study from 2002 to 2005. Weight change (percentage) was calculated by subtracting participants' weight in the previous year from that measured during a physical examination at study commencement. The five weight-change categories ranged from sizable weight loss (≤ -8.0%) to sizable weight gain (≥ +8.0%). Disability was defined according to LTCI certifications at follow-up. Hazard ratios (HRs) and 95% confidence intervals were calculated for new-onset disability using a Cox proportional hazards model that fitted the proportional subdistribution hazards regression model with weights for competing risks of death. RESULTS During the mean 10.5-year follow-up, 2994 participants developed a disability. Sizable weight loss (HR [95% confidence intervals], 1.41 [1.17-1.71]) and weight loss (1.20 [1.05-1.36]) were significant predictors of disability onset. Sizable weight gain (1.45 [1.07-1.97]) corresponded to severe disability. Stratified analyses by lifestyle and initial body mass index categories revealed more pronounced associations between weight change and disability risk in the unhealthy lifestyle and below initial normal body mass index groups. CONCLUSIONS Rapid and sizable weight gain could be additional criteria for disability risk in older adults. Geriatr Gerontol Int 2023; 23: 809-816.
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Grants
- JP17K09126 a grant-in-aid for Scientific Research (C) from the Japan Society for the Promotion of Science
- JP21K10477 a grant-in-aid for Scientific Research (C) from the Japan Society for the Promotion of Science
- 20FA1002 a grant-in-aid from the Ministry of Health, Labor and Welfare, Health and Labor Sciences Research Grants, Japan
- H23-Junkankitou [Seishuu]-Ippan-005 a grant-in-aid from the Ministry of Health, Labor and Welfare, Health and Labor Sciences Research Grants, Japan
- H26-Junkankitou [Seisaku]-Ippan-001 a grant-in-aid from the Ministry of Health, Labor and Welfare, Health and Labor Sciences Research Grants, Japan
- H29-Junkankitou-Ippan-003 a grant-in-aid from the Ministry of Health, Labor and Welfare, Health and Labor Sciences Research Grants, Japan
- Eli Lilly Japan K.K.
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Affiliation(s)
- Megumi Tsubota-Utsugi
- Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan
- Department of Hygiene and Preventive Medicine, Iwate Medical University, Morioka, Japan
| | - Kozo Tanno
- Department of Hygiene and Preventive Medicine, Iwate Medical University, Morioka, Japan
| | - Naomi Takahashi
- Department of Hygiene and Preventive Medicine, Iwate Medical University, Morioka, Japan
| | | | - Yuki Yonekura
- Graduate School of Nursing Science, St. Luke's International University, Tokyo, Japan
| | - Masaki Ohsawa
- Division of Cardiology, Department of Internal Medicine, Iwate Medical University, Morioka, Japan
| | - Shuko Takahashi
- Division of Medical Education, Iwate Medical University, Morioka, Japan
| | - Toru Kuribayashi
- Faculty of Humanities and Social Sciences, Iwate University, Morioka, Japan
| | - Ryo Itabashi
- Stroke Center, Division of Neurology and Gerontology, Department of Internal Medicine, School of Medicine, Iwate Medical University, Morioka, Japan
| | - Fumitaka Tanaka
- Division of Nephrology and Hypertension, Department of Internal Medicine, Iwate Medical University, Morioka, Japan
| | - Koichi Asahi
- Department of General Medicine, School of Medicine, Iwate Medical University, Morioka, Japan
| | - Shinichi Omama
- Department of Neurosurgery, School of Medicine, Iwate Medical University, Morioka, Japan
| | - Kuniaki Ogasawara
- Division of Diabetes, Metabolism and Endocrinology, Department of Internal Medicine, Iwate Medical University, Morioka, Japan
| | - Yasushi Ishigaki
- Department of Neurosurgery, School of Medicine, Iwate Medical University, Morioka, Japan
| | - Fumiaki Takahashi
- Department of Information Science, Iwate Medical University, Morioka, Japan
| | - Akemi Soma
- Iwate Health Service Association, Morioka, Japan
| | - Nobuyuki Takanashi
- Department of Hygiene and Preventive Medicine, Iwate Medical University, Morioka, Japan
| | - Kiyomi Sakata
- Department of Hygiene and Preventive Medicine, Iwate Medical University, Morioka, Japan
| | - Takayoshi Ohkubo
- Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan
| | - Akira Okayama
- Research Institute of Strategy for Prevention, Tokyo, Japan
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7
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Predictors of total mortality and their differential association on premature or late mortality in the SUN cohort. Exp Gerontol 2023; 172:112048. [PMID: 36521566 DOI: 10.1016/j.exger.2022.112048] [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: 10/21/2022] [Revised: 12/02/2022] [Accepted: 12/06/2022] [Indexed: 12/14/2022]
Abstract
Several studies have tried to analyse the association between all-cause mortality and different risk factors, (especially those which are modifiable, such as smoking, diet or exercise), to develop public health preventive strategies. However, a specific analysis of predictors of premature and late mortality is needed to give more precise recommendations. Considering that there are risk factors which exert an influence on some diseases and not on others, we expect that, similarly, they may have a different impact depending on the timing of mortality, separating premature (≤65 years) from late mortality (>65 years). Thus, we prospectively followed-up during a median of 12 years a cohort of 20,272 university graduates comprising an ample range of ages at inception. Time-dependent, covariate-adjusted Cox models were used to estimate adjusted hazard ratios (HR) and their 95 % confidence intervals (CI) for each predictor. The strongest independent predictor of mortality at any age was physical activity which was associated with reduced risk of total, premature and late mortality (range of HRs when comparing the highest vs. the lowest level: 0.24 to 0.48). Specific strong predictors for premature mortality were smoking, HR: 4.22 (95 % CI: 2.42-7.38), and the concurrence of ≥2 metabolic conditions at baseline, HR: 1.97 (1.10-3.51). The habit of sleeping a long nap (≥30 min/d), with HR: 2.53 (1.30-4.91), and poor adherence to the Mediterranean Diet (≤3 points in a 0 to 8 score vs. ≥6 points), with HR: 2.27 (1.08-4.76), were the strongest specific predictors for late mortality. Smoking, diet quality or lifestyles, probably should be differentially assessed as specific predictors for early and late mortality. In the era of precision medicine, this approach will allow tailored recommendations appropriate to each person's age and baseline condition.
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A Body Shape Index (ABSI) as a Variant of Conicity Index Not Affected by the Obesity Paradox: A Cross-Sectional Study Using Arterial Stiffness Parameter. J Pers Med 2022; 12:jpm12122014. [PMID: 36556235 PMCID: PMC9783005 DOI: 10.3390/jpm12122014] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Revised: 11/20/2022] [Accepted: 12/02/2022] [Indexed: 12/12/2022] Open
Abstract
A body shape index (ABSI) is an abdominal obesity index developed based on epidemiological statistics and designed to correlate minimally with body mass index (BMI). We examined the approximation between ABSI and other abdominal obesity indices based on biophysical concepts. The cross-sectional data from 62,514 Japanese urban residents were analyzed. Body adiposity indices comprising BMI, waist circumference (WC), ABSI, conicity index (CI), waist-to-height ratio (WHtR), and WC/BMI ratio were examined. ABSI and CI more strongly correlated with age and arterial stiffness assessed by cardio-ankle vascular index (CAVI) compared to the other indices. The discriminative power for high CAVI (≥9.0) was the strongest for ABSI followed by CI and other indices, in that order. The range and distribution of WC corresponding to the cutoff of ABSI (0.0801), or CI (1.23) seemed reasonable. The correlation between ABSI and CI was the strongest compared to any other combination of indices. CI correlated moderately with BMI, whereas ABSI correlated minimally with BMI. ABSI correlates strongly and approximates closely with CI. Hence, ABSI may be considered to reflect the degree of body shape change from cylindricity to conicity and is currently the only abdominal obesity index not affected by the obesity paradox.
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9
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Alharbi TA, Ryan J, Freak-Poli R, Gasevic D, Scali J, Ritchie K, Ancelin ML, Owen AJ. The Association of Weight Loss, Weight Status, and Abdominal Obesity with All-Cause Mortality in Older Adults. Gerontology 2022; 68:1366-1374. [PMID: 35176746 PMCID: PMC9808634 DOI: 10.1159/000522040] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 12/08/2021] [Indexed: 01/07/2023] Open
Abstract
OBJECTIVES The objectives of this study were to examine whether weight loss, weight status (based on body mass index [BMI] categories), and abdominal obesity (based on waist circumference [WC]) were associated with a 17-year mortality risk in community-dwelling older adults. METHODS Participants were 2,017 community-dwelling adults aged 65 years or above in the longitudinal Enquête de Santé Psychologique-Risques, Incidence et Traitement study. Self-reported weight loss was collected at baseline during face-to-face interviews. Bodyweight (kg), height (m), and WC (cm) were independently measured at the baseline. BMI was categorized as follows: underweight (BMI <18.5 kg/m2), normal weight (18.5-24.9 kg/m2), overweight (25-29.9 kg/m2), and obese (≥30 kg/m2). Abdominal obesity was defined by a WC of ≥102 cm in men and ≥88 cm in women. Adjusted Cox proportional hazards models were used to examine associations of weight loss, weight status, and abdominal obesity with all-cause mortality. RESULTS Over 17 years of follow-up (median 15.5 years), 812 participants died. Abdominal obesity compared to nonabdominal obesity was associated with a 49% increased mortality risk (95% confidence interval (CI): 1.22-1.83). However, being overweight (but not obese) was associated with a 20% decreased risk (95% CI: 0.66-0.97) compared to a normal BMI. Gender did not affect these associations. In the whole cohort, self-reported weight loss at baseline was not associated with an increased mortality risk after adjusting for health and lifestyle factors. However, in men, a baseline self-reported recent weight loss of >3 kg was associated with a 52% increase in mortality risk (95% CI: 1.05-2.18) in a fully adjusted model. CONCLUSION In community-dwelling adults aged ≥65 years, abdominal obesity was strongly associated with increased mortality risk. Being overweight appeared, however, to be protective against mortality. Modest self-reported weight loss was not associated with all-cause mortality in community-dwelling older adults after adjusting for health and lifestyle factors. However, men reporting recent weight loss of more than 3 kg may be at increased risk. The findings of this study support the use of WC, rather than BMI, as a predictor of mortality risk in older adults.
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Affiliation(s)
- Tagrid Abdullah Alharbi
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Joanne Ryan
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Rosanne Freak-Poli
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia,Department of Epidemiology, Erasmus Medical Centre, Rotterdam, The Netherlands
| | - Danijela Gasevic
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia,Usher Institute, University of Edinburgh, Edinburgh, UK
| | | | - Karen Ritchie
- INM, Univ Montpellier, INSERM, Montpellier, France,Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | | | - Alice J. Owen
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia,*Alice J. Owen,
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Balashova E, Trifonova O, Maslov D, Lichtenberg S, Lokhov P, Archakov A. Metabolome profiling in the study of aging processes. BIOMEDITSINSKAYA KHIMIYA 2022; 68:321-338. [DOI: 10.18097/pbmc20226805321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Aging of a living organism is closely related to systemic metabolic changes. But due to the multilevel and network nature of metabolic pathways, it is difficult to understand these connections. Today, this problem is solved using one of the main approaches of metabolomics — untargeted metabolome profiling. The purpose of this publication is to systematize the results of metabolomic studies based on such profiling, both in animal models and in humans.
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Affiliation(s)
| | | | - D.L. Maslov
- Institute of Biomedical Chemistry, Moscow, Russia
| | | | - P.G. Lokhov
- Institute of Biomedical Chemistry, Moscow, Russia
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11
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Balashova EE, Maslov DL, Trifonova OP, Lokhov PG, Archakov AI. Metabolome Profiling in Aging Studies. BIOLOGY 2022; 11:1570. [PMID: 36358271 PMCID: PMC9687709 DOI: 10.3390/biology11111570] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Revised: 10/18/2022] [Accepted: 10/24/2022] [Indexed: 06/07/2024]
Abstract
Organism aging is closely related to systemic metabolic changes. However, due to the multilevel and network nature of metabolic pathways, it is difficult to understand these connections. Today, scientists are trying to solve this problem using one of the main approaches of metabolomics-untargeted metabolome profiling. The purpose of this publication is to review metabolomic studies based on such profiling, both in animal models and in humans. This review describes metabolites that vary significantly across age groups and include carbohydrates, amino acids, carnitines, biogenic amines, and lipids. Metabolic pathways associated with the aging process are also shown, including those associated with amino acid, lipid, and energy metabolism. The presented data reveal the mechanisms of aging and can be used as a basis for monitoring biological age and predicting age-related diseases in the early stages of their development.
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Affiliation(s)
- Elena E. Balashova
- Institute of Biomedical Chemistry, Pogodinskaya St. 10, 119121 Moscow, Russia
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12
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Nagayama D, Sugiura T, Choi SY, Shirai K. Various Obesity Indices and Arterial Function Evaluated with CAVI - Is Waist Circumference Adequate to Define Metabolic Syndrome? Vasc Health Risk Manag 2022; 18:721-733. [PMID: 36120718 PMCID: PMC9480599 DOI: 10.2147/vhrm.s378288] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Accepted: 08/24/2022] [Indexed: 11/23/2022] Open
Abstract
Obesity has been known to relate to various diseases and metabolic disorders. Since the implication of body shape has been mentioned, obesity can be divided into visceral obesity and subcutaneous obesity. The former is considered the upstream pathophysiology of metabolic syndrome (MetS), and has been emphasized worldwide for the prevention of cardiovascular diseases in the last quarter century. However, some prospective studies have shown that cardiovascular mortality and morbidity are not necessarily higher in patients with MetS compared to those without. Recently, cardio-ankle vascular index (CAVI) has been established as an indicator of arteriosclerosis. This parameter is independent of blood pressure at the measuring time, and reflects systemic arterial stiffness from the aortic origin to the ankle. However, since CAVI is not necessarily high in MetS patients, attempts have been made to clarify this unexpected phenomenon. In several studies, CAVI was found to correlate negatively with body mass index (BMI), and also with waist circumference (WC) which is a widely used representative visceral obesity index. On the other hand, a body shape index (ABSI) is also a visceral obesity index designed to be minimally associated with BMI, and is calculated by dividing WC by an allometric regression of weight and height. Replacing high WC with high ABSI in MetS diagnosis promoted the identification of MetS patients with increased CAVI in cross-sectional studies on Japanese and Korean populations. Additionally, the incidence of MetS diagnosed using high ABSI was associated with significant increase in CAVI after 1 year of observation. Enhanced predictive ability for renal function decline by replacing WC with ABSI in MetS diagnosis was also observed in a longitudinal study in Japanese urban residents. These findings suggest that MetS diagnosis using high ABSI instead of high WC as a visceral obesity index needs to be reconsidered. However, further research is desirable on Caucasian, whose body shape differs slightly from that of Asians.
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Affiliation(s)
- Daiji Nagayama
- Department of Internal Medicine, Nagayama Clinic, Tochigi, Japan.,Center of Diabetes, Endocrinology and Metabolism, Toho University, Sakura Medical Center, Chiba, Japan
| | - Tomonori Sugiura
- Department of Cardiology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Su-Yeon Choi
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Hospital Healthcare System Gangnam Center, Seoul, Republic of Korea
| | - Kohji Shirai
- Department of Internal Medicine, Mihama Hospital, Chiba, Japan
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13
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Lv Y, Mao C, Gao X, Ji JS, Kraus VB, Yin Z, Yuan J, Chen H, Luo J, Zhou J, Li Z, Duan J, Zhu Q, Zeng Y, Wang W, Wang J, Shi X. The obesity paradox is mostly driven by decreased noncardiovascular disease mortality in the oldest old in China: a 20-year prospective cohort study. NATURE AGING 2022; 2:389-396. [PMID: 37118064 DOI: 10.1038/s43587-022-00201-3] [Citation(s) in RCA: 36] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Accepted: 03/07/2022] [Indexed: 04/30/2023]
Abstract
National and international recommendations of healthy body mass index (BMI) are primarily based on evidence in young and middle-aged populations, with an insufficient representation of the oldest old (aged ≥80 years). Here, we report associations between BMI and mortality risk in 27,026 community-dwelling oldest old (mean age, 92.7 ± 7.5 years) in China from 1998 to 2018. Nonlinear curves showed reverse J-shaped associations of BMI with cardiovascular disease (CVD), non-CVD and all-cause mortality, with a monotonic decreased risk up to BMIs in the overweight and mild obesity range and flat hazard ratios thereafter. Compared to normal weight, overweight and obesity were significantly associated with decreased non-CVD and all-cause mortality, but not with CVD mortality. Similar associations were found for waist circumference. Our results lend support to the notion that optimal BMI in the oldest old may be around the overweight or mild obesity range and challenge the application of international and national guidelines on optimal BMI in this age group.
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Affiliation(s)
- Yuebin Lv
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Chen Mao
- Division of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, Guangdong, China
| | - Xiang Gao
- Department of Nutrition and Food Hygiene, School of Public Health, Fudan University, Shanghai, China
| | - John S Ji
- Vanke School of Public Health, Tsinghua University, Beijing, China
- Environmental Sciences and Policy, Nicholas School of the Environment, Duke University, Durham, NC, USA
| | - Virginia Byers Kraus
- Duke Molecular Physiology Institute and Department of Medicine, Duke University School of Medicine, Durham, NC, USA
| | - Zhaoxue Yin
- Division of Non-Communicable Disease Control and Community Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Jinqiu Yuan
- Division of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, Guangdong, China
| | - Huashuai Chen
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Jiesi Luo
- Division of Non-Communicable Disease Control and Community Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Jinhui Zhou
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Zhihao Li
- Division of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, Guangdong, China
| | - Jun Duan
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Qingyang Zhu
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Yi Zeng
- Center for the study of Aging and Human Development and the Geriatric Division of School of Medicine, Duke University, Durham, NC, USA
- Center for Study of Healthy Aging and Development Studies, Peking University, Beijing, China
| | - Wentao Wang
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Jiaonan Wang
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
- Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Xiaoming Shi
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China.
- Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China.
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14
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Reinikainen J, Karvanen J. Bayesian subcohort selection for longitudinal covariate measurements in follow‐up studies. STAT NEERL 2022. [DOI: 10.1111/stan.12264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
| | - Juha Karvanen
- Department of Mathematics and Statistics University of Jyvaskyla Finland
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15
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Joo YS, Nam KH, Jhee JH, Yun HR, Lee S, Han SH, Yoo TH, Kang SW, Park JT. Body weight fluctuation is associated with rapid kidney function decline. Obesity (Silver Spring) 2022; 30:257-267. [PMID: 34889070 DOI: 10.1002/oby.23326] [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: 05/05/2021] [Revised: 09/08/2021] [Accepted: 10/05/2021] [Indexed: 11/09/2022]
Abstract
OBJECTIVE This study aimed to evaluate the effects of body weight fluctuations on kidney function deterioration in a prospective cohort of individuals with normal kidney function. METHODS Data were obtained from the Korean Genome and Epidemiology Study. Body weight fluctuations were determined using average successive variability (ASV), which was defined as the average absolute body weight change using repeated measurements for all participants. The decline of the estimated glomerular filtration rate (eGFR) over time was calculated using linear regression analysis of serial eGFR measurements for each patient. Rapid eGFR decline was defined as an average eGFR decline > 3 mL/min/1.73 m2 per year. RESULTS A total of 6,790 participants were analyzed. During a median follow-up of 11.7 years, rapid eGFR decline was observed in 913 (13.4%) participants. When the participants were categorized into tertiles according to ASV, rapid eGFR decline was more prevalent in the highest ASV tertile group than in the lowest. Analyses using multiple logistic regression models revealed that the risk of rapid eGFR decline was increased in the highest ASV tertile group compared with the lowest (odds ratio: 1.66). CONCLUSIONS Body weight fluctuations were significantly associated with an increased risk of rapid kidney function decline in participants with normal kidney function.
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Affiliation(s)
- Young Su Joo
- Institute of Kidney Disease Research, Department of Internal Medicine, College of Medicine, Yonsei University, Seoul, Republic of Korea
- Division of Nephrology, Department of Internal Medicine, Yongin Hospital, Yongin, Gyeonggi-do, Republic of Korea
| | - Ki Heon Nam
- Institute of Kidney Disease Research, Department of Internal Medicine, College of Medicine, Yonsei University, Seoul, Republic of Korea
- Division of Integrated Medicine, Department of Internal Medicine, College of Medicine, Yonsei University, Seoul, Republic of Korea
| | - Jong Hyun Jhee
- Division of Nephrology, Department of Internal Medicine, College of Medicine, Gangnam Severance Hospital, Yonsei University, Seoul, Republic of Korea
| | - Hae-Ryong Yun
- Institute of Kidney Disease Research, Department of Internal Medicine, College of Medicine, Yonsei University, Seoul, Republic of Korea
- Division of Nephrology, Department of Internal Medicine, Yongin Hospital, Yongin, Gyeonggi-do, Republic of Korea
| | - Sangmi Lee
- Institute of Kidney Disease Research, Department of Internal Medicine, College of Medicine, Yonsei University, Seoul, Republic of Korea
- Division of Integrated Medicine, Department of Internal Medicine, College of Medicine, Yonsei University, Seoul, Republic of Korea
| | - Seung Hyeok Han
- Institute of Kidney Disease Research, Department of Internal Medicine, College of Medicine, Yonsei University, Seoul, Republic of Korea
| | - Tae-Hyun Yoo
- Institute of Kidney Disease Research, Department of Internal Medicine, College of Medicine, Yonsei University, Seoul, Republic of Korea
| | - Shin-Wook Kang
- Institute of Kidney Disease Research, Department of Internal Medicine, College of Medicine, Yonsei University, Seoul, Republic of Korea
- Severance Biomedical Science Institute, Brain Korea 21 PLUS, Yonsei University, Seoul, Republic of Korea
| | - Jung Tak Park
- Institute of Kidney Disease Research, Department of Internal Medicine, College of Medicine, Yonsei University, Seoul, Republic of Korea
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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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Suh J, Cho YJ, Kim HJ, Choi SS. Age-Related Difference in Weight Change and All-Cause Mortality in Middle-Aged and Older Korean Populations: Korean Longitudinal Study of Aging. Korean J Fam Med 2021; 42:297-302. [PMID: 34320797 PMCID: PMC8321903 DOI: 10.4082/kjfm.20.0170] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Accepted: 01/20/2021] [Indexed: 11/30/2022] Open
Abstract
Background Obesity is associated with increased mortality as a significant risk factor for chronic diseases, including cardiovascular diseases and cancer. Several people believe that weight gain is harmful, and weight loss helps maintain health. However, some studies have shown that weight loss, particularly among older adults, is more likely to increase the risk of mortality than weight gain. Methods We used data for the cohort of the Korean Longitudinal Study of Aging, which is a nationwide stratified multi-stage sample of adults aged 45 years. The all-cause mortality risk was assessed using the survival status and the number of months of survival calculated from 2006 (baseline year) to 2016. Cox proportional hazard regression were used to study the causal link between weight change and all-cause mortality risk. Results The results showed interactive associations between weight loss and mortality among middle-aged and older adults. The hazard ratio was 1.62 (95% confidence interval [CI], 1.10–2.40) for the participants aged 45–65 years with weight losses greater than 5 kg and 1.56 (95% CI, 1.29–1.89) for those older than 65 years with weight losses greater than 5 kg. The results for the group with weight gain above 5 kg were not significant. Middle-aged and older men showed an increase in all-cause mortality associated with weight loss of more than 5 kg, but only the older women showed significant results. Conclusion This large-scale cohort study in Korea showed a relationship between weight loss and all-cause mortality in middle-aged and older individuals.
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Affiliation(s)
- Jungki Suh
- Department of Family Medicine, Daegu Catholic University School of Medicine, Daegu, Korea
| | - Yoon Jeong Cho
- Department of Family Medicine, Daegu Catholic University School of Medicine, Daegu, Korea
| | - Hyun Ji Kim
- Department of Family Medicine, Daegu Catholic University School of Medicine, Daegu, Korea
| | - Seong Soo Choi
- Department of Family Medicine, Daegu Catholic University School of Medicine, Daegu, Korea
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Park SE, Seo MH, Cho JH, Kwon H, Kim YH, Han KD, Jung JH, Park YG, Rhee EJ, Lee WY. Dose-Dependent Effect of Smoking on Risk of Diabetes Remains after Smoking Cessation: A Nationwide Population-Based Cohort Study in Korea. Diabetes Metab J 2021; 45:539-546. [PMID: 33662197 PMCID: PMC8369207 DOI: 10.4093/dmj.2020.0061] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Accepted: 08/31/2020] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND This study aimed to evaluate the dose-dependent effects of smoking on risk of diabetes among those quitting smoking. METHODS We analyzed clinical data from a total of 5,198,792 individuals age 20 years or older who received health care check-up arranged by the national insurance program of Korea between 2009 and 2016 using the Korean National Health Insurance Service database. Cumulative smoking was estimated by pack-years. Smokers were classified into four categories according to the amount of smoking: light smokers (0.025 to 5 smoking pack-years), medium smokers (5 to 14 smoking pack-years), heavy smokers (14 to 26 smoking pack-years), and extreme smokers (more than 26 smoking pack-years). RESULTS During the study period, 164,335 individuals (3.2% of the total population) developed diabetes. Compared to sustained smokers, the risk of diabetes was significantly reduced in both quitters (hazard ratio [HR], 0.858; 95% confidence interval [CI], 0.838 to 0.878) and nonsmokers (HR, 0.616; 95% CI, 0.606 to 0.625) after adjustment for multiple risk factors. The risk of diabetes gradually increased with amount of smoking in both quitters and current smokers. The risk of diabetes in heavy (HR, 1.119; 95% CI, 1.057 to 1.185) and extreme smokers (HR, 1.348; 95% CI, 1.275 to 1.425) among quitters was much higher compared to light smokers among current smokers. CONCLUSION Smoking cessation was effective in reducing the risk of diabetes regardless of weight change. However, there was a potential dose-dependent association between smoking amount and the development of diabetes. Diabetes risk still remained in heavy and extreme smokers even after smoking cessation.
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Affiliation(s)
- Se Eun Park
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Mi Hae Seo
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Soonchunhyang University Gumi Hospital, Soonchunhyang University College of Medicine, Gumi, Korea
| | - Jung-Hwan Cho
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korean Armed Forces Capital Hospital, Seongnam, Korea
| | - Hyemi Kwon
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Yang-Hyun Kim
- Department of Family Medicine, Korea University College of Medicine, Seoul, Korea
| | - Kyung-Do Han
- Department of Biostatistics, Biomedicine & Health Sciences, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Jin-Hyung Jung
- Department of Biostatistics, Biomedicine & Health Sciences, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Yong-Gyu Park
- Department of Biostatistics, Biomedicine & Health Sciences, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Eun-Jung Rhee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
- Corresponding authors: Won-Young Lee https://orcid.org/0000-0002-1082-7592 Division of Endocrinology and Metabolism, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 29 Saemunan-ro, Jongno-gu, Seoul 03181, Korea E-mail:
| | - Won-Young Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
- Corresponding authors: Won-Young Lee https://orcid.org/0000-0002-1082-7592 Division of Endocrinology and Metabolism, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 29 Saemunan-ro, Jongno-gu, Seoul 03181, Korea E-mail:
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Alharbi TA, Paudel S, Gasevic D, Ryan J, Freak-Poli R, Owen AJ. The association of weight change and all-cause mortality in older adults: a systematic review and meta-analysis. Age Ageing 2021; 50:697-704. [PMID: 33161429 DOI: 10.1093/ageing/afaa231] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVE there may be age-related differences in the impact of weight change on health. This study systematically reviewed the evidence on the relationship between weight change and all-cause mortality in adults aged 65 years and older. METHODS MEDLINE, EMBASE and CINAHL were searched from inception to 11 June 2020, PROSPERO CRD 42019142268. We included observational studies reporting on the association between weight change and all-cause mortality in older community-dwelling adults. A random-effects meta-analysis was performed to calculate pooled hazard ratios and scored based on the Agency for Healthcare Research and Quality guidelines. RESULTS a total of 30 studies, including 1,219,279 participants with 69,255 deaths, demonstrated that weight loss was associated with a 59% increase in mortality risk (hazard ratio (HR): 1.59; 95% confidence interval (CI): 1.45-1.74; P < 0.001). Twenty-seven studies that reported outcomes for weight gain (1,210,116 participants with 65,481 deaths) indicated that weight gain was associated with a 10% increase in all-cause mortality (HR: 1.10; 95%CI: 1.02, 1.17; P = 0.01). Four studies investigated weight fluctuation (2,283 events among 6,901 participants), which was associated with a 63% increased mortality risk (HR: 1.66; 95%CI: 1.28, 2.15). No evidence of publication bias was observed (all P > 0.05). CONCLUSION for community-dwelling older adults, weight changes (weight loss, gain or weight fluctuation) are associated with an increased risk of all-cause mortality risk relative to stable weight. Further research is needed to determine whether these associations vary depending upon initial weight, and whether or not the weight loss/gain was intentional.
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Affiliation(s)
- Tagrid A Alharbi
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Susan Paudel
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Danijela Gasevic
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
- Usher Institute, University of Edinburgh, Edinburgh EH8 9AG, UK
| | - Joanne Ryan
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
- PSNREC, INSERM, University of Montpellier, Montpellier 34000, France
| | - Rosanne Freak-Poli
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
- Department of Epidemiology, Erasmus Medical Centre, Rotterdam, The Netherlands
| | - Alice J Owen
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
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20
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Rikkonen T, Sund R, Sirola J, Honkanen R, Poole KES, Kröger H. Obesity is associated with early hip fracture risk in postmenopausal women: a 25-year follow-up. Osteoporos Int 2021; 32:769-777. [PMID: 33095419 PMCID: PMC8026440 DOI: 10.1007/s00198-020-05665-w] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 10/01/2020] [Indexed: 12/15/2022]
Abstract
UNLABELLED Association of body mass index and hip fracture has been controversial. In this study, women with lowest and highest body weight had the highest fracture incidence. A 25-year follow-up indicated that obesity associates with early hip fracture risk and suggested increasing trend in normal-weight women at a later stage. INTRODUCTION Obesity is a pandemic health issue. Its association with hip fracture risk remains controversial. We studied the long-term relationship of body mass index and hip fracture incidence in postmenopausal women. METHODS The cohort of 12,715 Finnish women born in 1932-1941 was followed for 25 years, covering ages from 58 up to 83. Fractures and deaths were obtained from national registries. Women were investigated in deciles of BMI as well as in WHO weight categories (normal, overweight, or obese). The follow-up analysis was carried out in two age strata as "early" (58-70 years) and "late" (> 70 years). Body weight information was updated accordingly. Femoral neck BMD was recorded for a subsample (n = 3163). Altogether, 427 hip fractures were observed. RESULTS A higher risk of early hip fracture was observed in obese and normal-weight compared with overweight women with hazard ratios (HRs) of 2.3 ((95% CI) 1.4-3.7) and 2.0 (1.3-3.1) while no difference was observed in late hip fracture risk between the three WHO categories (log rank p = 0.14). All-cause mortality during the follow-up was 19.3%. Compared with normal weight women, the obese women had a higher risk of death with an HR of 1.6 (1.4-1.8) and higher baseline BMD (p < 0.001). Faster bone loss was observed in the obese compared with other women (p < 0.001). CONCLUSION Obesity associates with earlier hip fracture and higher postfracture mortality. The obese women with low BMD have clearly the highest risk of hip fracture. This combination increases hip fracture risk more than either of the factors alone. After 75 years of age, risk appears to increase more in normal weight women, but this trend is in need of further confirmation.
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Affiliation(s)
- T Rikkonen
- Kuopio Musculoskeletal Research Unit, University of Eastern Finland, Kuopio, Finland.
| | - R Sund
- Kuopio Musculoskeletal Research Unit, University of Eastern Finland, Kuopio, Finland
| | - J Sirola
- Kuopio Musculoskeletal Research Unit, University of Eastern Finland, Kuopio, Finland
- Orthopaedics and Traumatology, Department of Orthopaedics, Traumatology and Hand Surgery, Kuopio University Hospital, Kuopio, Finland
| | - R Honkanen
- Kuopio Musculoskeletal Research Unit, University of Eastern Finland, Kuopio, Finland
- Department of Psychiatry, University of Oulu, Oulu, Finland
| | - K E S Poole
- University of Cambridge, Addenbrookes Hospital, Cambridge, UK
| | - H Kröger
- Kuopio Musculoskeletal Research Unit, University of Eastern Finland, Kuopio, Finland
- Orthopaedics and Traumatology, Department of Orthopaedics, Traumatology and Hand Surgery, Kuopio University Hospital, Kuopio, Finland
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21
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Zheng H, Echave P, Mehta N, Myrskylä M. Life-long body mass index trajectories and mortality in two generations. Ann Epidemiol 2021; 56:18-25. [PMID: 33493649 PMCID: PMC8009819 DOI: 10.1016/j.annepidem.2021.01.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 01/04/2021] [Accepted: 01/13/2021] [Indexed: 11/25/2022]
Abstract
PURPOSE To identify life-long body mass index (BMI) trajectories across two related generations and estimate their associated mortality risks and population attributable deaths. METHODS We use prospective cohort data from the Framingham Heart Study (1948-2011) original (4576 individuals, 3913 deaths) and offspring (3753 individuals, 967 deaths) cohorts and latent trajectory models to model BMI trajectories from age 31 to 80 years. Survival models are used to estimate trajectory-specific mortality risk. RESULTS We define seven BMI trajectories among original cohort and six among offspring cohort. Among original cohort, people who are normal weight at age 31 years and gradually move to overweight status in middle or later adulthood have the lowest mortality risk even compared to those who maintain normal weight throughout adulthood, followed by overweight stable, lower level of normal weight, overweight downward, class I obese upward, and class II/III upward trajectories. Mortality risks associated with obesity trajectories have declined across cohorts, while the prevalence of high-risk trajectories has increased. CONCLUSIONS The mortality impact of weight gain depends on an individual's BMI trajectory. Population attributable deaths associated with unhealthy weight trajectories have grown over generations because the prevalence has increased, offsetting the decline in trajectory-specific mortality risks.
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Affiliation(s)
- Hui Zheng
- Ohio State University, Columbus, OH.
| | | | - Neil Mehta
- University of Texas Medical Branch, Galveston, Texas
| | - Mikko Myrskylä
- Max Planck Institute for Demographic Research, Rostock, Germany
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22
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Pereira DDS, Oliveira MHD, Conde WL. Overweight and Risk of Noncommunicable Diseases in Adulthood: An Analysis of NHANES IV 2015-2016. J Am Coll Nutr 2021; 41:392-398. [PMID: 33783330 DOI: 10.1080/07315724.2021.1891586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND Worldwide, overweight is one of the main risk factors for Noncommunicable Diseases (NCDs). In this scenario, Body Mass Index (BMI) is the main tool to assess nutritional status of the adult population. AIM To analyze the association between overweight and the risk of developing type 2 diabetes Mellitus (T2DM) and/or high blood pressure (HBP) during adulthood. SUBJECTS AND METHODS We used data of subjects aged between 30-64 years old from the United States National Survey of Health and Nutrition Examination (2015-2016). We calculated the risk of developing T2DM and/or HBP in adulthood using a Log-Binomial Regression model. We included sampling weights in our analysis and we adjusted it for confounding factors. RESULTS We evaluated a total of 2,666 individuals. Overweight affected around 38% of the sample when they were 25 years old and around 70% during the interview. We found 4 factors (overweight, smoking, sedentary lifestyle, and age) that were positively associated with the development of T2DM and/or HBP. Long-term overweight more than doubles the risk of developing these diseases [RR = 2.44; 95%CI: 1.92-3.09]. CONCLUSION The incidence of T2DM and/or HBP were positively associated with the overweight in adulthood. These results suggest that the prevention of overweight could decrease NCDs prevalence into adulthood.
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Affiliation(s)
| | | | - Wolney Lisboa Conde
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil
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23
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Zhu Y, Zheng R, Hu C, Qin G, Wang B, Wang T, Yu X, Tang X, Hu R, Su Q, Zhang J, Zhang Y, Zhao Z, Xu Y, Li M, Chen Y, Wang S, Shi L, Wan Q, Chen G, Dai M, Zhang D, Gao Z, Wang G, Shen F, Luo Z, Qin Y, Chen L, Huo Y, Li Q, Ye Z, Zhang Y, Liu C, Wang Y, Wu S, Yang T, Deng H, Chen L, Zhao J, Mu Y, Yan L, Wang W, Ning G, Bi Y, Lu J, Xu M. Association of early adulthood weight and subsequent weight change with cardiovascular diseases: Findings from REACTION study. Int J Cardiol 2021; 332:209-215. [PMID: 33667580 DOI: 10.1016/j.ijcard.2021.02.086] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 02/07/2021] [Accepted: 02/26/2021] [Indexed: 02/06/2023]
Abstract
BACKGROUND Excessive adiposity in adulthood is positively associated with the risk of cardiovascular disease (CVD). However, it is less studied how the risk is separately explained by early adulthood weight and later weight change, especially in Asian ancestries. METHODS This study included 121160 participants in a large population-based cohort in China. Body weight at 20 and 40 years of age wase self-reported. Information on CVD history was obtained through standard questionnaires. RESULTS The odds ratios (ORs) were 1.20 (95% CI, 1.10-1.31) for coronary heart disease (CHD), 1.74 (95% CI, 1.36-2.22) for myocardial infarction (MI), 1.14 (95% CI, 0.99-1.32) for stroke and 1.21 (95% CI, 1.12-1.31) for total CVD among individuals with early overweight, and became more prominent for early obesity. Meanwhile, A moderate weight gain of 2.5 kg between early adulthood and midlife significantly increased the risk of CHD (OR: 1.18, 95% CI: 1.05-1.32), stroke (OR: 1.19, 95% CI: 1.03-1.38) and total CVD (OR: 1.15, 95% CI: 1.04-1.27), and the risk escalated with higher amounts of weight gain. Conversely, a weight loss of 2.5 kg conferred lower risk of CVD compared with a stable weight. In further cross-analysis, participants with early adulthood overweight or obesity and significant weight gain afterwards exhibited the greatest risk of CVD. CONCLUSIONS High early adulthood BMI and subsequent weight gain had both independent and combined effect on the risk of CVD after midlife. Therefore, weight management should start before early adulthood, and emphasized throughout adulthood for CVD prevention.
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Affiliation(s)
- Yuanyue Zhu
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai National Clinical Research Center for metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ruizhi Zheng
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai National Clinical Research Center for metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Chunyan Hu
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai National Clinical Research Center for metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Guijun Qin
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Bin Wang
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai National Clinical Research Center for metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Tiange Wang
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai National Clinical Research Center for metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xuefeng Yu
- Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xulei Tang
- The First Hospital of Lanzhou University, Lanzhou, China
| | - Ruying Hu
- Zhejiang Provincial Center for Disease Control and Prevention, China
| | - Qing Su
- Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Jie Zhang
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai National Clinical Research Center for metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yi Zhang
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai National Clinical Research Center for metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zhiyun Zhao
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai National Clinical Research Center for metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yu Xu
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai National Clinical Research Center for metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Mian Li
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai National Clinical Research Center for metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yuhong Chen
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai National Clinical Research Center for metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Shuangyuan Wang
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai National Clinical Research Center for metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Lixin Shi
- Affiliated Hospital of Guiyang Medical College, Guiyang, China
| | - Qin Wan
- The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Gang Chen
- Fujian Provincial Hospital, Fujian Medical University, Fuzhou, China
| | - Meng Dai
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai National Clinical Research Center for metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Di Zhang
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai National Clinical Research Center for metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zhengnan Gao
- Dalian Municipal Central Hospital, Dalian, China
| | - Guixia Wang
- The First Hospital of Jilin University, Changchun, China
| | - Feixia Shen
- The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Zuojie Luo
- The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Yingfen Qin
- The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Li Chen
- Qilu Hospital of Shandong University, Jinan, China
| | - Yanan Huo
- Jiangxi Provincial People's Hospital, Nanchang University, Nanchang, China
| | - Qiang Li
- The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Zhen Ye
- Zhejiang Provincial Center for Disease Control and Prevention, China
| | - Yinfei Zhang
- Central Hospital of Shanghai Jiading District, Shanghai, China
| | - Chao Liu
- Jiangsu Province Hospital on Integration of Chinese and Western Medicine, Nanjing, China
| | - Youmin Wang
- The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Shengli Wu
- Karamay Municipal People's Hospital, Xinjiang, China
| | - Tao Yang
- The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Huacong Deng
- The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Lulu Chen
- Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jiajun Zhao
- Shandong Provincial Hospital, Shandong University, Jinan, China
| | - Yiming Mu
- Chinese People's Liberation Army General Hospital, Beijing, China
| | - Li Yan
- Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Weiqing Wang
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai National Clinical Research Center for metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Guang Ning
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai National Clinical Research Center for metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yufang Bi
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai National Clinical Research Center for metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
| | - Jieli Lu
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai National Clinical Research Center for metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
| | - Min Xu
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai National Clinical Research Center for metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
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Whole Blood Metabolomics in Aging Research. Int J Mol Sci 2020; 22:ijms22010175. [PMID: 33375345 PMCID: PMC7796096 DOI: 10.3390/ijms22010175] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 12/25/2020] [Accepted: 12/25/2020] [Indexed: 02/08/2023] Open
Abstract
Diversity is observed in the wave of global aging because it is a complex biological process exhibiting individual variability. To assess aging physiologically, markers for biological aging are required in addition to the calendar age. From a metabolic perspective, the aging hypothesis includes the mitochondrial hypothesis and the calorie restriction (CR) hypothesis. In experimental models, several compounds or metabolites exert similar lifespan-extending effects, like CR. However, little is known about whether these metabolic modulations are applicable to human longevity, as human aging is greatly affected by a variety of factors, including lifestyle, genetic or epigenetic factors, exposure to stress, diet, and social environment. A comprehensive analysis of the human blood metabolome captures complex changes with individual differences. Moreover, a non-targeted analysis of the whole blood metabolome discloses unexpected aspects of human biology. By using such approaches, markers for aging or aging-relevant conditions were identified. This information should prove valuable for future diagnosis or clinical interventions in diseases relevant to aging.
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25
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Vasiloglou MF, Lu Y, Stathopoulou T, Papathanail I, Faeh D, Ghosh A, Baumann M, Mougiakakou S. Assessing Mediterranean Diet Adherence with the Smartphone: The Medipiatto Project. Nutrients 2020; 12:nu12123763. [PMID: 33297550 PMCID: PMC7762404 DOI: 10.3390/nu12123763] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 12/01/2020] [Accepted: 12/02/2020] [Indexed: 02/06/2023] Open
Abstract
The Mediterranean diet (MD) is regarded as a healthy eating pattern with beneficial effects both for the decrease of the risk for non-communicable diseases and also for body weight reduction. In the current manuscript, we propose an automated smartphone application which monitors and evaluates the user’s adherence to MD using images of the food and drinks that they consume. We define a set of rules for automatic adherence estimation, which focuses on the main MD food groups. We use a combination of a convolutional neural network (CNN) and a graph convolutional network to detect the types of foods and quantities from the users’ food images and the defined set of rules to evaluate the adherence to MD. Our experiments show that our system outperforms a basic CNN in terms of recognizing food items and estimating quantity and yields comparable results as experienced dietitians when it comes to overall MD adherence estimation. As the system is novel, these results are promising; however, there is room for improvement of the accuracy by gathering and training with more data and certain refinements can be performed such as re-defining the set of rules to also be able to be used for sub-groups of MD (e.g., vegetarian type of MD).
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Affiliation(s)
- Maria F. Vasiloglou
- ARTORG Center for Biomedical Engineering Research, University of Bern, 3008 Bern, Switzerland; (M.F.V.); (Y.L.); (T.S.); (I.P.)
| | - Ya Lu
- ARTORG Center for Biomedical Engineering Research, University of Bern, 3008 Bern, Switzerland; (M.F.V.); (Y.L.); (T.S.); (I.P.)
| | - Thomai Stathopoulou
- ARTORG Center for Biomedical Engineering Research, University of Bern, 3008 Bern, Switzerland; (M.F.V.); (Y.L.); (T.S.); (I.P.)
| | - Ioannis Papathanail
- ARTORG Center for Biomedical Engineering Research, University of Bern, 3008 Bern, Switzerland; (M.F.V.); (Y.L.); (T.S.); (I.P.)
| | - David Faeh
- Epidemiology, Biostatistics and Prevention Institute (EBPI), University of Zurich, 8001 Zurich, Switzerland;
| | - Arindam Ghosh
- Oviva S.A., 8852 Altendorf, Switzerland; (A.G.); (M.B.)
| | | | - Stavroula Mougiakakou
- ARTORG Center for Biomedical Engineering Research, University of Bern, 3008 Bern, Switzerland; (M.F.V.); (Y.L.); (T.S.); (I.P.)
- Correspondence: ; Tel.: +41-31-632-7592
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26
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Nicholson E, Allison DJ, Bullock A, Heisz JJ. Examining the obesity paradox: A moderating effect of fitness on adipose endocrine function in older adults. Mech Ageing Dev 2020; 193:111406. [PMID: 33278406 DOI: 10.1016/j.mad.2020.111406] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 11/16/2020] [Accepted: 11/17/2020] [Indexed: 01/26/2023]
Abstract
Despite evidence linking obesity with increased mortality, older adults with excessive adiposity seem protected, resulting in a so-called obesity paradox. Obesity is characterized by leptin resistance, which contributes to increased risk of all-cause mortality. Therefore, lifestyle factors, such as physical fitness, that lower leptin independent of adiposity may be confounding the obesity paradox. To investigate this, we evaluated whether physical fitness moderated the relationship between leptin and adiposity. We found older adults with higher fitness had lower body mass (r(39) = -0.43, p < 0.01), leptin (r(39) = -0.29, p = 0.03) and inflammation (IL-1β: (r(39) = -0.69, p < 0.01); TNF-α: (r(39) = -0.30, p = 0.03)). Fitness moderated the relationship between leptin and adiposity (F(5, 37) = 3.73, p < 0.01, R2 = 0.33) to reveal the obesity paradox in moderately and high fit individuals (b = 216.24, t(37) = 1.46, p = 0.15; b= -88.10, t(37) = -0.49, p = 0.63) but not in low fit individuals. These results show the link between obesity and mortality may not be dependent on total adiposity, but rather on endocrine function and adipocyte leptin secretion. These results have important implications for older adults struggling to maintain healthy body composition and suggest that fitness may promote overall wellbeing.
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Affiliation(s)
- E Nicholson
- McMaster University, 1280 Main Street West, Hamilton, Ontario, L8S 4L8, Canada
| | - D J Allison
- McMaster University, 1280 Main Street West, Hamilton, Ontario, L8S 4L8, Canada
| | - A Bullock
- University of British Columbia, 2215 Wesbrook Mall, Vancouver, British Columbia, V6T 2B5, Canada
| | - J J Heisz
- McMaster University, 1280 Main Street West, Hamilton, Ontario, L8S 4L8, Canada.
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Characteristics of individuals with tuberculosis in an urban, poor population in Osaka City, Japan - a case-control study. Western Pac Surveill Response J 2020; 11:22-28. [PMID: 32963888 PMCID: PMC7485515 DOI: 10.5365/wpsar.2018.9.1.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Objective To identify individual characteristics related to the development of pulmonary tuberculosis (PTB) among residents in the Airin area (Airin), Osaka City, Japan. Methods We conducted a retrospective case-control study of individual characteristics potentially related to the development of PTB by comparing PTB patients and residents without tuberculosis (TB) in Airin. The following binominal data of characteristics were compared: age (< 65 or > 65); body mass index (BMI) (< 18.5 or > 18.5); diabetes mellitus (diagnosed or not diagnosed); smoking (currently smoking any amount or not smoking); and alcohol use (currently drinking any amount or not drinking). Results We compared the individual characteristics of 192 PTB patients notified from January 2015 to December 2018 and 190 residents of supportive houses who attended a health education programme from April 2016 to March 2018. Univariable analysis showed that the following characteristics were significantly related with PTB: BMI < 18.5 (odds ratio [OR]: 6.54, 95% confidence interval [CI]: 3.58–11.97, P < 0.001) and current alcohol use (OR: 1.88; 95% CI: 1.24–2.85, P = 0.003). Multivariable analysis showed similar results: BMI < 18.5 (adjusted odds ratio [aOR]: 6.90, 95% CI: 3.72–12.79, P < 0.001) and current alcohol use (aOR: 2.15, 95% CI: 1.36–3.42, P = 0.001). Discussion Undernutrition and alcohol use are individual characteristics associated with PTB among residents in Airin, Osaka City. To strengthen the TB control programme further, it is suggested to develop new programmes for primary prevention.
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Association of body weight gain with subsequent cardiovascular event in non-obese general population without overt cardiovascular disease. Atherosclerosis 2020; 308:39-44. [DOI: 10.1016/j.atherosclerosis.2020.05.015] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Revised: 05/28/2020] [Accepted: 05/29/2020] [Indexed: 11/19/2022]
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Xie W, Lundberg DJ, Collins JM, Johnston SS, Waggoner JR, Hsiao CW, Preston SH, Manson JE, Stokes AC. Association of Weight Loss Between Early Adulthood and Midlife With All-Cause Mortality Risk in the US. JAMA Netw Open 2020; 3:e2013448. [PMID: 32797174 PMCID: PMC7428805 DOI: 10.1001/jamanetworkopen.2020.13448] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
IMPORTANCE Describing potential mortality risk reduction associated with weight loss between early adulthood and midlife is important for informing primary and secondary prevention efforts for obesity. OBJECTIVE To examine the risk of all-cause mortality among adults who lost weight between early adulthood and midlife compared with adults who were persistently obese over the same period. DESIGN, SETTING, AND PARTICIPANTS Combined repeated cross-sectional analysis was conducted using data from the National Health and Nutrition Examination Survey III (1988-1994) and continuous waves collected in 2-year cycles between 1999 and 2014. The data analysis was conducted from February 10, 2019, to April 20, 2020. Individuals aged 40 to 74 years at the time of survey (baseline) were included in the analyses (n = 24 205). EXPOSURES Weight history was assessed by self-reported weight at age 25 years, at 10 years before baseline (midlife: mean age, 44 years; interquartile range, 37-55), and measured weight at baseline. Body mass index (BMI) (calculated as weight in kilograms divided by height in meters squared) at each time was categorized as normal (18.5-24.9), overweight (25.0-29.9), and obese (≥30.0). Weight change patterns were assessed from age 25 years (early adulthood) to 10 years before baseline (midlife). MAIN OUTCOMES AND MEASURES Incident all-cause mortality using linked data from the National Death Index. RESULTS Of the 24 205 participants, 11 617 were women (49.0%) and 11 567 were non-Hispanic White (76.9%). The mean (SD) BMI was 29.0 (6.1) at baseline. During a mean (SD) follow-up of 10.7 (7.2) years, 5846 deaths occurred. Weight loss from obese to overweight was associated with a 54% (hazard ratio, 0.46; 95% CI, 0.27-0.77) reduction in mortality risk compared with individuals with stable obesity between early adulthood and midlife. An estimated 3.2% (95% CI, 1.6%-4.9%) of early deaths could have been avoided if those who maintained an obese BMI instead lost weight to an overweight BMI by midlife. Overall, an estimated 12.4% (95% CI, 8.1%-16.5%) of early deaths may be attributable to having weight in excess of the normal BMI range at any point between early and mid-adulthood. CONCLUSIONS AND RELEVANCE In this study, weight loss from obesity to overweight between early adulthood through midlife appeared to be associated with a mortality risk reduction compared with persistent obesity. These findings support the importance of population-based approaches to preventing weight gain across the life course and a need for greater emphasis on treating obesity early in life.
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Affiliation(s)
- Wubin Xie
- Department of Global Health, Boston University School of Public Health, Boston, Massachusetts
| | - Dielle J. Lundberg
- Department of Global Health, Boston University School of Public Health, Boston, Massachusetts
| | - Jason M. Collins
- University of North Carolina Gillings School of Public Health, Chapel Hill
| | - Stephen S. Johnston
- Epidemiology, Medical Devices, Johnson & Johnson Inc, New Brunswick, New Jersey
| | | | | | | | - JoAnn E. Manson
- Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
| | - Andrew C. Stokes
- Department of Global Health, Boston University School of Public Health, Boston, Massachusetts
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Rabin JS, Shirzadi Z, Swardfager W, MacIntosh BJ, Schultz A, Yang HS, Buckley RF, Gatchel JR, Kirn D, Pruzin JJ, Hedden T, Lipsman N, Rentz DM, Black SE, Johnson KA, Sperling RA, Chhatwal JP. Amyloid-beta burden predicts prospective decline in body mass index in clinically normal adults. Neurobiol Aging 2020; 93:124-130. [PMID: 32249013 DOI: 10.1016/j.neurobiolaging.2020.03.002] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Revised: 02/12/2020] [Accepted: 03/02/2020] [Indexed: 01/02/2023]
Abstract
In the present study, we tested the hypothesis that higher amyloid-beta (Aβ) burden at baseline is associated with greater longitudinal decline in body mass index (BMI) in clinically normal adults. Participants from the Harvard Aging Brain Study (n = 312) and the Alzheimer's Disease Neuroimaging Initiative (n = 336) underwent Aβ positron emission tomography at baseline. BMI was assessed longitudinally over a median of >4 years. Linear mixed models showed that higher baseline Aβ burden was significantly associated with greater decline in BMI in both the Harvard Aging Brain Study (t = -1.93; p = 0.05) and Alzheimer's Disease Neuroimaging Initiative cohorts (t = -2.54; p = 0.01), after adjusting for covariates, including cognitive performance and depressive symptoms. In addition, the association of Aβ burden with longitudinal decline in BMI persisted in both cohorts after excluding participants with diabetes/endocrine disturbances and participants classified as underweight or obese (BMI <18.5 or >30). These findings suggest that decline in BMI in clinically normal adults may be an early manifestation related to cerebral amyloidosis that precedes objective cognitive impairment. Therefore, unintentional BMI decline in otherwise healthy individuals might alert clinicians to increased risk of Alzheimer's disease.
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Affiliation(s)
- Jennifer S Rabin
- Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, Toronto, Ontario, Canada; Harquail Centre for Neuromodulation, Sunnybrook Research Institute, Toronto, Ontario, Canada; Department of Medicine, Division of Neurology, University of Toronto, Toronto, Ontario, Canada; Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Zahra Shirzadi
- Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, Toronto, Ontario, Canada; Department of Medical Biophysics, University of Toronto, Toronto, Ontario, Canada
| | - Walter Swardfager
- Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, Toronto, Ontario, Canada; Department of Pharmacology & Toxicology, University of Toronto, Toronto, Ontario, Canada
| | - Bradley J MacIntosh
- Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, Toronto, Ontario, Canada; Department of Medical Biophysics, University of Toronto, Toronto, Ontario, Canada
| | - Aaron Schultz
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA; Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Hyun-Sik Yang
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA; Center for Alzheimer Research and Treatment, Department of Neurology, Brigham and Women's Hospital; Boston, MA, USA
| | - Rachel F Buckley
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA; Center for Alzheimer Research and Treatment, Department of Neurology, Brigham and Women's Hospital; Boston, MA, USA; Florey Institutes of Neuroscience and Mental Health, Melbourne and Melbourne School of Psychological Science, University of Melbourne, Melbourne, Australia
| | - Jennifer R Gatchel
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Dylan Kirn
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Jeremy J Pruzin
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA; Center for Alzheimer Research and Treatment, Department of Neurology, Brigham and Women's Hospital; Boston, MA, USA
| | - Trey Hedden
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA; Department of Neurology, Icahn School of Medicine, Mount Sinai, New York, NY, USA
| | - Nir Lipsman
- Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, Toronto, Ontario, Canada; Harquail Centre for Neuromodulation, Sunnybrook Research Institute, Toronto, Ontario, Canada; Department of Medicine, Division of Neurosurgery, University of Toronto, Toronto, Ontario, Canada
| | - Dorene M Rentz
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA; Center for Alzheimer Research and Treatment, Department of Neurology, Brigham and Women's Hospital; Boston, MA, USA
| | - Sandra E Black
- Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, Toronto, Ontario, Canada; Department of Medicine, Division of Neurology, University of Toronto, Toronto, Ontario, Canada
| | - Keith A Johnson
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA; Center for Alzheimer Research and Treatment, Department of Neurology, Brigham and Women's Hospital; Boston, MA, USA; Division of Nuclear Medicine and Molecular Imaging, Massachusetts General Hospital, Boston, MA, USA
| | - Reisa A Sperling
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA; Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA; Center for Alzheimer Research and Treatment, Department of Neurology, Brigham and Women's Hospital; Boston, MA, USA
| | - Jasmeer P Chhatwal
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA; Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA; Center for Alzheimer Research and Treatment, Department of Neurology, Brigham and Women's Hospital; Boston, MA, USA.
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Banack HR, Bea JW, Stokes A, Kroenke CH, Stefanick ML, Beresford SA, Bird CE, Garcia L, Wallace R, Wild RA, Caan B, Wactawski-Wende J. It's Absolutely Relative: The Effect of Age on the BMI-Mortality Relationship in Postmenopausal Women. Obesity (Silver Spring) 2020; 28:171-177. [PMID: 31799808 PMCID: PMC6989046 DOI: 10.1002/oby.22662] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Accepted: 08/27/2019] [Indexed: 01/15/2023]
Abstract
OBJECTIVE The use of relative and absolute effect estimates has important implications for the interpretation of study findings. Likewise, examining additive and multiplicative interaction can lead to differing conclusions about the joint effects of two exposure variables. The aim of this paper is to examine the relationship between BMI and mortality on the relative and absolute scales and investigate interaction between BMI and age. METHODS Data from 68,132 participants in the Women's Health Initiative (WHI) study were used. The risk ratio and risk difference of BMI on mortality were estimated. A product term was also included to examine interaction between BMI and age on the multiplicative scale, and the relative excess risk of interaction was calculated to measure additive interaction. RESULTS Results demonstrated that the mortality risk ratio decreased as women aged, but the mortality risk difference increased as women aged. Evidence of additive and multiplicative interaction between age and BMI was found. CONCLUSIONS In postmenopausal women, the relative mortality risk associated with high BMI decreased with increasing age, but the absolute risk of high BMI increased with increasing age. This indicates the importance of considering the interaction between age and BMI to understand mortality risk in older women.
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Affiliation(s)
- Hailey R Banack
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, The State University of New York, Buffalo, New York, USA
| | - Jennifer W Bea
- Department of Nutrition Sciences, University of Arizona Cancer Center, University of Arizona, Tucson, Arizona, USA
| | - Andrew Stokes
- Department of Global Health and Center for Global Health and Development, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Candyce H Kroenke
- Division of Research, Kaiser Permanente Northern California, Oakland, California, USA
| | - Marcia L Stefanick
- Division of Cardiovascular Medicine, Department of Medicine, Stanford University School of Medicine, Stanford, California, USA
| | - Shirley A Beresford
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, Washington, USA
| | | | - Lorena Garcia
- Department of Public Health Sciences, University of California, Davis, Davis, California, USA
| | - Robert Wallace
- Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, Iowa, USA
| | - Robert A Wild
- Department of Obstetrics and Gynecology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - Bette Caan
- Division of Research, Kaiser Permanente Northern California, Oakland, California, USA
| | - Jean Wactawski-Wende
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, The State University of New York, Buffalo, New York, USA
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Chen C, Ye Y, Zhang Y, Pan XF, Pan A. Weight change across adulthood in relation to all cause and cause specific mortality: prospective cohort study. BMJ 2019; 367:l5584. [PMID: 31619383 PMCID: PMC6812615 DOI: 10.1136/bmj.l5584] [Citation(s) in RCA: 139] [Impact Index Per Article: 27.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/29/2019] [Indexed: 01/17/2023]
Abstract
OBJECTIVE To investigate the association between weight changes across adulthood and mortality. DESIGN Prospective cohort study. SETTING US National Health and Nutrition Examination Survey (NHANES) 1988-94 and 1999-2014. PARTICIPANTS 36 051 people aged 40 years or over with measured body weight and height at baseline and recalled weight at young adulthood (25 years old) and middle adulthood (10 years before baseline). MAIN OUTCOME MEASURES All cause and cause specific mortality from baseline until 31 December 2015. RESULTS During a mean follow-up of 12.3 years, 10 500 deaths occurred. Compared with participants who remained at normal weight, those moving from the non-obese to obese category between young and middle adulthood had a 22% (hazard ratio 1.22, 95% confidence interval 1.11 to 1.33) and 49% (1.49, 1.21 to 1.83) higher risk of all cause mortality and heart disease mortality, respectively. Changing from obese to non-obese body mass index over this period was not significantly associated with mortality risk. An obese to non-obese weight change pattern from middle to late adulthood was associated with increased risk of all cause mortality (1.30, 1.16 to 1.45) and heart disease mortality (1.48, 1.14 to 1.92), whereas moving from the non-obese to obese category over this period was not significantly associated with mortality risk. Maintaining obesity across adulthood was consistently associated with increased risk of all cause mortality; the hazard ratio was 1.72 (1.52 to 1.95) from young to middle adulthood, 1.61 (1.41 to 1.84) from young to late adulthood, and 1.20 (1.09 to 1.32) from middle to late adulthood. Maximum overweight had a very modest or null association with mortality across adulthood. No significant associations were found between various weight change patterns and cancer mortality. CONCLUSIONS Stable obesity across adulthood, weight gain from young to middle adulthood, and weight loss from middle to late adulthood were associated with increased risks of mortality. The findings imply that maintaining normal weight across adulthood, especially preventing weight gain in early adulthood, is important for preventing premature deaths in later life.
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Affiliation(s)
- Chen Chen
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
- Ministry of Education Key Laboratory of Environment and Health, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Yi Ye
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
- Ministry of Education Key Laboratory of Environment and Health, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Yanbo Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
- Ministry of Education Key Laboratory of Environment and Health, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Xiong-Fei Pan
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
- Ministry of Education Key Laboratory of Environment and Health, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - An Pan
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
- Ministry of Education Key Laboratory of Environment and Health, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
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Banack HR, Bea JW, Kaufman JS, Stokes A, Kroenke CH, Stefanick ML, Beresford SA, Bird CE, Garcia L, Wallace R, Wild RA, Caan B, Wactawski-Wende J. The Effects of Reverse Causality and Selective Attrition on the Relationship Between Body Mass Index and Mortality in Postmenopausal Women. Am J Epidemiol 2019; 188:1838-1848. [PMID: 31274146 DOI: 10.1093/aje/kwz160] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Revised: 06/25/2019] [Accepted: 06/26/2019] [Indexed: 12/12/2022] Open
Abstract
Concerns about reverse causality and selection bias complicate the interpretation of studies of body mass index (BMI, calculated as weight (kg)/height (m)2) and mortality in older adults. The objective of this study was to investigate methodological explanations for the apparent attenuation of obesity-related risks in older adults. We used data from 68,132 participants in the Women's Health Initiative (WHI) clinical trial for this analysis. All of the participants were postmenopausal women aged 50-79 years at baseline (1993-1998). To examine reverse causality and selective attrition, we compared rate ratios from inverse probability of treatment- and censoring-weighted Poisson marginal structural models with results from an unweighted adjusted Poisson regression model. The estimated mortality rate ratios and 95% confidence intervals for BMIs of 30.0-34.9, 35.0-39.9 and ≥40.0 were 0.86 (95% confidence interval (CI): 0.77, 0.96), 0.85 (95% CI: 0.72, 0.99), and 0.88 (95% CI: 0.72, 1.07), respectively, in the unweighted model. The corresponding mortality rate ratios were 0.96 (95% CI: 0.86, 1.07), 1.12 (95% CI: 0.97, 1.29), and 1.31 95% CI: (1.08, 1.57), respectively, in the marginal structural model. Results from the inverse probability of treatment- and censoring-weighted marginal structural model were attenuated in low BMI categories and increased in high BMI categories. The results demonstrate the importance of accounting for reverse causality and selective attrition in studies of older adults.
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Dose–response relationship between body mass index and risks of all-cause mortality and disability among the elderly: A systematic review and meta-analysis. Clin Nutr 2019; 38:1511-1523. [DOI: 10.1016/j.clnu.2018.07.021] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Accepted: 07/18/2018] [Indexed: 01/01/2023]
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Jeon J, Jung KJ, Jee SH. Waist circumference trajectories and risk of type 2 diabetes mellitus in Korean population: the Korean genome and epidemiology study (KoGES). BMC Public Health 2019; 19:741. [PMID: 31196038 PMCID: PMC6567400 DOI: 10.1186/s12889-019-7077-6] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Accepted: 05/30/2019] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND To classify waist circumference (WC) trajectories and examine each trajectory's association with risk of incident type 2 diabetes mellitus (T2DM). METHODS In Korean Genome and Epidemiology Study (KoGES 2001-2014), 4992 participants aged 40 years and above who received biennial health examinations from wave 1 to wave 4 (2001-2008) were selected. Five distinct trajectory groups were identified for WC using group-based trajectory modeling methods such as censored normal model. Cox proportional hazards model was used to examine the association of trajectories with risk of T2DM. RESULTS During 31,118 person-years of follow-up (mean follow-up duration, 6.2 years), 276 incident cases of T2DM were identified. Through trajectory analysis, 5 distinct WC patterns were found during wave1 to wave 4, which were "Group A" was stable on very low levels, "Group B" was stable on low levels, "Group C" was stable on moderate levels, "Group D" had increasing pattern on elevated levels, "Group E" was shown increasing on high levels. Age-standardized incidences rates per 100,000 person-years were increased with WC expanding trajectory group (193.9 for Group A, 498.4 for Group B, 661.9 for Group C, 1845.9 for Group D, and 2045.0 for Group E). In multivariate analysis after adjusting for confounding variable at wave 4, Group B (Hazard ratio (HR), 2.2; 95% confidence interval (CI), and 1.1-4.6), Group C (HR: 2.5, 95% CI: 1.2-5.0), Group D (HR: 5.4, 95% CI: 2.7-10.9), Group E (HR: 7.3, 95% CI: 3.5-15.4) had a higher risk of T2DM than Group A. After further adjusting for body mass index strongly correlated with WC, the association was attenuated. CONCLUSIONS WC trajectory was a significant predictor of T2DM risk in increasing trajectories on high level. This finding indicate the importance of WC management across prolong lifespan by assessing the prognosis and prevention strategies of high-risk populations for T2DM in middle-aged adults.
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Affiliation(s)
- Jooeun Jeon
- Department of Public Health, Graduate School, Yonsei University, 50 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea.,Department of Epidemiology and Health Promotion, Institute for Health Promotion, Graduate School of Public Health, Yonsei University, 50 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea
| | - Keum Ji Jung
- Department of Epidemiology and Health Promotion, Institute for Health Promotion, Graduate School of Public Health, Yonsei University, 50 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea.
| | - Sun Ha Jee
- Department of Epidemiology and Health Promotion, Institute for Health Promotion, Graduate School of Public Health, Yonsei University, 50 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea
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Nordstoga AL, Zotcheva E, Svedahl ER, Nilsen TIL, Skarpsno ES. Long-term changes in body weight and physical activity in relation to all-cause and cardiovascular mortality: the HUNT study. Int J Behav Nutr Phys Act 2019; 16:45. [PMID: 31109336 PMCID: PMC6528195 DOI: 10.1186/s12966-019-0809-2] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Accepted: 05/10/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Most previous studies have relied on single measurements of body weight and physical activity and have not considered the interplay between long-term changes in body weight and physical activity in relation to mortality. The aim of the current study was therefore to examine the joint effect of changes in body weight and leisure-time physical activity over a period of ~ 10 years on all-cause and cardiovascular mortality. METHODS The study population comprised 34,257 individuals who participated in the first (1984-86) and second (1995-97) waves of the HUNT Study, and were followed up through the Norwegian Cause of Death Registry until December 31st, 2013. We used Cox regression to estimate hazard ratios (HR) with 95% confidence intervals (CI) of death associated with changes in body weight and leisure-time physical activity. RESULTS Compared to the reference group with stable weight who were long-term physically active, people who gained ≥5% of their weight had a HR for all-cause mortality of 1.54 (95% CI: 1.28-1.85) if they were long-term physically inactive; a HR of 1.23 (1.09-1.40) if they became physically active, and a HR of 1.00 (95% CI 0.94-1.06) if they were long-term physically active. The corresponding HRs for cardiovascular mortality were 1.57 (95% CI 1.17-2.12), 1.28 (95% CI 1.04-1.58) and 1.06 (95% CI 0.96-1.16), respectively. Long-term physical inactivity was associated with increased all-cause (HR 1.29; 95% CI 1.08-1.53) and cardiovascular (HR 1.37; 95% CI 1.05-1.79) mortality among those who were weight stable. CONCLUSIONS The risk of all-cause and cardiovascular mortality is particularly evident among people who gain weight while remaining inactive during a ~ 10 year period. However, participants who remained physically active had the lowest risk of premature mortality, regardless of maintenance or increase in weight. These findings suggest that there is an interplay between long-term changes in body weight and physical activity that should receive particular attention in the prevention of premature mortality.
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Affiliation(s)
- Anne Lovise Nordstoga
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Håkon Jarls gate, 11, 7030, Trondheim, Norway
| | - Ekaterina Zotcheva
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Håkon Jarls gate, 11, 7030, Trondheim, Norway.
| | - Ellen Rabben Svedahl
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Håkon Jarls gate, 11, 7030, Trondheim, Norway
| | - Tom I L Nilsen
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Håkon Jarls gate, 11, 7030, Trondheim, Norway.,Clinic of Anaesthesia and Intensive Care, St Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Eivind Schjelderup Skarpsno
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Håkon Jarls gate, 11, 7030, Trondheim, Norway.,Department of Neurology and Clinical Neurophysiology, St. Olavs Hospital, Trondheim, Norway
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Zaninotto P, Lassale C. Socioeconomic trajectories of body mass index and waist circumference: results from the English Longitudinal Study of Ageing. BMJ Open 2019; 9:e025309. [PMID: 31005916 PMCID: PMC6500398 DOI: 10.1136/bmjopen-2018-025309] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVES To explore age trajectories of body mass index (BMI) and waist circumference (WC) and to examine whether these trajectories varied by wealth. DESIGN Nationally representative prospective cohort study. SETTING Observational study of people living in England. PARTICIPANTS 7416 participants aged 52 and over of the English Longitudinal Study of Ageing (2004-2012). PRIMARY OUTCOME MEASURES BMI and WC assessed objectively by a trained nurse. MAIN EXPOSURE MEASURE Total non-pension household wealth quintiles defined as financial wealth, physical wealth (such as business wealth, land or jewels) and housing wealth (primary and secondary residential housing wealth), minus debts. RESULTS Using latent growth curve models, we showed that BMI increased by 0.03 kg/m2 (95% CI 0.02 to 0.04, p<0.001) per year and WC by 0.18 cm (95% CI 0.15 to 0.22, p<0.001). Age (linear and quadratic) showed a negative association with BMI and WC baseline and rates of change, indicating that older individuals had smaller body sizes and that the positive rates of change flattened to eventually become negative. The decline occurred around the age of 71 years for BMI and 80 years for WC. Poorest wealth was significantly related to higher baseline levels of BMI (1.97 kg/m2 95% CI 0.99 to 1.55, p<0.001) and WC (4.66 cm 95% CI 3.68 to 2.40, p<0.001). However, no significant difference was found in the rate of change of BMI and WC by wealth, meaning that the age trajectories of BMI and WC were parallel across wealth categories and that the socioeconomic gap did not close at older ages. CONCLUSIONS Older English adults showed an increase in BMI and WC over time but this trend reversed at older old age to display a sharp decrease. At any given age wealthier people had more favourable BMI and WC profile.
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Affiliation(s)
- Paola Zaninotto
- Epidemiology and Public Health, University College London, London, UK
| | - Camille Lassale
- Epidemiology and Public Health, University College London, London, UK
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Kim MK, Han K, Koh ES, Kim ES, Lee MK, Nam GE, Kwon HS. Weight change and mortality and cardiovascular outcomes in patients with new-onset diabetes mellitus: a nationwide cohort study. Cardiovasc Diabetol 2019; 18:36. [PMID: 30890169 PMCID: PMC6423842 DOI: 10.1186/s12933-019-0838-9] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Accepted: 03/03/2019] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Because weight control is a cornerstone of diabetes management, it is important to understand the relationship of weight change to risk of cardiovascular disease (CVD) among patients with type 2 diabetes mellitus (DM). We aimed to investigate whether changes in weight early after diagnosis influence the incidence of CVD and all-cause mortality in patients with type 2 DM. METHODS Using nationally representative data from the Korean National Health Insurance System, 173,246 subjects with new-onset DM who underwent health examinations during 2007-2012 were included. Weight was measured at the time of diabetes diagnosis and 2 years later. Weight change over 2 years was divided into five categories of 5% weight change, from weight loss ≥ - 10% to weight gain ≥ 10%. RESULTS There were 3113 deaths (1.8%), 2060 cases of stroke (1.2%), and 1767 myocardial infarctions (MIs) (1.0%) during a median follow-up of 5.5 years. Subjects with weight gain ≥ 10% had a significantly higher risk of stroke (hazard ratio [HR] 1.51, 95% confidence interval [CI] 1.23-1.84), compared with the group with stable weight. There was no significant association between weight change after diagnosis of DM and incident MI. All-cause mortality showed a U-shaped curve according to weight change. The group with weight loss ≥ - 10% had the highest HR for all-cause mortality (HR 1.86; 95% CI 1.61-2.14) and the HR for weight gain ≥ 10% was 1.61 (95% CI 1.37-1.89). CONCLUSIONS Weight changes of more than 10% after diabetes diagnosis were associated with higher mortality and over 10% weight gain was associated with increased risk of stroke.
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Affiliation(s)
- Mee Kyoung Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, #10 63-ro, Yeongdeungpo-gu, Seoul, 07345, South Korea
| | - Kyungdo Han
- Department of Medical Statistics, College of Medicine, The Catholic University of Korea, Seoul, 06591, South Korea
| | - Eun Sil Koh
- Division of Nephrology, Department of Internal Medicine, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, 07345, South Korea
| | - Eun Sook Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, 21431, South Korea
| | - Min-Kyung Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Myongji Hospital, Goyang-Si, Gyeonggi-do, 10475, South Korea
| | - Ga Eun Nam
- Department of Family Medicine, Sahmyook Medical Center, Seoul, 02500, South Korea
| | - Hyuk-Sang Kwon
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, #10 63-ro, Yeongdeungpo-gu, Seoul, 07345, South Korea.
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Positive Mental Attitude Associated with Lower 35-Year Mortality: The Leisure World Cohort Study. J Aging Res 2019; 2018:2126368. [PMID: 30595919 PMCID: PMC6286774 DOI: 10.1155/2018/2126368] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Revised: 10/22/2018] [Accepted: 10/25/2018] [Indexed: 12/21/2022] Open
Abstract
Background Although emerging research has suggested that "positive psychological well-being" is associated with better health outcomes, studies of long-term health and mortality in the elderly are limited. This study assessed the relationship of mental attitude and mortality in older adults followed up for 35 years. Methods In the 1980s, the Leisure World Cohort Study recruited residents of a California retirement community to a prospective cohort study of health promotion and disease prevention. Participants completed a postal survey including seven positively worded items from the Zung self-rating depression scale. Age-adjusted and multivariable-adjusted (for lifestyle behaviors and disease conditions) hazard ratios (HRs) for death were calculated using Cox regression for 8682 women and 4992 men (median age at entry, 74 years). During follow-up (1981-2016), 13,405 participants died (median age at death, 88 years). Results In both women and men, HRs for death were significantly related to mental attitude with increasing risk with decreasing positive responses for total attitude and the seven individual items. The multivariable-adjusted HR (95% CI) for death for individuals in the lowest vs. highest quarter of total attitude was 1.24 (1.16, 1.32) for women and 1.30 (1.19, 1.41) for men. Some attenuation in the observed associations occurred after adjustment for potential confounders and after elimination of the first five years of follow-up. Conclusions Our study suggests that persons with negative attitude have an increased risk of death even after many years of follow-up. Research into strategies to improve mental outlook may help improve the quantity as well as the quality of life.
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LeBlanc ES, Rizzo JH, Pedula KL, Yaffe K, Ensrud KE, Cauley JA, Cawthon PM, Cummings SR, Hillier TA. Long-Term Weight Trajectory and Risk of Hip Fracture, Falls, Impaired Physical Function, and Death. J Am Geriatr Soc 2018; 66:1972-1979. [PMID: 30151825 DOI: 10.1111/jgs.15532] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
OBJECTIVES To determine the association between weight trajectory, health status, and mortality in older women. DESIGN Cohort study. SETTING Study of Osteoporotic Fractures. PARTICIPANTS Older community-dwelling women (age: baseline (1986-88), mean 68, range 65-81; Year 20 (2006-08), mean 88, range 83-102 (N = 1,323)). MEASUREMENTS Body weight measured repeatedly over 20 years (mean 8 times). Logistic and Cox proportional hazard models were used to evaluate whether 20-year weight trajectory measures were associated with hip fracture, falls, physical performance, and mortality. RESULTS In models adjusted for age, clinic, calcium use, Year 20 weight, walking speed, comorbidity score, smoking, self-reported health, and walking for exercise, women with moderate weight loss (>9.0 kg) over 20 years had a 74% greater risk of death (hazard ratio (HR) = 1.74, 95% confidence interval (CI) = 1.37-2.20) in the 5 years after the Year 20 visit than those with no weight loss and more than twice the risk of hip fracture (HR = 2.56, 95% CI = 1.39-4.70). They were 3.6 times (odds ratio (OR) = 3.60, 95% CI = 1.86-6.95) as likely to have poor physical function at the Year 20 visit as women with no weight loss but no greater risk of 2 or more falls in the 1.5 years after the Year 20 visit. Weight variability and abrupt weight decline were not associated with adverse health oucomes (falls, fractures, mortality), but those in the highest quartile of variability were 2.3 times (OR = 2.26, 95% CI = 1.34-3.80) as likely to have poor physical function scores. CONCLUSION In women surviving past 80 years of age, moderate weight loss over 20 years was associated with greater risk of hip fracture, poor physical function, and mortality but not of falls. Future work should separate voluntary from involuntary weight loss.
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Affiliation(s)
- Erin S LeBlanc
- Center for Health Research, Kaiser Permanente Northwest, Portland, Oregon
| | - Joanne H Rizzo
- Center for Health Research, Kaiser Permanente Northwest, Portland, Oregon
| | - Kathryn L Pedula
- Center for Health Research, Kaiser Permanente Northwest, Portland, Oregon
| | - Kristine Yaffe
- Departments of Psychiatry.,Neurology.,Epidemiology and Biostatistics, School of Medicine, University of California, San Francisco, San Francisco, California.,San Francisco Veterans Affairs Medical Center, San Francisco, California
| | - Kristine E Ensrud
- Department of Medicine, School of Medicine.,Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota.,Center for Chronic Disease Outcomes Research, Veterans Affairs Health Care System, Minneapolis, Minnesota
| | - Jane A Cauley
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Peggy M Cawthon
- Research Institute, California Pacific Medical Center, San Francisco, California
| | - Steven R Cummings
- Research Institute, California Pacific Medical Center, San Francisco, California
| | - Teresa A Hillier
- Center for Health Research, Kaiser Permanente Northwest, Portland, Oregon.,Center for Health Research, Kaiser Permanente Hawaii, Honolulu, Hawaii
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- Center for Health Research, Kaiser Permanente Northwest, Portland, Oregon
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The impact of obesity and overweight on medical expenditures and disease incidence in Korea from 2002 to 2013. PLoS One 2018; 13:e0197057. [PMID: 29746509 PMCID: PMC5944944 DOI: 10.1371/journal.pone.0197057] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2017] [Accepted: 04/25/2018] [Indexed: 12/25/2022] Open
Abstract
Objectives Few studies have assessed the long-term medical costs and incidence of obesity and overweight in Asia. We evaluated the impact of body mass index (BMI) on medical expenditures and disease incidence and prevalence over more than 10 years in South Korea. Methods Using 2002–2013 data from the Korean National Claims Database, we analysed two population sets (initial BMI in 2002–2003; consistent BMI in 2002–2003 and 2012–2013). Obesity was defined by Asian BMI criteria. Incremental medical expenditures or Charlson Comorbidity Index (CCI) ratios for obese compared to normal weight individuals were calculated. Medical expenditure over 11 years was estimated by BMI using a generalised linear model. Individual obesity-related disease incidence was determined and adjusted hazard ratios were calculated. Results Data for 496,469 and 214,477 individuals were included in the entire and consistent BMI level populations, respectively. Average CCI score change in normal weight and the obesity III (BMI 35–59.99 kg/m2) group over 11 years were 0.94 and 1.56, respectively in the entire population, and incremental ratio in the obesity III group was 66.0% compared to the normal weight group. In consistent BMI level population, incremental ratio (92.1%) for obesity III was higher than entire population. Medical costs in the obesity III groups versus the normal weight group in the entire and consistent BMI level populations increased by 38.4% and 77.1%, respectively. Over 11 years, individuals with BMI ≥30 kg/m2 in the entire and consistent BMI level populations had post-adjustment medical expenditures of 1.13–1.20 and 1.21–1.40 times the normal weight group, respectively. Incidence rate and adjusted hazard ratio of obesity-related disease increased in the obesity groups compared to the normal weight group. Conclusions Our findings emphasize the importance of the effective and sustainable obesity management strategies, considering the dramatic increase in obesity (BMI ≥30 kg/m2) in South Korea.
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Weng CH, Tien CP, Li CI, L'Heureux A, Liu CS, Lin CH, Lin CC, Lai SW, Lai MM, Lin WY. Mid-upper arm circumference, calf circumference and mortality in Chinese long-term care facility residents: a prospective cohort study. BMJ Open 2018; 8:e020485. [PMID: 29743327 PMCID: PMC5942455 DOI: 10.1136/bmjopen-2017-020485] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
OBJECTIVE To investigate the association between mid-upper arm circumference (MUAC), calf circumference (CC) and all-cause mortality in a Chinese population. DESIGN Prospective cohort study. SETTING Eight long-term care facilities in central Taiwan. PARTICIPANTS A total of 329 residents age 60 years and older (median 79.0 years, range 60-101; 139 men, 190 women) were enrolled. METHODS Anthropometrics and metabolic parameters were measured at the time of enrolment to the study. Mean MUAC and CC were 24.2±3.4 cm and 27.5±4.3 cm, respectively. Mortality data were obtained from the Department of Health in Taiwan. MAIN OUTCOME MEASURE To identify the association between all-cause mortality and MUAC or CC. RESULTS There were 255 deaths during the 7-year follow-up period. After adjusting for age, sex, cigarette smoking, betel nut chewing, alcohol use, Karnofsky Performance Status Scale score, serum albumin level, hypertension and diabetes mellitus, subjects in the highest tertile of MUAC (27.8±2.2 cm) and CC (32.1±2.6 cm) had a significantly lower mortality rate than did subjects in the lowest tertile (MUAC 20.6±1.7 cm; CC 22.8±1.9 cm). The adjusted HR for all-cause mortality in the highest versus lowest MUAC tertile was 0.64 (95% CI 0.45 to 0.90). The adjusted HR for all-cause mortality in the highest versus lowest CC tertile was 0.51 (95% CI 0.35 to 0.74). CONCLUSIONS MUAC and CC are negative predictors for all-cause mortality in older Chinese adults living in long-term care facilities. Participants with higher MUAC and CC had lower all-cause mortality.
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Affiliation(s)
- Chien-Hsiang Weng
- Department of Family Medicine, Brown University Warren Alpert Medical School, Providence, Rhode Island, USA
- NH Dartmouth Family Medicine Residency, Concord Hospital, Concord, New Hampshire, USA
- Department of Family Medicine, Providence Community Health Centers, Providence, Rhode Island, USA
| | - Chia-Ping Tien
- Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Chia-Ing Li
- Department of Medical Research, China Medical University Hospital, Taichung, Taiwan
| | - Abby L'Heureux
- Department of Family Medicine, Rural Medical Partners, Grand Forks, North Dakota, USA
| | - Chiu-Shong Liu
- Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan
- Department of Social Medicine, College of Medicine, China Medical University, Taichung, Taiwan
- Department of Family Medicine, College of Medicine, China Medical University, Taichung, Taiwan
| | - Chih-Hsueh Lin
- Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan
- Department of Family Medicine, College of Medicine, China Medical University, Taichung, Taiwan
| | - Cheng-Chieh Lin
- Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan
- Department of Social Medicine, College of Medicine, China Medical University, Taichung, Taiwan
- Department of Family Medicine, College of Medicine, China Medical University, Taichung, Taiwan
| | - Shih-Wei Lai
- Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan
- Department of Family Medicine, College of Medicine, China Medical University, Taichung, Taiwan
| | - Ming-May Lai
- Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Wen-Yuan Lin
- Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan
- Department of Social Medicine, College of Medicine, China Medical University, Taichung, Taiwan
- Department of Family Medicine, College of Medicine, China Medical University, Taichung, Taiwan
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Schultz TJ, Roupas P, Wiechula R, Krause D, Gravier S, Tuckett A, Hines S, Kitson A. Nutritional interventions for optimizing healthy body composition in older adults in the community: an umbrella review of systematic reviews. ACTA ACUST UNITED AC 2018; 14:257-308. [PMID: 27635754 DOI: 10.11124/jbisrir-2016-003063] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
BACKGROUND Optimizing body composition for healthy aging in the community is a significant challenge. There are a number of potential interventions available for older people to support both weight gain (for those who are underweight) and weight loss (for overweight or obese people). While the benefits of weight gain for underweight people are generally clearly defined, the value of weight loss in overweight or obese people is less clear, particularly for older people. OBJECTIVES This umbrella review aimed to measure the effectiveness of nutritional interventions for optimizing healthy body composition in older adults living in the community and to explore theirqualitative perceptions. INCLUSION CRITERIA TYPES OF PARTICIPANTS The participants were older adults, 60 years of age or older, living in the community. TYPES OF INTERVENTIONS The review examinedsix types of nutritional interventions: (i) dietary programs, (ii) nutritional supplements, (iii) meal replacements, (iv) food groups, (v) food delivery support and eating behavior, and (vi) nutritional counselling or education. TYPES OF STUDIES This umbrella review considered any quantitative systematic reviews and meta-analyses of effectiveness, or qualitative systematic reviews, or a combination (i.e. comprehensive reviews). TYPES OF OUTCOMES The quantitative outcome measures of body composition were: (i) nutritional status (e.g. proportion of overweight or underweight patients); (ii) fat mass (kg), (iii) lean mass or muscle mass (kg), (iv) weight (kg) or BMI (kg/m), (v) bone mass (kg) or bone measures such as bone mineral density, and (vi) hydration status. PHENOMENA OF INTEREST The phenomena of interestwere the qualitative perceptions and experiences of participants. SEARCH STRATEGY We developed an iterative search strategy for nine bibliometric databases and gray literature. METHODOLOGICAL QUALITY Critical appraisal of 13 studies was conducted independently in pairs using standard Joanna Briggs Institute tools. Six medium quality and seven high quality studies were identified. DATA EXTRACTION Data was extracted independently in pairs from all 13 included studies using the standard Joanna Briggs Institute data extraction tool. DATA SUMMARY Only quantitative studies of effectiveness were included. The strength of evidence assessing the effectiveness of interventionswas graded using a traffic light system (green, amber, red). An overall assessment of the quality of the evidence for each comparison was undertaken. RESULTS More systematic reviews investigating weight gain than those investigating weight loss were included. Studies onweight gain showed improved body composition for oral nutritional supplements on its own, for oral nutritional supplements in combination with resistance exercise training, and for oral nutritional supplements in combination with nutrition counselling. Studies on weight loss showed that diet in combination with exercise, diet in combination with exercise and nutrition counselling, and nutrition counselling on its own all can lead to reduced weight in older people. The outcomes of lean mass and weight/BMI were responsive to nutritional interventions, but fat mass did not vary. There were no qualitative reviews identified. CONCLUSIONS Although effective interventions for weight gain and weight loss to optimize body composition of older people in the community were identified,making long term, clinically relevant changes in body composition is difficult. Multiple interventions are more effective than single interventions.
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Affiliation(s)
- Timothy J Schultz
- 1School of Nursing, University of Adelaide, South Australia, Australia 2CSIRO Food and Nutrition, Werribee, Australia 3Centre for Evidence-based Practice South Australia (CEPSA): a Joanna Briggs Institute Centre of Excellence, South Australia, Australia 4School of Nursing, Midwifery and Social Work, The University of Queensland, Queensland, Australia 5Nursing Research Centre and Queensland Centre for Evidence Based Nursing and Midwifery: a Joanna Briggs Centre of Excellence, Mater Misericordiae Limited, Brisbane, Queensland, Australia 6Green Templeton College, University of Oxford, United Kingdom
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Park S, Pi S, Hwang J, Kang JH, Kwon JW. Effects of Initial Body Mass Index and Weight Change on All-Cause Mortality: A 10-Year Cohort Study in Korea. Asia Pac J Public Health 2018; 30:217-226. [DOI: 10.1177/1010539518756981] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
We evaluated the effects of baseline body mass index (BMI) and its changes over 4 years on all-cause mortality in Korean population. We analyzed 351 735 participants whose BMI was measured in both 2002/2003 and 2006/2007. Mortality was assessed until 2013. Multivariate hazard ratios for all-cause mortality were estimated. Underweight and severe obesity with BMI >30 kg/m2 were significantly associated with higher mortality. Similarly, >5% decrease or >10% increase of BMI for 4 years was associated with the increased risk of death. Comparing the results between baseline BMI and BMI change, the BMI change showed more stable associations with mortality than the baseline BMI in subgroup analysis such as nonsmokers and healthy participants. This study suggests that BMI change could be a useful health indicator along with obesity level by BMI. In addition, maintaining a healthy weight is needed for longevity, but rapid weight change should be carefully monitored.
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Affiliation(s)
- Susan Park
- College of Pharmacy and Research Institute of Pharmaceutical Sciences, Kyungpook National University, Daegu, Korea
| | - Sunmi Pi
- Department of Computer Science and Statistics, Daegu University, Gyeongsan, Gyeongbuk, South Korea
| | - Jinseub Hwang
- Department of Computer Science and Statistics, Daegu University, Gyeongsan, Gyeongbuk, South Korea
| | - Jae-Heon Kang
- Inje University Seoul Paik Hospital, Seoul, South Korea
| | - Jin-Won Kwon
- College of Pharmacy and Research Institute of Pharmaceutical Sciences, Kyungpook National University, Daegu, Korea
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Trajectories of body mass index among Canadian seniors and associated mortality risk. BMC Public Health 2017; 17:929. [PMID: 29202810 PMCID: PMC5715616 DOI: 10.1186/s12889-017-4917-0] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2017] [Accepted: 11/15/2017] [Indexed: 11/10/2022] Open
Abstract
Background This study aims to characterize the heterogeneity in BMI trajectories and evaluate how different BMI trajectories predict mortality risk in Canadian seniors. Methods Data came from the Canadian National Population Health Survey (NPHS, 1994–2011) and 1480 individuals aged 65–79 years with at least four BMI records were included in this study. Group-based trajectory model was used to identify distinct subgroups of longitudinal trajectories of BMI measured over 19 years for men and women. Cox proportional hazards models were used to examine the association between BMI trajectories and mortality risks. Results Distinct trajectory patterns were found for men and women: ‘Normal Weight-Down’(N-D), ‘Overweight-Normal weight’ (OV-N), ‘Obese I-Down’ (OB I-D), and ‘Obese II- Down’ (OB II-D) for women; and ‘Normal Weight-Down’ (N-D), ‘Overweight-Normal weight’ (OV-N), ‘Overweight-Stable’ (OV-S), and ‘Obese-Stable’ (OB-S) for men. Comparing with OV-N, men in the OV-S group had the lowest mortality risk followed by the N-D (HR = 1.66) and OB-S (HR = 1.98) groups, after adjusting for covariates. Compared with OV-N, women in the OB II-D group with three or more chronic health conditions had higher mortality risk (HR = 1.61); however, women in OB II-D had lower risk (HR = 0.56) if they had less than three conditions. Conclusion The course of BMI over time in Canadian seniors appears to follow one of four different patterns depending on gender. The findings suggest that men who were overweight at age 65 and lost weight over time had the lowest mortality risk. Interestingly, obese women with decreasing BMI have different mortality risks, depending on their chronic health conditions. The findings provide new insights concerning the associations between BMI and mortality risk.
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Kim YH, Kim SM, Han KD, Son JW, Lee SS, Oh SW, Lee WY, Yoo SJ. Change in Weight and Body Mass Index Associated With All-Cause Mortality in Korea: A Nationwide Longitudinal Study. J Clin Endocrinol Metab 2017; 102:4041-4050. [PMID: 28938403 DOI: 10.1210/jc.2017-00787] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2017] [Accepted: 08/17/2017] [Indexed: 12/17/2022]
Abstract
CONTEXT Many studies have reported conflicting evidence on the association between weight change and mortality. OBJECTIVE We investigated the association between weight change and subsequent all-cause mortality, using a large-scale, population-based cohort from the National Health Insurance System health checkup data between 2005 and 2015. METHODS A total of 11,524,763 subjects older than age 20 years were included. Weight was measured every 2 years and weight change over 4 years was divided into eight categories, from weight loss ≥15% to weight gain ≥20%, for every 5% of weight change. The hazard ratios (HRs) and 95% confidence intervals (CIs) for all-cause mortality were analyzed using multivariable Cox proportional hazard models compared with the stable weight group (weight change <5%) after adjusting for age, sex, smoking, drinking, exercise, diabetes mellitus, hypertension, dyslipidemia, cancer, and income. RESULTS Weight loss was associated with increased mortality rates compared with weight gain; the group with weight loss ≥15% had the highest HR for all-cause mortality (HR, 2.598; 95% CI, 2.537 to 2.659). The HR for all-cause mortality in the ≥20% weight gain group was 1.784 (95% CI, 1.695 to 1.877). Across all body mass index (BMI) categories, weight loss ≥15% was associated with increased mortality rates and the highest mortality rates were found in the BMI ≥30 kg/m2 group (HR, 3.469; 95% CI, 2.236 to 5.381). CONCLUSIONS Weight change over 4 years showed a reverse J-shaped all-cause mortality curve, independent of BMI status. Weight loss was associated with a greater risk of mortality than was weight gain.
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Affiliation(s)
- Yang-Hyun Kim
- Department of Family Medicine, Korea University College of Medicine, Seoul 02841, Korea
| | - Seon Mee Kim
- Department of Family Medicine, Korea University College of Medicine, Seoul 02841, Korea
| | - Kyung-do Han
- Department of Medical Statistics, Catholic University College of Medicine, Seoul 06591, Korea
| | - Jang-Won Son
- Division of Endocrinology and Metabolism, Department of Internal Medicine, The Catholic University of Korea, Seoul 14647, Korea
| | - Seong-Su Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, The Catholic University of Korea, Seoul 14647, Korea
| | - Sang Woo Oh
- Department of Family Medicine, Center for Obesity, Metabolism, and Nutrition, Dongguk University Ilsan Hospital, Dongguk University College of Medicine, Goyang 10326, Korea
| | - Won-Young Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul 03181, Korea
| | - Soon Jib Yoo
- Division of Endocrinology and Metabolism, Department of Internal Medicine, The Catholic University of Korea, Seoul 14647, Korea
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Grant JF, Chittleborough CR, Shi Z, Taylor AW. The association between A Body Shape Index and mortality: Results from an Australian cohort. PLoS One 2017; 12:e0181244. [PMID: 28759582 PMCID: PMC5536270 DOI: 10.1371/journal.pone.0181244] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2017] [Accepted: 06/28/2017] [Indexed: 12/27/2022] Open
Abstract
It is well recognised that obesity increases the risk of premature death. A Body Shape Index (ABSI) is a formula that uses waist circumference (WC), body mass index (BMI) and height to predict risk of premature mortality, where a high score (Quartile 4) indicates that a person's WC is more than expected given their height and weight. Our study examines the association between ABSI quartiles and all-cause-, cardiovascular- and cancer-related mortality, and primary cause of death. Self-reported demographic and biomedically measured health-related risk factor and weight data was from the baseline stage of the North West Adelaide Health Study (1999-2003, n = 4056), a longitudinal cohort of Australian adults. Death-related information was obtained from the National Death Index. Primary cause of death across ABSI quartiles was examined. The association between mortality and ABSI (quartile and continuous scores) was investigated using a Cox proportional hazards survival model and adjusting for socioeconomic, and self-reported and biomedical risk factors. The proportion of all three types of mortality steadily increased from ABSI Quartile 1 through to Quartile 4. After adjusting for demographic and health-related risk factors, the risk of all-cause mortality was higher for people in ABSI Quartile 4 (HR 2.64, 95% CI 01.56-4.47), and ABSI Quartile 3 (HR 1.95, 95% CI 1.15-3.33), with a moderate association for the continuous ABSI score (HR 1.32, 95% CI 1.18-1.48). ABSI is therefore positively associated with mortality in Australian adults. Different combined measures of obesity such as the ABSI are useful in examining mortality risk.
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Affiliation(s)
- Janet F. Grant
- School of Public Health and Robinson Research Institute, The University of Adelaide, Adelaide, South Australia, Australia
| | - Catherine R. Chittleborough
- School of Public Health and Robinson Research Institute, The University of Adelaide, Adelaide, South Australia, Australia
| | - Zumin Shi
- Population Research and Outcome Studies, Discipline of Medicine, The University of Adelaide, Adelaide, South Australia, Australia
| | - Anne W. Taylor
- Population Research and Outcome Studies, Discipline of Medicine, The University of Adelaide, Adelaide, South Australia, Australia
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Ng TP, Jin A, Chow KY, Feng L, Nyunt MSZ, Yap KB. Age-dependent relationships between body mass index and mortality: Singapore longitudinal ageing study. PLoS One 2017; 12:e0180818. [PMID: 28738068 PMCID: PMC5524359 DOI: 10.1371/journal.pone.0180818] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2017] [Accepted: 06/21/2017] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES The relationship between body mass index (BMI) with mortality risk, in particular the BMI category associated with the lowest all-cause and CVD-and-stroke mortality and the BMI threshold for defining overweight or obesity in older persons is controversial. This study investigated the age-dependent associations of BMI categories with all-cause and cardiovascular disease (CVD) and stroke mortality. METHOD Prospective cohort study (Singapore Longitudinal Ageing Studies) of older adults aged 55 and above, followed up from 2003 to 2011. Participants were 2605 Chinese with baseline BMI and other variables. Outcome Measurement: Mortality hazard ratios (HR) for all-cause and CVD and stroke mortality. RESULTS Overall, BMI showed a U-shaped relationship with all-cause and CVD and stroke mortality, being lowest at Normal Weight-II category (BMI 23.0-24.9 kg/m2). Most evidently among the middle-aged (55-64 years), all-cause mortality risks relative to Normal Weight-II were elevated for underweight (<BMI 18.5; HR = 4.92, p<0.0138), Normal Weight-I (BMI 18.5-22.9; HR = 3.41, p = 0.0149), and Overweight-Obese (BMI>30.0; HR = 4.05,p = 0.0423). Among the old (≥65 years), however, Overweight and Obese categories were not significantly associated with increased all-cause mortality (HR from 0.98 to 1.29), but Overweight-Obese was associated with increased CVD and stroke mortality (HR = 10.0, p = 0.0086). CONCLUSION BMI showed a U-shaped relationship with mortality. Among older persons aged 65 and above, the overweight-or-obese category of BMI was not associated with excess all-cause mortality.
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Affiliation(s)
- Tze Pin Ng
- Gerontology Research Programme, Department of Psychological Medicine, National University of Singapore, Singapore
- * E-mail:
| | - Aizhen Jin
- National Disease Registry Office, Health Promotion Board, Singapore
| | - Khuan Yew Chow
- National Disease Registry Office, Health Promotion Board, Singapore
| | - Liang Feng
- Gerontology Research Programme, Department of Psychological Medicine, National University of Singapore, Singapore
| | - Ma Shwe Zin Nyunt
- Gerontology Research Programme, Department of Psychological Medicine, National University of Singapore, Singapore
| | - Keng Bee Yap
- Department of Medicine, Alexandra Hospital, Singapore
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Significance of Body Mass Index for Postoperative Outcomes after Lung Cancer Surgery in Elderly Patients. World J Surg 2017; 42:153-160. [DOI: 10.1007/s00268-017-4142-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Zhou W, Kozikowski A, Pekmezaris R, Lolis J, Tommasulo B, Fishbein J, Wolf-Klein G. Association between Weight Change, Health Outcomes, and Mortality in Older Residents in Long-Term Care. South Med J 2017; 110:459-465. [DOI: 10.14423/smj.0000000000000673] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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