Background:
The association of weight gain from early to middle adulthood with a wide range of health outcomes later in life has not been systematically examined.
Methods:
We included 93,873 women from the Nurses’ Health Study and 25,374 men from the Health Professionals Follow-up Study who recalled weight at early adulthood (18 years in women, 21 years in men) and reported current weight in middle adulthood (55 years). Beginning from 55 years old, we prospectively followed them for incident cases of type 2 diabetes, hypertension, cardiovascular disease, cancer, three other medical conditions, and all-cause mortality. Among 51,185 women and 17,694 men who were at least 64 years of age in 2010, we also considered “healthy aging”, defined as no diagnosis of 11 major chronic diseases and no major cognitive impairment, physical impairment, or mental health limitations.
Results:
On average, female participants gained 12.55 kg (interquartile range: 14.36 kg) of body weight and males gained 9.68 kg (interquartile range: 11.19 kg) from early to middle adulthood. During a median follow-up of 18 years in women and 14 years in men, we documented 9360 incident cases of type 2 diabetes, 37,298 of hypertension, 9220 of cardiovascular disease, 20,222 of cancer (including 9458 of obesity-related cancers), 7438 of symptomatic cholelithiasis, 2702 of severe osteoarthritis, 31,960 of cataract extraction, and 27,250 deaths. In multivariate models, compared to those maintained stable weight (weight change <2.5kg), participants who gained 20+ kg had increased risks of: diabetes (hazard ratio [HR, 95%CI], 10.93[9.65–12.39] in women, 8.19[6.41–10.46] in men), hypertension (2.24[2.15–2.34] in women, 2.11[1.91–2.33] in men), cardiovascular disease (1.87[1.72–2.04] in women, 1.72[1.40–2.11] in men), obesity-related cancers (1.53[1.41–1.66] in women, 1.27[0.95–1.69] in men), and mortality (1.43[1.37–1.50] in women, 1.34[1.18–1.51] in men); they had decreased odds of healthy aging (odds ratio [OR, 95%CI], 0.36[0.32–0.40] in women and 0.50[0.43–0.57] in men). In a meta-analysis combing both sexes, the increase in risk associated with each 10 kg weight gain was 71% for type 2 diabetes, 27% for hypertension, 17% for cardiovascular disease, 31% for symptomatic cholelithiasis, 15% for obesity-related cancers, 9% for severe osteoarthritis, 5% for cataract extraction, and 9% for mortality; for the same weight gain the odds of healthy aging was 28% lower.
Conclusions:
Our data provide strong evidence that weight gain from early to middle adulthood is associated with substantially increased risk of major chronic diseases and mortality, and overall decreased odds of aging with good health and well-being among women and men.
A Shift Toward a Plant-Centered Diet From Young to Middle Adulthood and Subsequent Risk of Type 2 Diabetes and Weight Gain: The Coronary Artery Risk Development in Young Adults (CARDIA) Study
