Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Feb 19:15:1306551.
doi: 10.3389/fendo.2024.1306551. eCollection 2024.

Weight changes from early to middle adulthood and cardiometabolic multimorbidity later in life among middle-aged and older adults: a retrospective cohort study from the NHANES 1999-2018

Fayun Zhao  1 , Qiang Zhao  1 , Huandong Wang  1 , Kun Wang  1 , Shenke Kong  1 , Peiyao Ma  1 , Xin Wang  1
Affiliations

Weight changes from early to middle adulthood and cardiometabolic multimorbidity later in life among middle-aged and older adults: a retrospective cohort study from the NHANES 1999-2018

Fayun Zhao et al. Front Endocrinol (Lausanne). .

Abstract

Background: Weight gain in adulthood can influence the development of diabetes and cardiovascular diseases. It is speculated that weight gain is related to cardiometabolic multimorbility (CMM). This study was designed to examine the relationships between weight changes from early to middle adulthood and the risk of CMM.

Methods: Data of the National Health and Nutrition Examination Survey (NHANES) 1999-2018 cycles were analyzed in the present study. Weights at age 25 years and 10 years before recruitment were self-reported and were used to define five weight change patterns including stable normal, maximum overweight, obesity to non-obesity, non-obesity to obesity, and stable obesity patterns. Meanwhile, absolute weight changes were classified into five groups: weight loss≥ 2.5 kg, weight change within 2.5 kg, 2.5 kg≤ weight gain < 10.0 kg, 10.0 kg≤ weight gain < 20.0 kg, and weight gain≥ 20.0 kg. CMM was defined as the coexistence of two or three of diabetes, coronary heart disease (CHD), and stroke.

Results: A total of 25,994 participants were included. Across adulthood, compared to stable normal weight, maximal overweight, obesity to non-obesity, non-obesity to obesity, and stable obesity were consistently associated with increased risks of diabetes, CHD, and CMM. For instance, stable obesity was respectively related to 358.0% (HR: 4.58, 95% CI: 4.57, 4.58), 88.0% (HR: 1.88, 95% CI: 1.88, 1.88), and 292.0% (HR: 3.92, 95% CI: 3.91, 3.92) higher risks of diabetes, CHD, and CMM. Meanwhile, any account of weight loss and gain was linked to higher risks of diabetes, CHD, and CMM than weight change within 2.5 kg. However, participants with maximum overweight had a decreased incidence of stroke (HR: 0.85, 95% CI: 0.85, 0.86), and weight loss ≥ 2.5 kg and weight gain ≥ 2.5 and <20 kg were also related to a lower risk of stroke. J-shaped or U-shaped associations of absolute weight changes with the risks of diabetes, CHD, and CMM were observed.

Conclusions: Maintaining a stable normal weight can benefit more from the prevention of diabetes, CHD, and CMM. Both weight gain and loss across adulthood were accompanied by increased risks of diabetes, CHD, and CMM.

Keywords: body mass index; body weight changes; cardiometabolic diseases; cardiometabolic multimorbidity; obesity.

PubMed Disclaimer

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
The process of participant selection.
Figure 2
Figure 2
The schematic diagram of retrospective cohort study.
Figure 3
Figure 3
The non-linear associations of absolute weight changes across adulthood with the risks of single CMDs and CMM. (A) the outcome was diabetes; (B) the outcome was CHD; (C) the outcome was stroke; (D) the outcome was CMM.
Figure 4
Figure 4
The associations of weight changes across adulthood with the risk of CMM stratified by age and sex. (A) indicated the associations of weight change patterns with the risk of CMM stratified by age; (B) indicated the associations of absolute weight change with the risk of CMM stratified by age; (C) indicated the associations of weight change patterns with the risk of CMM stratified by sex; (D) indicated the associations of absolute weight change with the risk of CMM stratified by sex.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Zheng Y, Manson JE, Yuan C, Liang MH, Grodstein F, Stampfer MJ, et al. . Associations of weight gain from early to middle adulthood with major health outcomes later in life. JAMA: J Am Med Assoc (2017) 318:255–69. doi: 10.1001/jama.2017.7092. - DOI - PMC - PubMed
    1. Nielsen J, Narayan KV, Cunningham SA. Incidence of obesity across adulthood in the United States, 2001-2017-a national prospective analysis. Am J Clin Nutr (2023) 117:141–8. doi: 10.1016/j.ajcnut.2022.10.012. - DOI - PMC - PubMed
    1. Hales CM, Carroll MD, Fryar CD, Ogden CL. Prevalence of obesity and severe obesity among adults: United States, 2017-2018. NCHS Data Brief (2020) 360):1–8. - PubMed
    1. Collaborators GBDO, Afshin A, Forouzanfar MH, Reitsma MB, Sur P, Estep K, et al. . Health effects of overweight and obesity in 195 countries over 25 years. New Engl J Med (2017) 377:13–27. doi: 10.1056/NEJMoa1614362. - DOI - PMC - PubMed
    1. Roth GA, Mensah GA, Johnson CO, Addolorato G, Ammirati E, Baddour LM, et al. . Global burden of cardiovascular diseases and risk factors, 1990-2019: update from the GBD 2019 study. J Am Coll Cardiol (2020) 76:2982–3021. doi: 10.1016/j.jacc.2020.11.010 - DOI - PMC - PubMed