Weight gain in your 20s may be more important than later in life, new evidence shows that weight trends in early adulthood can determine your risk of death from heart disease, cancer and other chronic diseases decades later.
Study: Weight trends, obesity incidence, and cause-specific mortality from ages 17 to 60 years: Obesity and Disease Development Sweden (ODDS) pooled cohort study. Image credit: Flotsam/Shutterstock.com
research in e-clinical medicine Our findings suggest that weight gain in adulthood, especially before age 30, is associated with a higher risk of early death.
Weight change in midlife is associated with significant mortality risk
Existing evidence suggests that weight gain or change in body mass index (BMI) in midlife (40-65 years) is associated with increased all-cause, cardiovascular, and cancer mortality. In previous studies, cause-specific mortality analyzes were based on single-point weight measurements, ignoring the possibility of weight change over time.
Previous analyzes of the association between cause-specific mortality and weight change have used only two points in adulthood and have not been able to capture nonlinear or lifetime weight change.
Differences by gender and age
Men and women gain weight differently. For women, the rate of weight gain remains stable between ages 17 and 29. Conversely, most weight gain in men occurs during early adulthood.
Age-specific weight changes also reflect changes in body composition. Most weight gain in early adulthood is related to increased fat and muscle mass. Conversely, weight gain in later life is primarily due to increased fat mass.
Repeated measurements are used to model weight trajectories over the lifespan
The current study examines the association between long-term trends in body weight and mortality. The authors used repeated measurements instead of fixed time points to model continuous weight trajectories across adulthood. They emphasized the critical ages of 17 (the beginning of adulthood), 29 (the end of adolescence), and 60 (the beginning of older adulthood). Additionally, we seek to differentiate the effects of weight gain in early adulthood and midlife on mortality risk.
Data for this study were obtained from the ODDS and included 258,269 men and 361,784 women. Median follow-up was 23 years for men and 12 years for women. During this period, 86,673 men and 29,076 women died. The median age at death was 77 years for men and 78 years for women.
Median weight gain was similar between men and women
The median weight change from 17 to 60 years was 0.42 kg per year, and the median total body weight was 18 kg for men and 17 kg for women. Men gain weight most rapidly during early adulthood, but the prevalence of obesity increases with age.
Weight gain is associated with increased risk of death
All-cause mortality gradually increased among people who gained weight rapidly before age 60. I became obese as a young man. or significant weight gain early (17-29 years). This association was stronger when respiratory diseases and lung cancer were excluded from the analysis.
These combined exposure patterns were associated with progressive increases in cause-specific mortality for 13 of 23 diseases in men and 12 of 19 diseases in women, but not all causes showed significant associations.
The strongest associations were for mortality from type 2 diabetes mellitus (T2 DM), hypertension, liver cancer in men, and uterine cancer. Cardiovascular disease (CVD) accounted for 37% of excess deaths.
Obesity develops in early adulthood
Men who gained weight between the ages of 17 and 29 had a 69% higher risk of all-cause mortality than men who did not become obese until age 60. For women, this risk was 71% higher.
Early weight gain is associated with excess risk
Among 17- to 29-year-olds, weight gain was linearly associated with increased risk of all-cause, CVD, and cancer death. A 0.5 kg increase per year over this period increased all-cause mortality by 18% for men and 16% for women.
Late weight gain was generally more weakly associated with increased all-cause and most-cause mortality. Overall, the lowest risk of death was observed This suggests a J-shaped association rather than a strict threshold after 30 years.
Weight gain and cancer mortality
Cancer deaths accounted for 31% of deaths. The strongest association with cancer death in men was weight gain in early adulthood. Among women, cancer risk increased with weight gain across all age groups. However, in the main analyses, effect sizes were similar across age groups, and the pattern was closer to that observed in men when weight change was expressed as 1 standard deviation rather than 0.5 kg per year.
Rate of weight gain is associated with higher risk
Those who gained weight the fastest had a 40% higher risk of all-cause mortality compared to those whose weight changed slowest. This is markedly different from an American study that looked at similar results. The authors attribute this to differences in baseline age, the use of replication to establish age at 25 years, and the use of only two weight measurements, which introduces a risk of measurement error.
We performed a negative control analysis using brain tumors to test for spurious associations. this did not show an association and therefore did not suggest significant spurious bias in the observed results.
strengths and limitations
This study involved a large sample with multiple weight measurements across adulthood. The findings were primarily weighted by two large, nationally representative cohorts. Registry data enabled high-quality registration-based cause of death ascertainment. Negative control analysis supported the robustness of the findings to major biases, although residual confounding could not be completely excluded.
However, there are some limitations. The authors were unable to distinguish between intentional and inadvertent weight loss. Important confounders such as diet, physical activity, and comorbidities were not fully captured, and there may be unmeasured confounders that cannot fully explain our observations. The possibility of false positives cannot be excluded, and causality cannot be inferred from these observations.
Clinical impact
The weight gain pattern observed here is similar to that of a typical Western population, suggesting that the results are generalizable.
These findings suggest that weight gain in adulthood, especially in young adulthood, and becoming obese before age 30 are associated with increased risk of all-cause and CVD mortality. period of obesity The observed association suggests that it may be more important than weight gain in late adulthood, indicating the need for early obesity prevention strategies.
Future studies should include more detailed information on changes in fat mass, muscle mass, and central fat, as well as confounding factors.
Click here to download your PDF copy.
