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Adiposity and weight change in mid-life in relation to healthy survival after age 70 in women: prospective cohort study

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Sun, Qi, PhD, Townsend, Mary K., Okereke, Olivia I., Franco, Oscar H., Hu, Frank B. and Grodstein, Francine. (2009) Adiposity and weight change in mid-life in relation to healthy survival after age 70 in women: prospective cohort study. BMJ, Vol.339 . b3796. ISSN 0959-535X

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Official URL: http://dx.doi.org/10.1136/bmj.b3796

Abstract

Objective: To examine the hypothesis that mid-life adiposity is associated with a reduced probability of maintaining an optimal health status among those who survive to older ages.

Design: Prospective cohort study.

Setting: The Nurses’ Health Study, United States.

Participants: 17 065 women who survived until at least the age of 70, provided information on occurrence of chronic disease, cognitive function, physical function, and mental health at older ages, and were free from major chronic diseases at mid-life (mean age was 50 at baseline in 1976).

Main outcome measures: Healthy survival to age 70 and over was defined as having no history of 11 major chronic diseases and having no substantial cognitive, physical, or mental limitations.

Results: Of the women who survived until at least age 70, 1686 (9.9%) met our criteria for healthy survival. Increased body mass index (BMI) at baseline was significantly associated with linearly reduced odds of healthy survival compared with usual survival, after adjustment for various lifestyle and dietary variables (P<0.001 for trend). Compared with lean women (BMI 18.5-22.9), obese women (BMI ≥30) had 79% lower odds of healthy survival (odds ratio 0.21, 95% confidence interval 0.15 to 0.29). In addition, the more weight gained from age 18 until mid-life, the less likely was healthy survival after the age of 70. The lowest odds of healthy survival were among women who were overweight (BMI ≥25) at age 18 and gained ≥10 kg weight (0.18, 0.09 to 0.36), relative to women who were lean (BMI 18.5-22.9) and maintained a stable weight.

Conclusions: These data provide evidence that adiposity in mid-life is strongly related to a reduced probability of healthy survival among women who live to older ages, and emphasise the importance of maintaining a healthy weight from early adulthood.

Item Type:	Journal Article
Subjects:	R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
Divisions:	Faculty of Medicine > Warwick Medical School
Library of Congress Subject Headings (LCSH):	Older women -- Health and hygiene -- United States, Obesity in women -- United States, Cohort analysis
Journal or Publication Title:	BMJ
Publisher:	BMJ Group
ISSN:	0959-535X
Official Date:	29 September 2009
Volume:	Vol.339
Page Range:	b3796
Identification Number:	10.1136/bmj.b3796
Status:	Peer Reviewed
Access rights to Published version:	Open Access
Funder:	National Institutes of Health (U.S.) (NIH), Boston Obesity Nutrition Research Center (BONRC), Unilever (Firm)
Grant number:	AG13482 (NIH), AG15424 (NIH), CA40356 (NIH), DK46200 (BONRC)
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URI:	http://wrap.warwick.ac.uk/id/eprint/2481