The Library

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

Tools

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

	PDF (Article text) WRAP_Franco_Adiposity_weight_.pdf - Requires a PDF viewer such as GSview, Xpdf or Adobe Acrobat Reader Available under License Creative Commons Attribution Non-commercial. Download (141Kb)
	PDF (WRAP Coversheet) WRAP_Franco_coversheet_logo.pdf - Requires a PDF viewer such as GSview, Xpdf or Adobe Acrobat Reader Download (47Kb)

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
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)
References:	1 HetzelL,SmithA.The 65 years and over population: 2000. Washington, DC: US Census Bureau, 2001. 2 Flegal KM, Carroll MD, Kuczmarski RJ, Johnson CL. Overweight and obesity in the United States: prevalence and trends, 1960-1994. Int J Obes Relat Metab Disord 1998;22:39-47. 3 Ogden CL, Carroll MD, Curtin LR, McDowell MA, Tabak CJ, Flegal KM. Prevalence of overweight and obesity in the United States, 1999- 2004. JAMA 2006;295:1549-55. 4 Koster A, Leitzmann MF, Schatzkin A,Mouw T, Adams KF, van Eijk JT, et al. Waist circumference and mortality. Am J Epidemiol 2008;167:1465-75. 5 Manson JE, Willett WC, Stampfer MJ, Colditz GA, Hunter DJ, Hankinson SE, et al. Body weight and mortality among women. N Engl J Med 1995;333:677-85. 6 Olshansky SJ, Passaro DJ, Hershow RC, Layden J, Carnes BA, Brody J, et al. A potential decline in life expectancy in the United States in the 21st century.N Engl J Med 2005;352:1138-45. 7 Willett WC, Dietz WH, Colditz GA. Guidelines for healthy weight. N Engl J Med 1999;341:427-34. 8 Reed DM, Foley DJ, White LR, Heimovitz H, Burchfiel CM, Masaki K. Predictors of healthy aging in men with high life expectancies. Am J Public Health 1998;88:1463-8. 9 Willcox BJ, He Q, Chen R, Yano K, Masaki KH, Grove JS, et al. Midlife risk factors and healthy survival in men. JAMA 2006;296:2343-50. 10 Rowe JW, Kahn RL. Successful aging. Gerontologist 1997;37:433-40. 11 Depp CA, Glatt SJ, Jeste DV. Recent advances in research on successful or healthy aging. Curr Psychiatry Rep 2007;9:7-13. 12 Newman AB, Arnold AM, Naydeck BL, Fried LP, Burke GL, Enright P, et al. “Successful aging”: effect of subclinical cardiovascular disease. Arch Intern Med 2003;163:2315-22. 13 Colditz GA, Willett WC, Rotnitzky A, Manson JE. Weight gain as a risk factor for clinical diabetes mellitus in women. Ann InternMed 1995;122:481-6. 14 Barr RG, Herbstman J, Speizer FE, Camargo CA Jr. Validation of selfreported chronic obstructive pulmonary disease in a cohort study of nurses. Am J Epidemiol 2002;155:965-71. 15 Alonso A, Hernan MA, Ascherio A. Allergy, family history of autoimmune diseases, and the risk ofmultiple sclerosis. Acta Neurol Scand 2008;117:15-20. 16 SunQ,Ma J, CamposH,HankinsonSE,Manson JE,StampferMJ, et al. A prospective study of trans fatty acids in erythrocytes and risk of coronary heart disease. Circulation 2007;115:1858-65. 17 Stampfer MJ, Willett WC, Speizer FE, Dysert DC, Lipnick R, Rosner B, et al. Test of the National Death Index. Am J Epidemiol 1984;119:837-9. 18 Ware JE, SnowKK, Kosinski M, Gandek B. SF-36 health survey: manual and interpretation guide. Boston: The Health Institute, New England Medical Center, 1993. 19 Brandt J, SpencerM, FolsteinM. The telephone interview for cognitive status. Neuropsychiatry Neuropsychol Behav Neurol 1988;1:111-7. 20 Stampfer MJ, Kang JH, Chen J, Cherry R, Grodstein F. Effects of moderate alcohol consumption on cognitive function in women. N Engl J Med 2005;352:245-53. 21 Willett W, Stampfer MJ, Bain C, Lipnick R, Speizer FE, Rosner B, et al. Cigarette smoking, relative weight, and menopause. Am J Epidemiol 1983;117:651-8. 22 Troy LM, Hunter DJ, Manson JE, Colditz GA, Stampfer MJ, Willett WC. The validity of recalled weight among younger women. Int J Obes Relat Metab Disord 1995;19:570-2. 23 Rowe JW, Kahn RL. Human aging: usual and successful. Science 1987;237:143-9. 24 Strawbridge WJ, Cohen RD, Shema SJ, Kaplan GA. Successful aging: predictors and associated activities. Am J Epidemiol 1996;144:135-41. 25 Michael YL, Berkman LF, Colditz GA, Kawachi I. Living arrangements, social integration, and change in functional health status. Am J Epidemiol 2001;153:123-31. 26 Obesity: preventing and managing the global epidemic. Report of a WHO consultation.World HealthOrgan Tech Rep Ser 2000;894:i-xii,1-253. 27 Chan JM, Rimm EB, Colditz GA, Stampfer MJ, Willett WC. Obesity, fat distribution, and weight gain as risk factors for clinical diabetes in men. Diabetes Care 1994;17:961-9. 28 Folsom AR, Kushi LH, Anderson KE,Mink PJ, Olson JE, Hong CP, et al. Associations of general and abdominal obesity with multiple health outcomes in older women: the Iowa Women’s Health Study. Arch Intern Med 2000;160:2117-28. 29 Janssen I, Katzmarzyk PT, Ross R. Body mass index, waist circumference, and health risk: evidence in support of current National Institutes of Health guidelines. Arch Intern Med 2002;162:2074-9. 30 Houston DK, Stevens J, Cai J. Abdominal fat distribution and functional limitations and disability in a biracial cohort: the Atherosclerosis Risk in Communities Study. Int J Obes (Lond) 2005;29:1457-63. 31 Whitmer RA, Gustafson DR, Barrett-Connor E, Haan MN, Gunderson EP, Yaffe K. Central obesity and increased risk of dementia more than three decades later. Neurology 2008. 32 Li TY, Rana JS,Manson JE, Willett WC, StampferMJ, ColditzGA, et al. Obesity as compared with physical activity in predicting risk of coronary heart disease in women. Circulation 2006;113:499-506.
URI:	http://wrap.warwick.ac.uk/id/eprint/2481