Trajectories of Body Mass Index and Their Associations With Mortality Among Older Japanese: Do They Differ From Those of Western Populations?
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ABSTRACT:
SUBMITTER: Murayama H
PROVIDER: S-EPMC4692978 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:BackgroundExcess body fatness, commonly approximated by a one-off determination of body mass index (BMI), is associated with increased risk of at least 13 cancers. Modelling of longitudinal BMI data may be more informative for incident cancer associations, e.g. using latent class trajectory modelling (LCTM) may offer advantages in capturing changes in patterns with time. Here, we evaluated the variation in cancer risk with LCTMs using specific age recall versus decade recall BMI.MethodsWe obtained BMI profiles for participants from the Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial. We developed gender-specific LCTMs using recall data from specific ages 20 and 50 years (72,513 M; 74,837 W); decade data from 30s to 70s (42,113 M; 47,352 W) and a combination of both (74,106 M, 76,245 W). Using an established methodological framework, we tested 1:7 classes for linear, quadratic, cubic and natural spline shapes, and modelled associations for obesity-related cancer (ORC) incidence using LCTM class membership.ResultsDifferent models were selected depending on the data type used. In specific age recall trajectories, only the two heaviest classes were associated with increased risk of ORC. For the decade recall data, the shapes appeared skewed by outliers in the heavier classes but an increase in ORC risk was observed. In the combined models, at older ages the BMI values were more extreme.ConclusionsSpecific age recall models supported the existing literature changes in BMI over time are associated with increased ORC risk. Modelling of decade recall data might yield spurious associations.
| S-EPMC8097878 | biostudies-literature
Project description:Little research has addressed the heterogeneity and mortality risk in body mass index (BMI) trajectories among older populations. Applying latent class trajectory models to 9,538 adults aged 51 to 77 years from the US Health and Retirement Study (1992-2008), we defined 6 latent BMI trajectories: normal weight downward, normal weight upward, overweight stable, overweight obesity, class I obese upward, and class II/III obese upward. Using survival analysis, we found that people in the overweight stable trajectory had the highest survival rate, followed by those in the overweight obesity, normal weight upward, class I obese upward, normal weight downward, and class II/III obese upward trajectories. The results were robust after controlling for baseline demographic and socioeconomic characteristics, smoking status, limitations in activities of daily living, a wide range of chronic illnesses, and self-rated health. Further analysis suggested that BMI trajectories were more predictive of mortality risk than was static BMI status. Using attributable risk analysis, we found that approximately 7.2% of deaths after 51 years of age among the 1931-1941 birth cohort were due to class I and class II/III obese upward trajectories. This suggests that trajectories of increasing obesity past 51 years of age pose a substantive threat to future gains in life expectancy.
| S-EPMC3842899 | biostudies-other
Project description:Previously, we found that excess weight already in childhood has positive associations with endometrial cancer; however, associations with changes in body mass index (BMI) during childhood are not well understood. Therefore, we examined whether growth in childhood BMI is associated with endometrial cancer and its sub-types. A cohort of 155,505 girls from the Copenhagen School Health Records Register with measured weights and heights at the ages of 6-14 years and born 1930-1989 formed the analytical population. BMI was transformed to age-specific z scores. Using linear spline multilevel models, each girl's BMI growth trajectory was estimated as the deviance from the average trajectory for three different growth periods (6.25-7.99, 8.0-10.99, 11.0-14.0 years). Via a link to health registers, 1,020 endometrial cancer cases were identified, and Cox regressions were performed. A greater gain in BMI during childhood was positively associated with endometrial cancer but no differences between the different growth periods were detected in models adjusted for baseline BMI. The hazard ratios for the associations with overall growth during childhood per 0.1 z score increase were 1.15 (95% confidence interval [CI]: 1.07-1.24) for all endometrial cancers, 1.12 (95% CI: 1.04-1.21) for estrogen-dependent cancers, 1.16 (95% CI: 1.06-1.26) for endometrioid adenocarcinomas and 1.46 (95% CI: 1.16-1.84) for non-estrogen-dependent cancers. Growth in BMI in early life is positively linked to later endometrial cancer risk. We did not identify any sensitive childhood growth period, which suggests that excess gain in BMI during the entire childhood period should be avoided.
| S-EPMC5132154 | biostudies-literature
Project description:Background:The genetic associations with trajectories of body fatness over the life course remain unknown. Methods:We used a group-based modelling approach to identify trajectories of body fatness from age 5 years up to 65 for 7277 women from the Nurses' Health Study and 4645 men from the Health Professionals Follow-up Study. We created a genetic risk score (GRS) based on 97 variants associated with adulthood body mass index (BMI) and estimated its association with trajectories using logistic regression. Results:We identified four distinct trajectories: lean-medium, medium-medium, lean-heavy and medium-heavy. The GRS increased across the four groups in that order (P?<?0.001); 47% of women and 45% of men in the first decile of the GRS were in the lean-medium group, and these proportions reduced to 26% and 28%, respectively, for the highest decile. The corresponding proportions in the medium-heavy group were 8% and 5%, increasing to 21% and 14%, respectively. For women, compared with the odds of being in the lean-medium group, a 10-allele increment in the GRS was associated with a 40% [95% confidence interval (CI), 27-54%], 43% (30-58%), and 115% (91-143%) increase in the odds of being in the medium-medium, lean-heavy and medium-heavy groups, respectively. For men, the corresponding increases in the odds were 26% (12-42%), 27% (13-43%), and 81% (53-115%), respectively. Conclusions:Individuals with genetic variants for adulthood BMI were more likely to maintain a heavy body shape and gain weight throughout life. These findings support a persistent effect of genetic variants on body fatness across the lifespan.
| S-EPMC5913610 | biostudies-literature
Project description:It is unclear whether there are different body mass index (BMI) trajectories among a population with normal BMI levels, and the association between BMI patterns and incident hypertension is not well characterized. This prospective cohort study includes surveys conducted at baseline and three follow-ups. 3939 participants who are free of hypertension at baseline or first two follow-ups were enrolled. At baseline, the age of participants ranged from 35 to 82 years and the mean age was 45.9 years. The BMI trajectories were identified using latent mixture modeling with data from the baseline and first two follow-ups. The effects of different BMI trajectories on the development of hypertension were analyzed using a Cox proportional hazard model. Four distinct BMI trajectories were identified over the study period (2004-2010): normal-stable (n = 1456), normal-increasing (n = 2159), normal-fluctuated (n = 166), and normal-sharp-increasing (n = 158). Relative to the normal-stable BMI group, the hazard ratios (HRs) and 95% confidence intervals (CIs) after adjustment for confounding factors of the normal-increasing, normal-fluctuated, and normal-sharp-increasing groups were 1.244 (1.103-1.402), 1.331 (1.008-1.756), and 1.641 (1.257-2.142), respectively. Additionally, subgroup analysis showed that the normal-fluctuated BMI trajectory was associated with a significantly higher risk of hypertension only in women (HR = 1.362; 95% CI = 1.151-1.611). The BMI trajectories were significant predictors of hypertension incidence, and increasing BMI trajectories within the currently designated normal range were associated with an increased hypertension risk, especially in women.
| S-EPMC8678668 | biostudies-literature
Project description:BackgroundA single measure that distills complex body mass index (BMI) trajectories into one value could facilitate otherwise complicated analyses. This study creates and assesses the validity of such a measure: average excess BMI.MethodsWe use data from Waves I-IV of the National Longitudinal Study of Adolescent to Adult Health (n = 17,669). We calculate average excess BMI by integrating to find the area above a healthy BMI trajectory and below each subject-specific trajectory and divide this value by total study time. To assess validity and utility, we (1) evaluate relationships between average excess BMI from adolescence to adulthood and adult chronic conditions, (2) compare associations and fit to models using subject-specific BMI trajectory parameter estimates as predictors, and (3) compare associations to models using BMI trajectory parameter estimates as outcomes.ResultsAverage excess BMI from adolescence to adulthood is associated with increased odds of hypertension (OR = 1.56; 95% CI: 1.47, 1.67), hyperlipidemia (OR = 1.36; 95% CI: 1.26, 1.47), and diabetes (OR = 1.57; 95% CI: 1.47, 1.67). The odds associated with average excess BMI are higher than the odds associated with the BMI intercept, linear, or quadratic slope. Correlations between observed and predicted health outcomes are slightly lower for some models using average excess BMI as the focal predictor compared to those using BMI intercept, linear, and quadratic slope. When using trajectory parameters as outcomes, some co-variates associate with the intercept, linear, and quadratic slope in contradicting directions.ConclusionsThis study supports the utility of average excess BMI as an outcome. The higher an individual's average excess BMI from adolescence to adulthood, the greater their odds of chronic conditions. Future studies investigating longitudinal BMI as an outcome should consider using average excess BMI, whereas studies that conceptualize longitudinal BMI as the predictor should continue using traditional latent growth methods.
| S-EPMC6430191 | biostudies-literature
Project description:BackgroundObesity is a leading risk for poor health outcomes in England. We examined best- and worst-case scenarios for the future trajectory of the obesity epidemic.MethodsTaking the last 27 years of Health Survey for England data, we determined both position and shape of the adult body mass index (BMI) distribution and projected these parameters 20 years forward in time. For the best-case scenario, we fitted linear models, allowing for a quadratic relationship between the outcome variable and time, to reflect a potential reversal in upwards trends. For the worst-case scenario, we fitted non-linear models that applied an exponential function to reflect a potential flattening of trends over time. Best-fitting models were identified using Monte Carlo cross-validation on 1991-2014 data, and predictions of population prevalence across five BMI categories were then validated using 2015-17 data.ResultsBoth linear and non-linear models showed a close fit to observed data (mean absolute error <2%). In the best-case scenario, the proportion of the population at increased risk (BMI≥25kg/m2) is predicted to fall from 66% in 2017 to 53% (95% confidence interval: 41% to 64%) in 2035. In the worst-case scenario, this proportion is likely to remain relatively stable overall- 64% (37% to 90%) in 2035 -but with an increasing proportion of the population at highest risk (BMI≥35kg/m2).ConclusionsWhile obesity prediction depends on chosen modelling methods, even under optimistic assumptions it is likely that the majority of the English population will still be at increased risk of disease due to their weight until at least 2035, without greater allocation of resources to effective interventions.
| S-EPMC8172072 | biostudies-literature
Project description:Background: This study aimed to identify patterns of body mass index (BMI) changes in adolescence and to assess whether delivery mode (Cesarean and vaginal delivery) was associated with BMI trajectories. Methods: This study was conducted among 569 adolescents aged 10-15 years that resided in the city of Zibo, China. The height and weight of each participant were repeatedly measured at 10, 11, 12, 13, 14 and 15 years. Group based trajectory modeling (GBTM) was used to estimate BMI change trajectories, and multinomial logistic regression was conducted to evaluate the independent association of delivery mode and BMI trajectory classes. Results: Of the 569 participants, 407 (71.5%) were vaginal deliveries and 162 (28.5%) were Cesarean deliveries. Five distinct long-term BMI trajectories were identified: "persistent healthy weight" (57.5%), "persistent underweight" (6.5%), "obesity to healthy weight" (7.8%), "progressive overweight" (10.6%), "progressive obesity" (17.6%). Adjusted multinomial logistic models revealed a twofold increase in risks between ages 10-15 years of "progressive obesity" trajectory (OR = 2.50, 95% CI: 1.42, 4.41) for children born through Cesarean section compared with vaginal birth. Conclusions: Five distinct long-term BMI trajectories were identified during adolescence in our research, and we confirmed that Cesarean birth was significantly increased the risk of "progressive obesity" trajectory but not the "obesity to healthy weight" trajectory.
| S-EPMC7142989 | biostudies-literature
Project description:ObjectiveTo investigate the longitudinal associations between active commuting (walking and cycling to work) and body mass index (BMI).MethodWe used self-reported data on height, weight and active commuting from the Commuting and Health in Cambridge study (2009 to 2012; n=809). We used linear regression to test the associations between: a) maintenance of active commuting over one year and BMI at the end of that year; and b) change in weekly time spent in active commuting and change in BMI over one year.ResultsAfter adjusting for sociodemographic variables, other physical activity, physical wellbeing and maintenance of walking, those who maintained cycle commuting reported a lower BMI on average at one year follow-up (1.14kg/m(2), 95% CI: 0.30 to 1.98, n=579) than those who never cycled to work. No significant association remained after adjustment for baseline BMI. No significant associations were observed for maintenance of walking. An increase in walking was associated with a reduction in BMI (0.32kg/m(2), 95% CI: 0.03 to 0.62, n=651, after adjustment for co-variates and baseline BMI) only when restricting the analysis to those who did not move. No other significant associations between changes in weekly time spent walking or cycling on the commute and changes in BMI were observed.ConclusionsThis work provides further evidence of the contribution of active commuting, particularly cycling, to preventing weight gain or facilitating weight loss. The findings may be valuable for employees choosing how to commute and engaging employers in the promotion of active travel.
| S-EPMC5023394 | biostudies-literature
Project description:BackgroundEvidence suggests that childhood near-roadway air pollution (NRAP) exposures contribute to increased body mass index (BMI); however, effects of NRAP exposure during the vulnerable periods including in utero and first year of life have yet to be established. In this study, we examined whether exposure to elevated concentrations of NRAP during in utero and/or first year of life increase childhood BMI growth.MethodsParticipants in the Children's Health Study enrolled from 2002 to 2003 with annual visits over a four-year period and who changed residences before study entry were included (n = 2318). Annual height and weight were measured and lifetime residential NRAP exposures including in utero and first year of life periods were estimated by nitrogen oxides (NOx) using the California line-source dispersion model. Linear mixed effects models assessed in utero or first year near-road freeway and non-freeway NOx exposures and BMI growth after adjusting for age, sex, race/ethnicity, parental education, Spanish questionnaire, and later childhood near-road NOx exposure.ResultsA two-standard deviation difference in first year of life near-road freeway NOx exposure was associated with a 0.1 kg/m2 (95% confidence interval (CI): 0.03, 0.2) faster increase in BMI growth per year and a 0.5 kg/m2 (95% CI: 0.02, 0.9) higher attained BMI at age 10 years.ConclusionsHigher exposure to early life NRAP increased the rate of change of childhood BMI and resulted in a higher attained BMI at age 10 years that were independent of later childhood exposures. These findings suggest that elevated early life NRAP exposures contribute to increased obesity risk in children.
| S-EPMC6137930 | biostudies-literature