Overweight, obesity during young adulthood associated with greater CVD risk later in life
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Key takeaways:
- The higher a person’s BMI was when aged 18 to 34 years, the higher their risk for CVD later in life.
- Participants with a BMI of 30 kg/m2 or more had a 58% greater risk for CVD.
Higher BMI during early adulthood was associated with an elevated risk for CV outcomes, like heart disease and stroke, among adults aged 35 to 70 years, according to a study published in The Lancet Public Health.
“Along with the marked increase in the prevalence rate of both overweight and obesity among adolescents over the past 3 decades, its prevalence in early adulthood has also been increasing globally,” Yuanyuan Chen, MD, PhD, of the department of epidemiology and biostatistics in the School of Public Health at Peking University Health Science Center in Beijing, and colleagues wrote. “Thus, it is important to investigate the effect of early adulthood BMI on later health outcomes.”
The prospective analysis included 360,855 participants aged 35 to 70 years (mean age, 50 years; 57.6% women) from the China Kadoorie Biobank, a long-term cohort from five urban and five rural areas. Participants self-reported their BMI during early adulthood (aged 18-34 years) when completing a baseline survey between June 2004 and July 2008.
The primary outcome was CVD as a group, as well as ischemic heart disease, hemorrhagic stroke and ischemic stroke, tracked for a median follow-up of 12 years.
At follow-up, 57,203 (15.9%) of participants were diagnosed with CVD, 29,718 (8.2%) with ischemic heart disease, 5,978 (1.7%) with hemorrhagic stroke and 30,192 (8.4%) with ischemic stroke.
The incidence of CVD outcomes increased with higher BMI during early adulthood, compared with the reference group of a BMI of 20.5 kg/m2 to 22.4 kg/m2:
- 22.5 kg/m2 to 23.9 kg/m2: HR = 1.04; 95% CI, 1.02-1.07;
- 24 kg/m2 to 25.9 kg/m2: HR = 1.12; 95% CI, 1.09-1.15;
- 26 kg/m2 to 27.9 kg/m2: HR = 1.19; 95% CI, 1.14-1.24;
- 28 kg/m2 to 29.9 kg/m2: HR = 1.34; 95% CI, 1.25-1.44; and
- 30 kg/m2 and higher: HR = 1.58; 95% CI, 1.42-1.75.
Researchers observed similar trends when looking at individual diseases, with participants with the highest BMI again at greatest risk for ischemic heart disease (HR = 1.68; 95% CI, 1.45-1.93), hemorrhagic stroke (HR = 1.61; 95% CI, 1.24-2.09) and ischemic stroke (HR = 1.47; 95% CI, 1.26-1.7).
Participants with a BMI below the reference group had a slightly lower risk for CVD, with an HR of 0.97 (95% CI, 0.94-1) for a BMI less than 18.5 kg/m2 and 0.97 (95% CI, 0.95-0.99) for a BMI of 18.5 kg/m2 to 20.4 kg/m2. However, researchers noted this trend did not persist when evaluating hemorrhagic stroke alone.
“Findings from this study have crucial implications for public health, underlining the importance of weight management in early life,” the researchers wrote. “We want to emphasize that early adulthood is an imperative and relatively new target for obesity prevention when people often have frequent changes, such as in weight and lifestyle, and are more likely to form lifelong habits that influence their weight.”
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