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Obesity increases coronary heart disease risk among young adults

Obesity and weight gain elevated the risk for coronary heart disease among young adults, whereas weight loss reduced their risk, according to findings published in JAMA Internal Medicine.

“Older adults who lose weight lose mostly lean mass, which could contribute to the increased risk of CVD events after weight loss,” Seulggie Choi, MD, from Seoul National University, South Korea, and colleagues wrote. “Because the body composition of fat and muscle mass is altered with age, the contributions of BMI and change in BMI on [coronary heart disease] among middle-aged and elderly adults may differ from those among young adults. However, few studies have investigated the association between BMI or change in BMI with [coronary heart disease] among young adults.”

To address this gap in knowledge, Choi and colleagues analyzed data of 2,611,450 men and women aged between 20 and 39 years from the Korean National Health Insurance Service. The researchers used the WHO Western Pacific Region guidelines to classify participants as underweight, normal weight, overweight, obese grade 1 and obese grade 2 at baseline, then calculated change in BMI during a follow-up visit.

The mean BMI of all participants was 23.2 kg/m².

Data showed that the risk for coronary heart disease was increased in young men who were overweight (absolute risk [AR] = 1.38%; adjusted HR = 1.18; 95% CI, 1.14-1.22), obese grade 1 (AR = 1.86%; aHR = 1.45; 95% CI, 1.41-1.50) and obese grade 2 (AR = 2.69%; aHR = 1.97; 95% CI, 1.86-2.08), compared with normal weight men. Similarly, young women who were overweight (AR = 0.77%; aHR = 1.34; 95% CI, 1.24-1.46), obese grade 1 (AR = 0.95%; aHR = 1.52; 95% CI, 1.39-1.66) and obese grade 2 (AR = 1.01%; aHR = 1.64; 95% CI, 1.34-2.01) were more likely to develop coronary heart disease than normal weight women.

Both young men and women who became obese had a higher risk for coronary heart disease than those who maintained their weight. Young men and women who lost weight had a lower risk for coronary heart disease than obese participants.

“To our knowledge, this is the first study to show that losing weight and maintaining normal BMI is associated with decreased risk of [coronary heart disease] among young adults,” Choi and colleagues concluded.

“Future prospective studies that investigate the association of intentional and unintentional weight change with [coronary heart disease] are needed to clarify the interpretations of our findings,” they added. – by Alaina Tedesco

Disclosure: The authors report no relevant financial disclosures.