Obesity In Middle Age Research Articles

Anthropometric measures at different ages and endometrial cancer risk

Background:Endometrial cancer is strongly associated with body mass index (BMI), but the influence of BMI history and of different types of obesity is uncertain.Ethods:M A case–control study was carried out in Italy including 454 cases and 908 controls admitted to hospital for acute non-hormone-related conditions. Odds ratios (ORs) and 95% confidence intervals (CIs) were computed using multivariate logistic and spline regression models.Results:The OR for BMI >30 at diagnosis compared with 20 to <25 kg m−2 was 4.08 (95% CI: 2.90–5.74). The association for BMI was monotonic with a possible steeper increase for BMI above 28. Conversely, waist-to-hip ratio (WHR) showed a bell shaped curve with increased OR (2.10; 95% CI: 1.43–3.09) in the intermediate tertile only. After stratification by BMI at diagnosis, history of weight loss and BMI at age 30 did not influence endometrial cancer risk. History of obesity in middle age had a weak and not significant adverse effect among obese women (OR=1.60; 95% CI: 0.52–4.96).Conclusion:The predominant importance of recent weight compared to lifetime history, justifies encouraging weight reduction in women at any age.

Insulin Sensitivity as a Mediator of the Relationship Between BMI and Working Memory‐Related Brain Activation

Midlife obesity is associated with cognitive deficits and cerebral atrophy in older age. However, little is known about the early signs of these deleterious brain effects or the physiological mechanisms that underlie them. Functional magnetic resonance imaging (fMRI) allows us to detect early changes in brain response to cognitive challenges while behavioral performance is still intact. Accordingly, we examined the impact of obesity on functional activation during a 2-Back task in 32 cognitively normal middle-aged adults, who were classified into normal, overweight, and obese groups according to BMI. Additionally, we examined insulin sensitivity as a potential mediator of the relationship between BMI and brain activation. Insulin sensitivity is of special interest because insulin is strongly associated with both obesity and central nervous system functioning. Group differences in task-related brain activation were examined in a priori regions of interest (ROIs) using ANOVA. The obese BMI group displayed significantly lower task-related activation in the right parietal cortex, BA 40/7, (F(2,29) = 5.26, P = 0.011) than the normal (P = 0.016) and overweight (P = 0.047) BMI groups. Linear regression and bootstrapping methods for assessing indirect effects indicated that insulin sensitivity fully mediated the relationship between task-related activation in the right parietal cortex and BMI ((F(3,28) = 9.03, P = 0.000), β = 0.611, P = 0.001, 95% confidence interval: -2.548 to -0.468). In conclusion, obesity in middle age was related to alterations in brain activation during a cognitive challenge and this association appeared to be mediated by insulin sensitivity.

046 Association between birthweight and obesity in adult females

ObjectiveAdult obesity is associated with a variety of acute and chronic illnesses. Although high birthweight is known to predict obesity in middle age, the relationship between low birthweight and obesity...

The Predicted Effects of Chronic Obesity in Middle Age on Medicare Costs and Mortality

The prevalence of adult obesity has increased in recent decades. It is important to predict the long-term effect of body weight, and changes in body weight, in middle age on longevity and Medicare costs in older ages. The relationships between individuals' characteristics in middle age and subsequent Medicare costs and mortality were estimated from the linkage of the National Health and Nutrition Examination Survey I Epidemiologic Follow-up Study to Medicare administrative records (1991-2000) and mortality information (1971-2000). We predicted longevity and lifetime Medicare costs via simulation for 45-year-old persons by body weight in 1973 and changes in body weight between 1973 and 1983. Obese 45-year-olds had a smaller chance of surviving to age 65 and, if they did, incurred significantly higher average lifetime Medicare costs than normal-weight 45-year-olds ($163,000 compared with $117,000). Those who remained obese between ages 45 and 55 in 1973 to 1983 incurred significantly higher lifetime Medicare costs than those who maintained normal weight. Other weight change categories did not differ significantly from those who maintained normal weight in terms of life expectancy at age 65, but overweight and obese people who lost weight had less chance of surviving to age 65 and the lowest estimated life expectancies thereafter. Chronic obesity in middle age increases lifetime Medicare costs relative to those who remained normal weight. As the survival of obese persons improves, it is possible that Medicare costs may rise substantially in the future to meet the health care needs of today's obese middle-aged population. Thus, active engagement by both the private and public sectors to prevent and to reduce obesity are critically needed.

Central obesity in middle age increases the risk of dementia later in life

Central obesity in middle age increases the risk of dementia later in life

Central obesity in middle age increases the risk of dementia later in life

Central obesity in middle age increases the risk of dementia later in life

Body Mass Index and Groin Hernia

Inguinal hernias are very common disorders, especially in men, with inguinal herniorrhaphy being one of the most frequently performed general surgical procedures in men. Theoretically, obesity might increase the risk of groin hernia by increasing intra-abdominal pressure. The objective of the present study was to investigate whether overweight and obesity in middle age could significantly predict future groin hernia in men. Prospective cohort study; General population of men living in Gothenburg, Sweden; A community-based sample of 7483 men aged 47 to 55 years were followed-up from baseline (1970-1973) for a maximum of 34 years. A diagnosis of groin hernia according to the Swedish hospital discharge register. A total of 1017 men (13.6%) were diagnosed with groin hernia. An inverse relationship was found between body mass index (BMI) and risk of groin hernia. With each BMI unit (3-4 kg), the relative risk for groin hernia decreased by 4% (P < 0.0001). Compared with men of normal weight, obese men had a 43% lower risk (P = 0.0008, 95% confidence interval 21%-59%). Heavy smokers demonstrated a 26% lower risk for groin hernia (P = 0.003, 95% confidence interval 10%-39%). Diabetes, high physical activity, and blood pressure were not associated with groin hernia. Entering other variables potentially associated with groin hernia, as age, BMI, smoking, and serum cholesterol, in a multivariable analysis left the risk estimates for BMI and smoking virtually unchanged. In a large community-based sample of middle-aged men overweight and obesity were associated with a lower risk for groin hernia during an extended follow-up. Obesity, in comparison with normal weight, reduced the risk of groin hernia by 43%. A reduced risk of groin hernia was also noted in heavy smokers. Obviously, hernia may be more easily detected in lean men but a true protective effect cannot be excluded.

Childhood IQ in relation to obesity and weight gain in adult life: the National Child Development (1958) Study

To examine the relation of childhood intelligence (IQ) test results with obesity in middle age and weight gain across the life course. We analysed data from the National Child Development (1958) Study, a prospective cohort study of 17 414 births to parents residing in Great Britain in the late 1950s. Childhood IQ was measured at age 11 years and body mass index (BMI), an indicator of adiposity, was assessed at 16, 23, 33 and 42 years of age. Logistic regression (in which BMI was categorised into obese and non-obese) and structural equation growth curve models (in which BMI was retained as a continuous variable) were used to estimate the relation between childhood IQ and adult obesity, and childhood IQ and weight gain, respectively. In unadjusted analyses, lower childhood IQ scores were associated with an increased prevalence of adult obesity at age 42 years. This relation was somewhat stronger in women (OR(per SD decrease in IQ score) [95% CI]: 1.38 [1.26, 1.50]) than men (1.26 [1.15, 1.38]). This association remains statistically significant after adjusting for childhood characteristics, including socio-economic factors, but was heavily attenuated following control for adult characteristics, particularly education (women: 1.11 [0.99, 1.25]; men: 1.10 [0.98, 1.23]). When weight gain between age 16 and 42 years was the outcome of interest, structural equation modelling revealed that education and dietary characteristics in adult life mediated the association with childhood IQ. A lower IQ score in childhood is associated with obesity and weight gain in adulthood. In the present study, this relation appears to be largely mediated via educational attainment and the adoption of healthy diets in later life.

Age at menarche and adult BMI in the Aberdeen Children of the 1950s Cohort Study

Few studies have examined whether the inverse association of age at menarche with adult body mass index (BMI) is due to the tendency of BMI to track between childhood and adult life, with childhood BMI playing a causal role in determining age at menarche. The objective was to investigate whether the association of younger age at menarche with a high BMI and increased likelihood of obesity in middle age is due to confounding with early childhood BMI. In a historical cohort of 3743 Scottish females born between 1950 and 1955, height and weight were measured in early childhood, and age at menarche and height and weight in middle age were obtained by questionnaire. The age-adjusted change in mean adult BMI per additional year of age at menarche was -0.64 (95% CI: -0.78, -0.50). Adjustment for childhood BMI measured between 4 and 6 y reduced this value to -0.57 (-0.71, -0.43). Adjustment for childhood and adult social class, parity, smoking, and alcohol intake had little effect. The odds ratio for being obese compared with not being obese in adulthood was 0.82 (0.76, 0.86) per 1-y increase in age at menarche and was unchanged by adjustment for childhood BMI and other covariates. The inverse association of age at menarche with BMI and obesity in middle age is not explained by confounding by early childhood BMI. Instead, age at menarche may simply be a proxy marker for the pace of sexual maturation, which itself leads to differences in adiposity (and BMI) in the peripubertal period that track into adult life.

Obesity in middle age and future risk of dementia: a 27 year longitudinal population based study

Objective To evaluate any association between obesity in middle age, measured by body mass index and skinfold thickness, and risk of dementia later in life.Design Analysis of prospective data from...

Aging, Obesity, and Mortality

Although there is widespread agreement that obesity (body mass index [BMI] ≥ 30 kg/m(2)) raises health risks, debate has ensued on whether obese older adults are also at greater risk. This study examines the effect of obesity on mortality for younger and older adults to determine whether the risk of obesity is lessened in later life. Data from a 20-year follow-up of a national sample of adults were used to examine the risk of obesity on mortality (N = 6,767). Cox models reveal that obesity raises mortality risk for adults of all ages, but this relationship is nearly twice as strong for persons younger than 50 years of age. Being slightly overweight in later life is associated with lower mortality risk, but obesity raises mortality risk, especially for ischemic heart disease. Obesity in middle age is a grave public health concern, but obesity in later life also merits attention.

High prevalence of diabetes, obesity and dyslipidaemia in urban slum population in northern India.

In this study, a prevalence survey of various atherosclerosis risk factors was carried out on hitherto poorly studied rural-urban migrants settled in urban slums in a large metropolitan city in northern India, with the aim of studying anthropometric and metabolic characteristics of this population in socio-economic transition. A cross-sectional epidemiological descriptive study. A total of 532 subjects (170 males and 362 females) were included in the study (response rate approximately 40%). In this study, diabetes mellitus was recorded in 11.2% (95% CI 6.8-16.9) of males and 9.9% (95% CI 7.0-13.5) of females, the overall prevalence being 10.3% (95% CI 7.8-13.2). Based on body mass index (BMI), obesity was more prevalent in females (15.6%; 95% CI 10.7-22.3) than in males (13.3%; 95% CI 8.5-19.5). On the other hand, classifying obesity based on percentage body fat (%BF), 10.6% (95% CI 6.4-16.2) of males and 40.2% (95% CI 34.9-45.3) of females were obese. High waist-hip ratio (WHR) was observed in 9.4% (95% CI 5.4-14.8) of males and 51.1% (95% CI 45.8-56.3) of the females. All individual skinfolds and sum of skinfolds were significantly higher in females (P<0.001). In both males and females above 30 y of age, there was a steep increase in the prevalence of high WHR, and in females, %BF was very high (particularly in %BF quartile>30%). Furthermore, total cholesterol and low-density lipoprotein cholesterol were high in both males and females. Stepwise multiple linear regression analysis showed that for both males and females BMI, WHR and %BF were positive predictors of biochemical parameters, except for HDL-c, for which these parameters were negatively associated. Appreciable prevalence of obesity, dyslipidaemia, diabetes mellitus, substantial increase in body fat, generalised and regional obesity in middle age, particularly in females, need immediate attention in terms of prevention and health education in such economically deprived populations.

ETHNIC ISSUES IN THE EPIDEMIOLOGY OF CHILDHOOD OBESITY

Childhood obesity may be seen as a marker for high-risk dietary and physical inactivity practices. Recent increases in the prevalence of overweight and obesity among American children are not limited to one age, gender, or ethnic group, which suggests that unique behaviors of the members of various racial or ethnic subgroups of the population are unlikely to be the major contributing factors. Rather, it seems that environmental changes promoting increased energy intake and decreased energy output are occurring and have widespread impact on children from various backgrounds. Although no ethnic group is immune from the current shift in energy balance, differential rates of overweight seem to exist among ethnic groups. National probability samples of African-American, Hispanic, and white children in the United States provide clear evidence that white children are at lower risk for childhood overweight than are African-American or Hispanic children. Of concern is the lack of national data on the prevalence of overweight and obesity for Native-American and Asian-American groups. Also of concern is the aggregation of racial and ethnic subgroups, which may render prevalence rates meaningless. This possibility is clearly true with some surveys of weight status that combine diverse populations, such as Asians and Pacific Islanders, into one group. The high rates of obesity in African-American, Hispanic, and Native-American children are of concern. Although parental SES is associated inversely with childhood obesity among whites, higher SES does not seem to protect African-American and Hispanic children against obesity. In these groups, childhood obesity does not seem to be associated significantly with parental income and education. Health consequences of childhood obesity include a higher prevalence of type 2 diabetes and an increased risk for adverse levels of lipids, lipoproteins, and blood pressure. The effects of recently reported unprecedented levels of childhood overweight on subsequent risk for obesity in middle age are not known until future longitudinal data can be collected. It seems likely, however, that future health consequences of current early and severe childhood obesity will be staggering. Funding for adult follow-up of longitudinal studies of high-risk African American, Hispanic, and Native-American children is needed urgently to provide information on the long-term effects of childhood obesity. Halting the obesity epidemic is a formidable task, but the success in recent decades of drastically reducing childhood undernutrition offers hope and should spur similar action and leadership efforts. Promotion of efforts to reduce excess caloric intake with efforts to increase energy expenditure should receive paramount attention in the design of health programs. Given the relatively few published obesity-prevention and treatment studies that are designed to address specific cultural issues, it is important to promote the development of culturally appropriate intervention strategies that are shown to be effective among youth of diverse backgrounds. Although the dietary and activity goals will be similar, parental, family, and community messages and techniques grounded in cultural traditions and norms will be different for each ethnic group. This approach is crucial in the United States, a country with an increasingly diverse population.

Body mass index in young men and the risk of subsequent knee and hip osteoarthritis

PURPOSE: Obesity in middle age is associated with an increased risk of osteoarthritis of the knees in later life. We sought to determine whether body mass index in young men was a risk factor for the subsequent development of osteoarthritis of the knee and hip. SUBJECTS AND METHODS: Body mass index was assessed in 1,180 male medical students at age 23 ± 2 (mean ± SD) years and at several times during follow-up. The incidence of knee and hip osteoarthritis was ascertained by self-report and corroborated with information on symptoms and radiographic findings. RESULTS: During a median follow-up of 36 years, 62 participants developed knee osteoarthritis and 27 developed hip osteoarthritis. The incidence of knee, but not hip, osteoarthritis was strongly associated with body mass index assessed at ages 20 to 29 years and 30 to 39 years (both P <0.001). For body mass index assessed at ages 20 to 29 years, the incidence of knee osteoarthritis at age 65 years was 12.8% among the heaviest subjects (range 24.7 to 37.6 kg/m 2), threefold greater than the incidence of 4.0% in the leanest (15.6 to 22.8 kg/m 2) category of body mass index ( P = 0.0001). Thus, for a man who was 180 cm (5′ 11″) tall, each 8 kg (18 lb) greater weight at ages 20 to 29 years was associated with an increased risk of subsequent knee osteoarthritis (relative risk = 1.7, 95% confidence interval 1.3 to 2.1), after adjustment for year of birth, physical activity, and knee injury. Body mass index at ages 20 to 29 years was more predictive of future osteoarthritis than at ages 30 to 39 or 40 to 49 years. CONCLUSION: Greater body mass index in young men ages 20 to 29 years is associated with an increased risk of subsequent knee, but not hip, osteoarthritis, suggesting that cumulative exposure to greater weight during young adult life is an important cause of osteoarthritis.

Body weight patterns from 20 to 49 years of age and subsequent risk for diabetes mellitus: the Johns Hopkins Precursors Study.

Obesity in middle age is a well-known risk factor for the development of type 2 diabetes mellitus. However, the importance of weight and weight gain at younger ages is less certain. To determine the relationship of body weight patterns from 20 to 49 years of age with the subsequent risk for type 2 diabetes mellitus. An ongoing longitudinal study of former medical students. Nine hundred sixteen white men without diabetes at 50 years of age. Weight and height measured in medical school, then assessed by mailed questionnaire to 49 years of age. Incident type 2 diabetes mellitus based on physician self-report. During 14 255 person-years of follow-up, there were 35 incident cases of type 2 diabetes mellitus (2.5 per 1000 person-years). After simultaneous adjustment for age, physical activity, lifetime maternal history of diabetes, and smoking, body mass indexes (BMIs; calculated as weight in kilograms divided by the square of height in meters) at 25, 35, and 45 years of age were all strongly associated with diabetes risk (relative risks for overweight [BMI> or =25.0] vs. not overweight, >3.0; all Ps<.05), as were maximum and average BMI to 49 years of age. The relationship of BMI at 25 years of age to diabetes risk was substantially attenuated by adjustment for BMI at 45 years of age and average BMI, but was independent of weight change, weight variability, or maximum BMI. In men, overweight at 25 years of age strongly predicts diabetes risk in middle age, largely through its association with overweight at 45 years of age and high average BMI to 49 years of age.