Adult Weight Change Research Articles

Body image and weight change in middle age: a qualitative study.

To explore men's and women's experiences of weight change in adulthood, body image preferences and beliefs about the health consequences of overweight and to inform the development of a primary care intervention to prevent obesity. Seventy-two men and women aged 35-55, with a range of BMIs from 22 to 29.9, were identified from two UK general practice registers and invited to participate in an interview about experiences of weight change in adulthood. Audio tape recorded, semi-structured interviews were conducted in respondents' homes by trained researchers. Open-ended questions were used to collect experiences of weight change since early adulthood and views about weight change in middle age. Illustrations of a range of men's and women's body shapes were used to prompt discussion of respondents' preferences for male and female body shapes and their perspectives of the health, social and practical problems associated with underweight and overweight. The data were analysed using both quantitative and qualitative methods. Some 87% (33/38) of the women and 59% (20/34) of the men said that they had ever tried to lose weight. At least one instance of successful weight loss was reported by 58% of the women and 47% of the men, although many of these attempts were relatively short-lived and often motivated by specific goals such as a holiday or a wedding. Respondents were sceptical of the possibility of controlling weight without considerable personal sacrifice. Explanations for middle-age weight gain included a sedentary lifestyle, as well as several gender-specific reasons, including hormonal changes and comfort eating for women and beer drinking for men. Nearly all (97%) respondents associated heart disease with overweight, while diabetes was mentioned by only 22% and none mentioned cancer. People who have gained weight in middle age may be deterred from trying to prevent further gain by pessimism about the effort required. The efficacy of interventions to encourage relatively small substitutions and changes to diet and physical activity need to be tested. Interventions to help prevent weight gain in middle age could include information about the less widely known health risks such as diabetes and cancer.

Body mass index, weight change, and death in older adults: the systolic hypertension in the elderly program.

The relation between relative weight and health differs between young and old. In older populations, weight change may cloud the association between a single relative weight and health outcomes. To determine whether weight or weight change is a more important determinant of mortality in a population of older adults, the authors analyzed data from the Systolic Hypertension in the Elderly Program (1984-1990), a randomized clinical trial testing the efficacy of antihypertensive drug treatment to reduce the risk of stroke in older adults (aged 60 years or more) with isolated systolic hypertension. After adjustment for covariates, an average annualized weight loss of at least 1.6 kg/year (odds ratio = 4.9), a weight loss between 1.6 and 0.7 kg/year (odds ratio = 1.7), a weight gain of more than 0.5 kg/year (odds ratio = 2.4), and a baseline body mass index of less than 23.6 (odds ratio = 1.4) all had a significant (p < 0.05) association with all-cause mortality compared with a referent group that was weight stable and of intermediate body mass index (23.6 to <28.0 kg/m(2)) and weight change (-0.7 to <0.5 kg/year). The authors conclude that, in older adults, dynamic measures (e.g., annualized weight change) of weight change predict mortality better than do static weight measures (e.g., baseline body mass index). Even in those with high or low baseline body mass index, weight stability is associated with a lower mortality risk.

Weight change in old age and its association with mortality.

Previous studies of weight change and mortality in older adults have relied on self-reported weight loss, have not evaluated weight gain, or have had limited information on health status. Our objective was to determine whether 5% weight gain or loss in 3 years was predictive of mortality in a large sample of older adults. Longitudinal observational cohort study. Four U.S. communities. Four thousand seven hundred fourteen community-dwelling older adults, age 65 and older. Weight gain or loss of 5% in a 3-year period was examined in relationship to baseline health status and interim health events. Risk for subsequent mortality was estimated in those with weight loss or weight gain compared with the group whose weight was stable. Weight changes occurred in 34.6% of women and 27.3% of men, with weight loss being more frequent than gain. Weight loss was associated with older age, black race, higher weight, lower waist circumference, current smoking, stroke, any hospitalization, death of a spouse, activities of daily living disability, lower grip strength, and slower gait speed. Weight loss but not weight gain of 5% or more was associated with an increased risk of mortality that persisted after multivariate adjustment (Hazard ratio (HR) = 1.67, 95% CI = 1.29-2.15) and was similar in those with no serious illness in the period of weight change. Those with weight loss and low baseline weight had the highest crude mortality rate, although the HR for weight loss was similar for all tertiles of baseline weight and for those with or without a special diet, compared with those whose weight was stable. This study confirms that even modest decline in body weight is an important and independent marker of risk of mortality in older adults.

Weight gain and its predictors in Chinese adults

To describe 8 y weight change in Chinese adults and to determine the baseline characteristics of those who gained weight. A population-based cohort study of weight change and its predictors from 1989 to 1997. A cohort of 2488 adults aged 20-45 in 1989 drawn from seven provinces in China using multistage, random cluster sampling. Weight change over 8 y was the outcome variable. The key exposures were baseline energy intake, physical activity at work, alcohol consumption and smoking status. Baseline weight, weight status, height, age, residence, income and educational attainment were control variables. Overweight (body mass index, BMI>or=25 kg/m(2)) doubled in females (10.4-20.8%) and almost tripled in males (5.0-14.1%). Low physical activity was a strong predictor of weight gain. Compared to those whose weight remained stable (+/-2 kg/8 y), males and females who experienced large weight gain (>5 kg/8 y) were 3 and 1.8 times more likely to engage in light rather than heavy work-related physical activity. The prevalence of overweight increased dramatically in this cohort. Light work-related physical activity was the strongest predictor of this weight gain.

Body size and hip fracture risk. Swedish Hip Fracture Study Group.

The objective of this population-based case-control study was to determine the independent association between height, weight at different ages and adult weight change on hip fracture risk, and the joint effects of these factors. The study base comprised postmenopausal women 50-81 years of age who resided in six counties in Sweden during the period October 1993 to February 1995. The study included 1,327 cases with an incident hip fracture and 3,262 randomly selected controls. We obtained information on body measures and other factors possibly related to hip fracture through mailed questionnaires and telephone interviews. Height and weight change were dominant risk factors. Tall women (> or = 169 cm) had an odds ratio of 3.16 (95% confidence interval = 2.47-4.05) compared with women shorter than 159 cm. Weight gain during adult life was strongly protective: compared with those with moderate weight change (-3 to 3 kg), those with substantial weight gain (> or =12 kg) had a markedly decreased risk of hip fracture (odds ratio = 0.35; 95% confidence interval = 0.27-0.45), whereas weight loss was associated with an increased risk. Weight change retained important effects among all subjects, even after controlling for current weight and weight at age 18. In contrast, among women who gained weight, the separate effects of current weight and weight at age 18 were small or absent. Among women who lost weight, both current weight and weight at age 18 had effects that remained after controlling for weight change. Adult weight change and height are dominant body size risk factors for hip fracture. Weight loss vs weight changes demarcates different patterns of hip fracture risk.

Body weight change and carotid artery wall thickness. The Atherosclerosis Risk in Communities (ARIC) Study.

The impact of weight change in adulthood on cardiovascular disease is controversial. This study examined the association of change in body weight, from young adulthood to middle age, with average carotid artery intimal-medial wall thickness by B-mode ultrasound measured in middle age. Participants were 13,282 men and women aged 45-64 years from the baseline examination of the Atherosclerosis Risk in Communities (ARIC) Study (1987-1989). Weight change was calculated as the difference between weight at the baseline examination and self-reported weight at age 25. White men gained a mean of 9.7 kg; black men, 10.1 kg; white women, 12.0 kg; and black women, 20.8 kg. Weight change was positively, albeit modestly, associated with intimal-medial thickness in black men and white men and in white women, but not in black women. Adjusted for age, examination center, smoking, education, sports activity level, height, and body mass index at age 25, the differences in intimal-medial thickness associated with a 10-kg increment in weight change were 0.016 (95% confidence interval 0.010 to 0.022) mm in white men, 0.008 (95% confidence interval 0.001 to 0.015) mm in black men, 0.013 (95% confidence interval 0.009 to 0.017) mm in white women, and 0.002 (95% confidence interval -0.002 to 0.006) mm in black women. These findings support the hypothesis that weight gain in adulthood promotes atherosclerotic changes in white men and women and in black men.

Adult Weight Change Linked to Subsequent Hypertension

Obesity is related to hypertension risk in cross-sectional and prospective studies, but the role of modest weight change in adulthood is less clear. Investigators from the Nurses' Health Study followed 82,473 normotensive women aged 30 to 55 for 16 years to determine the effect of weight …

Dual Effects of Weight and Weight Gain on Breast Cancer Risk

Breast cancer is a major cause of mortality among women. It is important to identify modifiable risk factors for this disease. To examine body mass index (BMI) at the age of 18 years and at midlife and adult weight change in relation to breast cancer incidence and mortality. Cohort study. A cohort of 95256 US female nurses aged 30 to 55 years who were followed up for 16 years. Incident and fatal breast cancer. During 1203498 person-years, 2517 incident breast cancers (60% postmenopausal) were documented. Higher current BMI was associated with lower breast cancer incidence before menopause and was minimally associated with incidence after menopause. However, a stronger positive relationship was seen among postmenopausal women who never used hormone replacement (relative risk=1.59 for BMI >31 kg/m2 vs < or = 20 kg/m2; 95% confidence interval, 1.09-2.32; P for trend <.001). Higher BMI at the age of 18 years was associated with lower breast cancer incidence both before and after menopause. Weight gain after the age of 18 years was unrelated to breast cancer incidence before menopause, but was positively associated with incidence after menopause. This increased risk with weight gain was limited to women who never used postmenopausal hormones; among these women, the relative risk was 1.99 (95% confidence interval, 1.43-2.76) for weight gain of more than 20 kg vs unchanged weight (P for trend <.001). Current BMI and weight gain were even more strongly associated with fatal postmenopausal breast cancer. In this population, the percentage of postmenopausal breast cancer accounted for by weight gain alone was approximately 16% and by hormone replacement therapy alone was 5%, but when the interaction between these variables was considered, together they accounted for about one third of postmenopausal breast cancers. Avoiding adult weight gain may contribute importantly to the prevention of breast cancer after menopause, particularly among women who do not use postmenopausal hormones.

Relative weight, weight change, height, and breast cancer risk in Asian-American women.

Breast cancer incidence rates have historically been four to seven times higher in the United States than in China or Japan, although the reasons remain elusive. When Chinese, Japanese, or Filipino women migrate to the United States, their breast cancer risk rises over several generations and reaches that for white women in the United States, indicating that modifiable exposures are involved. In a previous report on this case-control study of breast cancer in Asian-American women, designed to take advantage of their diversity in risk and lifestyle, we demonstrated a sixfold gradient in risk by migration history, comparable to the international differences in breast cancer incidence rates. In this analysis, we have examined the roles of adult height, adiposity, and weight change in breast cancer etiology. A population-based, case-control study of breast cancer was conducted among women of Chinese, Japanese, and Filipino ethnicities, aged 20-55 years, living in San Francisco-Oakland (CA), Los Angeles (CA), and Oahu (HI) during the period from April 1, 1983, through June 30, 1987. We successfully interviewed 597 (70%) of 852 eligible case subjects and 966 (75%) of 1287 eligible control subjects from August 1985 through February 1989. Subjects were asked about current height, usual adult weight, and usual weight in each decade of life, excluding the most recent 3 years and any periods of pregnancy. Height, recent adiposity (weight in the current decade of life/height 1.5), and recent weight change (between the current and preceding decades of life) were strong predictors of breast cancer risk after adjustment was made for accepted breast cancer risk factors. Risk doubled (relative risk [RR] = 2.01; 95% confidence interval [CI] = 1.16-3.49) over the 7-inch (17.8-cm) range in height (two-sided P for trend = .003), with comparable effects in both premenopausal and postmenopausal women. Except for reduced risk in the heavy, younger women (weight/height 1.5 > 29 kg/m 1.5 and < 40 years old), risk was positively associated with usual adult adiposity. Trends in risk became more striking as adiposity in each succeeding decade of adult life was considered. Women in their 50s and in the top quintile for their age group had twice the breast cancer risk (RR = 2.13; 95% CI = 1.17-3.87) of women in the bottom quintile (two-sided P for trend = .004). Women in their 50s, above the median adiposity for their age group, and with a recent gain of more than 10 pounds had three times the risk (RR = 3.01; 95% CI = 1.45-6.25) of women below the median adiposity and with no recent weight change. Recent weight loss was consistently associated with reduced risk (RRs of approximately 0.7) relative to no recent weight change. Adult adiposity, weight change, and height are critical determinants of breast cancer risk. Increased adiposity and weight gain in the decade preceding diagnosis are especially influential, suggesting that excess weight may function as a late stage promoter. Weight maintenance and/or reduction as an adult, possibly accompanied by specific changes in diet and physical activity, may have a significant and rapid impact on breast cancer risk.

Weight Gain as a Risk Factor for Clinical Diabetes Mellitus in Women

To examine the relation between adult weight change and the risk for clinical diabetes mellitus among middle-aged women. Prospective cohort study with follow-up from 1976 to 1990. 11 U.S. states. 114,281 female registered nurses aged 30 to 55 years who did not have diagnosed diabetes mellitus, coronary heart disease, stroke, or cancer in 1976. Non-insulin-dependent diabetes mellitus. 2204 cases of diabetes were diagnosed during 1.49 million person-years of follow-up. After adjustment for age, body mass index was the dominant predictor of risk for diabetes mellitus. Risk increased with greater body mass index, and even women with average weight (body mass index, 24.0 kg/m2) had an elevated risk. Compared with women with stable weight (those who gained or lost less than 5 kg between age 18 years and 1976) and after adjustment for age and body mass index at age 18 years, the relative risk for diabetes mellitus among women who had a weight gain of 5.0 to 7.9 kg was 1.9 (95% CI, 1.5 to 2.3). The corresponding relative risk for women who gained 8.0 to 10.9 kg was 2.7 (CI, 2.1 to 3.3). In contrast, women who lost more than 5.0 kg reduced their risk for diabetes mellitus by 50% or more. These results were independent of family history of diabetes. The excess risk for diabetes with even modest and typical adult weight gain is substantial. These findings support the importance of maintaining a constant body weight throughout adult life and suggest that the 1990 U.S. Department of Agriculture guidelines that allow a substantial weight gain after 35 years of age are misleading.

A longitudinal analysis of the impact of dietary intake and physical activity on weight change in adults

The current investigation is a longitudinal analysis of the relationship between dietary intake, physical activity, and body weight change in adult men (n = 142) and women (n = 152). Measures of dietary intake, physical activity, and cigarette and alcohol consumption were obtained for 3 y. Results indicated a different pattern of predictors of weight change for men vs women. For women a high dietary energy and fat intake as well as increases in total energy intake were related to higher weight gain and increases in work activity levels were related to decreased weight gain. For men weight gain was predicted by increases in dietary fat intake. Sex differences are discussed as a possible moderator variable in the energy balance equation.

Obesity and mortality in the lipid research clinics program follow-up study

Using data from the Lipid Research Clinics Program for 1972–1983, the study presented here examined weight history and two indices of obesity: the body mass index (BMI) and the triceps skinfold (TSF) thickness. Cox regression analyses with and without adjustment for cardiovascular disease risk factors revealed a significant ( p < 0.05) quadratic association between BMI and all-causes mortality among men, but not women, after an average 8.4 years of follow-up; mortality was relatively high at both extremes of the BMI distribution. The association was stronger among smokers compared with nonsmokers, and it was apparent among male normotensives, but not hypertensives. All TSF-mortality associations and BMI associations with cancer and coronary heart disease mortality were weak and nonsignificant. Among men, per cent weight change in adulthood showed a significant inverse association with all-causes and cancer mortality. Because BMI and weight history were significantly associated with mortality after adjustment for other risk factors, they appear to be independent predictors of mortality among men.

Experimental comparison of restricted selection index and restricted independent culling levels in Tribolium castaneum

A selection index (I) method was compared with independent culling levels (N), with a restriction in the selection program, using two replicated single generation experiments in Tribolium castaneum, which are considered forms of antagonistic selection. The first experiment was designed to increase adult weight without changing pupal weight, while the second experiment was intended to improve egg laying without changing adult weight. In both experiments the genetic correlation between the traits involved were positive but were higher in experiment 1 than in experiment 2. The proportion of selection was 10%. In experiment 1, the effect of restriction was as expected in both lines since the changes in pupal weight were not significant. Adult weight change was positive for the I line and negative for the N line, showing that the index was a superior method to improve adult weight. In experiment 2, the effect of restriction was also as expected in both lines and changes in adult weight were not significant. Egg laying changed positively in both lines. Therefore, both selection methods were similar in this experiment, even though egg laying change was higher in the I than the N line. Key words: restricted index, restricted culling levels, antagonistic selection, Tribolium.

Patterns of adult weight and fat change in six Solomon Islands societies: A semi-longitudinal study

Semi-longitudinal changes with aging in weight, height, arm circumference, and subscapular and triceps skinfold circumference are presented for adult males and females in 6 different populations in the Solomon Islands and Papua New Guinea, which have differed dramatically in their exposure to modern industrialized societies over the past decade. Those groups who remain less acculturated show little or no evidence of a secular trend in adult body size and women in these groups lose weight through their childbearing years and into old age. Men lose less. In the more acculturated groups, weight gain due to increases in fatness have already become the norm for all female cohorts, and most male cohorts. In most groups there are significant losses in muscle mass after age 40 in men, regardless of acculturation status, which were not detected in women. Because changes in diet have been more extreme for men than women in the more acculturated groups, and childbearing and nursing patterns have not changed, the more consistent and significant shift in female fat changes with age is most likely due to a sharp change in activity pattern, in addition to dietary change.

Relation between socioeconomic status and obesity changes in 9046 women

A previous study from this population of 59,566 women showed an inverse relationship between socioeconomic status and obesity [Rimm, I., and Rimm, A. Prev. Med. 3, 543–572 (1974)]. In this study the data were reexamined to determine at what age levels socioeconomic status affects obesity. It was found that socioeconomic status is related to obesity primarily because of its effect on weight change during the child-bearing years. The difference in adult weight (adjusted for height) between the lowest and highest socioeconomic group is 17.5 pounds. Although this difference is large, this study shows that socioeconomic status is only one of many possible factors influencing weight change. Less than 2% of the variation in adult weight change during the child-bearing years is explained by socioeconomic status.

Reproduction, Growth and Development, and Behavior in the Mexican Prairie Dog, Cynomys mexicanus (Merriam)

Reproduction in C. mexicanus is unique among prairie dogs in that the reproductive season is extremely protracted, and may last for 6 months. The growth rate is equal to or greater than in other members of the genus. Molting in C. mexicanus is complex, involving four or more overlapping phases. Behavior patterns and vocalizations in C. mexicanus are most similar to those of C. ludovicianus. Alarm barks, chatter barks, growls, screams and elation calls of C. mexicanus show varying degrees of similarity to those of C. ludlovicianus. Considering the rapid development, it is estimated that C. mexicanus pups are capable of reproduction during their lst year. INTRODUCTION Although growth and development have been studied in numerous North American sciurid rodents (Clark, 1970), little information is available on the early postnatal growth and development in prairie dogs (Cynomys) prior to emergence of pups from their burrows at approximately 6 weeks of age. Johnson (1927) presented the first account of black-tailed (C. ludovicianus) pups born in captivity, and Anthony and Foreman (1951) provided additional data on growth and development during studies of reproductive physiology of the same species. Tileston and Lechleitner (1966) compared the biology of white-tailed (C. leucurus) and black-tailed (C. ludovicianus) prairie dogs from colonies in Colorado and presented data on seasonal weight changes in adults and pups after emergence. Bakko and Brown (1967) investigated reproductive physiology of white-tailed prairie dogs from Wyoming and also reported on seasonal weight changes of adults and postemergent young. King (1955) studied demography and behavior of black-tailed prairie dogs from colonies in South Dakota and Smith (1958) reported on the natural history of black-tails fror colonies in Kansas. Information on reproduction in white-tailed and Gunnison's prairie dogs also was presented by Stockard (1929), Aldous (1935), Longhurst (1944) and Scheffer (1947). We found no information on the biology of Cynomys mexicanus except for brief mention in systematic accounts (e.g., Hollister, 1916). The first laboratory breeding and subsequent birth of a litter of six C. mexicanus pups is reported herein. Information is provided on growth and development, behavior and vocalizations of adults in the laboratory and the field. Because C. mexicanus may represent a relict population derived from C. ludovicianus (Hoffmann and Jones, 1970), we have compared our data with similar published data for other Cynomys.

Total Body Water and Weight Changes in Normal Adults

OBSERVATIONS on a series of patients with changing total body water and body weight stimulated our interest in the constancy of variation in these measurements in normal health. Bartley, Krebs and O'Brien1 have looked for variations in body weight in normal subjects, but these were of no significance. Robinson and Watson2 have weighed twenty-eight healthy young women at different times throughout the menstrual cycle and showed that there was a variation of less than ±1.0 kg in 98.2 per cent of all the subjects investigated. Total body water has been measured by several methods in the past, but the published information on changes in this as estimated by the tritium space on two different occasions is limited.