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Lifelong Patterns of BMI and Cardiovascular Phenotype in Individuals Aged 60–64 Years in the 1946 British Birth Cohort Study: An Epidemiological Study
Study Questions:
What is the impact of lifelong patterns of adiposity on cardiovascular risk factors and carotid intima media thickness (cIMT) in later life in participants in the 1946 British birth cohort study?
Methods:
This is an analysis of patients who participated in the National Survey of Health and Development (NSHD) study. This study began with a nationally representative sample of 5,362 singleton births from March 1946. Since enrollment, the cohort has been followed up 23 times. The eligible population for the present study included the 60% of participants who were alive and attended a clinic assessment at the ages of 60-64 years. Weight and height were measured during childhood and adulthood (at ages 36, 43, 53, and 60-64 years). The authors made comparisons between individuals who were normal weight, overweight, and obese for cardiovascular risk factors and cIMT.
Results:
The analytic sample included 1,273 (45%) of 2,856 participants. At age 60-64 years, overweight or obese participants had a higher cIMT, compared to normal weight counterparts (mean difference, 0.03 mm; 95% confidence interval [CI], 0.015-0.045; p < 0.0001). Overweight/obese participants had an adverse cardiovascular risk factor profile with increased concentrations of inflammatory markers, leptin, and glycated hemoglobin, along with higher blood pressure and odds of developing diabetes mellitus. While childhood overweight/obesity was not associated with cIMT at age 60-64 years, there was a cumulative effect of exposure to adiposity on cIMT at age 60-64 years (i.e., individuals classified as overweight or obese at age 36 years had the highest cIMT). Those who dropped a body mass index (BMI) category in adulthood had lower cIMT, even if the weight reduction was not maintained.
Conclusions:
Exposure to adiposity in adulthood has a cumulative adverse impact of cardiovascular risk factor profile in later life, and this impact may be attenuated by weight loss at any age in adulthood and even if not sustained.
Perspective:
This is an important study from the oldest British cohort. While the cumulative effect of adiposity through adulthood on the accentuation of cardiovascular risk in later life may not be surprising, the authors demonstrate the value of weight loss (sufficient to drop a BMI category) at any point in adulthood and even if not sustained. The findings should corroborate public health efforts to encourage weight loss/healthy living in obese/overweight adults at any stage/age in their life.
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