TY - JOUR
T1 - Life-long body mass index trajectories and mortality in two generations
AU - Zheng, Hui
AU - Echave, Paola
AU - Mehta, Neil
AU - Myrskylä, Mikko
N1 - Funding Information:
We thank Anatoliy Yashin for helpful comments. This work was supported by the Grants R03AG053463 and P2CHD058484, funded by the National Institutes of Health. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the National Institutes of Health or the Department of Health and Human Services.
Funding Information:
We thank Anatoliy Yashin for helpful comments. This work was supported by the Grants R03AG053463 and P2CHD058484 , funded by the National Institutes of Health . Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the National Institutes of Health or the Department of Health and Human Services.
Publisher Copyright:
© 2021
PY - 2021/4
Y1 - 2021/4
N2 - Purpose: To identify life-long body mass index (BMI) trajectories across two related generations and estimate their associated mortality risks and population attributable deaths. Methods: We use prospective cohort data from the Framingham Heart Study (1948–2011) original (4576 individuals, 3913 deaths) and offspring (3753 individuals, 967 deaths) cohorts and latent trajectory models to model BMI trajectories from age 31 to 80 years. Survival models are used to estimate trajectory-specific mortality risk. Results: We define seven BMI trajectories among original cohort and six among offspring cohort. Among original cohort, people who are normal weight at age 31 years and gradually move to overweight status in middle or later adulthood have the lowest mortality risk even compared to those who maintain normal weight throughout adulthood, followed by overweight stable, lower level of normal weight, overweight downward, class I obese upward, and class II/III upward trajectories. Mortality risks associated with obesity trajectories have declined across cohorts, while the prevalence of high-risk trajectories has increased. Conclusions: The mortality impact of weight gain depends on an individual's BMI trajectory. Population attributable deaths associated with unhealthy weight trajectories have grown over generations because the prevalence has increased, offsetting the decline in trajectory-specific mortality risks.
AB - Purpose: To identify life-long body mass index (BMI) trajectories across two related generations and estimate their associated mortality risks and population attributable deaths. Methods: We use prospective cohort data from the Framingham Heart Study (1948–2011) original (4576 individuals, 3913 deaths) and offspring (3753 individuals, 967 deaths) cohorts and latent trajectory models to model BMI trajectories from age 31 to 80 years. Survival models are used to estimate trajectory-specific mortality risk. Results: We define seven BMI trajectories among original cohort and six among offspring cohort. Among original cohort, people who are normal weight at age 31 years and gradually move to overweight status in middle or later adulthood have the lowest mortality risk even compared to those who maintain normal weight throughout adulthood, followed by overweight stable, lower level of normal weight, overweight downward, class I obese upward, and class II/III upward trajectories. Mortality risks associated with obesity trajectories have declined across cohorts, while the prevalence of high-risk trajectories has increased. Conclusions: The mortality impact of weight gain depends on an individual's BMI trajectory. Population attributable deaths associated with unhealthy weight trajectories have grown over generations because the prevalence has increased, offsetting the decline in trajectory-specific mortality risks.
KW - Body mass index trajectories
KW - Cohort
KW - Framingham Heart Study
KW - Mortality
KW - Obesity
KW - United States
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U2 - 10.1016/j.annepidem.2021.01.003
DO - 10.1016/j.annepidem.2021.01.003
M3 - Article
C2 - 33493649
AN - SCOPUS:85100821978
SN - 1047-2797
VL - 56
SP - 18
EP - 25
JO - Annals of Epidemiology
JF - Annals of Epidemiology
ER -