Table 3. Associations of Weight Gain From Early to Middle Adulthood With Major Health Outcomes Later in Life in the Nurses’ Health Study (N = 92 837).
| Weight Loss >2.5 kg | Weight Loss ≤2.5 kg or Gain <2.5 kg |
Weight Gain Between ≥2.5 kg and <10.0 kg |
Weight Gain Between ≥10.0 kg and <20.0 kg |
Weight Gain ≥20.0 kg |
P Value for Trend |
|
|---|---|---|---|---|---|---|
| Type 2 Diabetes | ||||||
| No. of cases | 151 | 268 | 1135 | 2572 | 3681 | |
| Person-years | 121 868 | 214 925 | 516 181 | 497 850 | 283 136 | |
| Multivariable-adjusted incidence/100 000 person-yearsa | 80.3 (68.4 to 94.3) | 109.5 (97.2 to 123.3) | 207.2 (195.4 to 219.7) | 493.1 (473.9 to 513.0) | 1150 (1108 to 1193) | |
| Multivariable-adjusted ARD/100 000 person-yearsa | −29.2 (−43.7 to −11.5) | 0 | 97.8 (72.1 to 127.1) | 383.7 (325.6 to 449.7) | 1040.8 (905.1 to 1194.6) | |
| Age-adjusted IRR (95% CI)b | 0.99 (0.81 to 1.21) | 1 [Reference] | 1.77 (1.55 to 2.02) | 4.18 (3.68 to 4.74) | 10.61 (9.37 to 12.01) | <.001 |
| Multivariable-adjusted IRR (95% CI)a | 0.73 (0.60 to 0.90) | 1 [Reference] | 1.89 (1.66 to 2.16) | 4.50 (3.97 to 5.11) | 10.51 (9.27 to 11.91) | <.001 |
| Hypertension | ||||||
| No. of cases | 2222 | 3890 | 10 099 | 10 601 | 6181 | |
| Person-years | 77 201 | 136 158 | 296 100 | 248 338 | 108 987 | |
| Multivariable-adjusted incidence/100 000 person-yearsa | 2486 (2384 to 2592) | 2754 (2672 to 2837) | 3415 (3352 to 3480) | 4364 (4284 to 4445) | 5784 (5639 to 5934) | |
| Multivariable-adjusted ARD/100 000 person-yearsa | −267.7 (−388.6 to −140.7) | 0 | 661.5 (545.0 to 782.4) | 1610.3 (1458.9 to 1767.0) | 3031.3 (2804.3 to 3267.3) | |
| Age-adjusted IRR (95% CI)b | 1.01 (0.96 to 1.06) | 1 [Reference] | 1.19 (1.15 to 1.24) | 1.49 (1.44 to 1.54) | 1.98 (1.90 to 2.06) | <.001 |
| Multivariable-adjusted IRR (95% CI)a | 0.90 (0.86 to 0.95) | 1 [Reference] | 1.24 (1.20 to 1.28) | 1.58 (1.53 to 1.64) | 2.10 (2.02 to 2.19) | <.001 |
| Cardiovascular Disease | ||||||
| No. of cases | 617 | 815 | 2230 | 2206 | 1779 | |
| Person-years | 122 540 | 216 114 | 523 708 | 529 870 | 342 048 | |
| Multivariable-adjusted incidence/100 000 person-yearsa | 267.8 (245.2 to 292.6) | 247.9 (230.7 to 266.5) | 309.2 (295.2 to 323.9) | 334.4 (319.7 to 349.8) | 464.3 (442.4 to 487.3) | |
| Multivariable-adjusted ARD/100 000 person-yearsa | 19.9 (−7.0 to 49.8) | 0 | 61.3 (37.6 to 86.9) | 86.5 (60.5 to 114.7) | 216.4 (178.5 to 257.6) | |
| Age-adjusted IRR (95% CI)b | 1.32 (1.19 to 1.46) | 1 [Reference] | 1.17 (1.08 to 1.26) | 1.23 (1.14 to 1.33) | 1.74 (1.60 to 1.89) | <.001 |
| Multivariable-adjusted IRR (95% CI)a | 1.08 (0.97 to 1.20) | 1 [Reference] | 1.25 (1.15 to 1.35) | 1.35 (1.24 to 1.46) | 1.87 (1.72 to 2.04) | <.001 |
| Obesity-Related Cancerc | ||||||
| No. of cases | 500 | 932 | 2445 | 2873 | 2154 | |
| Person-years | 122 744 | 213 041 | 519 500 | 527 937 | 346 115 | |
| Multivariable-adjusted incidence/100 000 person-yearsa | 380.7 (346.8 to 418.0) | 415.0 (388.6 to 443.3) | 452.1 (433.9 to 471.0) | 535.1 (515.5 to 555.5) | 629.5 (602.9 to 657.1) | |
| Multivariable-adjusted ARD/100 000 person-yearsa | −34.3 (−74.3 to 10.3) | 0 | 37.0 (4.0 to 72.6) | 120.1 (81.3 to 161.9) | 214.4 (166.3 to 266.4) | |
| Age-adjusted IRR (95% CI)b | 0.93 (0.83 to 1.04) | 1 [Reference] | 1.08 (1.00 to 1.16) | 1.26 (1.17 to 1.35) | 1.45 (1.34 to 1.57) | <.001 |
| Multivariable-adjusted IRR (95% CI)a | 0.92 (0.82 to 1.02) | 1 [Reference] | 1.09 (1.01 to 1.17) | 1.29 (1.20 to 1.39) | 1.52 (1.40 to 1.64) | <.001 |
| Obesity-Related Cancer Among Never Smokersc | ||||||
| No. of cases | 145 | 343 | 1040 | 1320 | 1086 | |
| Person-years | 38 025 | 85 685 | 231 690 | 250 532 | 173 407 | |
| Multivariable-adjusted incidence/100 000 person-yearsa | 344.0 (290.0 to 408.2) | 373.9 (335.5 to 416.6) | 426.4 (400.3 to 454.2) | 517.3 (489.7 to 546.4) | 632.5 (595.6 to 671.8) | |
| Multivariable-adjusted ARD/100 000 person-yearsa | −29.8 (−91.5 to 45.3) | 0 | 52.5 (3.4 to 108.0) | 143.4 (84.8 to 209.5) | 258.7 (184.6 to 342.6) | |
| Age-adjusted IRR (95% CI)b | 0.95 (0.78 to 1.16) | 1 [Reference] | 1.13 (1.00 to 1.27) | 1.33 (1.18 to 1.50) | 1.60 (1.42 to 1.81) | <.001 |
| Multivariable-adjusted IRR (95% CI)a | 0.92 (0.76 to 1.12) | 1 [Reference] | 1.14 (1.01 to 1.29) | 1.38 (1.23 to 1.56) | 1.69 (1.49 to 1.92) | <.001 |
| Cholelithiasis | ||||||
| No. of cases | 364 | 703 | 2161 | 2964 | 2359 | |
| Person-years | 110 982 | 199 537 | 472 275 | 457 281 | 263 404 | |
| Multivariable-adjusted incidence/100 000 person-yearsa | 242.7 (217.6 to 270.8) | 316.4 (293.1 to 341.5) | 436.8 (417.8 to 456.7) | 640.7 (615.9 to 666.5) | 874.1 (834.7 to 915.3) | |
| Multivariable-adjusted ARD/100 000 person-yearsa | −73.7 (−103.3 to −39.8) | 0 | 120.4 (84.2 to 160.0) | 324.3 (271.9 to 381.5) | 557.8 (482.9 to 639.7) | |
| Age-adjusted IRR (95% CI)b | 0.93 (0.82 to 1.05) | 1 [Reference] | 1.30 (1.20 to 1.42) | 1.87 (1.72 to 2.03) | 2.62 (2.40 to 2.85) | <.001 |
| Multivariable-adjusted IRR (95% CI)a | 0.77 (0.67 to 0.87) | 1 [Reference] | 1.38 (1.27 to 1.51) | 2.03 (1.86 to 2.21) | 2.76 (2.53 to 3.02) | <.001 |
| Severe Osteoarthritis | ||||||
| No. of cases | 204 | 306 | 818 | 814 | 514 | |
| Person-years | 120 651 | 211 517 | 516 058 | 520 985 | 342 129 | |
| Multivariable-adjusted incidence/100 000 person-yearsa | 86.4 (73.2 to 100.8) | 92.4 (81.6 to 104.4) | 110.4 (102.0 to 120.0) | 120.0 (111.6 to 129.6) | 128.4 (116.4 to 141.6) | |
| Multivariable-adjusted ARD/100 000 person-yearsa | −5.8 (−20.4 to 11.9) | 0 | 18.7 (4.8 to 34.7) | 28.2 (12.9 to 45.8) | 36.8 (18.8 to 57.7) | |
| Age-adjusted IRR (95% CI)b | 1.16 (0.97 to 1.38) | 1 [Reference] | 1.14 (1.00 to 1.30) | 1.21 (1.06 to 1.39) | 1.33 (1.15 to 1.53) | <.001 |
| Multivariable-adjusted IRR (95% CI)a | 0.94 (0.78 to 1.13) | 1 [Reference] | 1.20 (1.05 to 1.38) | 1.31 (1.14 to 1.50) | 1.40 (1.20 to 1.62) | <.001 |
| Cataract Extraction | ||||||
| No. of cases | 2607 | 4590 | 11 083 | 11 189 | 7255 | |
| Person-years | 106 238 | 186 004 | 455 982 | 468 244 | 310 332 | |
| Multivariable-adjusted incidence/100 000 person-yearsa | 2152 (2081 to 2226) | 2240 (2186 to 2294) | 2255 (2219 to 2291) | 2293 (2257 to 2329) | 2345 (2299 to 2393) | |
| Multivariable-adjusted ARD/100 000 person-yearsa | −87.5 (−171.0 to −0.6) | 0 | 15.1 (−46.2 to 78.2) | 53.2 (−10.5 to 118.6) | 105.9 (33.6 to 180.5) | |
| Age-adjusted IRR (95% CI)b | 0.99 (0.95 to 1.02) | 1 [Reference] | 1.00 (0.97 to 1.03) | 1.01 (0.98 to 1.04) | 1.04 (1.01 to 1.07) | <.001 |
| Multivariable-adjusted IRR (95% CI)a | 0.96 (0.92 to 1.00) | 1 [Reference] | 1.01 (0.98 to 1.03) | 1.02 (1.00 to 1.05) | 1.05 (1.02 to 1.08) | <.001 |
| Mortality | ||||||
| No. of cases | 2716 | 3701 | 8331 | 8021 | 5740 | |
| Person-years | 126 457 | 221 939 | 540 076 | 546 068 | 354 830 | |
| Multivariable-adjusted incidence/100 000 person-yearsa | 1114 (1076 to 1153) | 1050 (1020 to 1080) | 1071 (1049 to 1093) | 1133 (1110 to 1156) | 1411 (1380 to 1443) | |
| Multivariable-adjusted ARD/100 000 person-yearsa | 64.5 (21.5 to 109.2) | 0 | 21.1 (−10.8 to 54.2) | 83.5 (48.7 to 119.4) | 361.6 (314.7 to 410.2) | |
| Age-adjusted IRR (95% CI)b | 1.27 (1.22 to 1.32) | 1 [Reference] | 0.96 (0.93 to 0.99) | 0.99 (0.96 to 1.02) | 1.25 (1.21 to 1.29) | <.001 |
| Multivariable-adjusted IRR (95% CI)a | 1.06 (1.02 to 1.10) | 1 [Reference] | 1.02 (0.99 to 1.05) | 1.08 (1.05 to 1.11) | 1.34 (1.30 to 1.39) | <.001 |
| Mortality Among Never Smokers | ||||||
| No. of cases | 528 | 1085 | 2956 | 3243 | 2655 | |
| Person-years | 39 231 | 88 894 | 240 739 | 259 997 | 178 126 | |
| Multivariable-adjusted incidence/100 000 person-yearsa | 745.9 (691.4 to 804.6) | 751.0 (711.4 to 792.7) | 801.7 (773.0 to 831.5) | 877.9 (848.4 to 908.4) | 1144 (1104 to 1186) | |
| Multivariable-adjusted ARD/100 000 person-yearsa | −5.1 (−66.6 to 61.9) | 0 | 50.8 (6.4 to 97.7) | 126.9 (78.5 to 178.2) | 392.9 (327.5 to 462.4) | |
| Age-adjusted IRR (95% CI)b | 1.12 (1.03 to 1.21) | 1 [Reference] | 1.04 (0.99 to 1.10) | 1.15 (1.08 to 1.21) | 1.56 (1.47 to 1.65) | <.001 |
| Multivariable-adjusted IRR (95% CI)a | 0.99 (0.91 to 1.08) | 1 [Reference] | 1.07 (1.01 to 1.13) | 1.17 (1.10 to 1.24) | 1.52 (1.44 to 1.62) | <.001 |
| Composite Healthy Aging Outcomed | ||||||
| Sample size | 2918 | 5764 | 14 910 | 16 329 | 11 019 | |
| No. of participants who achieved outcome | 753 | 1528 | 3651 | 3484 | 1503 | |
| Age-adjusted OR (95% CI)b | 0.97 (0.87 to 1.08) | 1 [Reference] | 0.81 (0.75 to 0.87) | 0.57 (0.53 to 0.61) | 0.26 (0.24 to 0.28) | <.001 |
| Multivariable-adjusted OR (95% CI)a | 1.22 (1.09 to 1.37) | 1 [Reference] | 0.78 (0.72 to 0.84) | 0.56 (0.52 to 0.60) | 0.28 (0.26 to 0.31) | <.001 |
Abbreviations: ARD, absolute rate difference; IRR, incident rate ratio; OR, odds ratio.
a
Included age at cohort recruitment (continuous), height (continuous), race (nonwhite or white), pack-years of smoking (never smokers; past smoker with <5, 5-20, or >20 pack-years; and current smoker with <5, 5-20, or >20 pack-years), regular aspirin use (yes or no), status of menopause and hormone therapy (premenopausal, postmenopausal and never use; postmenopausal and current use; or postmenopausal and past use), parity (nulliparous, 1, 2, 3, or ≥4 children), physical activity (in quintiles: <2.9, 2.9-7.1, 7.2-13.1, 13.2-23.6, or ≥23.7 metabolic equivalent task h/wk), alcohol consumption (0, 0.1-0.4, 0.5-1.9, 2.0-7.0, or ≥8.0 g/d), dietary qualify (Alternative Healthy Eating Index in quintiles), family history of respective diseases, and weight at age of 18 years.
b
Included age at cohort recruitment (continuous).
c
Included the esophagus (adenocarcinoma only), colon and rectum, pancreas, breast (after menopause), endometrium, ovaries, kidney, liver, and gallbladder.
d
Defined as meeting all of the following criteria: (1) no self-reported history of cancer, diabetes, coronary heart disease, coronary artery bypass graft surgery or percutaneous transluminal coronary angioplasty, congestive heart failure, stroke, kidney failure, chronic obstructive pulmonary disease, Parkinson disease, multiple sclerosis, or amyotrophic lateral sclerosis; (2) no cognitive decline; and (3) no physical limitations.