Table 4. Associations of Weight Gain From Early to Middle Adulthood With Major Health Outcomes Later in Life in the Health Professionals Follow-Up Study (N = 25 303).
| 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 | 56 | 87 | 370 | 608 | 491 | |
| Person-years | 25 145 | 50 920 | 131 069 | 103 693 | 37 569 | |
| Multivariable-adjusted incidence/100 000 person-yearsa | 131.4 (99.7 to 173.1) | 147.3 (119.3 to 181.9) | 258.4 (233.0 to 286.6) | 533.0 (490.2 to 579.6) | 1142 (1033 to 1262) | |
| Multivariable-adjusted ARD/100 000 person-yearsa | −16.0 (−54.1 to 37.7) | 0 | 111.1 (57.5 to 178.7) | 385.6 (277.9 to 520.5) | 993.9 (757.2 to 1292.7) | |
| Age-adjusted IRR (95% CI)b | 1.30 (0.93 to 1.82) | 1 [Reference] | 1.66 (1.31 to 2.09) | 3.47 (2.77 to 4.34) | 7.78 (6.20 to 9.77) | <.001 |
| Multivariable-adjusted IRR (95% CI)a | 0.89 (0.63 to 1.26) | 1 [Reference] | 1.75 (1.39 to 2.21) | 3.62 (2.89 to 4.53) | 7.75 (6.14 to 9.78) | <.001 |
| Hypertension | ||||||
| No. of cases | 396 | 844 | 2370 | 2165 | 817 | |
| Person-years | 16 442 | 34 451 | 81 361 | 55 935 | 16 755 | |
| Multivariable-adjusted incidence/100 000 person-yearsa | 2022 (1825 to 2241) | 2366 (2211 to 2532) | 2861 (2746 to 2981) | 3859 (3694 to 4031) | 5009 (4658 to 5387) | |
| Multivariable-adjusted ARD/100 000 person-yearsa | −343.6 (−572.0 to −86.1) | 0 | 494.9 (280.8 to 726.4) | 1492.9 (1192.7 to 1818.6) | 2642.8 (2161.2 to 3175.7) | |
| Age-adjusted IRR (95% CI)b | 0.98 (0.87 to 1.11) | 1 [Reference] | 1.19 (1.10 to 1.29) | 1.58 (1.46 to 1.71) | 2.00 (1.81 to 2.20) | <.001 |
| Multivariable-adjusted IRR (95% CI)a | 0.85 (0.76 to 0.96) | 1 [Reference] | 1.21 (1.12 to 1.31) | 1.63 (1.50 to 1.77) | 2.12 (1.91 to 2.34) | <.001 |
| Cardiovascular Disease | ||||||
| No. of cases | 107 | 210 | 590 | 581 | 264 | |
| Person-years | 25 868 | 51 631 | 132 748 | 108 068 | 43 279 | |
| Multivariable-adjusted incidence/100 000 person-yearsa | 291.6 (238.0 to 357.2) | 339.6 (294.8 to 391.2) | 382.6 (350.8 to 417.3) | 471.8 (432.8 to 514.4) | 545.7 (481.2 to 618.7) | |
| Multivariable-adjusted ARD/100 000 person-yearsa | −48.0 (−109.1 to 29.2) | 0 | 43.0 (−13.5 to 109.2) | 132.2 (61.1 to 216.0) | 206.0 (111.6 to 320.2) | |
| Age-adjusted IRR (95% CI)b | 1.02 (0.81 to 1.28) | 1 [Reference] | 1.11 (0.95 to 1.30) | 1.38 (1.18 to 1.62) | 1.62 (1.35 to 1.93) | <.001 |
| Multivariable-adjusted IRR (95% CI)a | 0.86 (0.68 to 1.09) | 1 [Reference] | 1.13 (0.96 to 1.32) | 1.39 (1.18 to 1.64) | 1.61 (1.33 to 1.94) | <.001 |
| Obesity-Related Cancerc | ||||||
| No. of cases | 63 | 103 | 331 | 243 | 123 | |
| Person-years | 27 046 | 54 258 | 138 634 | 114 475 | 46 258 | |
| Multivariable-adjusted incidence/100 000 person-yearsa | 189.5 (145.9 to 246.2) | 165.3 (135.4 to 201.9) | 207.5 (184.7 to 233.3) | 185.4 (162.4 to 211.7) | 231.8 (192.5 to 279.1) | |
| Multivariable-adjusted ARD/100 000 person-yearsa | 24.2 (−27.4 to 95.1) | 0 | 42.2 (0.5 to 94.4) | 20.1 (−18.9 to 69.4) | 66.4 (10.9 to 139.3) | |
| Age-adjusted IRR (95% CI)b | 1.23 (0.90 to 1.68) | 1 [Reference] | 1.27 (1.02 to 1.59) | 1.16 (0.92 to 1.46) | 1.50 (1.15 to 1.95) | .06 |
| Multivariable-adjusted IRR (95% CI)a | 1.15 (0.83 to 1.58) | 1 [Reference] | 1.26 (1.00 to 1.57) | 1.12 (0.89 to 1.42) | 1.40 (1.07 to 1.84) | .13 |
| Obesity-Related Cancer Among Never Smokersc | ||||||
| No. of cases | 25 | 55 | 153 | 95 | 51 | |
| Person-years | 13 285 | 28 283 | 71 482 | 52 623 | 19 752 | |
| Multivariable-adjusted incidence/100 000 person-yearsa | 143.0 (95.2 to 215.0) | 163.7 (124.5 to 215.2) | 184.1 (154.4 to 219.6) | 163.7 (132.6 to 202.1) | 238.9 (179.4 to 318.2) | |
| Multivariable-adjusted ARD/100 000 person-yearsa | −20.7 (−74.9 to 66.6) | 0 | 20.4 (−29.2 to 88.3) | 0 (−47.7 to 67.2) | 75.2 (−3.7 to 193.0) | |
| Age-adjusted IRR (95% CI)b | 0.96 (0.60 to 1.54) | 1 [Reference] | 1.11 (0.82 to 1.52) | 0.97 (0.70 to 1.36) | 1.44 (0.98 to 2.10) | .16 |
| Multivariable-adjusted IRR (95% CI)a | 0.87 (0.54 to 1.41) | 1 [Reference] | 1.12 (0.82 to 1.54) | 1.00 (0.71 to 1.41) | 1.46 (0.98 to 2.18) | .08 |
| Cholelithiasis | ||||||
| No. of cases | 60 | 119 | 327 | 328 | 160 | |
| Person-years | 24 964 | 50 097 | 129 188 | 103 912 | 40 330 | |
| Multivariable-adjusted incidence/100 000 person-yearsa | 158.7 (120.6 to 209.0) | 192.7 (159.6 to 232.8) | 213.0 (190.1 to 238.8) | 270.7 (240.6 to 304.5) | 339.5 (287.3 to 401.1) | |
| Multivariable-adjusted ARD/100 000 person-yearsa | −34.0 (−77.8 to 26.5) | 0 | 20.3 (−20.6 to 70.8) | 77.9 (25.1 to 143.5) | 146.7 (70.9 to 244.3) | |
| Age-adjusted IRR (95% CI)b | 1.01 (0.74 to 1.38) | 1 [Reference] | 1.08 (0.88 to 1.34) | 1.39 (1.12 to 1.71) | 1.81 (1.42 to 2.29) | <.001 |
| Multivariable-adjusted IRR (95% CI)a | 0.82 (0.60 to 1.14) | 1 [Reference] | 1.11 (0.89 to 1.37) | 1.40 (1.13 to 1.74) | 1.76 (1.37 to 2.27) | <.001 |
| Severe Osteoarthritis | ||||||
| No. of cases | 31 | 67 | 168 | 114 | 54 | |
| Person-years | 26 880 | 52 867 | 137 294 | 113 780 | 45 901 | |
| Multivariable-adjusted incidence/100 000 person-yearsa | 49.2 (33.6 to 73.2) | 81.6 (62.4 to 106.8) | 94.8 (79.2 to 111.6) | 87.6 (72.0 to 106.8) | 114.0 (86.4 to 148.8) | |
| Multivariable-adjusted ARD/100 000 person-yearsa | −32.0 (−49.5 to −4.9) | 0 | 12.4 (−10.8 to 43.4) | 6.0 (−17.3 to 37.7) | 31.9 (−2.9 to 82.1) | |
| Age-adjusted IRR (95% CI)b | 0.91 (0.59 to 1.39) | 1 [Reference] | 0.97 (0.73 to 1.29) | 0.81 (0.60 to 1.10) | 0.97 (0.68 to 1.40) | .61 |
| Multivariable-adjusted IRR (95% CI)a | 0.61 (0.39 to 0.94) | 1 [Reference] | 1.15 (0.87 to 1.53) | 1.07 (0.79 to 1.46) | 1.39 (0.96 to 2.01) | .003 |
| Cataract Extraction | ||||||
| No. of cases | 370 | 640 | 1722 | 1512 | 632 | |
| Person-years | 25 405 | 51 122 | 130 969 | 106 938 | 43 238 | |
| Multivariable-adjusted incidence/100 000 person-yearsa | 1192 (1077 to 1318) | 1093 (1013 to 1179) | 1165 (1111 to 1221) | 1269 (1207 to 1334) | 1322 (1226 to 1426) | |
| Multivariable-adjusted ARD/100 000 person-yearsa | 98.4 (−37.0 to 251.1) | 0 | 71.3 (−23.8 to 174.9) | 175.9 (68.1 to 293.6) | 229.2 (95.5 to 378.0) | |
| Age-adjusted IRR (95% CI)b | 1.16 (1.03 to 1.31) | 1 [Reference] | 1.07 (0.98 to 1.16) | 1.18 (1.08 to 1.29) | 1.26 (1.13 to 1.39) | <.001 |
| Multivariable-adjusted IRR (95% CI)a | 1.09 (0.97 to 1.23) | 1 [Reference] | 1.07 (0.98 to 1.16) | 1.16 (1.06 to 1.27) | 1.21 (1.09 to 1.35) | <.001 |
| Mortality | ||||||
| No. of cases | 309 | 541 | 1305 | 1147 | 611 | |
| Person-years | 26 457 | 52 873 | 136 900 | 112 106 | 44 782 | |
| Multivariable-adjusted incidence/100 000 person-yearsa | 746.2 (667.7 to 834.0) | 780.9 (717.9 to 849.3) | 748.5 (707.8 to 791.6) | 804.1 (758.3 to 852.7) | 1082 (1001 to 1170) | |
| Multivariable-adjusted ARD/100 000 person-yearsa | −34.6 (−125.5 to 68.9) | 0 | −32.4 (−99.2 to 41.1) | 23.3 (−51.0 to 105.2) | 301.3 (187.5 to 428.5) | |
| Age-adjusted IRR (95% CI)b | 1.14 (1.00 to 1.30) | 1 [Reference] | 0.95 (0.86 to 1.04) | 1.06 (0.96 to 1.17) | 1.47 (1.33 to 1.64) | <.001 |
| Multivariable-adjusted IRR (95% CI)a | 0.96 (0.84 to 1.09) | 1 [Reference] | 0.96 (0.87 to 1.05) | 1.03 (0.93 to 1.13) | 1.39 (1.24 to 1.55) | <.001 |
| Mortality Among Never Smokers | ||||||
| No. of cases | 114 | 228 | 547 | 420 | 221 | |
| Person-years | 13 008 | 27 964 | 70 938 | 51 971 | 19 186 | |
| Multivariable-adjusted incidence/100 000 person-yearsa | 538.8 (446.4 to 650.3) | 607.6 (533.1 to 692.5) | 598.3 (547.4 to 653.8) | 666.3 (604.5 to 734.5) | 952.2 (837.2 to 1083.0) | |
| Multivariable-adjusted ARD/100 000 person-yearsa | −68.8 (−172.7 to 60.0) | 0 | −9.3 (−90.5 to 84.6) | 58.7 (−36.3 to 169.5) | 344.7 (189.7 to 529.7) | |
| Age-adjusted IRR (95% CI)b | 1.07 (0.87 to 1.31) | 1 [Reference] | 0.96 (0.83 to 1.11) | 1.07 (0.92 to 1.24) | 1.60 (1.35 to 1.90) | <.001 |
| Multivariable-adjusted IRR (95% CI)a | 0.89 (0.72 to 1.10) | 1 [Reference] | 0.98 (0.85 to 1.14) | 1.10 (0.94 to 1.28) | 1.57 (1.31 to 1.87) | <.001 |
| Composite Healthy Aging Outcomed | ||||||
| Sample size | 1266 | 2538 | 6564 | 5377 | 1989 | |
| No. of participants who achieved outcome | 471 | 989 | 2405 | 1684 | 492 | |
| Age-adjusted OR (95% CI)b | 0.96 (0.83 to 1.11) | 1 [Reference] | 0.87 (0.79 to 0.96) | 0.63 (0.57 to 0.70) | 0.42 (0.37 to 0.48) | <.001 |
| Multivariable-adjusted OR (95% CI)a | 1.14 (0.98 to 1.33) | 1 [Reference] | 0.88 (0.79 to 0.97) | 0.66 (0.59 to 0.73) | 0.45 (0.39 to 0.52) | <.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), physical activity (in quintiles: <8.3, 8.3-17.2, 17.3-28.6, 28.7-46.9, or ≥47.0 metabolic equivalent task h/wk), alcohol consumption (0-4, 5-9, 10-14, 15-29, or ≥30 g/d), dietary qualify (Alternative Healthy Eating Index in quintiles), family history of respective diseases, and weight at age of 21 years.
b
Included age at cohort recruitment (continuous).
c
Included the esophagus (adenocarcinoma only), colon and rectum, pancreas, prostate (advanced only), 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.