Longitudinal trajectories of BMI and cardiovascular disease risk: The national longitudinal study of adolescent health

Authors

  • Samantha M. Attard,

    Corresponding author
    1. Department of Nutrition, Gillings School of Global Public Health and School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina at Chapel Hill, USA
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  • Amy H. Herring,

    1. Carolina Population Center, University of North Carolina, Chapel Hill, North Carolina, USA
    2. Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
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  • Annie Green Howard,

    1. Carolina Population Center, University of North Carolina, Chapel Hill, North Carolina, USA
    2. Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
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  • Penny Gordon-Larsen

    1. Department of Nutrition, Gillings School of Global Public Health and School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina at Chapel Hill, USA
    2. Carolina Population Center, University of North Carolina, Chapel Hill, North Carolina, USA
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  • Disclosures: The authors declared no conflicts of interest.

  • Funding agencies: This study was funded by National Institutes of Health Grant R01HD057194. The Carolina Population Center (R24 HD050924) provided general support. This research uses data from Add Health, a program project directed by Kathleen Mullan Harris and designed by J. Richard Udry, Peter S. Bearman, and Kathleen Mullan Harris at the University of North Carolina at Chapel Hill andfunded by Grant P01-HD31921 from the Eunice Kennedy Shriver National Institute of Child Health and Human Development, with cooperative funding from 23 other federal agencies and foundations.

Abstract

Objective

In adulthood, excess BMI is associated with cardiovascular disease (CVD); it is unknown whether risk differs by BMI trajectories from adolescence to adulthood.

Design and Methods

The National Longitudinal Study of Adolescent Health, a nationally representative, longitudinal adolescent cohort (mean age: 16.9 years) followed into adulthood (mean age: 28.8 years) [n = 13,984 individuals (41,982 observations)] was examined. Separate logistic regression models for diabetes, hypertension, and inflammation were used to examine odds of risk factors at given adult BMI according to varying BMI trajectories from adolescence to adulthood.

Results

CVD risk factor prevalence at follow-up ranged from 5.5% (diabetes) to 26.4% (hypertension) and 31.3% (inflammation); risk differed across BMI trajectories. For example, relative to men aged 27 years (BMI = 23 kg/m2 maintained over full study period), odds for diabetes were comparatively higher for men of the same age and BMI ≈ 30 kg/m2 with ≈8 BMI unit gain between 15 and 20 years (OR = 2.35; 95% CI, 1.51, 3.66) or in those who maintained BMI ≈ 30 kg/m2 across the study period (OR = 2.33; 1.92, 2.83) relative to the same ≈8 BMI unit gain, but between 20 and 27 years (OR = 1.44; 1.10, 1.87).

Conclusions

Specific periods and patterns of weight gain in the transition from adolescence to adulthood might be critical for CVD preventive efforts.

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