a1 Department of Nutrition, Simmons College, 300 The Fenway, Park Science Building, Boston, MA 02115, USA
a2 Department of Pediatrics, Boston University School of Medicine, Boston, MA, USA
a3 Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
a4 Framingham Heart Study, Framingham, MA, USA
a5 Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, USA
a6 Department of Mathematics and Statistics, Statistics and Consulting Unit, Boston University, Boston, MA, USA
a7 Department of Neurology, Boston University School of Medicine, Boston, MA, USA
a8 Department of Anesthesia and Perioperative Care, University of California, San Francisco, CA, USA
a9 Boston Nutrition Foundation and Millennium Prevention, Inc., Westwood, MA, USA
Objective To evaluate long-term patterns of weight change and progression to overweight and obesity during adulthood.
Design Prospective study. Changes in mean BMI, waist circumference (WC) and weight were assessed over a mean 26-year follow-up (1971–1975 to 1998–2001). Mean BMI (95 % CI) and mean WC (95 % CI) of men and women in BMI and age groups were computed. Mean weight change in BMI and age categories was compared using analysis of covariance.
Setting Framingham Heart Study Offspring/Spouse Nutrition Study.
Subjects Men and women (n 2394) aged 20–63 years.
Results During follow-up, increases in BMI (men: 2·2 kg/m2; women: 3·7 kg/m2) and WC (men: 5·7 cm; women: 15·1 cm) were larger in women than men. BMI gains were greatest in younger adults (20–39 years) and smallest in obese older adults (50–69 years). The prevalence of obesity doubled in men (to 33·2 %) and tripled in women (to 26·6 %). Among normal-weight individuals, abdominal obesity developed in women only. The prevalence of abdominal obesity increased 1·8-fold in men (to 53·0 %) and 2·4-fold in women (to 71·2 %). Weight gain was greatest in the youngest adults (20–29 years), particularly women. Gains continued into the fifth decade among men and then declined in the sixth decade; in women gains continued into the sixth decade.
Conclusions Patterns of weight change and progression to obesity during adulthood differ in men and women. Preventive intervention strategies for overweight and obesity need to consider age- and sex-specific patterns of changes in anthropometric measures.
(Received August 25 2011)
(Revised May 31 2012)
(Accepted June 17 2012)
(Online publication August 31 2012)
p1 Previous address: Division of Graduate Medical Sciences, Boston University School of Medicine Boston, 715 Albany Street, Boston, MA 02118, USA.
p2 Previous address: Department of Family Medicine, Boston University School of Medicine, One Boston Medical Center Plaza, Dowling 5, Boston, MA 02118, USA and Division of Graduate Medical Sciences, Boston University School of Medicine Boston, 715 Albany Street, Boston, MA 02118, USA.