Do rapid BMI growth in childhood and early-onset obesity offer cardiometabolic protection to obese adults in mid-life? Analysis of a longitudinal cohort study of Danish men. Issue 4 (15th April 2014)

• Record Type: Journal Article
• Authors: Howe, Laura D; Zimmermann, Esther; Weiss, Ram; Sørensen, Thorkild I A
• Is Part Of: BMJ open. Volume 4:Issue 4(2014)
• Publication Date: 2014-04-15
• Subjects: EPIDEMIOLOGY -- NUTRITION & DIETETICS -- PRIMARY CARE -- PUBLIC HEALTH; Medicine -- Research -- Periodicals; 610.72
• DOI: 10.1136/bmjopen-2014-004827
• Languages: English
• ISSNs: 2044-6055

Abstract

Abstract : Objective: Some obese individuals have no cardiometabolic abnormalities; they are 'metabolically healthy, but obese' (MHO). Similarly, some non-obese individuals have cardiometabolic abnormalities, that is, 'metabolically at risk, normal weight' (MANW). Previous studies have suggested that early-onset obesity may be associated with MHO. We aimed to assess whether body mass index (BMI) in childhood and early-onset obesity are associated with MHO. Setting: General population longitudinal cohort study, Denmark. Participants: From 362 200 young men (mean age 20) examined for Danish national service between 1943 and 1977, all obese men (BMI ≥31 kg/m 2, N=1930) were identified along with a random 1% sample of the others (N=3601). Our analysis includes 2392 of these men attending a research clinic in mid-life (mean age 42). For 613 of these men, data on childhood BMI are available. We summarised childhood BMI growth (7–13 years) using a multilevel model. Early-onset obesity was defined as obesity at examination for national service. Outcome measurement: We defined metabolic health at the mid-life clinic as non-fasting serum cholesterol <6.6 mmol/L, non-fasting glucose <8.39 mmol/L and pulse pressure <48 mm Hg. Participants were categorised into four groups according to their obesity (BMI ≥30 kg/m 2 ) and metabolic health in mid-life. Results: 297 of 1097 (27.1%) of obese men were metabolically healthy; 826 of 1295 (63.8%) non-obese men had at least one metabolic abnormality. There was no evidence that rapid BMI growth in childhood or early-onset obesity was associated with either MHO or the MANW phenotype, for example, among obese men in mid-life, the OR for MHO comparing early-onset obesity with non-early-onset obesity was 0.97 (95% CI 0.85 to 1.10). Conclusions: We found no robust evidence that early-onset obesity or rapid BMI growth in childhood is protective for cardiometabolic health.