Body weight and weight gain during adult life in men in relation to coronary heart disease and mortality - A prospective population study

Aims To assess the risk of death from coronary disease, and all causes asso ciated with body mass index and weight gain from age 20 to middle age. Methods and Results In this study, 6874 men aged 47 to 55 years at baseline and free of a history of myocardial infarction were followed with respect to mortality from coronary disease and from all causes over an average foll ow-up of 19.7 years, and with respect to non-fatal myocardial infarction fo r 11.8 years. High body mass index predicted death from coronary disease, b ut only at levels above 27.5m.kg(-2). Men with stable weight (defined as +/ - 4% change from age 20) had the lowest death rate from coronary disease an d the lowest risk of non-fatal myocardial infarction. Relative risk of coro nary death increased with increasing weight gain, from 1.57 (1.14-2.15) (af ter adjustment for age, physical activity, and smoking) in the group who ga ined 4 to 10%, to 2.76 (1.97-3.85) in men with a weight gain of more than 3 5% (P for trend 0.0001), compared to men who remained stable. After further adjustment for serum cholesterol, systolic blood pressure, and diabetes, r elative risks were reduced but still significantly elevated in all weight g ain groups (P for trend 0.004). Data concerning non-fatal myocardial infarc tion were available for the first 11.8 years and showed a relative risk of 3.35 (2.05-5.47) after adjustment for age, physical activity, and smoking i n men with a weight gain of more than 35%. Conclusion Weight gain from age 20, even a very moderate increase, is stron gly associated with an increased risk of coronary death and non-fatal myoca rdial infarction.