Lifetime overweight status in relation to serial changes in body composition and risk factors for cardiovascular disease: The Fels Longitudinal Study

Objective: The aims were to determine if 1) individuals who became and main tained overweight during their entire lifetime differ from those who were n ever-overweight in terms of annual changes in adiposity and concurrent chan ges in cardiovascular disease (CVD) risk factors; 2) the changes and their relationships to each other varied between these groups or by sex within th e groups; and 3) alcohol usage, smoking habits, and level of physical activ ity differed between groups. Research Methods and Procedures: Data from 16,315 examinations of 414 indiv iduals were utilized to assess lifetime overweight (body mass index [BMI] > 25 kg/m(2)) status. A regressive analytic approach was used to determine t he average annual changes for each individual over an adult serial interval ranging from 4 to 20 years. Results: Men and women who have become and maintained overweight have highe r blood pressure and a poorer lipid/lipoprotein risk profile than those who have never been overweight. There is an accelerated deterioration in the a therogenic profile of overweight men and women as indicated by annual chang es in CVD risk factors about double that of their never-overweight counterp arts, In women, increased risk is derived from increasing systolic and dias tolic blood pressure, whereas in men the increased risk comes not only from increasing diastolic blood pressure but also cholesterol. triglycerides, a nd low-density lipoprotein cholesterol levels and, to a lesser extent, decr easing high-density lipoprotein cholesterol. Discussion: The reduced physical activity observed in the overweight adults may be related to their accumulation of adipose tissue at a rate about dou ble their never-overweight counterparts, and this may be driving the higher rate of increase of CVD risk factors in the overweight groups.