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Epidemiology and Population Health

The role of family factors in the association between early adulthood BMI and risk of cardiovascular disease. An intergenerational study of BMI in early adulthood and cardiovascular mortality in parents, aunts and uncles

International Journal of Obesity volume 46, pages 228–234 (2022)Cite this article

Subjects

Abstract

Background

High body mass index (BMI) in childhood and adolescence is related to cardiovascular disease (CVD). Causality is not established because common genetic or early life socioeconomic factors (family factors) may explain this relationship. We aimed to study the role of family factors in the association between BMI and CVD by investigating if early adulthood BMI in conscripts and CVD mortality in their parents/aunts/uncles are related.

Methods

Data from the Armed Forces Personnel Database (including height and weight among conscripts) were linked with data from the Norwegian Population Registry, generational data from the Norwegian Family Based Life Course Study, the National Educational Registry and the Cause of Death Registry using unique personal identification numbers. The study sample (N = 369,464) was Norwegian males born 1967–1993, who could be linked to both parents and at least one maternal and one paternal aunt or uncle. Subsamples were identified as conscripts whose parents/aunts/uncles had data on cardiovascular risk factors available from Norwegian health surveys. Cox proportional hazards regression models were used to estimate hazard ratios (HR) of CVD mortality in the parental generation according to BMI categories of conscripts.

Results

Parents of conscripts with obesity or overweight had a higher hazard of CVD death (fathers HR obese: 1.99 (1.79, 2.21), overweight: 1.33 (1.24, 1.42) mothers HR obese: 1.65 (1.32, 2.07), overweight: 1.23 (1.07, 1.42)) than parents of normal- or underweight conscripts. Aunts and uncles of conscripts with obesity and overweight had an elevated hazard of CVD death, but less so than parents. Adjustment for CVD risk factors attenuated the results in parents, aunts and uncles.

Conclusions

Family factors may impact the relationship between early adulthood overweight and CVD in parents. These can be genes with impact on BMI over generations and genes with a pleiotropic effect on both obesity and CVD, as well as shared environment over generations.

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Data availability

Data are owned by Norwegian Institute of Public Health (NIPH) and cannot be shared. Application has to be sent to NIPH after approval of study from Norwegian Regional Committees for Medical and Health Research Ethics

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Funding

This work was supported by the Norwegian research Council [grant number 213788]. GDS and DC works in a unit which receives funding from the University of Bristol and the UK Medical Research Council (MC_UU_00011/1).

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Authors and Affiliations

  1. University of Oslo, Norway, Institute of Health and Society, Pb 1130 Blindern, 0318, Oslo, Norway

    M. K. R. Kjøllesdal, F. Shaikh & Ø Næss

  2. Norwegian University of Lifesciences. Faculty of Landscape and Society, Postbox 5003 NMBU, 1432, Ås, Norway

    M. K. R. Kjøllesdal

  3. MRC Integrative Epidemiology Unit at the University of Bristol, Oakfield House, Oakfield Grove, Bristol, BS8 2BN, UK

    D. Carslake & G. D. Smith

  4. Norwegian Institute of Public Health, Norway. Department Physical and Mental Health, Pb 222 Skøyen, 0213, Oslo, Norway

    Ø Næss

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  1. M. K. R. Kjøllesdal
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  4. F. Shaikh
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Contributions

ØN and MK conceived the idea of the article, MK did the statistical analyses and drafted the article and all authors have critically revised the manuscript and contributed in the final stage of writing.

Corresponding author

Correspondence to M. K. R. Kjøllesdal.

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Competing interests

The authors declare no competing interests.

Ethics approval

The study was approved by the Norwegian Regional Committees for Medical and Health Research Ethics (REK) (2012/827). Written informed consent was obtained from participants in the Age 40 Program and CONOR. Participants in the Counties studies gave written permission for their results to be sent to their physician. Permission to be absolved from this professional secrecy has been granted and concession to handle this personal health information has been given by the authorities. The health studies have been conducted in full accordance with the World Medical Association Declaration of Helsinki.

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Kjøllesdal, M.K.R., Carslake, D., Smith, G.D. et al. The role of family factors in the association between early adulthood BMI and risk of cardiovascular disease. An intergenerational study of BMI in early adulthood and cardiovascular mortality in parents, aunts and uncles. Int J Obes 46, 228–234 (2022). https://doi.org/10.1038/s41366-021-00987-z

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