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Adult weight gain and the risk of cardiovascular disease: a systematic review and dose–response meta-analysis of prospective cohort studies

Abstract

We aimed to examine the association of weight gain during adulthood with the risk of cardiovascular disease (CVD) in the general population. We performed a systematic search of PubMed and Scopus, from inception to June 2019. Prospective cohort studies investigating the association of weight gain during adulthood with the risk of CVD were included. The relative risks (RRs) were calculated by using random-effect models. Twenty-three prospective cohort studies with 1,093,337 participants were included. The RRs for a 5-kg increment in body weight were 1.11 (95% CI: 1.04, 1.19; I2 = 80%, n = 11) for CVD mortality, 1.18 (95% CI: 1.04, 1.32; I2 = 90%, n = 8) for coronary heart disease (CHD), 1.08 (95% CI: 1.04, 1.12; I2 = 0%, n = 3) for stroke, 1.18 (95% CI: 1.12, 1.25; I2 = 0%, n = 2) for myocardial infarction and 1.05 (95% CI: 0.86, 1.23; I2 = 80%, n = 2) for heart failure. A dose–response analysis demonstrated that the risk of CVD mortality was unchanged with weight gain of 0–5 kg, and then increased sharply and linearly (P for nonlinearity < 0.001). The analysis of CHD indicated a sharp increase in risk from baseline up to weight gain equal to 25 kg (P for nonlinearity = 0.12). Adult weight gain may be associated with a higher risk of CVD. Measuring weight gain during adulthood may be better than static, cross-sectional assessment of weight because it considers trend over time, and thus, can be used as a supplementary approach to predict CVD.

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Fig. 1: Weight gain during adulthood and the risk of CVD mortality.
Fig. 2: Weight gain during adulthood and the risk of CHD.
Fig. 3: Weight gain during adulthood and the risk of stroke.

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AJ, SS-B, and ARP conceived and designed the study; AE and MSZ conducted systematic search, screened articles and selected eligible articles; AE and SS extracted information from eligible studies; AJ, SS-B, and ARP performed analyses and interpreted the results; AJ, AE, SS, and MSZ wrote the first draft of the paper; SS-B and ARP critically revised the paper. SS-B is the guarantor. All authors have read and approved the final paper. All authors had full access to all the data and take responsibility for the integrity of the data and the accuracy of the data analysis.

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Correspondence to Sakineh Shab-Bidar.

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Jayedi, A., Rashidy-pour, A., Soltani, S. et al. Adult weight gain and the risk of cardiovascular disease: a systematic review and dose–response meta-analysis of prospective cohort studies. Eur J Clin Nutr 74, 1263–1275 (2020). https://doi.org/10.1038/s41430-020-0610-y

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