Estimated Risks for Developing Obesity in the Framingham Heart Study

Estimated Risks for Developing Obesity in the Framingham Heart Study

From the National Heart, Lung, and Blood Institute's Framingham Heart Study, Framingham, and Boston University, Boston, Massachusetts; and Unilever Research, Colworth, Bedfordshire, United Kingdom.

Abstract

Background: The short- and long-term risks for developing overweight or obesity are unknown.

Objectives: To estimate the short-term, long-term, and lifetime risks for developing overweight or obesity in adults in the community.

Design: Prospective cohort study, 1971 to 2001.

Setting: Community-based study, Framingham, Massachusetts.

Participants: 4117 white participants (51.9% women) from the Framingham Heart Study.

Measurements: The short-term (4 years) and long-term (10 to 30 years) risks for ever becoming overweight or more (body mass index [BMI] ≥ 25 kg/m²) or obese (BMI ≥ 30 kg/m²) for men and women at 30, 40, and 50 years of age with a normal BMI (between 18.5 kg/m² and 25.0 kg/m²).

Results: The observed 4-year rates of developing overweight varied from 14% to 19% in women and 26% to 30% in men. Four-year rates of developing obesity ranged from 5% to 7% in women and 7% to 9% in men. The long-term (30-year) risk estimates were similar for the 2 sexes generally; varied somewhat with age (in men, being lower for those 50 years of age); and, overall, exceeded 1 in 2 persons for overweight or more, 1 in 4 individuals for obesity, and 1 in 10 people for stage II obesity (BMI ≥ 35 kg/m²) across different age groups. The 30-year estimates correspond to the residual lifetime risk for overweight or more or obesity for participants 50 years of age.

Limitations: These findings may not be generalizable to other races or ethnicities.

Conclusions: The long-term risks for overweight or more or obesity exceeded 50% and 25%, respectively, indicating a large public health burden. These estimates suggest that the future burden of obesity-associated diseases may be substantial.

Article and Author Information

Grant Support: In part by the National Institutes of Health and National Heart, Lung, and Blood Institute contract N01-HC-38038. Dr. Vasan was partly supported by National Institutes of Health and National Heart, Lung, and Blood Institute grant 2K24 HL 04334.
Potential Financial Conflicts of Interest: Employment: M. Cobain (Unilever).
Requests for Single Reprints: Ramachandran S. Vasan, MD, The Framingham Heart Study, 73 Mount Wayte Avenue, Suite 2, Framingham, MA 01702-5803; e-mail, vasan{at}bu.edu.
Current Author Addresses: Dr. Vasan: The Framingham Heart Study, 73 Mount Wayte Avenue, Suite 2, Framingham, MA 01702-5803.
Drs. Pencina and D'Agostino: Boston University, 111 Cummington Street, Boston, MA 02135.
Dr. Cobain: Unilever Research, Colworth House, Sharnbrook, Bedforshire MK44 1LQ, United Kingdom.
Dr. Freiberg: University of Pittsburgh and Epidemiology Center for Research on Health Care, 230 McKee Place, Suite 600, Pittsburgh, PA 15213.
Author Contributions: Conception and design: R.S. Vasan, M.J. Pencina, R.B. D'Agostino.
Analysis and interpretation of the data: R.S. Vasan, M.J. Pencina, M. Cobain, M.S. Freiberg, R.B. D'Agostino.
Drafting of the article: R.S. Vasan, M.J. Pencina, M.S. Freiberg.
Critical revision of the article for important intellectual content: R.S. Vasan, M.J. Pencina, M. Cobain, M.S. Freiberg, R.B. D'Agostino.
Final approval of the article: R.S. Vasan, M.J. Pencina, M. Cobain, M.S. Freiberg, R.B. D'Agostino.
Statistical expertise: M.J. Pencina, R.B. D'Agostino.
Obtaining of funding: R.S. Vasan, R.B. D'Agostino.
Collection and assembly of data: R.B. D'Agostino.