Abstract 33: Early Loss of Normal Body Weight in Multiethnic US Populations: The Hispanic Community Health Study/Study of Latinos (HCHS/SOL), Strong Heart Family Study (SHFS), and the National Health and Nutrition Examination Survey (NHANES)
Approximately 69% of American adults are obese or overweight, with the greatest burdens shouldered by Hispanic/Latinos (HL), African Americans (AA), and American Indians (AI). Emerging evidence suggests that minority populations also transition away from normal weight at earlier ages than European Americans (EA), yet few studies have evaluated weight transition patterns across the life course in contemporary multi-ethnic populations. We therefore leveraged cross-sectional data from the HCHS/SOL (n=16,332, 2008-2011), NHANES (n=11,901, 2007-2012), and the SHFS (n=3,364, 2001-2003) and novel Markov models that accommodated complex sampling and family structure to estimate age-, sex-, and race/ethnic-specific net transition probabilities of moving between normal weight (body mass index (BMI)<25 kg/m2), overweight (BMI 25-29.99 kg/m2) and obesity (BMI≥30 kg/m2) among AA, AI, EA, and HL participants ≥18 years of age. At age 18, the prevalence of normal weight ranged 49-73%, with the highest prevalence observed in EA females and the lowest in AI females. Age 18 also marked a time of accelerated net transitions away from normal weight. For example, between 18-30 years, the population of normal weight AI males decreased approximately 6.9% (95% CI: 5.7%, 8.1%) per year. AI females [6.0% (95% CI: 5.0%, 6.9%)], HL males [5.6% (95% CI: 5.0%, 6.1%)], and AA females [5.2% (95% CI: 4.4%, 6.0%)] also experienced large annual reductions in the proportion of the population classified as normal weight during this time. Among overweight populations, estimated 1-year net transitions to obesity peaked at age 18, the earliest age under investigation, for all race/ethnic- and sex-specific groups, and were highest for AI females, where a net 10.6% (95% CI: 7.0%, 14%) of the overweight population transitioned to obesity one year later. For all populations, greater proportions of the population transitioned from overweight to obese than from obese to overweight until late middle age (range: 43-58 years), when transitions began to favor very modest decreases in the proportion of the population classified as obese, possibly reflecting selective survival. Our results suggest that by age 18, substantial proportions of AAs, AIs, and HLs, have already transitioned away from normal weight. Difficulties reattaining normal body weight throughout the life course support the design and implementation of evidence-based obesity prevention and control efforts targeted to children and adolescents, with emphasis on AA, AI, and HL populations.
Author Disclosures: C.L. Avery: None. K.M. Holliday: None. S. Chakladar: None. D.Y. Lin: None. A.E. Moncrieft: None. R.J. Ostfeld: None. J.P. Reis: None. P.J. Schreiner: None. C.M. Shay: None. J. Stamler: None. G.A. Talavera: None. F. Yeh: None. M. Youngblood: None. Y. Zhang: None. M.L. Daviglus: None. G. Heiss: None. D. Zeng: None.
- © 2015 by American Heart Association, Inc.