Commentary

Early BMI affects heart weight decades later


 

The British longitudinal film series “Seven Up!” may be more famous, but a longitudinal study by British cardiologist Dr. Arjun K. Ghosh carried more weight at the annual meeting of the American College of Cardiology in San Francisco.

His message: The earlier in life that people become overweight or obese, the heavier their hearts when they reach their 60s. And that’s not good.

Sherry Boschert/IMNG Medical Media

Dr. Arjun K. Ghosh presented his findings during a poster presentation at ACC 13.

Filmmakers recently released the latest installment of the “Seven Up!” series, which is following the lives of various Brits every seven years, since age 7. We’re now at “56 Up,” and the subjects seem to be doing better now, thank you very much, compared with some of the struggles in their earlier years and various midlife crises seen in “49 Up.”

In Dr. Ghosh’s study of 1,653 people – sort of a “60 Up” ‑ those who managed to stay normal weight or at least postpone putting on the pounds until later in life were doing better than their peers. The heart was 7% heavier on average in people who were overweight in their 20s compared with those who became overweight in their 60s.

Subjects came from the 1946 birth cohort of the Medical Research Council National Survey of Health and Development, the longest running birth cohort study in the United Kingdom. They had their body mass index measured at ages 20, 26, 36, 43, 53 years, and at 60-64 years they underwent echocardiography and again measured BMI. The investigators indexed the relationship between BMI and left ventricular mass to body surface area, height, and relative heart wall thickness.

Increased BMI from age 20 and up was associated with increase left ventricular mass index. Increased BMI from age 43 and up was associated with increased relative wall thickness. Those with higher BMIs at each time point had heavier hearts at ages 60-64 years after adjusting for the effects of gender, high blood pressure, and diabetes. The earlier that someone became overweight, the greater the left ventricular mass index and the relative wall thickness, reported Dr. Ghosh, a clinical research fellow at the International Centre for Circulatory Health, Imperial College, London.

Of course, once you put on weight, it’s hard to get it off. The numbers of overweight or obese participants who lost weight were too small to analyze any potential differences in their heart weights, he said in an interview.

“Even from the age of 20 years onwards, being overweight or having a high body mass index is associated with cardiac damage way, way down the line at the age of 60 to 64. Work like this hasn’t really been done looking at the long-term effects,” he said. “This just reinforces the fact that we should be preventing becoming overweight in the first place and preventing obesity.”

Well, that’s the Holy Grail, isn’t it? Whoever comes up with an easy way to turn around the world’s obesity epidemic will deserve their own film series and a star turn at a future ACC meeting.

Given these findings, we can almost imagine the heart mass of the various subjects who grew up in the “Up” series, based on their weights in earlier installments of the series. For some, it’s not a pretty thought.

Dr. Ghosh reported having no disclosures. The Medical Research Council of the United Kingdom funded the study.

--Sherry Boschert (on Twitter @sherryboschert)

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