Overweight and obesity pose an increasingly large burden in the UK and worldwide. While unhealthy dietary habits and physical inactivity are the fundamental drivers of excess body weight, there is accruing evidence that reproductive health factors may also be determinants of overweight and obesity. Previous studies, however, generally focussed on a single reproductive factor (mostly age at menarche). In 500,000 individuals from the UK Biobank, we assessed the cross-sectional associations between reproductive health factors and a range of measures of body adiposity. The analyses confirm the previously reported inverse association between age at menarche and body adiposity. We also show that age at first birth was inversely associated with body adiposity in later life, whereas there was little evidence for an association between age at menopause and body adiposity. A novel finding is that the association between number of live birth and body adiposity in women is also present in men; men who had fathered four or more children had a higher BMI as compared to men without children. This suggests that a significant proportion of the association between parity and later adiposity can be attributed to behavioural risk factors associated with childrearing, and not to biological factors related to childbearing.
Sex differences in the association between major and modifiable risk factors with cardiovascular disease
Most of the burden of cardiovascular diseases (CVD) is explained by a composite of physiological and lifestyle factors - chiefly, elevated blood pressure, obesity, diabetes, cigarette smoking, poor diet, and physical inactivity. There is increasing evidence that some of these risk factors have stronger effects on CVD in women than men. Although preventive strategies aimed at lowering the burden of these risk factors will benefit all, a sound knowledge of whether there are meaningful sex differences in relationships between traditional chronic disease risk factors and disease outcomes should help promote development of effective, sex-specific interventions. Addressing sex differences in relationships between risk factors and CVD risk is of importance from clinical and public health perspectives. Identifying significant sex differences in how risk factors relate to CVD risk should provide an impetus for targeted interventions aimed at reducing the prevalence of disease. Moreover, sex-specific estimates of disease risks associated with modifiable risk factors are essential for accurate estimation of the burden of disease due to these factors. These findings would help to inform the decision making process to maximize the efficacy of the allocation of health care resources, both in the UK and worldwide. Sex-specific estimates for the association between common lifestyle risk factors (elevated blood pressure, obesity, diabetes, cigarette smoking and a poor diet) and the risk of incident CVD will be determined. These sex-specific estimates will be used to evaluate whether or not the risk of stroke and coronary disease associated with these risk factors is similar between women and men. Analyses will be conducted in all individuals, as well as in subgroups defined by age, so as to identify sex-specific changes with ageing (for example, post-menopause), and socioeconomic status, to explore the effects of deprivation. Baseline and follow-up data on the full cohort of women and men in the UK Biobank, except those with pre-existing CVD at baseline, are requested.
|Lead investigator:||Professor Mark Woodward|
|Lead institution:||George Institute for Global Health|
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