“In collaboration with researchers from the University of Calgary and the University of British Columbia our team has developed a computer model to help doctors and their patients better understand how excess body weight contributes to reduced life expectancy and premature development of heart disease and diabetes,” says lead author Dr. Steven Grover, a Clinical Epidemiologist at the RI-MUHC and a Professor of Medicine at McGill University.
Diabetes and cardiovascular disease: the predictors of health
Dr. Grover and his colleagues used data from the National Health and Nutrition Examination Survey (from years 2003 to 2010) to develop a model that estimates the annual risk of diabetes and cardiovascular disease in adults with different body weights. This data from almost 4,000 individuals was also used to analyze the contribution of excess body weight to years of life lost and healthy years of life lost.
Their findings estimated that individuals who were very obese could lose up to 8 years of life, obese individuals could lose up to 6 years, and those who were overweight could lose up to three years. In addition, healthy life-years lost were two to four times higher for overweight and obese individuals compared to those who had a healthy weight, defined as 18.5-25 body mass index (BMI). The age at which the excess weight accumulated was an important factor and the worst outcomes were in those who gained their weight at earlier ages.
“The pattern is clear - the more an individual weighs and the younger their age, the greater the effect on their health,” Dr. Grover adds. “In terms of life-expectancy, we feel being overweight is as bad as cigarette smoking.”
The next steps are to personalize this information in order to make it more relevant and compelling for patients. “What may be interesting for patients are the ’what if?’ questions. What if they lose 10 to 15 pounds? Or, what if they are more active? How will this change the numbers?” says Dr. Grover. The research team is now conducting a three year study in community pharmacies across the country to see if engaging patients with this information and then offering them a web-based e-health program will help them adopt healthier lifestyles, including healthier diets and regular physical activity.
“These clinically meaningful models are useful for patients, and their healthcare professionals, to better appreciate the issues and the benefits of a healthier lifestyle, which we know is difficult for many of us to adopt and maintain, Dr. Grover adds.
About the study
This research was made possible thanks to funding from the Canadian Institutes of Health Research (CIHR)
The paper Years of life lost and healthy life-years lost from diabetes and cardiovascular disease in overweight and obese people: a modelling study was co-authored by Steven A Grover (Division of Clinical Epidemiology, RI-MUHC and Faculty of Medicine, Department of Medicine, McGill University, QC, Canada); Mohammed Kaouache and Philip Rempel (Division of Clinical Epidemiology, RI-MUHC, QC, Canada); Lawrence Joseph (Faculty of Medicine, Department of Medicine and Department of Epidemiology, Biostatistics and Occupational Health, McGill University, QC, Canada), Martin Dawes (Department of Family Practice, University of British Columbia, BC, Canada); David C W Lau( Diabetes and Endocrine Research Group, University of Calgary, Calgary, AB, Canada); and Ilka Lowensteyn (Division of Clinical Epidemiology, RI-MUHC, QC, Canada).