Damigou Evangelia, Anastasiou Costas, Chrysohoou Christina, Barkas Fotios, Liberopoulos Evangelos, Pitsavos Christos, Tsioufis Costas, Sfikakis Petros P, Panagiotakos Demosthenes
Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, 17676, Athens, Greece.
First Cardiology Clinic, Medical School, National and Kapodistrian University of Athens, 15772, Athens, Greece.
Int J Obes (Lond). 2025 May 6. doi: 10.1038/s41366-025-01796-4.
BACKGROUND/OBJECTIVES: The growing prevalence of overweight and obesity globally highlights the need to reconsider the thresholds for defining excess body weight, especially as the health risks associated with weight gain continue to impact population health metrics. This study aimed to evaluate the population attributable fraction (PAF) and prevented fraction for the population (PFP) of CVD cases by body weight trajectories over a 20-year period (2002-2022).
SUBJECTS/METHODS: The studied population-based sample was 1348 individuals (39(10) years old, 48% males), initially free-of-CVD, from the ATTICA cohort study (2002-2022). Combined fatal/non-fatal CVD outcomes were evaluated; body weight and height measurements were performed in 2002, 2012, and 2022 examinations, following standard procedures. Body weight trends, based on cumulative average BMI during 2002-2022, were also calculated. PAF and PFP were computed.
Twenty-nine percent (95%Confidence Interval: 22%, 35%) of CVD cases were prevented by maintaining a normal body weight status during 2002-2022. If increased BMI (>25 kg/m) had been eliminated, 30% (8.7%, 38%) of CVD cases would have been prevented. Three-times more CVD cases would have been prevented if overweight had been managed compared to if obesity had been managed [i.e., 23% (5.1%, 29%) vs 7.2% (1.1%, 9.1%), respectively]. Variations of the PAFs and PFPs were observed by sex, age group, Mediterranean diet adherence, physical activity status, presence of comorbidities, and anxiety trajectories.
Future public health actions should not neglect to also include people with overweight for the effective management of body weight, which can offer significant long-term benefits for cardiovascular health. A graphical representation of the main study findings on population prevented and attributable fractions by long-term body weight status (n = 1348); the ATTICA study (2002-2022). CVD cardiovascular disease.
背景/目的：全球超重和肥胖患病率的不断上升凸显了重新审视定义超重的阈值的必要性，尤其是随着与体重增加相关的健康风险继续影响人群健康指标。本研究旨在评估20年期间（2002 - 2022年）按体重轨迹划分的心血管疾病（CVD）病例的人群归因分数（PAF）和人群预防分数（PFP）。
受试者/方法：研究的基于人群的样本来自阿提卡队列研究（2002 - 2022年），共1348人（年龄39（10）岁，48%为男性），最初无CVD。评估了致命/非致命CVD综合结局；按照标准程序在2002年、2012年和2022年检查时测量了体重和身高。还计算了基于2002 - 2022年期间累积平均BMI的体重趋势。计算了PAF和PFP。
在2002 - 2022年期间，通过维持正常体重状态可预防29%（95%置信区间：22%，35%）的CVD病例。如果消除BMI升高（>25 kg/m²），则可预防30%（8.7%，38%）的CVD病例。与管理肥胖相比，管理超重可预防的CVD病例数多出两倍[即分别为23%（5.1%，29%）和7.2%（1.1%，9.1%）]。观察到PAF和PFP因性别、年龄组、地中海饮食依从性、身体活动状况、合并症的存在以及焦虑轨迹而有所不同。
未来的公共卫生行动不应忽视将超重人群纳入体重有效管理，这可为心血管健康带来显著的长期益处。关于长期体重状况对人群预防和归因分数的主要研究结果的图形表示（n = 1348）；阿提卡研究（2002 - 2022年）。CVD：心血管疾病
