Diana Kuh

Menopausal transition and the risk of urinary incontinence: results from a British prospective cohort

Study Type – Aetiology (inception cohort)
Level of Evidence 2b

A Life Course Perspective on Body Size and Cardio-metabolic Health

The growth of a child and the amount of weight gained across the life course is associated with risk for many chronic degenerative diseases. The life course approach to this area of epidemiological research has burgeoned over the last 25 years, since the initial observation of an inverse relationship between birth weight and coronary heart disease. We review the substantial amount of published research to demonstrate which age-related body size trajectories are indicative of increased risk of cardio-metabolic diseases such as coronary heart disease, stroke, and type two diabetes. Association does not mean causation. The chapter thus also provides an overview of the key sociocultural and other factors responsible for deleterious trajectories, and the biological pathways through which they act, to show how the trajectories are driven by biology but modifiable by the environment. Attention is paid to critical periods and transitions, both biological (e.g., puberty) and behavioural (e.g., marriage), and the influences that these might have on an individual’s trajectory. We highlight the importance of life course trajectories of body size and their associations with trajectories of markers of cardio-metabolic health such as blood pressure and lipids, and the need to integrate biological and social research to move towards a more complete understanding of cardio-metabolic disease processes and, ultimately, how to delay the onset of disease.