Body mass and the epidemic of chronic inflammation in early mid-adulthood

Thomas W. McDade; Jess M. Meyer; Stephanie M. Koning; Kathleen Mullan Harris

doi:10.1016/j.socscimed.2021.114059

Body mass and the epidemic of chronic inflammation in early mid-adulthood

Thomas W. McDade^*, Jess M. Meyer, Stephanie M. Koning, Kathleen Mullan Harris

^*Corresponding author for this work

Anthropology

Research output: Contribution to journal › Article › peer-review

27 Scopus citations

Abstract

Objectives: Chronic inflammation is a potentially important mechanism through which social inequalities may contribute to health inequalities over the life course. Excess body fat contributes to chronic inflammation, and younger adults in the US have come of age during a pronounced secular increase in body mass index (BMI). We aim to document levels of chronic inflammation in a nationally representative sample of 33-to-44 year-old adults in the US, and to describe associations with BMI, race/ethnicity, and education. Methods: High sensitivity C-reactive protein (CRP) was measured in Wave V (2016–18) of the National Longitudinal Study of Adolescent to Adult Health, with complete data available for 4349 participants. Sex-stratified weighted regression models were implemented to investigate CRP in association with education, race/ethnicity, and BMI. Results: Geometric mean CRP was 1.9 mg/L, and 35.4% of the sample had CRP >3 mg/L. Females had significantly higher CRP than males. Body mass index was a strong positive predictor of CRP, and education level was negatively associated with CRP. Associations between education and CRP were substantially attenuated after adjusting for BMI. High risk CRP increased linearly with BMI even among the obese: 87.0 percent of females and 74.1 percent of males with class 3 obesity (BMI ≥40) were predicted to have high risk CRP > 3 mg/L. Conclusions: The obesity epidemic is producing an epidemic of chronic inflammation in early mid-adulthood in the US. Strong associations between BMI and chronic inflammation portend high risk for future disease—and inequitable distribution of disease—as the cohort ages.

Original language	English (US)
Article number	114059
Journal	Social Science and Medicine
Volume	281
DOIs	https://doi.org/10.1016/j.socscimed.2021.114059
State	Published - Jul 2021

Funding

Research reported in this publication was supported by the Eunice Kennedy Shriver National Institute of Child Health and Human Development of the National Institutes of Health under Award Numbers R21HD101757 and F32HD102152 as well as T32HD091058 and P2CHD050924 . The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. This research uses data from Add Health, a program project directed by Kathleen Mullan Harris and designed by J. Richard Udry, Peter S. Bearman, and Kathleen Mullan Harris at the University of North Carolina at Chapel Hill , and funded by grant P01-HD31921 from the Eunice Kennedy Shriver National Institute of Child Health and Human Development , with cooperative funding from 23 other federal agencies and foundations. Information on how to obtain the Add Health data files is available on the Add Health website ( https://dev-addhealth.cpc.unc.edu/ ). No direct support was received from grant P01-HD31921 for this analysis.

Keywords

C-reactive protein
Education
Health disparities
Obesity
Overweight

ASJC Scopus subject areas

Health(social science)
History and Philosophy of Science

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1016/j.socscimed.2021.114059

Cite this

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title = "Body mass and the epidemic of chronic inflammation in early mid-adulthood",

abstract = "Objectives: Chronic inflammation is a potentially important mechanism through which social inequalities may contribute to health inequalities over the life course. Excess body fat contributes to chronic inflammation, and younger adults in the US have come of age during a pronounced secular increase in body mass index (BMI). We aim to document levels of chronic inflammation in a nationally representative sample of 33-to-44 year-old adults in the US, and to describe associations with BMI, race/ethnicity, and education. Methods: High sensitivity C-reactive protein (CRP) was measured in Wave V (2016–18) of the National Longitudinal Study of Adolescent to Adult Health, with complete data available for 4349 participants. Sex-stratified weighted regression models were implemented to investigate CRP in association with education, race/ethnicity, and BMI. Results: Geometric mean CRP was 1.9 mg/L, and 35.4% of the sample had CRP >3 mg/L. Females had significantly higher CRP than males. Body mass index was a strong positive predictor of CRP, and education level was negatively associated with CRP. Associations between education and CRP were substantially attenuated after adjusting for BMI. High risk CRP increased linearly with BMI even among the obese: 87.0 percent of females and 74.1 percent of males with class 3 obesity (BMI ≥40) were predicted to have high risk CRP > 3 mg/L. Conclusions: The obesity epidemic is producing an epidemic of chronic inflammation in early mid-adulthood in the US. Strong associations between BMI and chronic inflammation portend high risk for future disease—and inequitable distribution of disease—as the cohort ages.",

keywords = "C-reactive protein, Education, Health disparities, Obesity, Overweight",

author = "McDade, {Thomas W.} and Meyer, {Jess M.} and Koning, {Stephanie M.} and Harris, {Kathleen Mullan}",

note = "Publisher Copyright: {\textcopyright} 2021 Elsevier Ltd",

year = "2021",

month = jul,

doi = "10.1016/j.socscimed.2021.114059",

language = "English (US)",

volume = "281",

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AU - McDade, Thomas W.

AU - Meyer, Jess M.

AU - Koning, Stephanie M.

AU - Harris, Kathleen Mullan

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N2 - Objectives: Chronic inflammation is a potentially important mechanism through which social inequalities may contribute to health inequalities over the life course. Excess body fat contributes to chronic inflammation, and younger adults in the US have come of age during a pronounced secular increase in body mass index (BMI). We aim to document levels of chronic inflammation in a nationally representative sample of 33-to-44 year-old adults in the US, and to describe associations with BMI, race/ethnicity, and education. Methods: High sensitivity C-reactive protein (CRP) was measured in Wave V (2016–18) of the National Longitudinal Study of Adolescent to Adult Health, with complete data available for 4349 participants. Sex-stratified weighted regression models were implemented to investigate CRP in association with education, race/ethnicity, and BMI. Results: Geometric mean CRP was 1.9 mg/L, and 35.4% of the sample had CRP >3 mg/L. Females had significantly higher CRP than males. Body mass index was a strong positive predictor of CRP, and education level was negatively associated with CRP. Associations between education and CRP were substantially attenuated after adjusting for BMI. High risk CRP increased linearly with BMI even among the obese: 87.0 percent of females and 74.1 percent of males with class 3 obesity (BMI ≥40) were predicted to have high risk CRP > 3 mg/L. Conclusions: The obesity epidemic is producing an epidemic of chronic inflammation in early mid-adulthood in the US. Strong associations between BMI and chronic inflammation portend high risk for future disease—and inequitable distribution of disease—as the cohort ages.

AB - Objectives: Chronic inflammation is a potentially important mechanism through which social inequalities may contribute to health inequalities over the life course. Excess body fat contributes to chronic inflammation, and younger adults in the US have come of age during a pronounced secular increase in body mass index (BMI). We aim to document levels of chronic inflammation in a nationally representative sample of 33-to-44 year-old adults in the US, and to describe associations with BMI, race/ethnicity, and education. Methods: High sensitivity C-reactive protein (CRP) was measured in Wave V (2016–18) of the National Longitudinal Study of Adolescent to Adult Health, with complete data available for 4349 participants. Sex-stratified weighted regression models were implemented to investigate CRP in association with education, race/ethnicity, and BMI. Results: Geometric mean CRP was 1.9 mg/L, and 35.4% of the sample had CRP >3 mg/L. Females had significantly higher CRP than males. Body mass index was a strong positive predictor of CRP, and education level was negatively associated with CRP. Associations between education and CRP were substantially attenuated after adjusting for BMI. High risk CRP increased linearly with BMI even among the obese: 87.0 percent of females and 74.1 percent of males with class 3 obesity (BMI ≥40) were predicted to have high risk CRP > 3 mg/L. Conclusions: The obesity epidemic is producing an epidemic of chronic inflammation in early mid-adulthood in the US. Strong associations between BMI and chronic inflammation portend high risk for future disease—and inequitable distribution of disease—as the cohort ages.

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Body mass and the epidemic of chronic inflammation in early mid-adulthood

Abstract

Funding

Keywords

ASJC Scopus subject areas

UN SDGs

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