Physical impairment and body weight history in postmenopausal women: the Women's Health Initiative.
To examine whether weight history and weight transitions over adult lifespan contribute to physical impairment among postmenopausal women.



BMI categories were calculated among postmenopausal women who reported their weight and height at age 18 years. Multiple-variable logistic regression was used to determine the association between BMI at age 18 years and BMI transitions over adulthood on severe physical impairment (SPI), defined as scoring <60 on the Physical Functioning subscale of the Rand thirty-six-item Short-Form Health Survey.



Participants were part of the Women's Health Initiative Observational Study (WHI OS), where participants' health was followed over time via questionnaires and clinical assessments.



Postmenopausal women (n 76 016; mean age 63·5 (sd 7·3) years).



Women with overweight (BMI=25·0-29·9 kg/m2) or obesity (BMI≥30·0 kg/m2) at 18 years had greater odds (OR (95 % CI)) of SPI (1·51 (1·35, 1·69) and 2·14 (1·72, 2·65), respectively) than normal-weight (BMI=18·5-24·9 kg/m2) counterparts. Transitions from normal weight to overweight/obese or to underweight (BMI<18·5 kg/m2) were associated with greater odds of SPI (1·97 (1·84, 2·11) and 1·35 (1·06, 1·71), respectively) compared with weight stability. Shifting from underweight to overweight/obese also had increased odds of SPI (1·52 (1·11, 2·09)). Overweight/obese to normal BMI transitions resulted in a reduced SPI odds (0·52 (0·39, 0·71)).



Higher weight history and transitions into higher weight classes were associated with higher likelihood of SPI, while transitioning into lower weight classes for those with overweight/obesity was protective among postmenopausal women.
1Department of Epidemiology,University of Florida,2004 Mowry Road,Cubicle 2148-C4,Gainesville,FL 32608,USA.
Amal A
AA
Wanigatunga
3Internal Medicine Service and Gerontology Clinic,Toulouse,France.
Sandrine S
SS
Sourdet
4Department of Epidemiology and Environmental Health,University of Buffalo,Buffalo,NY,USA.
Michael J
MJ
LaMonte
5Department of Quantitative Health Sciences,University of Massachusetts,Worcester,MA,USA.
Molly E
ME
Waring
7Department of Biochemistry and Molecular Medicine,University of California Davis,Davis,CA,USA.
Rami
R
Nassir
8Department of Public Health Sciences,University of California Davis,Davis,CA,USA.
Lorena
L
Garcia
9Department of Nutritional Sciences,University of Arizona,Tucson,AZ,USA.
Jennifer W
JW
Bea
10Division of Nutritional Sciences,Cornell University,Ithaca,NY,USA.
Rebecca A
RA
Seguin
11Division of Preventive and Behavioral Medicine,University of Massachusetts,Worcester,MA,USA.
Judith K
JK
Ockene
12Department of Obstetrics and Gynecology,University of Wisconsin,Madison,WI,USA.
Gloria E
GE
Sarto
13Standford Prevention Research Center,Stanford University,Stanford,CA,USA.
Marcia L
ML
Stefanick
14Department of Medicine,University of Florida,Gainesville,FL,USA.
Marian
M
Limacher
2Department of Aging & Geriatric Research,Institute on Aging,University of Florida,Gainesville,FL,USA.
Todd M
TM
Manini
D000368:Aged; D015992:Body Mass Index; D001835:Body Weight; D005260:Female; D006304:Health Status; D006801:Humans; D008875:Middle Aged; D051346:Mobility Limitation; D009765:Obesity / Q000503:physiopathology; D050177:Overweight / Q000503:physiopathology; D017698:Postmenopause; D012307:Risk Factors; D016387:Women's Health
BMI; Body weight; Disability; Physical function; Physical impairment; Weight change