title: Determinants and Consequences of Obesity.
abstract: OBJECTIVE
  To review the contribution of the Nurses' Health Studies (NHS and NHS II) in addressing hypotheses regarding risk factors for and consequences of obesity.
  
  
  METHODS
  Narrative review of the publications of the NHS and NHS II between 1976 and 2016.
  
  
  RESULTS
  Long-term NHS research has shown that weight gain and being overweight or obese are important risk factors for type 2 diabetes, cardiovascular diseases, certain types of cancers, and premature death. The cohorts have elucidated the role of dietary and lifestyle factors in obesity, especially sugar-sweetened beverages, poor diet quality, physical inactivity, prolonged screen time, short sleep duration or shift work, and built environment characteristics. Genome-wide association and gene-lifestyle interaction studies have shown that genetic factors predispose individuals to obesity but that such susceptibility can be attenuated by healthy lifestyle choices. This research has contributed to evolving clinical and public health guidelines on the importance of limiting weight gain through healthy dietary and lifestyle behaviors.
  
  
  CONCLUSIONS
  The NHS cohorts have contributed to our understanding of the risk factors for and consequences of obesity and made a lasting impact on clinical and public health guidelines on obesity prevention.
authors.affiliation: Adela Hruby is with the Nutritional Epidemiology Program, Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA. Vasanti S. Malik, Eric B. Rimm, Qi Sun, Walter C. Willett, and Frank B. Hu are with the Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston. JoAnn E. Manson is with the Division of Preventive Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston. Lu Qi is with the Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA.
authors.forename: Adela
authors.initials: A
authors.lastname: Hruby
authors.affiliation: Adela Hruby is with the Nutritional Epidemiology Program, Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA. Vasanti S. Malik, Eric B. Rimm, Qi Sun, Walter C. Willett, and Frank B. Hu are with the Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston. JoAnn E. Manson is with the Division of Preventive Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston. Lu Qi is with the Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA.
authors.forename: JoAnn E
authors.initials: JE
authors.lastname: Manson
authors.affiliation: Adela Hruby is with the Nutritional Epidemiology Program, Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA. Vasanti S. Malik, Eric B. Rimm, Qi Sun, Walter C. Willett, and Frank B. Hu are with the Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston. JoAnn E. Manson is with the Division of Preventive Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston. Lu Qi is with the Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA.
authors.forename: Lu
authors.initials: L
authors.lastname: Qi
authors.affiliation: Adela Hruby is with the Nutritional Epidemiology Program, Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA. Vasanti S. Malik, Eric B. Rimm, Qi Sun, Walter C. Willett, and Frank B. Hu are with the Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston. JoAnn E. Manson is with the Division of Preventive Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston. Lu Qi is with the Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA.
authors.forename: Vasanti S
authors.initials: VS
authors.lastname: Malik
authors.affiliation: Adela Hruby is with the Nutritional Epidemiology Program, Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA. Vasanti S. Malik, Eric B. Rimm, Qi Sun, Walter C. Willett, and Frank B. Hu are with the Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston. JoAnn E. Manson is with the Division of Preventive Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston. Lu Qi is with the Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA.
authors.forename: Eric B
authors.initials: EB
authors.lastname: Rimm
authors.affiliation: Adela Hruby is with the Nutritional Epidemiology Program, Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA. Vasanti S. Malik, Eric B. Rimm, Qi Sun, Walter C. Willett, and Frank B. Hu are with the Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston. JoAnn E. Manson is with the Division of Preventive Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston. Lu Qi is with the Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA.
authors.forename: Qi
authors.initials: Q
authors.lastname: Sun
authors.affiliation: Adela Hruby is with the Nutritional Epidemiology Program, Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA. Vasanti S. Malik, Eric B. Rimm, Qi Sun, Walter C. Willett, and Frank B. Hu are with the Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston. JoAnn E. Manson is with the Division of Preventive Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston. Lu Qi is with the Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA.
authors.forename: Walter C
authors.initials: WC
authors.lastname: Willett
authors.affiliation: Adela Hruby is with the Nutritional Epidemiology Program, Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA. Vasanti S. Malik, Eric B. Rimm, Qi Sun, Walter C. Willett, and Frank B. Hu are with the Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston. JoAnn E. Manson is with the Division of Preventive Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston. Lu Qi is with the Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA.
authors.forename: Frank B
authors.initials: FB
authors.lastname: Hu
mesh_terms: D000328:Adult; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000209:etiology; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology / Q000209:etiology; D004032:Diet; D016021:Epidemiologic Studies; D005260:Female; D006801:Humans; D008019:Life Style; D008137:Longitudinal Studies; D008875:Middle Aged; D061213:Mortality, Premature; D009369:Neoplasms / Q000453:epidemiology / Q000209:etiology; D009726:Nurses; D009765:Obesity / Q000150:complications* / Q000453:epidemiology*; D011446:Prospective Studies; D012307:Risk Factors; D057185:Sedentary Behavior; D014481:United States / Q000453:epidemiology; D016387:Women's Health