Association of an Evolutionary-Concordance Score with Weight Change in the REGARDS Cohort Public

Abstract

Background: The prevalence of obesity has increased substantially worldwide over the past 20 years. Evolutionary-concordance (EC) scores have been used to investigate associations of lifestyle and dietary patterns with health outcomes. However, there are no reported studies of associations of evolutionary-concordance dietary and lifestyle scores with weight change.

Methods: We analyzed data from 9,472 Black and White men and women in the prospective REGARDS cohort with baseline (2003–2007) and 10-year follow-up anthropometrics. Baseline information also included sociodemographic, medical, lifestyle, dietary (via a Block98 food frequency questionnaire), and psychosocial characteristics. We calculated a four-component (alcohol intake, physical activity, sedentary behavior, and social network size) EC lifestyle score, a 13- component EC diet score, and a five-component total EC score (the four lifestyle components plus the EC diet score as the fifth component), such that higher scores indicated higher evolutionary concordance. We used multivariable general linear models to calculate adjusted mean absolute and proportional 10-year weight changes according to baseline EC score quintiles.

Results: Crude and adjusted mean and proportional weight and BMI changes in all score quintiles were small (mean changes: ≤ 0.85 kg; proportional changes: < 1%). There were no substantial or clear patterns of differences across the score quintiles. These findings were similar regardless of sex, race, or baseline age or smoking or comorbidity status.

Conclusion: Our findings suggest that evolutionary-concordance scores were not associated with weight change over 10 years in the REGARDS cohort, regardless of race, sex and replacement hormone therapy use, age, and baseline smoking or comorbidity status. Further studies of associations of evolutionary-concordance dietary and lifestyle pattern scores with weight change in populations with more substantial long-term weight change are needed. 

Table of Contents

Introduction.......................................................................................................................... 1 Methods................................................................................................................................ 6 Results................................................................................................................................ 12 Discussion .......................................................................................................................... 14 References .......................................................................................................................... 20 Tables................................................................................................................................. 31

Table 1 Selected participant characteristics according to quintiles of a total evolutionary-concordance score at baseline (2003–2007) in the REGARDS cohort................................................................................................................32

Table 2 Associations of the total evolutionary concordance score with absolute and proportional weight and body mass index changes over 10 years in the REGARDS cohort ............................................................................... 33

Table 3 Associations of the evolutionary concordance lifestyle score with absolute and proportional weight and body mass index changes over 10 years in the REGARDS cohort ............................................................................... 35

Table 4 Associations of the evolutionary concordance diet score with absolute and proportional weight and body mass index changes over 10 years in the REGARDS cohort ............................................................................... 37

Figures ............................................................................................................................... 39

Figure 1 Exclusion flow chart among the REasons for Geographic and Racial Differences in Stroke (REGARDS) cohort................................................................................................................................................................39

Appendix ............................................................................................................................ 40

Supplemental Table 1 Differences in baseline participant characteristics between participants with and without follow-up weight data in the REGARDS Cohort .............................................................................................................41

Supplemental Table 2 Associations of the total evolutionary concordance score with absolute and proportional waist circumference changes over 10 years in the REGARDS cohort .........................................................................42

Supplemental Table 3 Multivariable-adjusted mean absolute and proportional weight and BMI changes across total evolutionary-concordance score quintiles, stratified by baseline smoking status in the REGARDS cohort 43

Supplemental Table 4 Multivariable-adjusted mean absolute and proportional weight and BMI changes across total evolutionary-concordance score quintiles, stratified by baseline age category in the REGARDS cohort ....44

Supplemental Table 5 Multivariable-adjusted mean absolute and proportional weight and BMI changes across total evolutionary-concordance score quintiles, stratified by race in the REGARDS cohort...................................45

Supplemental Table 6 Multivariable-adjusted mean absolute and proportional weight and BMI changes across total evolutionary-concordance score quintiles, stratified by sex and hormone replacement therapy (HRT) use in the REGARDS cohort............................................................................................................................................................46

Supplemental Table 7 Multivariable-adjusted mean absolute and proportional weight and BMI changes across total evolutionary-concordance score quintiles, stratified by baseline comorbidity status in the REGARDS cohort ......................................................................................................................................................................................... 47

Supplemental Table 8 Multivariable-adjusted mean absolute and proportional weight and BMI changes over 10 years among those in the highest relative to the lowest quintiles of the total evolutionary-concordance score, overall and after removing and replacing each of its five components one at a time; REGARDS cohort ............ 48 

About this Master's Thesis

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School	Rollins School of Public Health
Department	Epidemiology
Subfield / Discipline	Epidemiology - MPH & MSPH
Degree	M.P.H.
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, General Health Sciences, Public Health
Mot-clé	Evolutionary-concordance Weight Obesity
Committee Chair / Thesis Advisor	Terryl J. Hartman, Emory University Roberd M. Bostick, Emory University

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