Body size trajectories and cardio-metabolic resilience to obesity

Individuals with obesity do not represent a single homogenous group in terms of cardio-metabolic health prospects. The concept of metabolically-healthy obesity is a crude way of capturing this heterogeneity and has resulted in a plethora of research linking to future outcomes to show that it is not a benign condition. By contrast, very few studies have looked back in time and modelled the life course processes and exposures that explain the heterogeneity in cardio-metabolic health and morbidity and mortality risk among people with the same body mass index (BMI) (or waist circumference or percentage body fat). The aim of the Medical Research Council New Investigator Research Grant (MR/P023347/1) ‘Body size trajectories and cardio-metabolic resilience to obesity in three United Kingdom birth cohorts’ is to reveal the body size trajectories, pubertal development patterns, and other factors (e.g. early-life adversity) that might attenuate the positive associations of adulthood obesity makers (e.g. BMI) with cardio-metabolic disease risk factors and other outcomes, thereby providing some degree of protection against the adverse effects of obesity. This work builds on the principle investigator’s previous research as part of the Cohort and Longitudinal Studies Enhancement Resources initiative and focuses on secondary data analysis in the nationally representative UK birth cohort studies (initiated in 1946, 1958, and 1970), which have life course body size and exposure data and a biomedical sweep in adulthood. The grant will provide novel evidence on the life course processes and exposures that lead to some people developing a cardio-metabolic complication or disease or dying while other people with the same BMI do not. This paper details the grant’s scientific rationale, research objectives, and potential impact.