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Development and validation of a risk score predicting substantial weight gain over 5 years in middle-aged European men and women.

This paper is available in a repository.
This paper is available in a repository.

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Abstract

BACKGROUND Identifying individuals at high risk of excess weight gain may help targeting prevention efforts at those at risk of various metabolic diseases associated with weight gain. Our aim was to develop a risk score to identify these individuals and validate it in an external population. METHODS We used lifestyle and nutritional data from 53°758 individuals followed for a median of 5.4 years from six centers of the European Prospective Investigation into Cancer and Nutrition (EPIC) to develop a risk score to predict substantial weight gain (SWG) for the next 5 years (derivation sample). Assuming linear weight gain, SWG was defined as gaining ≥ 10% of baseline weight during follow-up. Proportional hazards models were used to identify significant predictors of SWG separately by EPIC center. Regression coefficients of predictors were pooled using random-effects meta-analysis. Pooled coefficients were used to assign weights to each predictor. The risk score was calculated as a linear combination of the predictors. External validity of the score was evaluated in nine other centers of the EPIC study (validation sample). RESULTS Our final model included age, sex, baseline weight, level of education, baseline smoking, sports activity, alcohol use, and intake of six food groups. The model's discriminatory ability measured by the area under a receiver operating characteristic curve was 0.64 (95% CI = 0.63-0.65) in the derivation sample and 0.57 (95% CI = 0.56-0.58) in the validation sample, with variation between centers. Positive and negative predictive values for the optimal cut-off value of ≥ 200 points were 9% and 96%, respectively. CONCLUSION The present risk score confidently excluded a large proportion of individuals from being at any appreciable risk to develop SWG within the next 5 years. Future studies, however, may attempt to further refine the positive prediction of the score. ; Journal Article; Research Support, Non-U.S. Gov't; This publication arises from a collaboration of two EU projects, the Diet, Obesity and Genes (DiOGenes) project and the Physical Activity, Nutrition, Alcohol, Cessation of Smoking, Eating out of Home and Obesity (PANACEA) project. DiOGenes is a pan-European study within the EU Sixth Framework Programme for Research and Technological Development (2005-2009) (FOOD-CT-2005-513946, http://www.diogenes.eu.org). PANACEA received funding from the EU in the framework of the Public Health Programme (project 2005328). This work was further supported by the European Commission: Public Health and Consumer Protection Directorate 1993–2004, the Research Directorate-General 2005, the Ligue contre le Cancer, the Societe´ 3M, the Mutuelle Ge´ne´ rale de l’Education Nationale, and the Institut National de la Sante´ et de la Recherche Me´ dicale; German Cancer Aid, the German Cancer Research Center, and the Federal Ministry of Education and Research (Germany); the Danish Cancer Society (Denmark); Health Research Fund (FIS) of the Spanish Ministry of Health RTICC ’Red Tema´tica de Investigacio´n Cooperativa en Ca´ncer (grant number C03/10, R06/0020); the participating regional governments and institutions of Spain; Cancer Research United Kingdom, the Medical Research Council, the Stroke Association, the British Heart Foundation, the Department of Health, the Food Standards Agency, and the Wellcome Trust (United Kingdom); the Italian Association for Research on Cancer and the National Research Council (Italy); the Dutch Ministry of Public Health, Welfare and Sports, the Dutch Ministry of Health, Dutch Prevention Funds, LK Research Funds, the Dutch Zorg Onderzoek Nederland, and the World Cancer Research Fund (Netherlands); the Swedish Cancer Society, the Swedish Scientific Council, and the Regional Government of Skane. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.