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Original Article
Volume 338:1-7 January 1, 1998 Number 1
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The Effect of Age on the Association between Body-Mass Index and Mortality
June Stevens, Ph.D., Jianwen Cai, Ph.D., Elsie R. Pamuk, Ph.D., David F. Williamson, Ph.D., Michael J. Thun, M.D., and Joy L. Wood, M.S.

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ABSTRACT

Background The effect of age on optimal body weight is controversial, and few studies have had adequate numbers of subjects to analyze mortality as a function of body-mass index across age groups.

Methods We studied mortality over 12 years among white men and women who participated in the American Cancer Society's Cancer Prevention Study I (from 1960 through 1972). The 62,116 men and 262,019 women included in this analysis had never smoked cigarettes, had no history of heart disease, stroke, or cancer (other than skin cancer) at base line in 1959–1960, and had no history of recent unintentional weight loss. The date and cause of death for subjects who died were determined from death certificates. The associations between body-mass index (defined as the weight in kilograms divided by the square of the height in meters) and mortality were examined for six age groups in analyses in which we adjusted for age, educational level, physical activity, and alcohol consumption.

Results Greater body-mass index was associated with higher mortality from all causes and from cardiovascular disease in men and women up to 75 years of age. However, the relative risk associated with greater body-mass index declined with age. For example, for mortality from cardiovascular disease, the relative risk associated with an increment of 1 in the body-mass index was 1.10 (95 percent confidence interval, 1.04 to 1.16) for 30-to-44-year-old men and 1.03 (95 percent confidence interval, 1.02 to 1.05) for 65-to-74-year-old men. For women, the corresponding relative risk estimates were 1.08 (95 percent confidence interval, 1.05 to 1.11) and 1.02 (95 percent confidence interval, 1.02 to 1.03).

Conclusions Excess body weight increases the risk of death from any cause and from cardiovascular disease in adults between 30 and 74 years of age. The relative risk associated with greater body weight is higher among younger subjects.


Source Information

From the Departments of Nutrition (J.S.), Biostatistics (J.C.), and Epidemiology (J.S., J.L.W.), School of Public Health, University of North Carolina, Chapel Hill; the National Center for Health Statistics, Hyattsville, Md. (E.R.P.); the National Center for Chronic Disease Prevention and Health Promotion, Atlanta (D.F.W.); and the American Cancer Society, Atlanta (M.J.T.).

Address reprint requests to Dr. Stevens at the Departments of Nutrition and Epidemiology, CB 7400, University of North Carolina, Chapel Hill, NC 27599-7400.

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Related Letters:

The Obesity Problem
Field A. E., Krauss R. M., Eckel R. H., Dietz W. H., Franks A. L., Marks J. S., Gaesser G. A., McGinnis J. M., Foege W. H., Werner A., Gruber H., Abraham S., Imperato J. P., Kassirer J. P., Angell M.
Extract | Full Text  
N Engl J Med 1998; 338:1156-1158, Apr 16, 1998. Correspondence

Age, Body-Mass Index, and Mortality
Lesser G. T., Pierson R. N., Pesola G. R., Redberg R. F., Stevens J., Cai J., Wood J. L.
Extract | Full Text  
N Engl J Med 1998; 338:1158-1159, Apr 16, 1998. Correspondence

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