FREE NEJM E-TOC    HOME   |   SUBSCRIBE   |   CURRENT ISSUE   |   PAST ISSUES   |   COLLECTIONS   |   Search Term  Advanced Search

Sign in | Get NEJM's E-Mail Table of Contents — Free | Subscribe

Previous Volume 355:763-778 August 24, 2006 Number 8 Next

	Full Text PDF PDA Full Text PowerPoint Slide Set Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited E-mail When Letters Appear PubMed Citation

ABSTRACT

Background Obesity, defined by a body-mass index (BMI) (the weight in kilograms divided by the square of the height in meters) of 30.0 or more, is associated with an increased risk of death, but the relation between overweight (a BMI of 25.0 to 29.9) and the risk of death has been questioned.

Methods We prospectively examined BMI in relation to the risk of death from any cause in 527,265 U.S. men and women in the National Institutes of Health–AARP cohort who were 50 to 71 years old at enrollment in 1995–1996. BMI was calculated from self-reported weight and height. Relative risks and 95 percent confidence intervals were adjusted for age, race or ethnic group, level of education, smoking status, physical activity, and alcohol intake. We also conducted alternative analyses to address potential biases related to preexisting chronic disease and smoking status.

Results During a maximum follow-up of 10 years through 2005, 61,317 participants (42,173 men and 19,144 women) died. Initial analyses showed an increased risk of death for the highest and lowest categories of BMI among both men and women, in all racial or ethnic groups, and at all ages. When the analysis was restricted to healthy people who had never smoked, the risk of death was associated with both overweight and obesity among men and women. In analyses of BMI during midlife (age of 50 years) among those who had never smoked, the associations became stronger, with the risk of death increasing by 20 to 40 percent among overweight persons and by two to at least three times among obese persons; the risk of death among underweight persons was attenuated.

Conclusions Excess body weight during midlife, including overweight, is associated with an increased risk of death.

Source Information

From the Nutritional Epidemiology Branch (K.F.A., A.S., T.M., M.F.L.), Division of Cancer Epidemiology and Genetics and the Biometry Research Group (V.K.), Division of Cancer Prevention, and the Division of Cancer Control and Population Sciences (R.B.-B.), National Cancer Institute, and the Laboratory of Epidemiology, Demography, and Biometry, National Institute on Aging (T.B.H.), the National Institutes of Health, Bethesda, Md.; and the AARP, Washington, D.C. (A.H.).

Address reprint requests to Dr. Adams at the Nutritional Epidemiology Branch, 6120 Executive Blvd., Suite 320, Rockville, MD 20852, or at adamske{at}mail.nih.gov.

Full Text of this Article

This article has been cited by other articles:

• Sauvaget, C., Ramadas, K., Thomas, G., Vinoda, J., Thara, S., Sankaranarayanan, R. (2008). Body mass index, weight change and mortality risk in a prospective study in India. Int J Epidemiol 37: 990-1004 [Abstract] [Full Text]  
• Chiuve, S. E., Rexrode, K. M., Spiegelman, D., Logroscino, G., Manson, J. E., Rimm, E. B. (2008). Primary Prevention of Stroke by Healthy Lifestyle. Circulation 118: 947-954 [Abstract] [Full Text]  
• Litwin, S. E. (2008). Which Measures of Obesity Best Predict Cardiovascular Risk?. J Am Coll Cardiol 52: 616-619 [Full Text]  
• Eichinger, S., Hron, G., Bialonczyk, C., Hirschl, M., Minar, E., Wagner, O., Heinze, G., Kyrle, P. A. (2008). Overweight, Obesity, and the Risk of Recurrent Venous Thromboembolism. Arch Intern Med 168: 1678-1683 [Abstract] [Full Text]  
• Mullen, J. T., Davenport, D. L., Hutter, M. M., Hosokawa, P. W., Henderson, W. G., Khuri, S. F., Moorman, D. W. (2008). Impact of Body Mass Index on Perioperative Outcomes in Patients Undergoing Major Intra-abdominal Cancer Surgery. Ann. Surg. Oncol. 15: 2164-2172 [Abstract] [Full Text]  
• Li, P. K.-T., Kwan, B. C.-H., Szeto, C. C., Ko, G. T.-C. (2008). Metabolic syndrome in peritoneal dialysis patients. NDT Plus 1: 206-214 [Abstract] [Full Text]  
• Reedy, J., Mitrou, P. N., Krebs-Smith, S. M., Wirfalt, E., Flood, A., Kipnis, V., Leitzmann, M., Mouw, T., Hollenbeck, A., Schatzkin, A., Subar, A. F. (2008). Index-based Dietary Patterns and Risk of Colorectal Cancer: The NIH-AARP Diet and Health Study. Am J Epidemiol 168: 38-48 [Abstract] [Full Text]  
• Carroll, D., Phillips, A. C., Der, G. (2008). Body Mass Index, Abdominal Adiposity, Obesity, and Cardiovascular Reactions to Psychological Stress in a Large Community Sample. Psychosom. Med. 70: 653-660 [Abstract] [Full Text]  
• Koster, A., Leitzmann, M. F., Schatzkin, A., Mouw, T., Adams, K. F., van Eijk, J. Th. M., Hollenbeck, A. R., Harris, T. B. (2008). Waist Circumference and Mortality. Am J Epidemiol 167: 1465-1475 [Abstract] [Full Text]  
• Muller-Ehmsen, J., Braun, D., Schneider, T., Pfister, R., Worm, N., Wielckens, K., Scheid, C., Frommolt, P., Flesch, M. (2008). Decreased number of circulating progenitor cells in obesity: beneficial effects of weight reduction. Eur Heart J 29: 1560-1568 [Abstract] [Full Text]  
• Samat, A., Rahim, A., Barnett, A. (2008). Pharmacotherapy for obesity in menopausal women. Menopause Int 14: 57-62 [Abstract] [Full Text]  
• Bessesen, D. H. (2008). Update on Obesity. J. Clin. Endocrinol. Metab. 93: 2027-2034 [Abstract] [Full Text]  
• Van Gaal, L. F, Gutkin, S. W, Nauck, M. A (2008). Exploiting the antidiabetic properties of incretins to treat type 2 diabetes mellitus: glucagon-like peptide 1 receptor agonists or insulin for patients with inadequate glycemic control?. Eur J Endocrinol 158: 773-784 [Abstract] [Full Text]  
• Mujahid, M. S., Roux, A. V. D., Shen, M., Gowda, D., Sanchez, B., Shea, S., Jacobs, D. R. Jr., Jackson, S. A. (2008). Relation between Neighborhood Environments and Obesity in the Multi-Ethnic Study of Atherosclerosis. Am J Epidemiol 167: 1349-1357 [Abstract] [Full Text]  
• Mozaffarian, D., Kamineni, A., Prineas, R. J., Siscovick, D. S. (2008). Metabolic Syndrome and Mortality in Older Adults: The Cardiovascular Health Study. Arch Intern Med 168: 969-978 [Abstract] [Full Text]  
• Cameron, A. J., Zimmet, P. Z. (2008). Expanding Evidence for the Multiple Dangers of Epidemic Abdominal Obesity. Circulation 117: 1624-1626 [Full Text]  
• Gildengers, A. G., Whyte, E. M., Drayer, R. A., Soreca, I., Fagiolini, A., Kilbourne, A. M., Houck, P. R., Reynolds, C. F. III, Frank, E., Kupfer, D. J., Mulsant, B. H. (2008). Medical Burden in Late-Life Bipolar and Major Depressive Disorders. AJGP 16: 194-200 [Abstract] [Full Text]  
• Ringback Weitoft, G., Eliasson, M., Rosen, M. (2008). Underweight, overweight and obesity as risk factors for mortality and hospitalization. Scand J Public Health 36: 169-176 [Abstract]  
• Aasheim, E. T, Hofso, D., Hjelmesaeth, J., Birkeland, K. I, Bohmer, T. (2008). Vitamin status in morbidly obese patients: a cross-sectional study. Am. J. Clin. Nutr. 87: 362-369 [Abstract] [Full Text]  
• Rosamond, W., Flegal, K., Furie, K., Go, A., Greenlund, K., Haase, N., Hailpern, S. M., Ho, M., Howard, V., Kissela, B., Kittner, S., Lloyd-Jones, D., McDermott, M., Meigs, J., Moy, C., Nichol, G., O'Donnell, C., Roger, V., Sorlie, P., Steinberger, J., Thom, T., Wilson, M., Hong, Y., for the American Heart Association Statistics Comm, (2008). Heart Disease and Stroke Statistics--2008 Update: A Report From the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Circulation 117: e25-e146 [Full Text]  
• Jacobsen, B. K., Heuch, I., Kvale, G. (2007). Association of Low Age at Menarche with Increased All-Cause Mortality: A 37-Year Follow-up of 61,319 Norwegian Women. Am J Epidemiol 166: 1431-1437 [Abstract] [Full Text]  
• Dyer, D. N. (2007). How Can Obesity Be Healthy?. Arch Intern Med 167: 2527-2528 [Full Text]  
• Sui, X., LaMonte, M. J., Laditka, J. N., Hardin, J. W., Chase, N., Hooker, S. P., Blair, S. N. (2007). Cardiorespiratory Fitness and Adiposity as Mortality Predictors in Older Adults. JAMA 298: 2507-2516 [Abstract] [Full Text]  
• Krumholz, H. M., Masoudi, F. A. (2007). The Year in Epidemiology, Health Services Research, and Outcomes Research. J Am Coll Cardiol 50: 2254-2262 [Full Text]  
• O'Neil, C. E., Nicklas, T. A. (2007). State of the Art Reviews: Relationship Between Diet/ Physical Activity and Health. AMERICAN JOURNAL OF LIFESTYLE MEDICINE 1: 457-481 [Abstract]  
• Logroscino, G., Sesso, H. D., Paffenbarger, R. S. Jr, Lee, I-M. (2007). Body Mass Index and Risk of Parkinson's Disease: A Prospective Cohort Study. Am J Epidemiol 166: 1186-1190 [Abstract] [Full Text]  
• Alley, D. E., Chang, V. W. (2007). The Changing Relationship of Obesity and Disability, 1988-2004. JAMA 298: 2020-2027 [Abstract] [Full Text]  
• Rubin, C. T., Capilla, E., Luu, Y. K., Busa, B., Crawford, H., Nolan, D. J., Mittal, V., Rosen, C. J., Pessin, J. E., Judex, S. (2007). Adipogenesis is inhibited by brief, daily exposure to high-frequency, extremely low-magnitude mechanical signals. Proc. Natl. Acad. Sci. USA 104: 17879-17884 [Abstract] [Full Text]  
• Burgio, K. L., Richter, H. E., Clements, R. H., Redden, D. T., Goode, P. S. (2007). Changes in Urinary and Fecal Incontinence Symptoms With Weight Loss Surgery in Morbidly Obese Women. Obstet Gynecol 110: 1034-1040 [Abstract] [Full Text]  
• Tichelli, A., Bucher, C., Rovo, A., Stussi, G., Stern, M., Paulussen, M., Halter, J., Meyer-Monard, S., Heim, D., Tsakiris, D. A., Biedermann, B., Passweg, J. R., Gratwohl, A. (2007). Premature cardiovascular disease after allogeneic hematopoietic stem-cell transplantation. Blood 110: 3463-3471 [Abstract] [Full Text]  
• Balkau, B., Deanfield, J. E., Despres, J.-P., Bassand, J.-P., Fox, K. A.A., Smith, S. C. Jr, Barter, P., Tan, C.-E., Van Gaal, L., Wittchen, H.-U., Massien, C., Haffner, S. M. (2007). International Day for the Evaluation of Abdominal Obesity (IDEA): A Study of Waist Circumference, Cardiovascular Disease, and Diabetes Mellitus in 168 000 Primary Care Patients in 63 Countries. Circulation 116: 1942-1951 [Abstract] [Full Text]  
• Nonogaki, K., Nozue, K., Oka, Y. (2007). Social Isolation Affects the Development of Obesity and Type 2 Diabetes in Mice. Endocrinology 148: 4658-4666 [Abstract] [Full Text]  
• Gundewar, S., Calvert, J. W., Elrod, J. W., Lefer, D. J. (2007). Cytoprotective effects of N,N,N-trimethylsphingosine during ischemia- reperfusion injury are lost in the setting of obesity and diabetes. Am. J. Physiol. Heart Circ. Physiol. 293: H2462-H2471 [Abstract] [Full Text]  
• Lim, U., Morton, L. M., Subar, A. F., Baris, D., Stolzenberg-Solomon, R., Leitzmann, M., Kipnis, V., Mouw, T., Carroll, L., Schatzkin, A., Hartge, P. (2007). Alcohol, Smoking, and Body Size in Relation to Incident Hodgkin's and Non-Hodgkin's Lymphoma Risk. Am J Epidemiol 166: 697-708 [Abstract] [Full Text]  
• Kwan, B. C.H., Murtaugh, M. A., Beddhu, S. (2007). Associations of Body Size with Metabolic Syndrome and Mortality in Moderate Chronic Kidney Disease. CJASN 2: 992-998 [Abstract] [Full Text]  
• Guize, L., Thomas, F., Pannier, B., Bean, K., Jego, B., Benetos, A. (2007). All-Cause Mortality Associated With Specific Combinations of the Metabolic Syndrome According to Recent Definitions. Diabetes Care 30: 2381-2387 [Abstract] [Full Text]  
• Thalmann, S., Meier, C. A. (2007). Local adipose tissue depots as cardiovascular risk factors. Cardiovasc Res 75: 690-701 [Abstract] [Full Text]  
• Sjostrom, L., Narbro, K., Sjostrom, C. D., Karason, K., Larsson, B., Wedel, H., Lystig, T., Sullivan, M., Bouchard, C., Carlsson, B., Bengtsson, C., Dahlgren, S., Gummesson, A., Jacobson, P., Karlsson, J., Lindroos, A.-K., Lonroth, H., Naslund, I., Olbers, T., Stenlof, K., Torgerson, J., Agren, G., Carlsson, L. M.S., the Swedish Obese Subjects Study, (2007). Effects of Bariatric Surgery on Mortality in Swedish Obese Subjects. NEJM 357: 741-752 [Abstract] [Full Text]  
• Adams, T. D., Gress, R. E., Smith, S. C., Halverson, R. C., Simper, S. C., Rosamond, W. D., LaMonte, M. J., Stroup, A. M., Hunt, S. C. (2007). Long-Term Mortality after Gastric Bypass Surgery. NEJM 357: 753-761 [Abstract] [Full Text]  
• See, R., Abdullah, S. M., McGuire, D. K., Khera, A., Patel, M. J., Lindsey, J. B., Grundy, S. M., de Lemos, J. A. (2007). The Association of Differing Measures of Overweight and Obesity With Prevalent Atherosclerosis: The Dallas Heart Study. J Am Coll Cardiol 50: 752-759 [Abstract] [Full Text]  
• Callaway, L. K., McIntyre, H. D., O'Callaghan, M., Williams, G. M., Najman, J. M., Lawlor, D. A. (2007). The Association of Hypertensive Disorders of Pregnancy with Weight Gain over the Subsequent 21 Years: Findings from a Prospective Cohort Study. Am J Epidemiol 166: 421-428 [Abstract] [Full Text]  
• Anderson, J. L., Adams, C. D., Antman, E. M., Bridges, C. R., Califf, R. M., Casey, D. E. Jr, Chavey, W. E. II, Fesmire, F. M., Hochman, J. S., Levin, T. N., Lincoff, A. M., Peterson, E. D., Theroux, P., Wenger, N. K., Wright, R. S., Smith, S. C. Jr, Jacobs, A. K., Adams, C. D., Anderson, J. L., Antman, E. M., Halperin, J. L., Hunt, S. A., Krumholz, H. M., Kushner, F. G., Lytle, B. W., Nishimura, R., Ornato, J. P., Page, R. L., Riegel, B. (2007). ACC/AHA 2007 Guidelines for the Management of Patients With Unstable Angina/Non-ST-Elevation Myocardial Infarction: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 2002 Guidelines for the Management of Patients With Unstable Angina/Non-ST-Elevation Myocardial Infarction) Developed in Collaboration with the American College of Emergency Physicians, the Society for Cardiovascular Angiography and Interventions, and the Society of Thoracic Surgeons Endorsed by the American Association of Cardiovascular and Pulmonary Rehabilitation and the Society for Academic Emergency Medicine. J Am Coll Cardiol 50: e1-e157 [Full Text]  
• Dansinger, M. L., Tatsioni, A., Wong, J. B., Chung, M., Balk, E. M. (2007). Meta-analysis: The Effect of Dietary Counseling for Weight Loss. ANN INTERN MED 147: 41-50 [Abstract] [Full Text]  
• Tyson, G. H. III, Rodriguez, E., Elci, O. C., Koutlas, T. C., Chitwood, W. R. Jr, Ferguson, T. B., Kypson, A. P. (2007). Cardiac Procedures in Patients With a Body Mass Index Exceeding 45: Outcomes and Long-Term Results. Ann. Thorac. Surg. 84: 3-9 [Abstract] [Full Text]  
• Adams, K. F., Leitzmann, M. F., Albanes, D., Kipnis, V., Mouw, T., Hollenbeck, A., Schatzkin, A. (2007). Body Mass and Colorectal Cancer Risk in the NIH-AARP Cohort. Am J Epidemiol 166: 36-45 [Abstract] [Full Text]  
• Leung, C. C., Lam, T. H., Chan, W. M., Yew, W. W., Ho, K. S., Leung, G., Law, W. S., Tam, C. M., Chan, C. K., Chang, K. C. (2007). Lower Risk of Tuberculosis in Obesity. Arch Intern Med 167: 1297-1304 [Abstract] [Full Text]  
• Botkin, C. D., Osman, M. M. (2007). Prevalence, Challenges, and Solutions for 18F-FDG PET Studies of Obese Patients: A Technologist's Perspective. J. Nucl. Med. Technol. 35: 80-83 [Abstract] [Full Text]  
• Wouters, E. F. M. (2007). Decision Making in Chronic Hypercapnic Respiratory Failure: A Real Challenge!. Chest 131: 1622-1624 [Full Text]  
• Power, C., Atherton, K., Strachan, D. P, Shepherd, P., Fuller, E., Davis, A., Gibb, I., Kumari, M., Lowe, G., Macfarlane, G. J, Rahi, J., Rodgers, B., Stansfeld, S. (2007). Life-course influences on health in British adults: effects of socio-economic position in childhood and adulthood. Int J Epidemiol 36: 532-539 [Abstract] [Full Text]  
• Zhang, X., Shu, X.-O., Yang, G., Li, H., Cai, H., Gao, Y.-T., Zheng, W. (2007). Abdominal Adiposity and Mortality in Chinese Women. Arch Intern Med 167: 886-892 [Abstract] [Full Text]  
• Sanz, J., Moreno, P. R., Fuster, V. (2007). The Year in Atherothrombosis. J Am Coll Cardiol 49: 1740-1749 [Full Text]  
• Gibbons, R. J. (2007). Leading the Elephant Out of the Corner: The Future of Health Care: Presidential Address at the American Heart Association 2006 Scientific Sessions. Circulation 115: 2221-2230 [Full Text]  
• Shimizu, H., Inoue, K., Mori, M. (2007). The leptin-dependent and -independent melanocortin signaling system: regulation of feeding and energy expenditure. J Endocrinol 193: 1-9 [Abstract] [Full Text]  
• de Mutsert, R., Snijder, M. B., van der Sman-de Beer, F., Seidell, J. C., Boeschoten, E. W., Krediet, R. T., Dekker, J. M., Vandenbroucke, J. P., Dekker, F. W., for the Netherlands Cooperative Study on the Adequ, (2007). Association between Body Mass Index and Mortality Is Similar in the Hemodialysis Population and the General Population at High Age and Equal Duration of Follow-Up. J. Am. Soc. Nephrol. 18: 967-974 [Abstract] [Full Text]  
• Gostin, L. O. (2007). Law as a Tool to Facilitate Healthier Lifestyles and Prevent Obesity. JAMA 297: 87-90 [Full Text]  
• Appels, C. W.Y., Vandenbroucke, J. P., Hoofnagle, J. H., Barzel, U. S., Spitzer, J., Adams, K. F., Schatzkin, A., Leitzmann, M. F. (2006). Overweight, obesity, and mortality.. NEJM 355: 2699-2699 [Full Text]  
• de Lemos, J. A. (2006). The Latest and Greatest New Biomarkers: Which Ones Should We Measure for Risk Prediction in Our Practice?. Arch Intern Med 166: 2428-2430 [Full Text]  
• Malik, I. (2006). JournalScan. Heart 92: 1886-1888 [Full Text]  
• (2006). Obesity Is Risky. What About Being Merely Overweight?. Journal Watch Cardiology 2006: 2-2 [Full Text]  
• Fister, K. (2006). What's new in the other general journals. BMJ 333: 490-490 [Full Text]  
• (2006). Body-Mass Index and Mortality in the U.S.. JWatch General 2006: 1-1 [Full Text]