Overweight, Obesity, and Mortality in a Large Prospective Cohort of Persons 50 to 71 Years Old
Kenneth F. Adams, Ph.D., Arthur Schatzkin, M.D., Tamara B. Harris, M.D., Victor Kipnis, Ph.D., Traci Mouw, M.P.H., Rachel Ballard-Barbash, M.D., Albert Hollenbeck, Ph.D., and Michael F. Leitzmann, M.D.
Background Obesity, defined by a body-mass index (BMI) (theweight 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 riskof death from any cause in 527,265 U.S. men and women in theNational Institutes of HealthAARP cohort who were 50to 71 years old at enrollment in 19951996. BMI was calculatedfrom self-reported weight and height. Relative risks and 95percent confidence intervals were adjusted for age, race orethnic group, level of education, smoking status, physical activity,and alcohol intake. We also conducted alternative analyses toaddress potential biases related to preexisting chronic diseaseand smoking status.
Results During a maximum follow-up of 10 years through 2005,61,317 participants (42,173 men and 19,144 women) died. Initialanalyses showed an increased risk of death for the highest andlowest categories of BMI among both men and women, in all racialor ethnic groups, and at all ages. When the analysis was restrictedto healthy people who had never smoked, the risk of death wasassociated with both overweight and obesity among men and women.In analyses of BMI during midlife (age of 50 years) among thosewho had never smoked, the associations became stronger, withthe risk of death increasing by 20 to 40 percent among overweightpersons 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.
Overweight, Obesity, and Mortality
Appels C. W.Y., Vandenbroucke J. P., Hoofnagle J. H., Barzel U. S., Spitzer J., Adams K. F., Schatzkin A., Leitzmann M. F.
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N Engl J Med 2006;
355:2699-2701, Dec 21, 2006.
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