Weight History and All-Cause and Cause-Specific Mortality in Three Prospective Cohort Studies.
Ann Intern Med
; 166(9): 613-620, 2017 May 02.
Article
in En
| MEDLINE
| ID: mdl-28384755
ABSTRACT
BACKGROUND:
The relationship between body mass index (BMI) and mortality is controversial.OBJECTIVE:
To investigate the relationship between maximum BMI over 16 years and subsequent mortality.DESIGN:
3 prospective cohort studies.SETTING:
Nurses' Health Study I and II and Health Professionals Follow-Up Study.PARTICIPANTS:
225 072 men and women with 32 571 deaths observed over a mean of 12.3 years of follow-up. MEASUREMENTS Maximum BMI over 16 years of weight history and all-cause and cause-specific mortality.RESULTS:
Maximum BMIs in the overweight (25.0 to 29.9 kg/m2) (multivariate hazard ratio [HR], 1.06 [95% CI, 1.03 to 1.08]), obese I (30.0 to 34.9 kg/m2) (HR, 1.24 [CI, 1.20 to 1.29]), and obese II (≥35.0 kg/m2) (HR, 1.73 [CI, 1.66 to 1.80]) categories were associated with increases in risk for all-cause death. The pattern of excess risk with a maximum BMI above normal weight was maintained across strata defined by smoking status, sex, and age, but the excess was greatest among those younger than 70 years and never-smokers. In contrast, a significant inverse association between overweight and mortality (HR, 0.96 [CI, 0.94 to 0.99]) was observed when BMI was defined using a single baseline measurement. Maximum overweight was also associated with increased cause-specific mortality, including death from cardiovascular disease and coronary heart disease.LIMITATION:
Residual confounding and misclassification.CONCLUSION:
The paradoxical association between overweight and mortality is reversed in analyses incorporating weight history. Maximum BMI may be a useful metric to minimize reverse causation bias associated with a single baseline BMI assessment. PRIMARY FUNDING SOURCE National Institutes of Health.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Body Mass Index
/
Cause of Death
Type of study:
Etiology_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limits:
Adult
/
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Language:
En
Journal:
Ann Intern Med
Year:
2017
Type:
Article