Weight History, All-Cause and Cause-Specific Mortality in Three Prospective Cohort Studies

Details

• Alternative Title:
  Ann Intern Med
• Personal Author:
  Yu, Edward ; Stokes, Andrew C. ; Ley, Sylvia H. ; Manson, JoAnn E. ; Willett, Walter ; Satija, Ambika ; Hu, Frank B.
• Description:
  BACKGROUND
  
  The relationship between body mass index (BMI) and mortality remains controversial.
  
  OBJECTIVE
  
  To investigate the relationship between maximum BMI over 16 years and subsequent mortality.
  
  DESIGN
  
  Three prospective cohort studies.
  
  SETTING
  
  Nurses’ Health Study I and II, Health Professionals Follow-up Study.
  
  PARTICIPANTS
  
  225,072 men and women accruing 32,571 deaths 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% confidence interval (CI), 1.03 – 1.08), obese I (30.0 to 34.9 kg/m2), (HR, 1.24; 95% CI, 1.20 – 1.29), and obese II (≥ 35.0 kg/m2) (HR, 1.73; 95% CI, 1.66 – 1.80) categories were associated with increases in risk of all-cause mortality. 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 <70 years old and never smokers. In contrast, a significant inverse association between overweight and mortality (HR, 0.96; 95% CI, 0.94 – 0.99) was observed when BMI was defined using a single baseline measurement. Maximum overweight was also associated with increased cause-specific mortality, including deaths from cardiovascular diseases and coronary heart disease.
  
  LIMITATIONS
  
  Residual confounding and misclassification.
  
  CONCLUSIONS
  
  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.
  
  
• Subjects:
  Adult Aged Body Mass Index Cause Of Death Female Follow-Up Studies Humans Male Middle Aged Obesity Overweight Prospective Studies

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• Source:
  Ann Intern Med. 166(9):613-620
• Pubmed ID:
  28384755
• Pubmed Central ID:
  PMC5518318
• Document Type:
  Journal Article
• Funding:
  R03 SH000037/SH/NCHS CDC HHSUnited States/ ; UM1 CA176726/CA/NCI NIH HHSUnited States/ ; R01 HL034594/HL/NHLBI NIH HHSUnited States/ ; UM1 CA186107/CA/NCI NIH HHSUnited States/ ; R01 AG040212/AG/NIA NIH HHSUnited States/ ; UM1 CA167552/CA/NCI NIH HHSUnited States/ ; R01 HL035464/HL/NHLBI NIH HHSUnited States/ ; R01 HL088521/HL/NHLBI NIH HHSUnited States/
• Volume:
  166
• Issue:
  9
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:0fbf343a15e2feebfd8780553e2a2945c196e36ac900e582d0899f5a1a3ed425
• Download URL:
  https://stacks.cdc.gov/view/cdc/46856/cdc_46856_DS1.pdf
• File Type:
  [PDF - 233.90 KB ]