Body mass index and mortality in nonsmoking older adults: the Cardiovascular Health Study.

Diehr, Paula; Bild, Diane E.; Harris, Tamara B.; Duxbury, Andrew; Siscovick, David S.; Rossi, M

doi:10.2105/ajph.88.4.623

Cited by 191 publications

(156 citation statements)

References 26 publications

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“…[47][48][49][50][51][52][53][54][55][56][57][58][59][60][61][62][63][64][65][66] Heiat et al 67 recently reviewed all studies evaluating the relation between obesity and mortality in the elderly published, from 1966 to 1999. They searched Medline, and from 444 papers they presented data from 13 studies on the basis of the following inclusion criteria: subjects older than 65 y, age adjustment performed, inclusion of at least 100 subjects, adjustments for smoking, baseline health status, and selection of nonhospitalized subjects.…”

Section: Obesity and Aging M Zamboni Et Almentioning

confidence: 99%

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Health consequences of obesity in the elderly: a review of four unresolved questions

et al. 2005

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Obesity prevalence is growing progressively even among older age groups. Controversy exists about the potential harms of obesity in the elderly. Debate persists about the relation between obesity in old age and total or disease-specific mortality, the definition of obesity in the elderly, its clinical relevance, and about the need for its treatment. Knowledge of age-related body composition and fat distribution changes will help us to better understand the relationships between obesity, morbidity and mortality in the elderly. Review of the literature supports that central fat and relative loss of fat-free mass may become relatively more important than BMI in determining the health risk associated with obesity in older ages. Weight gain or fat redistribution in older age may still confer adverse health risks (for earlier mortality, comorbidities conferring independent adverse health risks, or for functional decline). Evaluation of comorbidity and weight history should be performed in the elderly in order to generate a comprehensive assessment of the potential adverse health effects of overweight or obesity. The risks of obesity in the elderly have been underestimated by a number of confounders such as survival effect, competing mortalities, relatively shortened life expectancy in older persons, smoking, weight change and unintentional weight loss. Identification of elderly subjects with sarcopenic obesity is probably clinically relevant, but the definition of sarcopenic obesity, the benefits of its clinical identification, as well as its relation to clinical consequences require further study. Studies on the effect of voluntary weight loss in the elderly are scarce, but they suggest that even small amounts of weight loss (between 5-10% of initial body weight) may be beneficial. In older as well as in younger adults, voluntary weight loss may help to prevent the adverse health consequences of obesity.

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Section: Obesity and Aging M Zamboni Et Almentioning

confidence: 99%

“…Seven [48][49][50]53,54,59,66 out of 20 studies presented in Table 2 were able to take into account weight changes in the relation between obesity and mortality. However, six 48,49,53,54,59,66 out of seven showed lower mortality in subjects with lower BMI, or at least a U-shaped relation between BMI and mortality.…”

Section: Obesity and Aging M Zamboni Et Almentioning

confidence: 99%

Health consequences of obesity in the elderly: a review of four unresolved questions

et al. 2005

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“…As in our study and others, 11,13 the authors demonstrated modification of the association between BMI and mortality by smoking and prior disease. As reviewed elsewhere, 11,25 previous studies suggesting Ushaped, J-shaped or inverse associations between BMI and mortality [26][27][28][29][30] have generally not comprehensively accounted for major potential sources of bias. A few studies have emphasized a lack of increased mortality among those who are overweight 27 -a potentially precarious public health message in the setting of the growing prevalence of overweight and obesity.…”

Section: Relative Riskmentioning

confidence: 99%

Body mass index and mortality in men: evaluating the shape of the association

et al. 2007

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Objective: Controversy regarding the relationship between body mass index (BMI) and mortality continues to exist. Most of the previous studies have not comprehensively accounted for major sources of bias. We examined the association between BMI and all-cause mortality according to pre-existing disease and smoking status in a large prospective cohort. Methods: Participants were 99 253 male physicians in the Physicians' Health Study enrollment cohort (40-84 years) who provided self-reported information in 1982. We used Cox proportional hazards regression to examine the association between baseline BMI and mortality. Results: A total of 5438 men died (median follow-up, 5.7 years). Although a U-shaped association between BMI and all-cause mortality was seen among all men, we found a linear relationship when accounting for potential sources of bias. In the optimal model excluding men who died within 2 years, and adjusting for age, smoking, alcohol consumption, physical activity, prior disease and interactions between BMI and prior disease, and between BMI and smoking, those with BMI o20.0 kg/m 2 had a relative risk (RR) of death of 0.88 (95% confidence interval (CI), 0.56-1.40), as compared to men with BMI 22.5-24.9 kg/m 2 . By contrast, men with BMI 30.0-34.9 kg/m 2 had an RR of 1.45 (95% CI, 1.10-1.91) and those with BMI X35.0 kg/m 2 had an RR of 1.62 (95% CI, 1.12-2.35; P for linear trend, o0.001). According to WHO categories, men in the 'overweight' range (BMI 25.0-29.9 kg/m 2 ) had an RR of 1.20 (95% CI, 1.05-1.38) as compared to men in the 'normal' range (BMI o25.0 kg/m 2 ). Conclusions: In this large, prospective cohort, we found a consistent linear association between higher BMI and increased risk of mortality after accounting for several potential sources of bias, even among those within the 'overweight' range of BMI. Public health messages should emphasize the preponderance of evidence supporting the adverse health effects associated with higher body weight.

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“…Epidemiological studies have shown an inconsistent relationship between body mass index (BMI) and mortality risk, with associations being J-or U-shaped [4][5][6][7][8][9][10][11][12], direct linear [13][14][15][16] or absent [17,18]. This could be due to the inadequate control for smoking status and pre-existing chronic diseases, both of which are associated with a low BMI and an increased risk of death [19].…”

Section: Introductionmentioning

confidence: 99%

Effects of physical activity, body mass index, waist-to-hip ratio and waist circumference on total mortality risk in the Swedish National March Cohort

Bellocco

Jia

et al. 2010

Eur J Epidemiol

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Body mass index and mortality in nonsmoking older adults: the Cardiovascular Health Study.

Cited by 191 publications

References 26 publications

Health consequences of obesity in the elderly: a review of four unresolved questions

Health consequences of obesity in the elderly: a review of four unresolved questions

Body mass index and mortality in men: evaluating the shape of the association

Effects of physical activity, body mass index, waist-to-hip ratio and waist circumference on total mortality risk in the Swedish National March Cohort

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