Impact of obesity on life expectancy among different European countries: secondary analysis of population-level data over the 1975–2012 period

Abstract

ObjectiveThis study assesses the impact of obesity on life expectancy for 26 European national populations and the USA over the 1975–2012 period.DesignSecondary analysis of population-level obesity and mortality data.SettingEuropean countries, namely Austria, Belarus, Belgium, the Czech Republic, Denmark, Estonia, Finland, France, Hungary, Iceland, Ireland, Italy, Latvia, Lithuania, Luxembourg, the Netherlands, Norway, Poland, Portugal, the Russian Federation, Slovakia, Spain, Sweden, Switzerland, Ukraine and the UK; and the USA.ParticipantsNational populations aged 18–100 years, by sex.MeasurementsUsing data by age and sex, we calculated obesity-attributable mortality by multiplying all-cause mortality (Human Mortality Database) with obesity-attributable mortality fractions (OAMFs). OAMFs were obtained by applying the weighted sum method to obesity prevalence data (non-communicable diseases (NCD) Risk Factor Collaboration) and European relative risks (Dynamic Modeling for Health Impact Assessment (DYNAMO- HIA)). We estimated potential gains in life expectancy (PGLE) at birth by eliminating obesity-attributable mortality from all-cause mortality using associated single-decrement life tables.ResultsIn the 26 European countries in 2012, PGLE due to obesity ranged from 0.86 to 1.67 years among men, and from 0.66 to 1.54 years among women. In all countries, PGLE increased over time, with an average annual increase of 2.68% among men and 1.33% among women. Among women in Denmark, Switzerland, and Central and Eastern European countries, the increase in PGLE levelled off after 1995. Without obesity, the average increase in life expectancy between 1975 and 2012 would have been 0.78 years higher among men and 0.30 years higher among women.ConclusionsObesity was proven to have an impact on both life expectancy levels and trends in Europe. The differences found in this impact between countries and the sexes can be linked to contextual factors, as well as to differences in people’s ability and capacity to adopt healthier lifestyles.

Obesity Prevalence in the Long-Term Future in 18 European Countries and in the USA

“…This outcome is in line with their current forerunner positions, the previous literature, and a previous forecast that focused on few European countries and the USA [8]. The UK is regarded as the forerunner in obesity in Europe, not only because it has high levels of obesity, but because the increase in obesity prevalence has been greater than increases elsewhere in Europe [20, 30-34] and are similar to trends observed in the USA [32, 34, 35]. In addition to having similar obesity levels and progression histories [1, 34, 35], the UK and USA share certain characteristics that might predispose their populations to having similar eating and physical activity habits (e.g., there is widespread consumption of fast food, levels of socioeconomic inequality are high, and obese people are stigmatized) [35, 36].…”

“…The UK is regarded as the forerunner in obesity in Europe, not only because it has high levels of obesity, but because the increase in obesity prevalence has been greater than increases elsewhere in Europe [20, 30-34] and are similar to trends observed in the USA [32, 34, 35]. In addition to having similar obesity levels and progression histories [1, 34, 35], the UK and USA share certain characteristics that might predispose their populations to having similar eating and physical activity habits (e.g., there is widespread consumption of fast food, levels of socioeconomic inequality are high, and obese people are stigmatized) [35, 36]. However, the UK is expected to reach lower maximum levels and a couple of years later than the USA, possibly due to differences in socioeconomic conditions, food policies, and access to food technology in these 2 countries [32, 35].…”

Changing contribution of smoking to the sex differences in life expectancy in Europe, 1950–2014

“…The country differences in the trend since 1995 in the contribution of non-smoking-attributable mortality likely point to a different balance of trends in sex differences in the differential risk behaviours other than smoking. For example, European men generally experienced slightly stronger increases in obesity-attributable mortality than European women, but more so in Eastern than in Western Europe [11]. Whereas in the United Kingdom, the Netherlands, Belgium, and most Former Soviet Republics (up to 2000), men have experienced stronger increases in alcohol-attributable mortality than women, in Hungary, declines in alcohol-attributable mortality have been greater among men than among women since 1995 (own unpublished results).…”

Testosterone Therapy for Prevention and Treatment of Obesity in Men

“…16 Even though the prevalence of obesity (BMI ‡30 kg/m 2 ) is slightly higher in women than men, men suffer from more obesityrelated comorbidities and are at a higher risk of obesity-related premature death. 1,[17][18][19] A study that investigated patterns of weight regain among men and women during a long-term followup found that men have poorer weight loss maintenance than women. 20 The Look Action for Health in Diabetes (AHEAD) trial likewise found sex differences in response to an intensive lifestyle intervention (ILI); although both men and women lost body fat and lean mass compared with the control group at year 1, by year 8, men in the ILI group had regained all body fat but not the lost lean mass, so that there was no dif-ference in body fat but a significantly reduced lean mass compared with the control group at study end.…”