The Influence of Cigarette Smoking on the Association between Body Weight and Mortality. The Framingham Heart Study Revisited

Sempos, Christopher T.; Durazo‐Arvizu, Ramón; McGee, Daniel; Cooper, Richard S.; Prewitt, T. Elaine; Rd,

doi:10.1016/s1047-2797(97)00233-0

Cited by 36 publications

(28 citation statements)

References 9 publications

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“…Although overweight (BMI, 25 to 29.9 kg/m 2 ) male smokers lost approximately 1 year of life expectancy, overweight female smokers showed no survival disadvantage compared with smokers of normal weight. Studies differ on the effects of smoking on the relationship between body weight and mortality (12,27,28). In our sample, the interaction between smoking status and the effect of overweight on mortality was significant.…”

Section: Discussionmentioning

confidence: 53%

Obesity in Adulthood and Its Consequences for Life Expectancy: A Life-Table Analysis

et al. 2003

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Section: Discussionmentioning

confidence: 53%

Obesity in Adulthood and Its Consequences for Life Expectancy: A Life-Table Analysis

et al. 2003

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“…It is well known that smokers are thinner 68 and have an elevated mortality compared with nonsmokers. 69 This association could explain data presented in several studies demonstrating an association between lower body weight and increased mortality. Most studies have included some adjustment for smoking status.…”

Section: Obesity and Aging M Zamboni Et Almentioning

confidence: 75%

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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“…Moreover, aside from any possible confounding, effect modification by covariates might also be in evidence (Seidell, 1995b). In this respect, however, the literature is divided as to whether residual confounding or effect modification by smoking (or pre-existing illness or weight fluctuation) is likely (World Health Organization, 2000;Manson et al, 1987;Troiano et al, 1996;National Institutes of Health, 1998;Allison et al, 1999;Lew & Garfinkel, 1979;Stevens et al, 1998;Calle et al 1999;Sempos et al, 1998). Thus, in line with other studies (Allison et al, 1999), we estimated attributable deaths separately, using RRs for all subjects and using RRs for non-or never-smokers (and additionally for apparently healthy subjects).…”

Section: Discussionmentioning

confidence: 99%

A simple estimate of mortality attributable to excess weight in the European Union

et al. 2003

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Objective: To estimate the current burden of mortality attributable to excess weight in the European Union (EU). Methods: Prevalence of overweight (body mass index, BMI 25 -29.9 kg=m 2 ) and obesity (BMI 30 kg=m 2 ) were based on selfreported data from a survey with samples representative of the 15 EU Member States in 1997. Primary source of relative risk (RR) of death by BMI was the first American Cancer Prevention Study (CPS I). Additional calculations were performed to account for effect of smoking (using CPS I data for non-or never-smokers), for pre-existing illness (using the second CPS, CPS II, data for healthy never-smokers) and using RRs derived from European rather than US data (using data from a meta-analysis of prospective studies). Mortality attributable to excess weight was calculated by combining the prevalences of overweight and obesity, the RRs, and the number of deaths in the EU countries. Results: Annual deaths attributable to overweight and obesity totalled approximately 279 000 when RRs for all subjects were used. When RRs for nonsmokers only were applied to the entire population, about 304 000 deaths were attributable to excess weight. In analyses using RRs which controlled for both smoking and history of disease, the number of deaths attributable to excess weight was estimated at about 337 000 based on European data and at about 401 000 based on US data. In the EU, therefore, a minimum of 279 000 deaths were attributable to excess weight (7.7% of all deaths, varying from 5.8% for France through 8.7% for the UK). More attributable deaths occurred among the obese (175 000) than among the overweight (104 000). Around 70% were cardiovascular disease deaths (195 000) and 20% cancer deaths (53 000).

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The Influence of Cigarette Smoking on the Association between Body Weight and Mortality. The Framingham Heart Study Revisited

Cited by 36 publications

References 9 publications

Obesity in Adulthood and Its Consequences for Life Expectancy: A Life-Table Analysis

Obesity in Adulthood and Its Consequences for Life Expectancy: A Life-Table Analysis

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

A simple estimate of mortality attributable to excess weight in the European Union

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