| Title: | Body-mass index and all-cause mortality: individual-participant-data meta-analysis of 239 prospective studies in four continents |
| Journal: | The Lancet |
| Published: | 13 Jul 2016 |
| Pubmed: | https://pubmed.ncbi.nlm.nih.gov/27423262/ |
| DOI: | https://doi.org/10.1016/s0140-6736(16)30175-1 |
| URL: | http://www.thelancet.com/article/S0140673616301751/pdf |
| Citations: | 1965 (489 in last 2 years) as of 8 Aug 2024 |
Publication 3049
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Abstract
BACKGROUND: Overweight and obesity are increasing worldwide. To help assess their relevance to mortality in different populations we conducted individual-participant data meta-analyses of prospective studies of body-mass index (BMI), limiting confounding and reverse causality by restricting analyses to never-smokers and excluding pre-existing disease and the first 5 years of follow-up.</p>
METHODS: Of 10 625 411 participants in Asia, Australia and New Zealand, Europe, and North America from 239 prospective studies (median follow-up 13·7 years, IQR 11·4-14·7), 3 951 455 people in 189 studies were never-smokers without chronic diseases at recruitment who survived 5 years, of whom 385 879 died. The primary analyses are of these deaths, and study, age, and sex adjusted hazard ratios (HRs), relative to BMI 22·5-<25·0 kg/m(2).</p>
FINDINGS: All-cause mortality was minimal at 20·0-25·0 kg/m(2) (HR 1·00, 95% CI 0·98-1·02 for BMI 20·0-<22·5 kg/m(2); 1·00, 0·99-1·01 for BMI 22·5-<25·0 kg/m(2)), and increased significantly both just below this range (1·13, 1·09-1·17 for BMI 18·5-<20·0 kg/m(2); 1·51, 1·43-1·59 for BMI 15·0-<18·5) and throughout the overweight range (1·07, 1·07-1·08 for BMI 25·0-<27·5 kg/m(2); 1·20, 1·18-1·22 for BMI 27·5-<30·0 kg/m(2)). The HR for obesity grade 1 (BMI 30·0-<35·0 kg/m(2)) was 1·45, 95% CI 1·41-1·48; the HR for obesity grade 2 (35·0-<40·0 kg/m(2)) was 1·94, 1·87-2·01; and the HR for obesity grade 3 (40·0-<60·0 kg/m(2)) was 2·76, 2·60-2·92. For BMI over 25·0 kg/m(2), mortality increased approximately log-linearly with BMI; the HR per 5 kg/m(2) units higher BMI was 1·39 (1·34-1·43) in Europe, 1·29 (1·26-1·32) in North America, 1·39 (1·34-1·44) in east Asia, and 1·31 (1·27-1·35) in Australia and New Zealand. This HR per 5 kg/m(2) units higher BMI (for BMI over 25 kg/m(2)) was greater in younger than older people (1·52, 95% CI 1·47-1·56, for BMI measured at 35-49 years vs 1·21, 1·17-1·25, for BMI measured at 70-89 years; pheterogeneity<0·0001), greater in men than women (1·51, 1·46-1·56, vs 1·30, 1·26-1·33; pheterogeneity<0·0001), but similar in studies with self-reported and measured BMI.</p>
INTERPRETATION: The associations of both overweight and obesity with higher all-cause mortality were broadly consistent in four continents. This finding supports strategies to combat the entire spectrum of excess adiposity in many populations.</p>
FUNDING: UK Medical Research Council, British Heart Foundation, National Institute for Health Research, US National Institutes of Health.</p>
62 Authors
- The Global BMI Mortality Collaboration
- Emanuele Di Angelantonio
- Shilpa N Bhupathiraju
- David Wormser
- Pei Gao
- Stephen Kaptoge
- Amy Berrington de Gonzalez
- Benjamin J Cairns
- Rachel Huxley
- Chandra L Jackson
- Grace Joshy
- Sarah Lewington
- JoAnn E Manson
- Neil Murphy
- Alpa V Patel
- Jonathan M Samet
- Mark Woodward
- Wei Zheng
- Maigen Zhou
- Narinder Bansal
- Aurelio Barricarte
- Brian Carter
- James R Cerhan
- Rory Collins
- George Davey Smith
- Xianghua Fang
- Oscar H Franco
- Jane Green
- Jim Halsey
- Janet S Hildebrand
- Keum Ji Jung
- Rosemary J Korda
- Dale F McLerran
- Steven C Moore
- Linda M O'Keeffe
- Ellie Paige
- Anna Ramond
- Gillian K Reeves
- Betsy Rolland
- Carlotta Sacerdote
- Naveed Sattar
- Eleni Sofianopoulou
- June Stevens
- Michael Thun
- Hirotsugu Ueshima
- Ling Yang
- Young Duk Yun
- Peter Willeit
- Emily Banks
- Valerie Beral
- Zhengming Chen
- Susan M Gapstur
- Marc J Gunter
- Patricia Hartge
- Sun Ha Jee
- Tai-Hing Lam
- Richard Peto
- John D Potter
- Walter C Willett
- Simon G Thompson
- John Danesh
- Frank B Hu
1 Application
| Application ID | Title |
|---|---|
| 7439 | Comparissons of measures of adiposity including body-mass index, waist-circumference, waist-to-hip ratio, and percentage body fat mass |
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