Body-mass index and all-1 cause mortality: Individual-participant-data meta-analysis of 239 prospective studies in four continents
<strong>Background:</strong> Overweight and obesity are increasing worldwide. To help assess their relevance to mortality in different populations we conducted individual-participant-data meta-analyses of the prospective studies of body mass index (BMI), limiting confounding and reverse...
| Hoofdauteurs: | , , , , , , , , , , , |
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| Formaat: | Journal article |
| Gepubliceerd in: |
Elsevier
2016
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| _version_ | 1826302071778836480 |
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| author | Di Angelantonio, E Woodward, M Cairns, B Lewington, S Collins, R Green, J Halsey, J Reeves, G Yang, L Beral, V Chen, Z Peto, R |
| author_facet | Di Angelantonio, E Woodward, M Cairns, B Lewington, S Collins, R Green, J Halsey, J Reeves, G Yang, L Beral, V Chen, Z Peto, R |
| author_sort | Di Angelantonio, E |
| collection | OXFORD |
| description | <strong>Background:</strong> Overweight and obesity are increasing worldwide. To help assess their relevance to mortality in different populations we conducted individual-participant-data meta-analyses of the prospective studies of body mass index (BMI), limiting confounding and reverse causality by restricting analyses to never-smokers and excluding prior disease and the first 5 years of follow- up. <strong>Methods:</strong> Of 10,625,411 participants in Asia, Australia/New Zealand, Europe, and North America from 239 prospective studies (median follow-up 13·7 [IQR: 11·4-14·7] years), 3,951,455 in 189 studies were never-smokers without specific chronic diseases at recruitment who survived 5 years, of whom 385,879 died. The primary analyses are of these deaths, using age and sex-adjusted hazard ratios (HRs). <strong>Findings:</strong> All-cause mortality was minimal (HR=1) at BMI (kg/m2) 20-25, and increased significantly both just below this range (BMI 18·5-<20: HR=1·13, 95%CI 1·09-1·17; BMI 15- <18·5: HR=1·51, 1·43-1·59) and throughout the overweight range just above it (BMI 25-<27·5: HR=1·07, 1·07-1·08; BMI 27·5-<30: HR=1·20, 1·18-1·22). Continuing upwards, HRs for obesity grade I, II, and III (BMI 30-<35, 35-<40, 40-<60) were 1·45 (1·41-1·48), 1·94 (1·87-2.01), and 2·76 (2·60-2·92), respectively. For BMI>25, mortality increased approximately log-linearly with BMI; HR per 5 units higher BMI was 1·31 (1·29-1·33) in all regions; 1·39 (1·35-1·43) 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/New Zealand. This HR per 5 units higher BMI (for BMI>25) was greater in younger than older people (1.52 at 35–49 years vs 1·21 at 70-89 years; Pheterogeneity<0·0001), greater in men than women (1·51 vs 1·30; Pheterogeneity<0·0001), but similar in studies with self-reported and measured BMI. <strong>Interpretation:</strong> The associations of both overweight and obesity with higher all-cause mortality were broadly consistent in four continents. This supports strategies to combat the entire spectrum of excess adiposity in many populations. |
| first_indexed | 2024-03-07T05:41:57Z |
| format | Journal article |
| id | oxford-uuid:e5e3b775-c5c6-4c14-8b23-0fede9c743b6 |
| institution | University of Oxford |
| last_indexed | 2024-03-07T05:41:57Z |
| publishDate | 2016 |
| publisher | Elsevier |
| record_format | dspace |
| spelling | oxford-uuid:e5e3b775-c5c6-4c14-8b23-0fede9c743b62022-03-27T10:27:13ZBody-mass index and all-1 cause mortality: Individual-participant-data meta-analysis of 239 prospective studies in four continentsJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:e5e3b775-c5c6-4c14-8b23-0fede9c743b6Symplectic Elements at OxfordElsevier2016Di Angelantonio, EWoodward, MCairns, BLewington, SCollins, RGreen, JHalsey, JReeves, GYang, LBeral, VChen, ZPeto, R<strong>Background:</strong> Overweight and obesity are increasing worldwide. To help assess their relevance to mortality in different populations we conducted individual-participant-data meta-analyses of the prospective studies of body mass index (BMI), limiting confounding and reverse causality by restricting analyses to never-smokers and excluding prior disease and the first 5 years of follow- up. <strong>Methods:</strong> Of 10,625,411 participants in Asia, Australia/New Zealand, Europe, and North America from 239 prospective studies (median follow-up 13·7 [IQR: 11·4-14·7] years), 3,951,455 in 189 studies were never-smokers without specific chronic diseases at recruitment who survived 5 years, of whom 385,879 died. The primary analyses are of these deaths, using age and sex-adjusted hazard ratios (HRs). <strong>Findings:</strong> All-cause mortality was minimal (HR=1) at BMI (kg/m2) 20-25, and increased significantly both just below this range (BMI 18·5-<20: HR=1·13, 95%CI 1·09-1·17; BMI 15- <18·5: HR=1·51, 1·43-1·59) and throughout the overweight range just above it (BMI 25-<27·5: HR=1·07, 1·07-1·08; BMI 27·5-<30: HR=1·20, 1·18-1·22). Continuing upwards, HRs for obesity grade I, II, and III (BMI 30-<35, 35-<40, 40-<60) were 1·45 (1·41-1·48), 1·94 (1·87-2.01), and 2·76 (2·60-2·92), respectively. For BMI>25, mortality increased approximately log-linearly with BMI; HR per 5 units higher BMI was 1·31 (1·29-1·33) in all regions; 1·39 (1·35-1·43) 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/New Zealand. This HR per 5 units higher BMI (for BMI>25) was greater in younger than older people (1.52 at 35–49 years vs 1·21 at 70-89 years; Pheterogeneity<0·0001), greater in men than women (1·51 vs 1·30; Pheterogeneity<0·0001), but similar in studies with self-reported and measured BMI. <strong>Interpretation:</strong> The associations of both overweight and obesity with higher all-cause mortality were broadly consistent in four continents. This supports strategies to combat the entire spectrum of excess adiposity in many populations. |
| spellingShingle | Di Angelantonio, E Woodward, M Cairns, B Lewington, S Collins, R Green, J Halsey, J Reeves, G Yang, L Beral, V Chen, Z Peto, R Body-mass index and all-1 cause mortality: Individual-participant-data meta-analysis of 239 prospective studies in four continents |
| title | Body-mass index and all-1 cause mortality: Individual-participant-data meta-analysis of 239 prospective studies in four continents |
| title_full | Body-mass index and all-1 cause mortality: Individual-participant-data meta-analysis of 239 prospective studies in four continents |
| title_fullStr | Body-mass index and all-1 cause mortality: Individual-participant-data meta-analysis of 239 prospective studies in four continents |
| title_full_unstemmed | Body-mass index and all-1 cause mortality: Individual-participant-data meta-analysis of 239 prospective studies in four continents |
| title_short | Body-mass index and all-1 cause mortality: Individual-participant-data meta-analysis of 239 prospective studies in four continents |
| title_sort | body mass index and all 1 cause mortality individual participant data meta analysis of 239 prospective studies in four continents |
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