Association between BMI and mortality in adults

January 01, 0001

Association between BMI and mortality in adults

A high body-mass index (BMI, the weight in kilograms divided by the square of the height in meters) is associated with increased mortality from cardiovascular disease and certain cancers. These authors from multiple countries assessed the relationship with all-cause mortality using Cox regression in a meta-analysis of observational studies. They adjusted for age, study, physical activity, alcohol consumption, education, and marital status in pooled data from 19 prospective studies encompassing 1.46 million white adults, 19 to 84 years of age (median, 58).

They found: "The median baseline BMI was 26.2. During a median follow- up period of 10 years (range, 5 to 28), 160,087 deaths were identified. Among healthy participants who never smoked, there was a J-shaped relationship between BMI and all-cause mortality. With a BMI of 22.5 to 24.9 as the reference category, hazard ratios among women were 1.47 for a BMI of 15.0 to 18.4; 1.14 for a BMI of 18.5 to 19.9; 1.00 for a BMI of 20.0 to 22.4; 1.13 for a BMI of 25.0 to 29.9; 1.44 for a BMI of 30.0 to 34.9; 1.88 for a BMI of 35.0 to 39.9; and 2.51 for a BMI of 40.0 to 49.9. In general, the hazard ratios for the men were similar. Hazard ratios for a BMI below 20.0 were attenuated with longer-term follow-up."

The authors concluded: "In white adults, overweight and obesity (and possibly underweight) are associated with increased all-cause mortality. All-cause mortality is generally lowest with a BMI of 20.0 to 24.9."

These results are as expected. The range of relatively low risk BMI is more like 18.5 - 29.9.

For the full abstract, click here.

N Engl J Med 363:2211-2219, 2 December 2010
© 2010 to the Massachusetts Medical Society
Body-Mass Index and Mortality among 1.46 Million White Adults. Amy Berrington de Gonzalez, Patricia Hartge, James R. Cerhan, et al. Correspondence to Dr. Berrington:

Category: T. Endocrine/Metabolic/Nutritional. Keywords: body mass index, BMI, mortality, meta-analysis of prospective cohort studies, journal watch.
Synopsis edited by Dr Linda French, Toledo, Ohio. Posted on Global Family Doctor 4 January 2011

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.