BACKGROUND: Body mass index (BMI) (kg/m(2)) has a U- or J-shaped relationship with all-cause mortality in Western and East Asian populations. However, this relationship is not well characterized in Bangladesh, where the BMI distribution is shifted towards lower values. METHODS: Using data on 11,445 individuals (aged 18-75 years) participating in the Health Effects of Arsenic Longitudinal Study (HEALS) in Araihazar, Bangladesh, we prospectively examined associations of BMI (measured at baseline) with all-cause mortality during approximately 6 years of follow-up. We also examined this relationship within strata of key covariates (sex, age, smoking, education and arsenic exposure). Cox proportional hazards models adjusted for these covariates and BMI-related illnesses were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for BMI categories defined by the World Health Organization. RESULTS: Low BMI was strongly associated with increased mortality in this cohort (P-trend < 0.0001). Severe underweight (BMI < 16 kg/m(2); HR 2.06, CI 1.53-2.77) and moderate underweight (16.0-16.9 kg/m(2); HR 1.39, CI 1.01-2.90) were associated with increased all-cause mortality compared with normal BMI (18.6-22.9 kg/m(2)). The highest BMI category (> or =23.0 kg/m(2)) did not show a clear association with mortality (HR 1.10, CI 0.77-1.53). The BMI-mortality association was stronger among individuals with <5 years of formal education (interaction P = 0.02). CONCLUSIONS: Underweight (presumably due to malnutrition) is a major determinant of mortality in the rural Bangladeshi population.
BACKGROUND: Body mass index (BMI) (kg/m(2)) has a U- or J-shaped relationship with all-cause mortality in Western and East Asian populations. However, this relationship is not well characterized in Bangladesh, where the BMI distribution is shifted towards lower values. METHODS: Using data on 11,445 individuals (aged 18-75 years) participating in the Health Effects of Arsenic Longitudinal Study (HEALS) in Araihazar, Bangladesh, we prospectively examined associations of BMI (measured at baseline) with all-cause mortality during approximately 6 years of follow-up. We also examined this relationship within strata of key covariates (sex, age, smoking, education and arsenic exposure). Cox proportional hazards models adjusted for these covariates and BMI-related illnesses were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for BMI categories defined by the World Health Organization. RESULTS: Low BMI was strongly associated with increased mortality in this cohort (P-trend < 0.0001). Severe underweight (BMI < 16 kg/m(2); HR 2.06, CI 1.53-2.77) and moderate underweight (16.0-16.9 kg/m(2); HR 1.39, CI 1.01-2.90) were associated with increased all-cause mortality compared with normal BMI (18.6-22.9 kg/m(2)). The highest BMI category (> or =23.0 kg/m(2)) did not show a clear association with mortality (HR 1.10, CI 0.77-1.53). The BMI-mortality association was stronger among individuals with <5 years of formal education (interaction P = 0.02). CONCLUSIONS: Underweight (presumably due to malnutrition) is a major determinant of mortality in the rural Bangladeshi population.
Authors: Elan D Louis; Danella Hafeman; Faruque Parvez; Xinhua Liu; Roy N Alcalay; Tariqul Islam; Alauddin Ahmed; Abu Bakar Siddique; Tazul Islam Patwary; Stephanie Melkonian; Maria Argos; Diane Levy; Habibul Ahsan Journal: Mov Disord Date: 2011-03-25 Impact factor: 10.338
Authors: Elan D Louis; Danella Hafeman; Faruque Parvez; Roy N Alcalay; Tariqul Islam; Abu Baker Siddique; Tajul Islam Patwary; Stephanie Melkonian; Maria Argos; Diane Levy; Habibul Ahsan Journal: Neuroepidemiology Date: 2011-01-19 Impact factor: 3.282
Authors: Yikyung Park; Sophia Wang; Cari M Kitahara; Steven C Moore; Amy Berrington de Gonzalez; Leslie Bernstein; Ellen T Chang; Alan J Flint; D Michal Freedman; J Michael Gaziano; Robert N Hoover; Martha S Linet; Mark Purdue; Kim Robien; Catherine Schairer; Howard D Sesso; Emily White; Bradley J Willcox; Michael J Thun; Patricia Hartge; Walter C Willett Journal: Am J Public Health Date: 2014-01-16 Impact factor: 9.308