Arthur L Klatsky1, Jasmine Zhang2, Natalia Udaltsova3, Yan Li4, H Nicole Tran5. 1. Senior Consultant in Cardiology and an Adjunct Investigator in the Division of Research, Kaiser Permanente Medical Care Program in Oakland, CA. hartmavn@pacbell.net. 2. High School Student in Orinda, CA. jazzy.zhang@gmail.com. 3. Data Consultant at the Division of Research in Oakland, CA. natalia.udaltsova@kp.org. 4. Hematologist and Oncologist at the Oakland Medical Center in CA. yan.li@kp.org. 5. Internist at the Oakland Medical Center in CA. nicole.h.tran@kp.org.
Abstract
CONTEXT: Controversy persists about optimal body weight. Many experts define "normal" (healthy) body mass index (BMI) as 18.5 to 24.9 kg/m2, 25 to 29.9 kg/m2 as overweight, and 30 kg/m2 or greater as obese. Obesity is subdivided into 30 to 34.9 kg/m2 (Grade 1), 35 to 39.9 kg/m2 (Grade 2), and 40 kg/m2 and above (Grade 3). Studies consistently show higher mortality for underweight and Grade 2 or 3 obesity, but results conflict for the overweight category and Grade 1 obesity. OBJECTIVE: To study 30-year risk of death related to baseline BMI. DESIGN: Retrospective cohort study in a multiracial population of 273,843 persons using logistic regression with 7 covariates (sex, age, race-ethnicity, education, marital status, smoking, alcohol intake). MAIN OUTCOME MEASURES: Mortality risk by baseline BMI. RESULTS: With average follow-up exceeding 30 years, there were 103,218 deaths: 41,215 attributed to cardiovascular causes and 62,003 to noncardiovascular causes. Odds ratios (and 95% confidence intervals) for all deaths in BMI categories, with a BMI of 18.5 to 24.9 kg/m2 as the referent, were BMI below 18.5 kg/m2 = 1.1 (1.0-2.0), BMI 25 to 29 kg/m2 = 1.1 (1.1-1.2), BMI 30 to 34 kg/m2 = 1.5 (1.4-1.5), BMI 35 to 39 kg/m2 = 2.1 (1.9-2.3), and BMI 40 kg/m2 or higher = 2.7 (2.4-3.0). Disparities existed regarding age, race/ethnicity, cause of death, and interval to death. CONCLUSION: Compared with persons with BMI defined as normal, persons who were underweight, overweight, and obese were at increased risk of death over 30 years.
CONTEXT: Controversy persists about optimal body weight. Many experts define "normal" (healthy) body mass index (BMI) as 18.5 to 24.9 kg/m2, 25 to 29.9 kg/m2 as overweight, and 30 kg/m2 or greater as obese. Obesity is subdivided into 30 to 34.9 kg/m2 (Grade 1), 35 to 39.9 kg/m2 (Grade 2), and 40 kg/m2 and above (Grade 3). Studies consistently show higher mortality for underweight and Grade 2 or 3 obesity, but results conflict for the overweight category and Grade 1 obesity. OBJECTIVE: To study 30-year risk of death related to baseline BMI. DESIGN: Retrospective cohort study in a multiracial population of 273,843 persons using logistic regression with 7 covariates (sex, age, race-ethnicity, education, marital status, smoking, alcohol intake). MAIN OUTCOME MEASURES: Mortality risk by baseline BMI. RESULTS: With average follow-up exceeding 30 years, there were 103,218 deaths: 41,215 attributed to cardiovascular causes and 62,003 to noncardiovascular causes. Odds ratios (and 95% confidence intervals) for all deaths in BMI categories, with a BMI of 18.5 to 24.9 kg/m2 as the referent, were BMI below 18.5 kg/m2 = 1.1 (1.0-2.0), BMI 25 to 29 kg/m2 = 1.1 (1.1-1.2), BMI 30 to 34 kg/m2 = 1.5 (1.4-1.5), BMI 35 to 39 kg/m2 = 2.1 (1.9-2.3), and BMI 40 kg/m2 or higher = 2.7 (2.4-3.0). Disparities existed regarding age, race/ethnicity, cause of death, and interval to death. CONCLUSION: Compared with persons with BMI defined as normal, persons who were underweight, overweight, and obese were at increased risk of death over 30 years.
Authors: Irma B Ancheta; Joan M Carlson; Cynthia A Battie; Nancy Borja-Hart; Sarah Cobb; Christine V Ancheta Journal: Appl Nurs Res Date: 2014-06-12 Impact factor: 2.257
Authors: Amy Berrington de Gonzalez; Patricia Hartge; James R Cerhan; Alan J Flint; Lindsay Hannan; Robert J MacInnis; Steven C Moore; Geoffrey S Tobias; Hoda Anton-Culver; Laura Beane Freeman; W Lawrence Beeson; Sandra L Clipp; Dallas R English; Aaron R Folsom; D Michal Freedman; Graham Giles; Niclas Hakansson; Katherine D Henderson; Judith Hoffman-Bolton; Jane A Hoppin; Karen L Koenig; I-Min Lee; Martha S Linet; Yikyung Park; Gaia Pocobelli; Arthur Schatzkin; Howard D Sesso; Elisabete Weiderpass; Bradley J Willcox; Alicja Wolk; Anne Zeleniuch-Jacquotte; Walter C Willett; Michael J Thun Journal: N Engl J Med Date: 2010-12-02 Impact factor: 91.245
Authors: Stephen B Kritchevsky; Kristen M Beavers; Michael E Miller; M Kyla Shea; Denise K Houston; Dalane W Kitzman; Barbara J Nicklas Journal: PLoS One Date: 2015-03-20 Impact factor: 3.240
Authors: W D Francois Venter; Simiso Sokhela; Alexandra Calmy; Luckyboy Mkhondwane; Bronwyn Bosch; Nomathemba Chandiwana; Andrew Hill; Kenly Sekwese; Nkuli Mashabane; Anton Pozniak; Saye Khoo; Mohammed Ali; Eric Delaporte; Samanta Lalla-Edwards; Polly Clayden; Vincent C Marconi; Mark J Siedner; Marta Boffito; Celicia Serenata; Mary Carman; Simon Collins Journal: AIDS Date: 2021-12-15 Impact factor: 4.632
Authors: Joe-Ann S Moser; Arturo Galindo-Fraga; Ana A Ortiz-Hernández; Wenjuan Gu; Sally Hunsberger; Juan-Francisco Galán-Herrera; María Lourdes Guerrero; Guillermo M Ruiz-Palacios; John H Beigel Journal: Influenza Other Respir Viruses Date: 2018-12-04 Impact factor: 4.380
Authors: An Tran-Duy; Josh Knight; Andrew J Palmer; Dennis Petrie; Tom W C Lung; William H Herman; Björn Eliasson; Ann-Marie Svensson; Philip M Clarke Journal: Diabetes Care Date: 2020-06-12 Impact factor: 19.112