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  • Original Article
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Past body mass index and risk of mortality among women

International Journal of Obesity volume 32, pages 730–739 (2008)Cite this article

Abstract

Background:

Epidemiologic studies of body mass index (BMI) in relation to mortality commonly exclude persons with health conditions and/or a history of smoking to prevent bias resulting from illness-related weight loss (‘reverse causation’). Analysis of BMI from an earlier time period may minimize reverse causation without requiring exclusion of participants based on disease or smoking history.

Methods:

We prospectively examined BMI based on technician measurements of weight and height from 10 years prior to start of follow-up in relation to subsequent mortality in a cohort of 50 186 women who were 40–93 years old at baseline in 1987–1989. Deaths were ascertained through the US National Death Index. Proportional hazards regression was used to estimate hazard ratios (HRs) of mortality, adjusted for age, education, race/ethnicity, income, menopausal hormone use, smoking and physical activity.

Results:

During 10 years of follow-up through 1997, 5201 women died. Overall, we observed a J-shaped association between BMI and mortality, with increased risk for women who were underweight, overweight or obese. The HRs and 95% confidence intervals of mortality for BMI categories of <18.5, 18.5–20.9, 21.0–23.4 (reference), 23.5–24.9, 25.0–27.4, 27.5–29.9, 30.0–34.9 and 35.0+ kg m−2 were 1.43 (1.19, 1.72), 1.07 (0.98, 1.17), 1.00 (reference), 1.10 (1.00, 1.20), 1.20 (1.11, 1.31), 1.23 (1.11, 1.37), 1.60 (1.44, 1.77) and 1.92 (1.64, 2.24). There was little evidence that pre-existing conditions (heart disease, diabetes and/or cancer) or smoking history modified the past BMI and mortality relation (P=0.54 and 0.76).

Conclusions:

In this large cohort of women, BMI based on technician measurements of weight and height from 10 years prior to baseline showed increased risk for mortality across the range of overweight and obesity, regardless of disease and smoking history. Observed associations between overweight, obesity and mortality in healthy individuals may also apply to persons with a history of disease or smoking.

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Acknowledgements

This study was supported by the Intramural Research Program and TU2CA105666 from the National Cancer Institute, National Institutes of Health. We have no conflict of interest relevant to this study. The views expressed are those of the authors. We thank Leslie Carroll and Matthew Butcher at Information Management Services and Tawanda Roy at the Nutritional Epidemiology Branch for research assistance.

Author information

Author notes

  1. S C Moore, B I Graubard, A Schatzkin, D Albanes, C Schairer, R N Hoover & M F Leitzmann

    Present address: 5Current address: Division of Cancer Epidemiology and Genetics, National Cancer Institute, EPS South, 6120 Executive Boulevard, MSC 7232, Bethesda, MD 20892, USA.,

  2. S T Mayne

    Present address: 6Current address: Department of Epidemiology and Public Health, Yale University School of Medicine, 60 College Street, New Haven, CT 06520-8034, USA.,

Authors and Affiliations

  1. Division of Cancer Epidemiology and Genetics, Nutritional Epidemiology Branch, National Cancer Institute, Department of Health and Human Services, Bethesda, MD, USA

    S C Moore, A Schatzkin, D Albanes & M F Leitzmann

  2. Department of Epidemiology and Public Health, Yale University School of Medicine, New Haven, CT, USA

    S C Moore & S T Mayne

  3. Division of Cancer Epidemiology and Genetics, Biostatistics Branch, National Cancer Institute, Department of Health and Human Services, Bethesda, MD, USA

    B I Graubard & C Schairer

  4. Division of Cancer Epidemiology and Genetics, Epidemiology and Biostatistics Program, National Cancer Institute, Department of Health and Human Services, Bethesda, MD, USA

    R N Hoover

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Correspondence to S C Moore.

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Moore, S., Mayne, S., Graubard, B. et al. Past body mass index and risk of mortality among women. Int J Obes 32, 730–739 (2008). https://doi.org/10.1038/sj.ijo.0803801

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