Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Original Article
  • Published:

Increase in body mass index category since age 20 years and all-cause mortality: a prospective cohort study (the Ohsaki Study)

International Journal of Obesity volume 33, pages 490–496 (2009)Cite this article

Abstract

Background:

It is still unclear whether weight gain from early to late adulthood affects longevity. Furthermore, no study has addressed its association with all-cause and cause-specific mortality in an Asian population.

Methods:

We prospectively assessed the association between an increase in body mass index (BMI) category since age 20 years and risk of all-cause, cardiovascular disease (CVD) and cancer mortality. Self-reported information pertaining to BMI was collected from 38 080 Japanese men and women aged 40–79 years at study entry in 1994 after exclusion of participants with a BMI of <18.5 kg/m2 at age 20 years or at study entry. We defined six patterns of increase in BMI category at age 20 years and study entry: stable normal, overweight and obese, normal to overweight or obese, and overweight to obese.

Results:

During 7 years of follow-up, 2617 participants died. After adjustment for potential confounders, we observed a significantly increased risk of all-cause mortality for the pattern of normal weight at age 20 years and obese at study entry and of stable obese compared with stable normal in BMI category, the multivariate HRs (95% confidence interval (CI)) being 1.42 (1.08–1.88) and 2.26 (1.45–3.51), respectively. For the pattern of overweight at age 20 years and obese at study entry, the multivariate hazard ratio (95% CI) was 1.35 (0.92–1.98). In contrast, we did not observe an increased risk of all-cause mortality for normal weight at age 20 years and overweight at study entry, and stable overweight. For CVD and cancer mortality, these results were consistently observed.

Conclusion:

We observed an increased risk of all-cause mortality both among participants who had been persistently obese since early adulthood and participants who showed an increase in BMI category from normal to obese, compared with participants with a stable normal BMI category.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Similar content being viewed by others

References

  1. Gunnell DJ, Frankel SJ, Nanchahal K, Peters TJ, Davey Smith G . Childhood obesity and adult cardiovascular mortality: a 57-y follow-up study based on the Boyd Orr cohort. Am J Clin Nutr 1998; 67: 1111–1118.

    Article  CAS  Google Scholar 

  2. Whittemore AS, Paffenbarger Jr RS, Anderson K, Lee JE . Early precursors of site-specific cancers in college men and women. J Natl Cancer Inst 1985; 74: 43–51.

    CAS  PubMed  Google Scholar 

  3. Must A, Strauss RS . Risks and consequences of childhood and adolescent obesity. Int J Obes Relat Metab Disord 1999; 23: S2–S11.

    Article  Google Scholar 

  4. World Health Organization. Obesity: Preventing and Managing the Global Epidemic: Report of a WHO Consultation WHO Technical Report Series 894 World Health Organization: Geneva, 2000.

  5. World Cancer Research Fund/American Institute for Cancer Research. Food, Nutrition, Physical Activity, and the Prevention of Cancer: a Global Perspective. AICR: Washington DC, 2007.

  6. Corrada MM, Kawas CH, Mozaffar F, Paganini-Hill A . Association of body mass index and weight change with all-cause mortality in the elderly. Am J Epidemiol 2006; 163: 938–949.

    Article  Google Scholar 

  7. Hu FB, Willett WC, Li T, Stampfer MJ, Colditz GA, Manson JE . Adiposity as compared with physical activity in predicting mortality among women. N Engl J Med 2004; 351: 2694–2703.

    Article  CAS  Google Scholar 

  8. Jeffreys M, McCarron P, Gunnell D, McEwen J, Smith GD . Body mass index in early and mid-adulthood, and subsequent mortality: a historical cohort study. Int J Obes Relat Metab Disord 2003; 27: 1391–1397.

    Article  CAS  Google Scholar 

  9. Yarnell JW, Patterson CC, Thomas HF, Sweetnam PM . Comparison of weight in middle age, weight at 18 years, and weight change between, in predicting subsequent 14 year mortality and coronary events: Caerphilly Prospective Study. J Epidemiol Community Health 2000; 54: 344–348.

    Article  CAS  Google Scholar 

  10. Rosengren A, Wedel H, Wilhelmsen L . Body weight and weight gain during adult life in men in relation to coronary heart disease and mortality. A prospective population study. Eur Heart J 1999; 20: 269–277.

    Article  CAS  Google Scholar 

  11. Wilcosky T, Hyde J, Anderson JJ, Bangdiwala S, Duncan B . Obesity and mortality in the Lipid Research Clinics Program Follow-up Study. J Clin Epidemiol 1990; 43: 743–752.

    Article  CAS  Google Scholar 

  12. Tsuji I, Nishino Y, Ohkubo T, Kuwahara A, Ogawa K, Watanabe Y et al. A prospective cohort study on National Health Insurance beneficiaries in Ohsaki, Miyagi Prefecture, Japan: study design, profiles of the subjects and medical cost during the first year. J Epidemiol 1998; 8: 258–263.

    Article  CAS  Google Scholar 

  13. Tsuji I, Kuwahara A, Nishino Y, Ohkubo T, Sasaki A, Hisamichi S . Medical cost for disability: a longitudinal observation of national health insurance beneficiaries in Japan. J Am Geriatr Soc 1999; 47: 470–476.

    Article  CAS  Google Scholar 

  14. Kuriyama S, Shimazu T, Ohmori K, Kikuchi N, Nakaya N, Nishino Y et al. Green tea consumption and mortality due to cardiovascular disease, cancer, and all causes in Japan: the Ohsaki study. JAMA 2006; 296: 1255–1265.

    Article  CAS  Google Scholar 

  15. Ogawa K, Tsubono Y, Nishino Y, Watanabe Y, Ohkubo T, Watanabe T et al. Validation of a food-frequency questionnaire for cohort studies in rural Japan. Public Health Nutr 2003; 6: 147–157.

    Article  Google Scholar 

  16. World Health Organization. Physical status: the use interpretation of anthropometry Report of a WHO Expert Committee. WHO Tech Rep Ser 1995; 5: 153–157.

    Google Scholar 

  17. Kuriyama S, Tsuji I, Ohkubo T, Anzai Y, Takahashi K, Watanabe Y et al. Medical care expenditure associated with body mass index in Japan: the Ohsaki Study. Int J Obes Relat Metab Disord 2002; 26: 1069–1074.

    Article  CAS  Google Scholar 

  18. World Health Organization. International Statistical Classification of Diseases and Related Health Problems. 10th Revision. World Health Organization: Geneva, 1992.

  19. SAS Institute. SAS/STAT 9.1 User's Guide. SAS Institute: Cary, NC, 2004.

  20. Tsubono Y, Tsuji I, Fujita K, Nakaya N, Hozawa A, Ohkubo T et al. Validation of walking questionnaire for population-based prospective studies in Japan: comparison with pedometer. J Epidemiol 2002; 12: 305–309.

    Article  Google Scholar 

  21. Tamakoshi K, Yatsuya H, Kondo T, Hirano T, Hori Y, Yoshida T et al. The accuracy of long-term recall of past body weight in Japanese adult men. Int J Obes Relat Metab Disord 2003; 27: 247–252.

    Article  CAS  Google Scholar 

Download references

Acknowledgements

This study was supported by a Health Sciences Research Grant for Health Services (H18-Choju-Ippan-014, H16-Seisaku-Ippan-023, H18-Junkankitou (Seisyu)-Ippan-012) from the Ministry of Health, Labour and Welfare, Japan. We are grateful to all the participants of this study. None of the authors had any conflict of interest.

Author information

Authors and Affiliations

  1. Division of Epidemiology, Department of Public Health and Forensic Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan

    T Shimazu, S Kuriyama, K Ohmori-Matsuda, N Kikuchi, N Nakaya & I Tsuji

  2. Epidemiology and Prevention Division, Research Center for Cancer Prevention and Screening, National Cancer Center, Tokyo, Japan

    T Shimazu

Authors
  1. T Shimazu
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. S Kuriyama
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. K Ohmori-Matsuda
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. N Kikuchi
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. N Nakaya
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. I Tsuji
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to T Shimazu.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Shimazu, T., Kuriyama, S., Ohmori-Matsuda, K. et al. Increase in body mass index category since age 20 years and all-cause mortality: a prospective cohort study (the Ohsaki Study). Int J Obes 33, 490–496 (2009). https://doi.org/10.1038/ijo.2009.29

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/ijo.2009.29

Keywords

This article is cited by

Search

Advanced search

Quick links