Peer-Reviewed Journal Details
Mandatory Fields
Global BMI Mortality Collaboration ;Di Angelantonio E;Bhupathiraju ShN;Wormser D;Gao P;Kaptoge S;Berrington de Gonzalez A;Cairns BJ;Huxley R;Jackson ChL;Joshy G;Lewington S;Manson JE;Murphy N;Patel AV;Samet JM;Woodward M;Zheng W;Zhou M;Bansal N;Barricarte A;Carter B;Cerhan JR;Smith GD;Fang X;Franco OH;Green J;Halsey J;Hildebrand JS;Jung KJ;Korda RJ;McLerran DF;Moore SC;O'Keeffe LM;Paige E;Ramond A;Reeves GK;Rolland B;Sacerdote C;Sattar N;Sofianopoulou E;Stevens J;Thun M;Ueshima H;Yang L;Yun YD;Willeit P;Banks E;Beral V;Chen Zh;Gapstur SM;Gunter MJ;Hartge P;Jee SH;Lam TH;Peto R;Potter JD;Willett WC;Thompson SG;Danesh J;Hu FB;
The Lancet
Body-mass index and all-cause mortality: individual-participant-data meta-analysis of 239 prospective studies in four continents.
Optional Fields
Overweight and obesity are increasing worldwide. To help assess their relevance to mortality in different populations we conducted individual-participant data meta-analyses of prospective studies of body-mass index (BMI), limiting confounding and reverse causality by restricting analyses to never-smokers and excluding pre-existing disease and the first 5 years of follow-up. Of 10625411 participants in Asia, Australia and New Zealand, Europe, and North America from 239 prospective studies (median follow-up 137 years, IQR 114-147), 3951455 people in 189 studies were never-smokers without chronic diseases at recruitment who survived 5 years, of whom 385879 died. The primary analyses are of these deaths, and study, age, and sex adjusted hazard ratios (HRs), relative to BMI 225-<250 kg/m(2). All-cause mortality was minimal at 200-250 kg/m(2) (HR 100, 95% CI 098-102 for BMI 200-<225 kg/m(2); 100, 099-101 for BMI 225-<250 kg/m(2)), and increased significantly both just below this range (113, 109-117 for BMI 185-<200 kg/m(2); 151, 143-159 for BMI 150-<185) and throughout the overweight range (107, 107-108 for BMI 250-<275 kg/m(2); 120, 118-122 for BMI 275-<300 kg/m(2)). The HR for obesity grade 1 (BMI 300-<350 kg/m(2)) was 145, 95% CI 141-148; the HR for obesity grade 2 (350-<400 kg/m(2)) was 194, 187-201; and the HR for obesity grade 3 (400-<600 kg/m(2)) was 276, 260-292. For BMI over 250 kg/m(2), mortality increased approximately log-linearly with BMI; the HR per 5 kg/m(2) units higher BMI was 139 (134-143) in Europe, 129 (126-132) in North America, 139 (134-144) in east Asia, and 131 (127-135) in Australia and New Zealand. This HR per 5 kg/m(2) units higher BMI (for BMI over 25 kg/m(2)) was greater in younger than older people (152, 95% CI 147-156, for BMI measured at 35-49 years vs 121, 117-125, for BMI measured at 70-89 years; pheterogeneity<00001), greater in men than women (151, 146-156, vs 130, 126-133; pheterogeneity<00001), but similar in studies with self-reported and measured BMI. The associations of both overweight and obesity with higher all-cause mortality were broadly consistent in four continents. This finding supports strategies to combat the entire spectrum of excess adiposity in many populations. UK Medical Research Council, British Heart Foundation, National Institute for Health Research, US National Institutes of Health.
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