Objective: Assess the association of BMI and BMI change with mortality. Methods: Using data from the Wisconsin Longitudinal Study (WLS) on participants born mainly in 1939 (n=4922), we investigated the associations between various measures of BMI across the life course (age 54 BMI; age 65 BMI; age 72 BMI; lifetime maximum BMI; BMI change between ages 54 and 65; BMI change between ages 65 and 72) and mortality. We also assessed whether these associations are mediated by late life health. Results: BMI at age 54 was more strongly associated with late life mortality than BMI at older ages. The association between BMI change and mortality varied based on the timing of weight change. Health at age 72, particularly self-rated health, diabetes, and physical functioning, mediated the observed associations. Conclusion: Knowing older people’s weight at midlife and how their weight has changed may be more important in assessing late life mortality risk than their current weight.
AbdullahA.PeetersA.de CourtenM.StoelwinderJ. (2010). The magnitude of association between overweight and obesity and the risk of diabetes: A meta-analysis of prospective cohort studies. Diabetes Research and Clinical Practice, 89(3), 309–319. https://doi.org/10.1016/j.diabres.2010.04.012
2.
AbdullahA.WolfeR.StoelwinderJ. U.de CourtenM.StevensonC.WallsH. L.PeetersA. (2011). The number of years lived with obesity and the risk of all-cause and cause-specific mortality. International Journal of Epidemiology, 40(4), 985–996. https://doi.org/10.1093/ije/dyr018
3.
AdamsK. F.SchatzkinA.HarrisT. B.KipnisV.MouwT.Ballard-BarbashR.HollenbeckA.LeitzmannM. F. (2006). Overweight, obesity, and mortality in a large prospective cohort of persons 50 to 71 years old. New England Journal of Medicine, 355(8), 763–778. https://doi.org/10.1056/NEJMoa055643
4.
AzurM. J.StuartE. A.FrangakisC.LeafP. J. (2011). Multiple imputation by chained equations: what is it and how does it work?International Journal of Methods in Psychiatric Research, 20(1), 40–49. https://doi.org/10.1002/mpr.329
5.
BanackH. R.BeaJ. W.KaufmanJ. S.StokesA.KroenkeC. H.StefanickM. L.BeresfordS. A.BirdC. E.GarciaL.WallaceR.WildR. A.CaanB.Wactawski-WendeJ. (2019). The effects of reverse causality and selective attrition on the relationship between body mass index and mortality in postmenopausal women. American Journal of Epidemiology, 188(10), 1838–1848. https://doi.org/10.1093/aje/kwz160
6.
Berrington de GonzalezA.HartgeP.CerhanJ. R.FlintA. J.HannanL.MacInnisR. J.MooreS. C.TobiasG. S.Anton-CulverH.FreemanL. B.BeesonW. L.ClippS. L.EnglishD. R.FolsomA. R.FreedmanD. M.GilesG.HakanssonN.HendersonK. D.Hoffman-BoltonJ.ThunM. J. (2010). Body-Mass Index and mortality among 1.46 Million white adults. New England Journal of Medicine, 363(23), 2211–2219. https://doi.org/10.1056/NEJMoa1000367
7.
BhaskaranK.Dos-Santos-SilvaI.LeonD. A.DouglasI. J.SmeethL. (2018). Association of BMI with overall and cause-specific mortality: A population-based cohort study of 3.6 million adults in the UK. The Lancet Diabetes and Endocrinology, 6(12), 944–953. https://doi.org/10.1016/S2213-8587(18)30288-2
8.
CarslakeD.SmithG. D.GunnellD.DaviesN.NilsenT. I. L.RomundstadP. (2018). Confounding by ill health in the observed association between BMI and mortality: Evidence from the HUNT Study using offspring BMI as an instrument. International Journal of Epidemiology, 47(3), 760–770. https://doi.org/10.1093/ije/dyx246
9.
ConnerS. C.LodiS.LunettaK. L.CasasJ. P.LubitzS. A.EllinorP. T.AndersonC. D.HuangQ.ColemanJ.WhiteW. B.BenjaminE. J.TrinquartL. (2019). Refining the association between body mass index and atrial fibrillation: G-formula and restricted mean survival times. Journal of the American Heart Association, 8(16), 1–11. https://doi.org/10.1161/JAHA.119.013011
10.
DixonJ. B.EggerG. J.FinkelsteinE. A.KralJ. G.LambertG. W. (2015). “Obesity paradox” misunderstands the biology of optimal weight throughout the life cycle. International Journal of Obesity, 39(1), 82–84. https://doi.org/10.1038/ijo.2014.59
11.
FlegalK.CarrollM.KuczmarskiR.JohnsonC. (1998). Overweight and obesity in the United States: Prevalence and trends, 1960-1994. International Journal of Obesity, 22(1), 39–47.
12.
FlegalK. M.GraubardB. I.WilliamsonD. F.CooperR. S. (2011). Reverse causation and illness-related weight loss in observational studies of body weight and mortality. American Journal of Epidemiology, 173(1), 1–9. https://doi.org/10.1093/aje/kwq341
13.
FlegalK. MGraubardB. I.WilliamsonD. F.GailM. H. (2005). Excess deaths assocaited with underweight, overweight, and obesity. JAMA, 293(15), 1861–1867. https://doi.org/10.1001/jama.293.15.1861
14.
FlickerL.McCaulK. A.HankeyG. J.JamrozikK.BrownW. J.BylesJ. E.AlmeidaO. P. (2010). Body mass index and survival in men and women aged 70 to 75. Journal of the American Geriatrics Society, 58(2), 234–241. https://doi.org/10.1111/j.1532-5415.2009.02677.x
15.
Ghaem MaralaniH.TaiB. C.WongT. Y.TaiE. S.LiJ.WangJ. J.MitchellP. (2014). The prognostic role of body mass index on mortality amongst the middle-aged and elderly: A competing risk analysis. Diabetes Research and Clinical Practice, 103(1), 42–50. https://doi.org/10.1016/j.diabres.2013.11.025
16.
GlymourM. M.WeuveJ.BerkmanL. F.KawachiI.RobinsJ. M. (2005). When is baseline adjustment useful in analyses of change? An example with education and cognitive change. American Journal of Epidemiology, 162(3), 267–278. https://doi.org/10.1093/aje/kwi187
17.
HalesC.CarrollM.FryarC.OgdenC. (2020). Prevalence of obesity and severe obesity among Adults: United States, 2017-2018. NCHS Data Brief, 360(360), 1–8. http://www.ncbi.nlm.nih.gov/pubmed/26633046
18.
HauserR. M.RoanC. L. (2006). The class of 1957 in their mid-60s: A first look. In Center for Demography and Ecology (No. 2006–03).
19.
HerdP.CarrD.RoanC. (2014). Cohort Profile: Wisconsin longitudinal study (WLS). International Journal of Epidemiology, 43(1), 34–41. https://doi.org/10.1093/ije/dys194
20.
HernánM. A.TaubmanS. L. (2008). Does obesity shorten life? The importance of well-defined interventions to answer causal questions. International Journal of Obesity, 32(1), S8–S14. https://doi.org/10.1038/ijo.2008.82
21.
HolmeI.TonstadS. (2015). Survival in elderly men in relation to midlife and current BMI. Age and Ageing, 44(3), 434–439. https://doi.org/10.1093/ageing/afu202
22.
HuF. B. (2008). Obesity epidemiology. Oxford University Press.
23.
IdlerE. L.BenyaminiY. (1997). Self-rated health and mortality: A review of twenty-seven community studies, 38(1), 21–37. Published by : American Sociologic.
JavedA. A.AljiedR.AllisonD. J.AndersonL. N.MaJ.RainaP. (2020). Body mass index and all-cause mortality in older adults: A scoping review of observational studies. Obesity Reviews, March. https://doi.org/10.1111/obr.13035
26.
JylhäM. (2009). What is self-rated health and why does it predict mortality? Towards a unified conceptual model. Social Science & Medicine, 69(3), 307–316. https://doi.org/10.1016/j.socscimed.2009.05.013
27.
KarampelaI.ChrysanthopoulouE.ChristodoulatosG. S.DalamagaM. (2020). Is There an obesity paradox in critical illness? Epidemiologic and metabolic considerations. Current Obesity Reports. https://doi.org/10.1007/s13679-020-00394-x
28.
KarlsonK. B.HolmA.BreenR. (2012). Comparing regression coefficients between same-sample nested models using logit and probit: A new method. Sociological Methodology, 42(1), 286–313. https://doi.org/10.1177/0081175012444861
29.
KushnerR. F.BatsisJ. A.ButschW. S.DavisN.GoldenA.HalperinF.KidambiS.MachineniS.NovickM.PortA.RubinoD. M.SaundersK. H.Shapiro ManningL.SoleymaniT.KahanS. (2020). Weight history in clinical practice: The state of the science and future directions. Obesity, 28(1), 9–17. https://doi.org/10.1002/oby.22642
30.
LeeJ. M.PilliS.GebremariamA.KeirnsC. C.DavisM. M.VijanS.FreedG. L.HermanW. H.GurneyJ. G. (2010). Getting heavier, younger: Trajectories of obesity over the life course. International Journal of Obesity, 34(4), 614–623. https://doi.org/10.1038/ijo.2009.235
31.
MehtaN. K.AbramsL. R.MyrskyläM. (2020). US life expectancy stalls due to cardiovascular disease, not drug deaths. Proceedings of the National Academy of Sciences of the United States of America, 117(13), 6998–7000. https://doi.org/10.1073/pnas.1920391117
32.
MurayamaH.LiangJ.BennettJ. M.ShawB. A.BotoseneanuA.KobayashiE.FukayaT.ShinkaiS. (2015). Trajectories of body mass index and their associations with mortality among older Japanese: Do they differ from those of Western populations?American Journal of Epidemiology, 182(7), 597–605. https://doi.org/10.1093/aje/kwv107
33.
NilssonP. M.NilssonJ. Å.HedbladB.BerglundG.LindgärdeF. (2002). The enigma of increased non-cancer mortality after weight loss in healthy men who are overweight or obese. Journal of Internal Medicine, 252(1), 70–78. https://doi.org/10.1046/j.1365-2796.2002.01010.x
34.
PrestonS. H.MehtaN. K.StokesA. (2013). Modeling obesity histories in cohort analyses of health and mortality. Epidemiology, 24(1), 158–166. https://doi.org/10.1097/EDE.0b013e3182770217
35.
PrestonS. H.StokesA. (2014). Obesity paradox: Conditioning on disease enhances biases in estimating the mortality risks of obesity. Epidemiology, 25(3), 454–461. https://doi.org/10.1097/EDE.0000000000000075
36.
ProsperM.-H. (2009). Obesity as a predictor of self-rated health. American Journal of Health Behavior, 33(3), 319–329. https://doi.org/10.5993/AJHB.33.3.10
37.
ReitherE. N.HauserR. M.YangY. (2009). Do birth cohorts matter? Age-period-cohort analyses of the obesity epidemic in the United States. Social Science & Medicine, 69(10), 1439–1448. https://doi.org/10.1016/j.socscimed.2009.08.040
38.
ReitherE. N.MastersR. K.YangY. C.PowersD. A.ZhengH.LandK. C. (2015). Should age-period-cohort studies return to the methodologies of the 1970s?Social Science & Medicine, 128(1), 356–365. https://doi.org/10.1016/j.socscimed.2015.01.011
39.
SchaapL. A.QuirkeT.WijnhovenH. A. H.VisserM. (2018). Changes in body mass index and mid-upper arm circumference in relation to all-cause mortality in older adults. Clinical Nutrition, 37(6), 2252–2259. https://doi.org/10.1016/j.clnu.2017.11.004
40.
SiegelP. M. (1971). Prestige in the American occupational structure. University of Chicago.
41.
StataCorp. (2019). Stata statistical software: Release 16. StataCorp LLC.
42.
StokesA. (2014). Using maximum weight to redefine body mass index categories in studies of the mortality risks of obesity. Population Health Metrics, 12(1), 6. https://doi.org/10.1186/1478-7954-12-6
43.
StokesA.NiY. (2016). Validating a summary measure of weight history for modeling the health consequences of obesity. Annals of Epidemiology, 26(12), 821–826.e2. https://doi.org/10.1016/j.annepidem.2016.10.005
44.
StokesA.PrestonS. H. (2017). Deaths attributable to diabetes in the United States: Comparison of data sources and estimation approaches. Plos One, 12(1), 1–12. https://doi.org/10.1371/journal.pone.0170219
45.
StokesA. C.XieW.LundbergD. J.HempsteadK.ZajacovaA.ZimmerZ.GleiD. A.MearaE.PrestonS. H. (2020). Increases in BMI and chronic pain for US adults in midlife, 1992 to 2016. SSM - Population Health, 12(1), 100644. https://doi.org/10.1016/j.ssmph.2020.100644
46.
Von BonsdorffM. B.TörmäkangasT.RantanenT.SalonenM. K.OsmondC.KajantieE.ErikssonJ. G. (2015). Early life body mass trajectories and mortality in older age: Findings from the Helsinki Birth Cohort Study. Annals of Medicine, 47(1), 34–39. https://doi.org/10.3109/07853890.2014.963664
47.
WadeK. H.CarslakeD.TyneliusP.SmithG. D.MartinR. M. (2019). Variation of all-cause and cause-specific mortality with body mass index in one million Swedish parent-son pairs: An instrumental variable analysis. Plos Medicine, 16(8), 1–15. https://doi.org/10.1371/journal.pmed.1002868
XieW.LundbergD. J.CollinsJ. M.JohnstonS. S.WaggonerJ. R.HsiaoC. W.PrestonS. H.MansonJ. E.StokesA. C. (2020). Association of weight loss between early adulthood and midlife with all-cause mortality risk in the US. JAMA Network Open, 3(8), 1–11. https://doi.org/10.1001/jamanetworkopen.2020.13448
50.
XuH.CupplesL. A.StokesA.LiuC.-T. (2018). Association of obesity with mortality over 24 years of weight history. JAMA Network Open, 1(7), Article e184587. https://doi.org/10.1001/jamanetworkopen.2018.4587
51.
YuE.LeyS. H.MansonJ. A. E.WillettW.SatijaA.HuF. B.StokesA. (2017). Weight history and all-cause and cause-specific mortality in three prospective cohort studies. Annals of Internal Medicine, 166(9), 613–620. https://doi.org/10.7326/M16-1390
52.
ZhengH.TuminD.QianZ. (2013). Obesity and mortality risk: New findings from body mass index trajectories. American Journal of Epidemiology, 178(11), 1591–1599. https://doi.org/10.1093/aje/kwt179
Supplementary Material
Please find the following supplemental material available below.
For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.
For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.
