Top

Published in:

01-09-2008 | Mortality

The burden of mortality of obesity at middle and old age is small. A life table analysis of the US Health and Retirement Survey

Authors: Mieke Reuser, Luc Bonneux, Frans Willekens

Published in: European Journal of Epidemiology | Issue 9/2008

Abstract

The evidence of effect of overweight and obesity on mortality at middle and old age is conflicting. The increased relative risk of cardiovascular disease and diabetes for overweight and obese individuals compared to normal weight is well documented, but the absolute risk of cardiovascular death has decreased spectacularly since the 1980s. We estimate the burden of mortality of obesity among middle and old aged adults in the Health and Retirement Survey (HRS), a US prospective longitudinal study. We calculate univariate and multivariate age-specific probabilities and proportional hazard ratios of death in relation to self-reported body mass index (BMI), smoking and education. The life table translates age specific adjusted event rates in survival times, dependent on risk factor distributions (smoking, levels of education and self reported BMI). 95% confidence intervals are calculated by bootstrapping. The highest life expectancy at age 55 was found in overweight (BMI 25–29.9), highly educated non smokers: 30.7 (29.5–31.9) years (men) and 33.2 (32.1–34.3) (women), slightly higher than a BMI 23–24.9 in both sexes. Smoking decreased the population life expectancy with 3.5 (2.7–4.4) years (men) and 1.8 (1.0–2.5) years (women). Less than optimal education cost men and women respectively 2.8 (2.1–3.6) and 2.6 (1.6–3.6) years. Obesity and low normal weight decreased population life expectancy respectively by 0.8 (0.2–1.3) and 0.8 (0.0–1.5) years for men and women in a contemporary, US population. The burden of mortality of obesity is limited, compared to smoking and low education.

Mokdad AH, Marks JS, Stroup DF, et al. Actual causes of death in the United States, 2000. JAMA. 2004;291:1238–45. doi:10.1001/jama.291.10.1238.PubMedCrossRef

McTigue K, Harris R, Hemphill MB, et al. Screening and interventions for overweight and obesity in adults. Systematic review for the US preventive services task force. US Department of Health and Human Services. Rockville: Agency for Healthcare Research and Quality; 2003.

Littlejohns P. New NICE guideline calls for urgent action to stem the rising tide of obesity in England and Wales. Press release. National Institute for Health and Clinical Excellence; 2006.

Flegal KM, Graubard BI, Williamson DF, et al. Excess deaths associated with underweight, overweight, and obesity. JAMA. 2005;293:1861–7. doi:10.1001/jama.293.15.1861.PubMedCrossRef

Peeters A, Barendregt JJ, Willekens F, et al. Obesity in adulthood and its consequences for life expectancy: a life-table analysis. Ann Intern Med. 2003;138:24–32.PubMed

Sempos C, Cooper R, Kovar MG, et al. Divergence of the recent trends in coronary mortality for the four major race-sex groups in the United States. Am J Public Health. 1988;78:1422–7.PubMedCrossRef

Kimm SY, Ornstein SM, DeLong ER, et al. Secular trends in ischemic heart disease mortality: regional variation. Circulation. 1983;68:3–8.PubMed

Gregg EW, Cheng YJ, Cadwell BL, et al. Secular trends in cardiovascular disease risk factors according to body mass index in US adults. JAMA. 2005;293:1868–74. doi:10.1001/jama.293.15.1868.PubMedCrossRef

McGee DL. Body mass index and mortality: a meta-analysis based on person-level data from twenty-six observational studies. Ann Epidemiol. 2005;15:87–97. doi:10.1016/j.annepidem.2004.05.012.PubMedCrossRef

10.

Andreyeva T, Michaud PC, van Soest A. Obesity and health in Europeans aged 50 years and older. Public Health. 2007;121:497–509. doi:10.1016/j.puhe.2006.11.016.PubMedCrossRef

11.

Willis J, Health and Retirement Study. Institutional Review Board Information. UM Health Sciences IRB Protocol H03-00002774-M8. Sponsor NIA. 2005;U01:AG09740.

12.

Klein JP, Moeschberger ML. Survival analysis: techniques for censored and truncated data. Statistics for biology and health. Springer; 2005.

13.

Kleinbaum DG, Klein M. Evaluating the proportional hazards assumption (chapter 4). In: Survival analysis. A self-learning text. Statistics for biology and health. Springer Science and Business Media: New York; 2005.

14.

Chiang CL. The life table and its applications. Malabar: Robert E Krieger Publishing Company; 1984. p. 163.

15.

Diekmann A. Der Einfluss schulischer Bildung und die Auswirkungen der Bildungsexpansion auf das Heiratsverhalten. Z Soziol. 1990;19:265–77.

16.

Al Snih S, Ottenbacher KJ, Markides KS, et al. The effect of obesity on disability vs mortality in older Americans. Arch Intern Med. 2007;167:774–80. doi:10.1001/archinte.167.8.774.PubMedCrossRef

17.

Gu D, He J, Duan X, et al. Body weight and mortality among men and women in China. JAMA. 2006;295:776–83. doi:10.1001/jama.295.7.776.PubMedCrossRef

18.

Visscher TL, Viet AL, Kroesbergen IH, et al. Underreporting of BMI in adults and its effect on obesity prevalence estimations in the period 1998 to 2001. Obesity (Silver Spring). 2006;14:2054–63. doi:10.1038/oby.2006.240.CrossRef

19.

Nawaz H, Chan W, Abdulrahman M, et al. Self-reported weight and height. Implications for obesity research. Am J Prev Med. 2001;20:294–8. doi:10.1016/S0749-3797(01)00293-8.PubMedCrossRef

20.

Metha NK, Chang VW. Mortality attributable to obesity among middle and older aged adults in the US: Results from the Health & Retirement Study. Population Association of America (PAA), Conference Proceedings: New Orleans; 2008.

21.

Visscher TL, Seidell JC, Molarius A, et al. A comparison of body mass index, waist-hip ratio and waist circumference as predictors of all-cause mortality among the elderly: the Rotterdam study. Int J Obes Relat Metab Disord. 2001;25:1730–5. doi:10.1038/sj.ijo.0801787.PubMedCrossRef

22.

Bray GA, Bouchard C, James WP. Handbook of obesity. Marcel Dekker Inc.: New York; 1997.

23.

Wannamethee SG, Shaper AG, Lennon L, et al. Decreased muscle mass and increased central adiposity are independently related to mortality in older men. Am J Clin Nutr. 2007;86:1339–46.PubMed

24.

Calle EE, Thun MJ, Petrelli JM, et al. Body-mass index and mortality in a prospective cohort of U.S. adults. N Engl J Med. 1999;341:1097–105. doi:10.1056/NEJM199910073411501.PubMedCrossRef

25.

Adams KF, Schatzkin A, Harris TB, et al. Overweight, obesity, and mortality in a large prospective cohort of persons 50 to 71 years old. N Engl J Med. 2006;355:763–78. doi:10.1056/NEJMoa055643.PubMedCrossRef

26.

Wilson PW, D’Agostino RB, Sullivan L, et al. Overweight and obesity as determinants of cardiovascular risk: the Framingham experience. Arch Intern Med. 2002;162:1867–72. doi:10.1001/archinte.162.16.1867.PubMedCrossRef

27.

Kuriyama S, Ohmori K, Miura C, et al. Body mass index and mortality in Japan: the Miyagi Cohort Study. J Epidemiol. 2004;14(Suppl 1):S33–8. doi:10.2188/jea.14.S33

28.

Manson JE, Willett WC, Stampfer MJ, et al. Body weight and mortality among women. N Engl J Med. 1995;333:677–85. doi:10.1056/NEJM199509143331101.PubMedCrossRef

29.

Jeffery RW, Sherwood NE. Is the obesity epidemic exaggerated? No. BMJ. 2008;336:245. doi:10.1136/bmj.39458.495127.AD.PubMedCrossRef

30.

Basham P, Luik J. Is the obesity epidemic exaggerated? Yes. BMJ. 2008;336:244. doi:10.1136/bmj.39458.480764.AD.PubMedCrossRef

31.

Barendregt JJ, Bonneux L, van der Maas PJ. The health care costs of smoking. N Engl J Med. 1997;337:1052–7. doi:10.1056/NEJM199710093371506.PubMedCrossRef

32.

Mamun AA, Peeters A, Barendregt J, et al. Smoking decreases the duration of life lived with and without cardiovascular disease: a life course analysis of the Framingham Heart Study. Eur Heart J. 2004;25:409–15. doi:10.1016/j.ehj.2003.12.015.PubMedCrossRef

33.

Andreyeva T, Sturm R, Ringel JS. Moderate and severe obesity have large differences in health care costs. Obes Res. 2004;12:1936–43.PubMedCrossRef

34.

Reynolds SL, Saito Y, Crimmins EM. The impact of obesity on active life expectancy in older American men and women. Gerontologist. 2005;45:438–44.PubMed

35.

Olshansky SJ, Passaro DJ, Hershow RC, et al. A potential decline in life expectancy in the United States in the 21st century. N Engl J Med. 2005;352:1138–45. doi:10.1056/NEJMsr043743.PubMedCrossRef

Title: The burden of mortality of obesity at middle and old age is small. A life table analysis of the US Health and Retirement Survey
Authors: Mieke Reuser
Luc Bonneux
Frans Willekens
Publication date: 01-09-2008
Publisher: Springer Netherlands
Published in: European Journal of Epidemiology / Issue 9/2008
Print ISSN: 0393-2990
Electronic ISSN: 1573-7284
DOI: https://doi.org/10.1007/s10654-008-9269-8

Keynote webinar | Spotlight on medication adherence

Springer Medicine

The burden of mortality of obesity at middle and old age is small. A life table analysis of the US Health and Retirement Survey

Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 9/2008

Reduction of urinary tract infections acquired in an intensive care unit during a 10-year surveillance program

Differences in precision in bone mineral density measured by SXA and DXA: the NOREPOS study

Survival analysis: up from Kaplan–Meier–Greenwood

Problems in using incidence to analyze risk factors in follow-up studies

Does population mixing measure infectious exposure in children at the community level?

Changes in the prevalence of dyspepsia and Helicobacter pylori infection after 17 years: The Sørreisa gastrointestinal disorder study