Surgical outcomes researchEffect of diabetes and hypertension on obesity-related mortality
Section snippets
National Health Interview Survey database
The National Health Interview Survey (NHIS) is a population-based survey that is the principal device used by the US government to track disease prevalence. In continuous operation since 1957, the NHIS uses a complex multiscale design with oversampling of black and Hispanic individuals to acquire population-representative health-related information. Probability samples that are socioeconomically and racially representative of the entire US population are determined from the US census. Once
Results
The completed database, after ineligible cases were excluded, contained 662,443 records. Of these, there were 49,391 deaths in a patient cohort having a mean follow-up period of 74 months and ranging from 1 to 144 months, totaling 4,060,524 person-years.
Hazard ratios for age-adjusted mortality as a function of BMI and stratified for gender and race are presented in the Figure. BMI = 25.0-29.9 was associated with the lowest mortality. Compared with individuals with BMIs ranging from 18.5 to 25.0,
Discussion
Obesity unquestionably increases mortality; however, with two thirds of the American population being overweight or obese, it is impractical to provide treatment for all individuals at risk for early mortality. Current guidelines recommend maintenance of a healthy weight by dietary control and exercise.3., 31. For the extremely obese, pharmacological or surgical therapy may be used. Medical treatment of severe obesity generally results in modest, transient weight loss,32 with greater and more
References (55)
- et al.
An overview of body-weight of older persons, including the impact on mortality. The National Health and Nutrition Examination Survey I—Epidemiologic Follow-up Study
J Clin Epidemiol
(1991) - et al.
Relative weight and mortality in US blacks and whites: findings from representative national population samples
Ann Epidemiol
(1997) - et al.
Variations in mortality by weight among 750,000 men and women
J Chronic Dis
(1979) Obesity: adverse effects on health and longevity
Am J Clin Nutr
(1979)- et al.
Epidemiology and consequences of obesity
J Gastrointest Surg
(2003) Obesity and its surgical management
Am J Surg
(2002)- et al.
National trends in utilization and in-hospital outcomes of bariatric surgery
J Gastrointest Surg
(2002) - et al.
The gastric bypass operation reduces the progression and mortality of non-insulin-dependent diabetes mellitus
J Gastrointest Surg
(1997) - et al.
Body weight, pre-existing disease, and all-cause mortality in a cohort of male employees in the German construction industry
J Clin Epidemiol
(1997) - et al.
Body mass index and 15-year mortality in a cohort of black men and women
J Clin Epidemiol
(1990)
Varying body mass index cutoff points to describe overweight prevalence among US Adults: NHANES III (1988 to 1994)
Obes Res
Gastrointestinal surgery for severe obesity. Consensus Development Conference Panel
Ann Intern Med
Body-mass index and mortality in a prospective cohort of US adults
N Engl J Med
Years of life lost due to obesity
JAMA
Coronary mortality and its prediction in samples of US and Italian railroad employees in 25 years within the Seven Countries Study of cardiovascular diseases
Int J Epidemiol
The effect of age on the association between body-mass index and mortality
N Engl J Med
Body weight and mortality among women
N Engl J Med
The relationship between body weight and mortality: a quantitative analysis of combined information from existing studies
Int J Obes
The direct health care costs of obesity in the United States
Am J Public Health
Annual deaths attributable to obesity in the United States
JAMA
Body-fat distribution and 5-year risk of death in older women
JAMA
Overweight and mortality
Cancer
Body-mass index and mortality among nonsmoking older persons: the Framingham Heart Study
JAMA
Body-mass index and patterns of mortality among 7th-day-adventist men
Int J Obes
Body mass and 26-year risk of mortality among women who never smoked: findings from the Adventist mortality study
Am J Epidemiol
Body mass and 26-year risk of mortality from specific diseases among women who never smoked
Epidemiology
Cited by (36)
A meta-analysis but not a systematic review: an evaluation of the Global BMI Mortality Collaboration
2017, Journal of Clinical EpidemiologyPericardial fat, insulin resistance, and left ventricular structure and function in morbid obesity
2014, Nutrition, Metabolism and Cardiovascular DiseasesBody mass index at age 25 and all-cause mortality in whites and African Americans: The atherosclerosis risk in communities study
2012, Journal of Adolescent HealthCitation Excerpt :In a review on the effect of BMI on all-cause mortality in African Americans in 2000 [16], it was noted that several studies indicated that the impact of BMI on mortality may be weaker in African Americans compared with whites. Since the appearance of this review, we know of only three studies that have compared associations of BMI and all-cause mortality between African Americans and white Americans [19–21]. Interactions with ethnicity and BMI were not always tested and CIs were large or not shown, but nevertheless, all three studies showed that the relative risk associated with elevated BMI in African Americans tended to be smaller than that observed in white Americans.
Ageing, adiposity indexes and low muscle mass in a clinical sample of overweight and obese women
2012, Obesity Research and Clinical PracticeCitation Excerpt :Studies have frequently reported that weight loss in older aged individuals was a significant predictor of mortality [25] and also demonstrated that being overweight in old age may be associated with lower risk for cardiovascular diseases and mortality [26–28], probably due to a higher metabolic reserve to fight pathological insults [29]. However, the risk appears to be modified at both ends of the BMI distribution as mortality increased respectively in underweight and in obese subjects [30] particularly in presence of abdominal adiposity [31] and metabolic co-morbidities such as type 2 diabetes, hypertension or dyslipidaemia [27,32,33]. In addition, the individual risk was greater if excess adiposity occurs in presence of sarcopenia (low muscle mass and/or strength) as SO was associated with greater risk for cardiometabolic comorbidities and reduced physical function compared to sarcopenia or obesity alone [4,7,8,34,35].
Mortality and longevity of elite athletes
2010, Journal of Science and Medicine in SportCitation Excerpt :Miller et al.42 also found that the prevalence of metabolic syndrome (e.g., obesity and raised fasting glucose) among professional American football linemen who train similar to power athletes was significantly higher than that among nonlinemen counterparts (59.8% vs. 30.1%) whose activity consists of a combination of aerobic and anaerobic exercise. Evidence shows that obesity, when combined with diabetes, can substantially increase disease-specific mortality.43,44 In addition, the differences in mortality or longevity between power athletes and other groups of athletes may partly be a result of anabolic steroid use that is frequently reported among weightlifters and powerlifters.45,46
Do current body mass index criteria for obesity surgery reflect cardiovascular risk?
2007, Surgery for Obesity and Related Diseases