American Journal of Epidemiology Vol. 147, No. 8: 739-749
Copyright © 1998 by The Johns Hopkins University School of Hygiene and Public Health
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Mortality and Optimal Body Mass Index in a Sample of the US Population
Department of Preventive Medicine and Epidemiology, Stritch School of Medicine, Loyola University Maywood, IL
In this paper, the authors model the nonmonotonic relation between body mass index (BMI) (weight (kg)/height2 (m2)) and mortality in 13,242 black and white participants in the NHANES I Epidemiologic Follow-up Study in order to estimate the BMI at which minimum mortality occurs. The BMI of minimum mortality was 27.1 for black men (95% confidence interval (Cl) 24.8–29.4), 26.8 for black women (95% CI 24.7–28.9), 24.8 for white men (95% CI 23.8–25.9), and 24.3 for white women (95% Cl 23.3–25.4). Each confidence interval included the group average. Analyses conducted by smoking status and after exclusion of persons with baseline illness and persons who died during the first 4 years of follow-up led to virtually identical estimates. The authors determined the range of values over which risk of all-cause mortality would increase no more than 20% in comparison with the minimum. This interval was nine BMI units wide, and it included 70% of the population. These results were confirmed by parallel analyses using quantiles. The model used allowed the estimation of parameters in the BMI-mortality relation. The resulting empirical findings from each of four race/sex groups, which are representative of the US population, demonstrate a wide range of BMIs consistent with minimum mortality and do not suggest that the optimal BMI is at the lower end of the distribution for any subgroup. Am J Epidemiol 1998;147:739–49.
body mass index; mortality; obesity
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