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American Journal of Epidemiology Vol. 151, No. 7: 660-666
Copyright © 2000 by The Johns Hopkins University School of Hygiene and Public Health
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Underweight and Overweight in Relation to Mortality Among Men Aged 40–59 and 50–69 Years
The Seven Countries Study
1Department of Chronic Disease Epidemiology, National Institute of Public Health and the Environment Bilthoven, the Netherlands
2The Netherlands Institute for Health Sciences, Erasmus University Medical School Rotterdam, the Netherlands
3Division of Epidemiology, School of Public Health, Unversity of Minnesota Minneapolis, Minnesota
4Department of Community Health and General Practice, Medical Faculty, University of Kuopio Helsinki, Finland
This study investigated the relation between body mass index (BMI) and the all-cause mortality rate among 7,985 European men. Starting around 1960, when all men were aged 40–59 years, mortality was followed for 15 years (1960–1975); starting around 1970, the survivors were followed for an additional 15 years (1970–1985). For the first and second follow-up periods, a BMI of 18.5–25 kg/m2 around 1960 and 1970, respectively, was considered the reference category. The authors found that the hazard ratios of mortality for a BMI of <18.5 kg/m2 was 2.1 (95% confidence interval (CI): 1.5, 2.8) for the first follow-up period and 1.7 (95% CI: 1.3, 2.2) for the second. A BMI of 25–30 kg/m2 was not related to increased mortality. Among never smokers, the hazard ratios for a BMI of <30 kg/m2 were 1.8 (95% Cl: 1.2, 2.8) for the 1960–1975 follow-up period and 1.4 (95% CI: 1.0, 1.9) for the 1970–1985 follow-up period. A BMI of <30 kg/m2 was not related to increased mortality among current smokers. When mortality was followed for more than 15 years, the hazard ratio for a BMI of 48.5 kg/m2 declined and the hazard ratios for a BMI of <30 kg/m2 did not change. Underweight among those in all smoking categories and severe overweight in never smokers remained predictors of increased mortalrty when middle-aged men became older. Am J Epidemiol 2000; 151:660–6.
aged; aging; body mass index; cohort effect; follow-up studies; mortality; obesity; public health
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