American Journal of Epidemiology Advance Access published online on May 13, 2008
American Journal of Epidemiology, doi:10.1093/aje/kwn096
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Original Contribution |
Body Mass Index in Adolescence in Relation to Cause-specific Mortality: A Follow-up of 230,000 Norwegian Adolescents
1 Section for Epidemiology and Medical Statistics, Department of Public Health and Primary Health Care, University of Bergen, Bergen, Norway
2 Division of Epidemiology, Norwegian Institute of Public Health, Bergen, Norway
3 Division of Epidemiology, Norwegian Institute of Public Health, Oslo, Norway
4 MRC Centre for Causal Analyses in Translational Epidemiology, Department of Social Medicine, University of Bristol, Bristol, United Kingdom
Correspondence to Prof. Tone Bjørge, Section for Epidemiology and Medical Statistics, Department of Public Health and Primary Health Care, University of Bergen, N-5018 Bergen, Norway (e-mail: tone.bjorge{at}isf.uib.no).
Received for publication November 26, 2007. Accepted for publication March 19, 2008.
The prevalence of obesity in childhood and adolescence has increased worldwide. Long-term effects of adolescent obesity on cause-specific mortality are not well specified. The authors studied 227,000 adolescents (aged 14–19 years) measured (height and weight) in Norwegian health surveys in 1963–1975. During follow-up (8 million person-years), 9,650 deaths were observed. Cox proportional hazards regression was used to compare cause-specific mortality among individuals whose baseline body mass index (BMI) was below the 25th percentile, between the 75th and 84th percentiles, and above the 85th percentile in a US reference population with that of individuals whose BMI was between the 25th and 75th percentiles. Risk of death from endocrine, nutritional, and metabolic diseases and from circulatory system diseases was increased in the two highest BMI categories for both sexes. Relative risks of ischemic heart disease death were 2.9 (95% confidence interval (CI): 2.3, 3.6) for males and 3.7 (95% CI: 2.3, 5.7) for females in the highest BMI category compared with the reference. There was also an increased risk of death from colon cancer (males: 2.1, 95% CI: 1.1, 4.1; females: 2.0, 95% CI: 1.2, 3.5), respiratory system diseases (males: 2.7, 95% CI: 1.4, 5.2; females: 2.5, 95% CI: 1.4, 4.8), and sudden death (males: 2.2, 95% CI: 1.2, 4.3; females: 2.7, 95% CI: 1.1, 6.6). Adolescent obesity was related to increased mortality in middle age from several important causes.
adolescent; body mass index; cause of death; follow-up studies; mortality; Norway; obesity
Abbreviations: BMI, body mass index; CI, confidence interval; RR, relative risk
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