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

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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.

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Abbreviations

BMI:

Body mass index

HRS:

Health and Retirement Survey

CI:

Confidence interval

AHEAD:

Asset and Health Dynamics Among the Oldest Old

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Acknowledgements

The authors like to thank Dr. Oscar Franco, Dr. Anna Peeters, Dr. Rick Rogers and an anonymous reviewer for constructive comments on an earlier draft. Funding: This research was funded by the Royal Netherlands Academy of Science funding for research on Demography, Epidemiology and Actuarial science. The Health and Retirement Study is a public use dataset, produced and distributed by the University of Michigan with funding from the National Institute on Aging (grant number NIA U01AG009740). Ann Arbor, MI, (2006). Contributors: FW had the original idea for the study, which was designed by LB, FW and MR. MR extracted and analyzed the data, all participated in interpretation. MR drafted the paper, all authors contributed to the final version. FW is the guarantor.

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Authors and Affiliations

  1. Netherlands Interdisciplinary Demographic Institute (NIDI), P.O. Box 11650, 2502 AR, The Hague, The Netherlands

    Mieke Reuser, Luc Bonneux & Frans Willekens

  2. University of Groningen, Groningen, The Netherlands

    Mieke Reuser & Frans Willekens

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  1. Mieke Reuser
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  2. Luc Bonneux
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Correspondence to Mieke Reuser.

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Reuser, M., Bonneux, L. & Willekens, F. The burden of mortality of obesity at middle and old age is small. A life table analysis of the US Health and Retirement Survey. Eur J Epidemiol 23, 601–607 (2008). https://doi.org/10.1007/s10654-008-9269-8

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