Joint Association of Adiposity and Smoking with Mortality among U.S. Adults.
Department of Intramural Research, American Cancer Society, Atlanta, GA. Electronic address: . Preventive Medicine
(Impact Factor: 3.09).
12/2012; 56(3-4). DOI: 10.1016/j.ypmed.2012.12.012
Assessment of death risk for different combinations of body-mass index (BMI) and smoking status among a nationally representative cohort of U.S. adults.
A total of 210,818 participants of the National Health Interview Surveys 1987-1995 were followed through 2006. Relative risks of death from all causes, cardiovascular disease (CVD), and cancer were estimated for each joint group of smoking and BMI by age, using Cox models with the adjustment for age, gender, education, and race.
Across all the joint groups of BMI and smoking, extremely obese and underweight current smokers were the two groups having the highest risks of death from all causes, CVD, and cancer. For example, among middle-aged adults, the hazard ratios of death from all causes were 4.47 (95% confidence interval [CI], 3.59-5.57) and 5.28 (4.38-6.37) for extremely obese and underweight current smokers, respectively. Overweight was associated with a higher risk of death in middle-aged never smokers, but not in the elderly or in current smokers.
The coexistence of obesity or underweight with current smoking was associated with an especially large risk of death and the associations of BMI with mortality varied by smoking status, age, and cause of death.
Available from: PubMed Central
- "Smoking and obesity have been identified as a major risk factor for premature death in some developed countries and those experiencing rapid economic growth (1,2). The two can be attributed to poor lifestyle habits and are closely associated with chronic metabolic diseases such as preventable diabetes, hypertension, metabolic syndrome (MetS), and cardiovascular disease (CVD) (3,4). "
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ABSTRACT: This study aimed to identify changes in the level of neuropeptides among current smokers, former smokers, and individuals who had never smoked, and how smoking habits affect obesity and metabolic syndrome (MetS). Neuropeptide levels, anthropometric parameters, and metabolic syndrome diagnostic indices were determined among male workers; 117 of these had never smoked, whereas 58 and 198 were former and current smokers, respectively. The total sample comprised 373 male workers. The results obtained from anthropometric measurements showed that current smokers attained significantly lower body weight, body mass index, waist circumference, and abdominal fat thickness values than former smokers and those who had never smoked. Current smokers' eating habits proved worse than those of non-smokers and individuals who had never smoked. The level of brain-derived neurotrophic factor (BDNF) in the neuropeptides in the case of former smokers was 23.6 ± 9.2 pg/ml, higher than that of current smokers (20.4 ± 6.1) and individuals who had never smoked (22.4 ± 5.8) (F = 6.520, p = 0.002). The level of adiponectin among former smokers was somewhat lower than that of current smokers, whereas leptin levels were higher among former smokers than current smokers; these results were not statistically significant. A relationship was found between adiponectin and triglyceride among non-smokers (odds ratio = 0.660, β value = -0.416, p < 0.01) and smokers (odds ratio = 0.827, β value = -0.190, p < 0.05). Further, waist circumference among non-smokers (odds ratio = 1.622, β value = 0.483, p < 0.001) and smokers (odds ratio = 1.895, β value = 0.639, p < 0.001) was associated with leptin. It was concluded that cigarette smoking leads to an imbalance of energy expenditure and appetite by changing the concentration of neuropeptides such as adiponectin, BDNF, leptin, and hsCRP, and influences food intake, body weight, the body mass index, blood pressure, and abdominal fat, which are risk factors for MetS and cardiovascular disease.
Toxicological Research 06/2014; 30(2):91-7. DOI:10.5487/TR.2014.30.2.091
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ABSTRACT: Smoking and excess body weight are major preventable risk factors for premature death. This study aimed at analysing their single and combined association with site-specific cancer mortality.
Our study population comprised 35,784 men and women aged 14-99 years, who participated in population-based health surveys conducted 1977-1993 in Switzerland and were followed-up for mortality until 2008. Multivariable Cox proportional hazards models were calculated for different cancer sites, and population attributable fractions were derived.
The hazard ratio of dying from cancer (all sites) was 2.32 [95% CI: 2.04, 2.63] for heavy smokers (vs. never smokers) and 1.15 [1.01, 1.32] for obese (body mass index (BMI) ≥ 30 kg/m2) vs. normal weight individuals. Heavy smoking (≥ 20 cigarettes/day) was associated with increased mortality due to cancer of the lung, upper aero-digestive tract, pancreas, bladder, liver, and the total of remaining sites. Obesity was associated with higher risk of dying from cancer of the liver and the female genital tract (essentially corpus or cervix uteri and ovary). More than 20% of all cancer deaths in our population were attributable to ever smoking and overweight (BMI ≥ 25 kg/m2).
Smoking was a much stronger risk factor for cancer than excess body weight. For lung, liver and pancreatic cancer the combination of excess body weight and smoking lead to cumulated higher risks.
Our findings support recommendations for obese persons to quit smoking despite potential post-cessation weight gain.
Copyright © 2015, American Association for Cancer Research.
Cancer Epidemiology Biomarkers & Prevention 07/2015; DOI:10.1158/1055-9965.EPI-15-0415 · 4.13 Impact Factor
Available from: Emanuele Cereda
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ABSTRACT: Body mass index (BMI) and mortality in old adults from the general population have been related in a U-shaped or J-shaped curve. However, limited information is available for elderly nursing home populations, particularly about specific cause of death. A systematic PubMed/EMBASE/CINAHL/SCOPUS search until 31 May 2014 without language restrictions was conducted. As no published study reported mortality in standard BMI groups (<18.5, 18.5-24.9, 25-29.9, ≥30 kg/m(2) ), the most adjusted hazard ratios (HRs) according to a pre-defined list of covariates were obtained from authors and pooled by random-effect model across each BMI category. Out of 342 hits, 20 studies including 19,538 older nursing home residents with 5,223 deaths during a median of 2 years of follow-up were meta-analysed. Compared with normal weight, all-cause mortality HRs were 1.41 (95% CI = 1.26-1.58) for underweight, 0.85 (95% CI = 0.73-0.99) for overweight and 0.74 (95% CI = 0.57-0.96) for obesity. Underweight was a risk factor for higher mortality caused by infections (HR = 1.65 [95% CI = 1.13-2.40]). RR results corroborated primary HR results, with additionally lower infection-related mortality in overweight and obese than in normal-weight individuals. Like in the general population, underweight is a risk factor for mortality in old nursing home residents. However, uniquely, not only overweight but also obesity is protective, which has relevant nutritional goal implications in this population/setting.
© 2015 World Obesity.
Obesity Reviews 08/2015; 16(11). DOI:10.1111/obr.12309 · 8.00 Impact Factor
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