McGee DL. Body mass index and mortality: a meta-analysis based on person-level data from twenty-six observational studies. Ann Epidemiol 15, 87-97

Department of Statistics, Florida State University, Tallahassee, FL 32306-4330, USA.
Annals of Epidemiology (Impact Factor: 2). 03/2005; 15(2):87-97. DOI: 10.1016/j.annepidem.2004.05.012
Source: PubMed


For this report, we examined the relationships between the conditions of being overweight and obese and mortality from all causes, heart disease, cardiovascular disease, and cancer.
We defined the categories of body weight according to level of body mass index, BMI=wt(kg)/ht(m)2, using classifications suggested by the National Institutes of Health and the World Health Organization. These classifications are as follows: "normal weight" is defined as BMI > or = 18.5, but less than 25; "overweight" equals BMI > or = 25, but less than 30; and "obese" individuals have BMIs > or = 30. Our investigation is based on person-level data from 26 observational studies that include both genders, several racial and ethnic groups, and samples from the US and other countries. The database consists of 74 analytic cohorts, arranged according to natural strata including gender, race, and area of residence. It includes 388,622 individuals, with 60,374 deaths during follow-up. We use proportional hazards models to examine the relationships between the BMI categories and mortality, controlling for age and smoking status. We use random-effects models to assess summary relative risks associated with the overweight and obesity conditions across cohorts.
The relative risks among the heaviest individuals for overall death, death caused by coronary heart disease (CHD), and death caused by cardiovascular disease (CVD) are 1.22, 1.57, and 1.48, respectively, when compared with the those within the lowest BMI category. The summary relative risk among the heaviest participants for death from cancer is 1.07.
We document once again, excess mortality associated with obesity. Our results do, however, question whether the current classification of individuals as "overweight" is optimal in the sense, since there is little evidence of increased risk of mortality in this group.

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    • "Our analysis contributes to answering the question of whether differences in BMI between Turkish immigrants and native Germans could be mainly explained by differences in socioeconomic characteristics or whether they are mainly due to unobserved genetic 2 and behavior differences. From the perspective of economists and public health scientists, the difference in obesity prevalence between Turkish immigrants and German native-borns is a matter of concern, given that obesity has been linked to numerous chronic diseases 3 , such as type-2 diabetes, coronary disease, hypertension , breast cancer or colon cancer, etc. (see McGee (2005)) All of these problems place pressure upon the health care system by increasing health care costs for the German society. 4 In addition, inequalities in BMI between different ethnic groups may be a refection of other inequalities in socioeconomic status (see, among others, Morris (2006) 5 ). "
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    DESCRIPTION: In this paper, we decompose body mass index (BMI) differences between Turkish immigrants and Germans in West Germany for women and men. We focus on isolating the part of BMI differences that can be explained by differences in observed socioeconomic status from the part attributable to differences in coefficients. Our results reveal that female Turkish immigrants are on average more obese than female Germans; however, there exists no significant difference in obesity among males. Our results also indicate that differences in socioeconomic status between female Turkish immigrants and Germans explain significant parts of the obesity disparities between these two groups.
    Full-text · Research · Sep 2015
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    • "Thus the results should be reexamined in the future with longitudinal data. However, several investigators (Abell et al. 2007; Flegal et al. 2013; McGee et al. 2005; Pischon et al. 2008) in longitudinal population-based studies have also reported no significant or a marginally significant association between the standard BMI-based overweight and CVD mortality. Third, in this study, body fat information based on the hydrodensitometry or DXA methods, known as a more accurate adiposity measures than the skinfold PBF, was not available. "
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    ABSTRACT: Purpose: This study aims to examine whether body mass index (BMI) overestimates the prevalence of overweight or obese firefighters when compared to waist circumference (WC) and skinfold-based percent body fat (PBF) and to investigate differential relationships of the three adiposity measures with other biological cardiovascular disease (CVD) risk factors. Methods: The adiposity of 355 (347 males and 8 females) California firefighters was assessed using three different measures. Other CVD risk factors (high blood pressure, high lipid profiles, high glucose, and low VO2 max) of the firefighters were also clinically assessed. Results: The prevalence of total overweight and obesity was significantly (p < 0.01) higher by BMI (80.4%) than by WC (48.7 %) and by PBF (55.6 %) in male firefighters. In particular, the prevalence of overweight firefighters was much higher (p < 0.01) by BMI (57.3%) than by WC (24.5%) and PBF (38.3%). 60%-64% of male firefighters who were assessed as normal-weight by WC and PBF were misclassified as overweight by BMI. When overweight by BMI was defined as 27.5 - 29.9 kg/m2 (vs. the standard definition of 25.0-29.9 kg/m2), the agreement of the adiposity classification increased between BMI and other two adiposity measures. Obese firefighters had the highest CVD risk profiles across all three adiposity measures. Only when overweight by BMI was defined narrowly, overweight firefighters had substantially higher CVD risk profiles. Obesity and overweight were less prevalent in female and Asian male firefighters. Conclusions: BMI overestimated the prevalence of total overweight and obesity among male firefighters, compared to WC and skinfold-based PBF. Overweight by BMI needs to be more narrowly defined or the prevalence of BMI-based overweight (27.5 to 29.9 kg/m2) should be reported additionally for prevention of CVD among male firefighters.
    Full-text · Article · Jul 2015 · International Archives of Occupational and Environmental Health
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    • "The main impact of these associations tends to be on the cardiovascular system, although the effects on an individual can be modified or compounded by environmental or genetic factors [8]. Meta-analysis reports show that obesity is a risk factor for CVD, type 2 diabetes mellitus, hypertension, some forms of cancer [9- 11] and all-cause mortality in adults [12] [13] [14]. One of the most important confounding factors profoundly "
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    ABSTRACT: Regional body composition changes with aging. Some of the changes in composition are considered major risk factors for developing obesity related chronic diseases which in turn may lead to increased mortality in adults. The role of anthropometry is well recognized in the screening, diagnosis and follow-up of adults for risk classification, regardless of age. Regional body composition is influenced by a number of intrinsic and extrinsic factors. Therapeutic measures recommended to lower cardiovascular disease risk include lifestyle changes. The aim of this review is to systematically summarize studies that assessed the relationships between anthropometry and regional body composition. The potential benefits and limitations of anthropometry for use in clinical practice are presented and suggestions for future research given.
    Full-text · Article · Dec 2014 · Aging and Disease
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