Association between Body-Mass Index and Risk of Death in More Than 1 Million Asians
By Wei Zheng, D. McLerran, Betsy Rolland, Xianglan Zhang, M. Inoue, K. Matsuo, Jiang He, P. Gupta, K. Ramadas, S. Tsugane and 34 more. New England Journal of Medicine, 2011
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Background Most studies that have evaluated the association between the body-mass index (BMI) and the risks of death from any cause and from specific causes have been conducted in populations of European origin. Methods We performed pooled analyses to evaluate the association between BMI and the risk of death among more than 1.1 million persons recruited in 19 cohorts in Asia. The analyses included approximately 120,700 deaths that occurred during a mean follow-up period of 9.2 years. Cox regression models were used to adjust for confounding factors. Results In the cohorts of East Asians, including Chinese, Japanese, and Koreans, the lowest risk of death was seen among persons with a BMI (the weight in kilograms divided by the square of the height in meters) in the range of 22.6 to 27.5. The risk was elevated among persons with BMI levels either higher or lower than that range — by a factor of up to 1.5 among those with a BMI of more than 35.0 and by a factor of 2.8 among those with a BMI of 15.0 or less. A similar U-shaped association was seen between BMI and the risks of death from cancer, from cardiovascular diseases, and from other causes. In the cohorts comprising Indians and Bangladeshis, the risks of death from any cause and from causes other than cancer or cardiovascular disease were increased among persons with a BMI of 20.0 or less, as compared with those with a BMI of 22.6 to 25.0, whereas there was no excess risk of either death from any cause or cause-specific death associated with a high BMI. Conclusions Underweight was associated with a substantially increased risk of death in all Asian populations. The excess risk of death associated with a high BMI, however, was seen among East Asians but not among Indians and Bangladeshis.
Subfields: Endocrinology, Diabetes and Metabolism, Oncology, Public Health, Environmental and Occupational Health
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Citations in the corpus
- Prevalence of Obesity Among Adults and Youth: United States, 2015-2016. (2017, background): “Among some Asian subgroups, risk may begin to increase at a lower BMI compared with other race and Hispanic-origin groups, although study results have varied (5,6).”
- The Age-Specific Quantitative Effects of Metabolic Risk Factors on Cardiovascular Diseases and Diabetes: A Pooled Analysis (2013, methodology): “We did not use the National Cancer Institute (NCI) Cohort Consortium [14] and a recent pooled analysis of Asian cohorts [15] for BMI effect sizes because these studies reported RRs for cardiovascular diseases (CVD) combined but not separately for ischemic heart disease (IHD) and stroke.”
- Association of Body Mass Index With Lifetime Risk of Cardiovascular Disease and Compression of Morbidity (2018, neutral): “Total cholesterol, mean (SD), mg/dL 190 (37) 182 (34) 210 (40) 212 (42) 208 (41) 227 (45)”
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- Causal Relationship between Obesity and Vitamin D Status: Bi-Directional Mendelian Randomization Analysis of Multiple Cohorts (2013, background): “The prevalence of obesity has increased in the last two decades and it is presently the most common and costly nutritional problem [1–4].”