Citation

Sorjonen K, Nilsonne G, Falkstedt D, Hemmingsson T, Melin B, Ingre M. Obes. Sci. Pract. 2021; 7(2): 168-175.

Copyright

(Copyright © 2021, World Obesity, Publisher John Wiley and Sons)

DOI

10.1002/osp4.473

PMID

unavailable

Abstract

INTRODUCTION: Body mass index (BMI) is a composite variable of weight and height, often used as a predictor of health outcomes, including mortality. The main purpose of combining weight and height in one variable is to obtain a measure of obesity independent of height. It is however unclear how accurate BMI is as a predictor of mortality compared with models including both weight and height or a weight × height interaction as predictors.

METHODS: The current study used conscription data on weight, height, and BMI of Swedish men (N = 48,904) in 1969/70 as well as linked data on mortality (3442 deaths) between 1969 and 2008. Cox proportional hazard models including combinations of weight, height, and BMI at conscription as predictors of subsequent all-cause and cause-specific mortality were fitted to data.

RESULTS: An increase by one standard deviation on weight and BMI were associated with an increase in hazard for all-cause mortality by 5.4% and 11.5%, respectively, while an increase by one standard deviation on height was associated with a decrease in hazard for all-cause mortality by 9.4%. The best-fitting model indicated lowest predicted all-cause mortality for those who weighed 60.5 kg at conscription, regardless of height. Further analyses of cause-specific mortality suggest that this weight seems to be a compromise between lower optimal weights to avoid cancer and CVD mortality and a higher optimal weight to not die by suicide.

CONCLUSIONS: According to the present findings, there are several ways to make better use of measured weight and height than to calculate BMI when predicting mortality. © 2020 The Authors. Obesity Science & Practice published by World Obesity and The Obesity Society and John Wiley & Sons Ltd.

Language: en

Keywords

adult; human; suicide; male; injury; mortality; prediction; obesity; alcohol consumption; smoking; height; drinking; model; cardiovascular disease; cohort analysis; cancer mortality; body mass; Article; weight; BMI; cardiovascular mortality; survival prediction; malignant neoplasm; all cause mortality; conscripts