Body-mass index and all-cause mortality: individual-participant-data meta-analysis of 239 prospective studies in four continents

  title={Body-mass index and all-cause mortality: individual-participant-data meta-analysis of 239 prospective studies in four continents},
  author={Emanuele Di Angelantonio and Shilpa N. Bhupathiraju and David Wormser and Pei Gao and Stephen Kaptoge and Amy Berrington de Gonz{\'a}lez and Benjamin J. Cairns and Rachel R. Huxley and Chandra L. Jackson and Grace Joshy and Sarah Lewington and JoAnn E. Manson and Neil Murphy and Alpa V Patel and Jonathan M Samet and Mark Woodward and Wei Zheng and Maigeng Zhou and Narinder Bansal and Aurelio Barricarte and B. Carter and James R. Cerhan and Rory Collins and George Davey Smith and Xianghua Fang and Oscar H. Franco and Jane Green and Jim Halsey and Janet S. Hildebrand and Keum Ji Jung and Rosemary J Korda and Dale McLerran and Steven C. Moore and Linda M. O’Keeffe and Ellie Paige and Anna Ramond and Gillian K Reeves and Betsy Rolland and Carlotta Sacerdote and Naveed Sattar and Eleni Sofianopoulou and J Stevens and Michael J. Thun and Hirotsugu Ueshima and Ling Yang and Young Duk Yun and Peter Willeit and Emily Banks and Valerie Beral and Zhengming Chen and Susan M Gapstur and Marc J. Gunter and Patricia Hartge and Sun Ha Jee and Tai Hing Lam and Richard Peto and John D. Potter and Walter C. Willett and Simon G Thompson and John Danesh and Frank B. Hu},
  journal={Lancet (London, England)},
  pages={776 - 786}

Figures and Tables from this paper

Association Between Body Mass Index and All-Cause Mortality in a Prospective Cohort of Southern Chinese Adults Without Morbid Obesity

Compared to the normal weight category, adults in the moderate obesity category had lower all-cause mortality, whereas being underweight was associated with increased all- cause mortality.

Independent and joint effects of body mass index and metabolic health in mid- and late-life on all-cause mortality: a cohort study from the Swedish Twin Registry with a mean follow-up of 13 Years

MHS strongly influenced the BMI-mortality association, such that individuals who were metabolically healthy with overweight or obesity in mid- or late-life did not carry excess risks of mortality.

Body-mass index and long-term risk of sepsis-related mortality: a population-based cohort study of 0.5 million Chinese adults

Underweight, lower normal weight, and abdominal obesity are associated with increased future risk of sepsis-related mortality over 10 years in the Chinese population, and the double burden of underweight and obesity indicates a heavy sepsi burden faced by low- and middle-income countries.

Body-mass index and risk of advanced chronic kidney disease: Prospective analyses from a primary care cohort of 1.4 million adults in England

Direct evidence is provided that being overweight increases risk of advanced CKD, that being obese substantially increases such risk, and that this remains true for those with and without diabetes, hypertension or cardiovascular disease.

Adiposity change and mortality in middle-aged to older Chinese: an 8-year follow-up of the Guangzhou Biobank Cohort Study

In older people, unintentional BMI/WC loss, especially in those who were underweight was associated with higher mortality risk, however, BMI gain in those with obesity showed excess risks of all-cause and cancer mortality, but not CVD mortality.

Trajectories of body mass index in adulthood and all-cause and cause-specific mortality in the Melbourne Collaborative Cohort Study

The findings highlight the importance of weight management throughout adulthood to reduce mortality and identify groups of individuals who followed specific group-based BMI trajectories across adulthood.

Weight History and All-Cause and Cause-Specific Mortality in Three Prospective Cohort Studies

Risks for all-cause and cause-specific death associated with overweight and obesity in 3 large cohorts of health professionals in the United States are examined to generate estimates that minimized reverse causality without imposing the strict exclusion criteria applied in the prior literature.

Lifestyle risk factors and all-cause and cause-specific mortality: assessing the influence of reverse causation in a prospective cohort of 457,021 US adults

Using multivariable Cox models to account for reverse causation suggest different effects of reverse causation on the associations between lifestyle risk factors and mortality.

Sex-specific associations between body mass index and death before life expectancy: a comparative study from the USA and Sweden

This study demonstrates a markedly increased risk of premature death associated with increasing BMI among Swedish males, a pattern not duplicated among females.



Body mass index and cardiovascular disease in the Asia-Pacific Region: an overview of 33 cohorts involving 310 000 participants.

This overview provides the most reliable estimates to date of the associations between BMI and cardiovascular disease in the Asia-Pacific region, and the first direct comparisons within the region, indicating considerable potential for cardiovascular disease reduction with population-wide lowering of BMI.

Sex-age-specific association of body mass index with all-cause mortality among 12.8 million Korean adults: a prospective cohort study

Women had a lower optimal BMI than men, especially at younger ages, and the optimal BMI increased with age, however, change in optimal BMI with age was more profound in women than in men.

BMI and all cause mortality: systematic review and non-linear dose-response meta-analysis of 230 cohort studies with 3.74 million deaths among 30.3 million participants

There was a U shaped association between BMI and mortality in analyses with a greater potential for bias including all participants, current, former, or ever smokers, and in studies with a short duration of follow-up (<5 years or <10 years), or with moderate study quality scores.

Body mass index and all-cause mortality in a large Chinese cohort.

BMI and all-cause mortality had a U-shaped association among adult Chinese people in this study, and the findings do not support the use of a lower cutoff value for overweight and obesity in the adult Chinese population.

Abdominal Obesity and the Risk of All-Cause, Cardiovascular, and Cancer Mortality: Sixteen Years of Follow-Up in US Women

Anthropometric measures of abdominal adiposity were strongly and positively associated with all-cause, CVD, and cancer mortality independently of body mass index and potential confounders.

Body mass index and mortality in an ethnically diverse population: the Multiethnic Cohort Study

The results indicate that the association of BMI with mortality is generally consistent across sex and ethnic groups, with some variation in the strength of the effect, and the effect of overweight in young adulthood appears to be much stronger than that of obese in later adulthood on mortality in later life.

Body Mass Index and All-Cause Mortality in a Large Prospective Cohort of White and Black U.S. Adults

Results from this study demonstrate for the first time that the BMI-mortality relationship differs for men and women who smoke or have prevalent disease compared to healthy never-smokers, and further support recommendations for maintaining a BMI between 20–25 kg/m2 for optimal health and longevity.