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Underweight, overweight and obesity as risk factors for mortality and hospitalization.

Abstract

AIMS

The prevalence of overweight and obesity is increasing in many countries. We aimed to investigate differences in mortality and severe morbidity between underweight people (body mass index (BMI)<18.5), overweight people (BMI 25 to <30), obese people (BMI> or =30), and those with normal weights (BMI 18.5 to <25).

METHODS

Random samples of the Swedish population aged 16-74 years in 1980-81 and 1988-89 were followed for 12 years with regard to all-cause mortality and mortality from circulatory diseases, all inpatient care, and inpatient care for circulatory and musculoskeletal diseases. Relative risks (RRs) for different levels of BMI were adjusted for age, longstanding illness, smoking, and educational level at baseline. In addition, analyses were made with delayed entry until the fourth-year after interview.

RESULTS

Obesity and underweight, but not overweight, was associated with higher all-cause mortality. Among underweight men, the adjusted RR for all-cause mortality was 2.4 (95% confidence interval 1.6-3.6), and among underweight women it was 2.0 (1.5-2.7), but population attributable risks (PARs) were small, at 1.2% and 2.7%, respectively. Overweight was associated with increased risks for inpatient care for circulatory diseases, with PARs being 13.4% among men and 8.1% among women, and musculoskeletal diseases (PARs were 12.7% and 12.9%, respectively). Obese men and women had about 50% higher risks of all-cause mortality than normal-weight people, PARs being 3.2% and 3.8% respectively.

CONCLUSIONS

This study supports the findings of other studies, in that overweight seems to be an exaggerated risk factor for all-cause mortality, but is related to other chronic disease. Underweight and obesity generally implies greater increases of RRs, but avoidance of overweight may have greater effect on the population level with regard to reduced cardiovascular and locomotor disease.

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  • Publisher Full Text
  • Authors+Show Affiliations

    ,

    Centre for Epidemiology, Swedish National Board of Health and Welfare, Stockholm. gunilla.ringback@socialstyrelsen.se

    ,

    Source

    MeSH

    Adolescent
    Adult
    Aged
    Body Mass Index
    Cardiovascular Diseases
    Cause of Death
    Cohort Studies
    Female
    Follow-Up Studies
    Hospitalization
    Humans
    Male
    Middle Aged
    Obesity
    Overweight
    Risk Factors
    Surveys and Questionnaires
    Sweden
    Thinness

    Pub Type(s)

    Journal Article
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    18519281

    Citation

    Ringbäck Weitoft, Gunilla, et al. "Underweight, Overweight and Obesity as Risk Factors for Mortality and Hospitalization." Scandinavian Journal of Public Health, vol. 36, no. 2, 2008, pp. 169-76.
    Ringbäck Weitoft G, Eliasson M, Rosén M. Underweight, overweight and obesity as risk factors for mortality and hospitalization. Scand J Public Health. 2008;36(2):169-76.
    Ringbäck Weitoft, G., Eliasson, M., & Rosén, M. (2008). Underweight, overweight and obesity as risk factors for mortality and hospitalization. Scandinavian Journal of Public Health, 36(2), pp. 169-76. doi:10.1177/1403494807085080.
    Ringbäck Weitoft G, Eliasson M, Rosén M. Underweight, Overweight and Obesity as Risk Factors for Mortality and Hospitalization. Scand J Public Health. 2008;36(2):169-76. PubMed PMID: 18519281.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Underweight, overweight and obesity as risk factors for mortality and hospitalization. AU - Ringbäck Weitoft,Gunilla, AU - Eliasson,Mats, AU - Rosén,Måns, PY - 2008/6/4/pubmed PY - 2008/6/6/medline PY - 2008/6/4/entrez SP - 169 EP - 76 JF - Scandinavian journal of public health JO - Scand J Public Health VL - 36 IS - 2 N2 - AIMS: The prevalence of overweight and obesity is increasing in many countries. We aimed to investigate differences in mortality and severe morbidity between underweight people (body mass index (BMI)<18.5), overweight people (BMI 25 to <30), obese people (BMI> or =30), and those with normal weights (BMI 18.5 to <25). METHODS: Random samples of the Swedish population aged 16-74 years in 1980-81 and 1988-89 were followed for 12 years with regard to all-cause mortality and mortality from circulatory diseases, all inpatient care, and inpatient care for circulatory and musculoskeletal diseases. Relative risks (RRs) for different levels of BMI were adjusted for age, longstanding illness, smoking, and educational level at baseline. In addition, analyses were made with delayed entry until the fourth-year after interview. RESULTS: Obesity and underweight, but not overweight, was associated with higher all-cause mortality. Among underweight men, the adjusted RR for all-cause mortality was 2.4 (95% confidence interval 1.6-3.6), and among underweight women it was 2.0 (1.5-2.7), but population attributable risks (PARs) were small, at 1.2% and 2.7%, respectively. Overweight was associated with increased risks for inpatient care for circulatory diseases, with PARs being 13.4% among men and 8.1% among women, and musculoskeletal diseases (PARs were 12.7% and 12.9%, respectively). Obese men and women had about 50% higher risks of all-cause mortality than normal-weight people, PARs being 3.2% and 3.8% respectively. CONCLUSIONS: This study supports the findings of other studies, in that overweight seems to be an exaggerated risk factor for all-cause mortality, but is related to other chronic disease. Underweight and obesity generally implies greater increases of RRs, but avoidance of overweight may have greater effect on the population level with regard to reduced cardiovascular and locomotor disease. SN - 1403-4948 UR - https://www.unboundmedicine.com/medline/citation/18519281/Underweight_overweight_and_obesity_as_risk_factors_for_mortality_and_hospitalization_ L2 - http://journals.sagepub.com/doi/full/10.1177/1403494807085080?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -