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7 January 2003 | Volume 138 Issue 1 | Pages 24-32
Background: Overweight and obesity in adulthood are linked to an increased risk for death and disease. Their potential effect on life expectancy and premature death has not yet been described.
Objective: To analyze reductions in life expectancy and increases in premature death associated with overweight and obesity at 40 years of age.
Design: Prospective cohort study.
Setting: The Framingham Heart Study with follow-up from 1948 to 1990.
Participants: 3457 Framingham Heart Study participants who were 30 to 49 years of age at baseline.
Measurements: Mortality rates specific for age and body mass index group (normal weight, overweight, or obese at baseline) were derived within sex and smoking status strata. Life expectancy and the probability of death before 70 years of age were analyzed by using life tables.
Results: Large decreases in life expectancy were associated with overweight and obesity. Forty-year-old female nonsmokers lost 3.3 years and 40-year-old male nonsmokers lost 3.1 years of life expectancy because of overweight. Forty-year-old female nonsmokers lost 7.1 years and 40-year-old male nonsmokers lost 5.8 years because of obesity. Obese female smokers lost 7.2 years and obese male smokers lost 6.7 years of life expectancy compared with normal-weight smokers. Obese female smokers lost 13.3 years and obese male smokers lost 13.7 years compared with normal-weight nonsmokers. Body mass index at ages 30 to 49 years predicted mortality after ages 50 to 69 years, even after adjustment for body mass index at age 50 to 69 years.
Conclusions: Obesity and overweight in adulthood are associated with large decreases in life expectancy and increases in early mortality. These decreases are similar to those seen with smoking. Obesity in adulthood is a powerful predictor of death at older ages. Because of the increasing prevalence of obesity, more efficient prevention and treatment should become high priorities in public health.
*For members of the Netherlands Epidemiology and Demography Compression of Morbidity Research Group, see Appendix.
Editors' Notes
Context
Contribution
Cautions
–The Editors
Author and Article Information
From Erasmus MC, Rotterdam, and University of Groningen, Groningen, the Netherlands.
Acknowledgments: The authors thank Caspar Looman, René Eijkemans, and Tommy Visscher for their contributions to the development of this study. The authors also thank the Framingham Heart Study coordinators for access to the original data set.
Grant Support: By grants from the Netherlands Heart Foundation (contract 98.138) and the Netherlands Organization for Scientific Research (contract 904-66-093), The Hague, the Netherlands.
Requests for Single Reprints: Anna Peeters, PhD, Department of Public Health, Erasmus MC, PO Box 1738, 3000 DR Rotterdam, the Netherlands; e-mail, peeters{at}mgz.fgg.eur.nl.
Current Author Addresses: Drs. Peeters, Barendregt, Mackenbach, and Bonneux: Department of Public Health, Erasmus MC, PO Box 1738, 3000 DR Rotterdam, the Netherlands.
Drs. Willekens and Al Mamun: Population Research Center, University of Groningen, PO Box 800, 9700 AV Groningen, the Netherlands.
Author Contributions: Conception and design: A. Peeters, J.P. Mackenbach, L. Bonneux.
Analysis and interpretation of the data: A. Peeters, J.J. Barendregt, J.P. Mackenbach, A. Al Mamun, L. Bonneux.
Drafting of the article: A. Peeters, L. Bonneux.
Critical revision of the article for important intellectual content: A. Peeters, J.J. Barendregt, J.P. Mackenbach, L. Bonneux.
Final approval of the article: A. Peeters, J.J. Barendregt, J.P. Mackenbach, L. Bonneux.
Provision of study materials or patients: A. Peeters.
Statistical expertise: J.J. Barendregt, F. Willekens, A. Al Mamun.
Obtaining of funding: J.J. Barendregt, J.P. Mackenbach, L. Bonneux. ARTICLE
Obesity in Adulthood and Its Consequences for Life Expectancy: A Life-Table Analysis
30 kg/m2) at age 40 years lived 6 to 7 years less than their normal-weight counterparts. Adults who were overweight (BMI, 25 to 29.9 kg/m2) and did not smoke lived about 3 years less than normal-weight nonsmokers. Adults who were obese and smoked lived 13 to 14 years less than normal-weight nonsmokers.
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A. R P Walker The obesity pandemic. Is it beyond control? Perspectives in Public Health, September 1, 2003; 123(3): 150 - 151. [PDF]
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 OTHER ARTICLES NOTED (24 Jan 03 to 18 Apr 03) Evid. Based Nurs., July 1, 2003; 6(3): e1 - 12. [Full Text] [PDF]
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A. Peeters, L. Bonneux, J. Barendregt, and W. Nusselder Methods of Estimating Years of Life Lost Due to Obesity JAMA, June 11, 2003; 289(22): 2941 - 2941. [Full Text] [PDF]
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D. B. Allison, A. O. Westfall, D. T. Redden, C. Wang, and K. R. Fontaine Methods of Estimating Years of Life Lost Due to Obesity--Reply JAMA, June 11, 2003; 289(22): 2941 - 2942. [Full Text] [PDF]
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 Obesity: Large Effect on Mortality Journal Watch Dermatology, February 26, 2003; 2003(226): 9 - 9. [Full Text]
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 Minerva BMJ, January 25, 2003; 326(7382): 232 - 232. [Full Text] [PDF]
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 Obesity: Large Effect on Mortality Journal Watch (General), January 24, 2003; 2003(124): 3 - 3. [Full Text]
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