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18 July 2006 | Volume 145 Issue 2 | Pages 91-97
Background: The impact of adiposity in adolescence on death during adulthood is uncertain.
Objective: To examine the relation between adiposity in adolescence and premature death in women.
Design: Prospective cohort study.
Setting: United States.
Participants: 102 400 women from the Nurses' Health Study II who were 24 to 44 years of age and free of cancer at baseline. Ninety percent were of non-Hispanic white ethnicity.
Measurements: In 1989, current weight and height and recalled weight at age 18 years were assessed by using validated questionnaires, and body mass index (BMI) was calculated. Hazard ratios for death and 95% CIs were adjusted for potential confounders, including cigarette smoking, alcohol use, and physical activity during adolescence.
Results: During 12 years of follow-up, 710 participants died. Compared with a BMI of 18.5 to 21.9 kg/m2 at age 18 years, the hazard ratio for premature death was 0.98 (95% CI, 0.78 to 1.23) for a BMI less than 18.5 kg/m2, 1.18 (CI, 0.97 to 1.43) for a BMI of 22.0 to 24.9 kg/m2, 1.66 (CI, 1.31 to 2.10) for a BMI of 25.0 to 29.9 kg/m2, and 2.79 (CI, 2.04 to 3.81) for a BMI of 30 kg/m2 or greater. Among participants who never smoked, a BMI of 22.0 to 24.9 kg/m2 at age 18 years was also associated with increased premature death (hazard ratio, 1.50 [CI, 1.16 to 1.94]). Associations between BMI at age 18 years and death could only partly be explained by adult BMI measured in 1989.
Limitations: Because of the observational study design, residual confounding by imperfectly measured or unknown confounders may still be present.
Conclusion: Moderately higher adiposity at age 18 years is associated with increased premature death in younger and middle-aged U.S. women.
Editors' Notes
Context
Contribution
Implications
—The Editors
Author and Article Information
From Harvard School of Public Health, Brigham and Women's Hospital, and Harvard Medical School, Boston, Massachusetts; and Vrije Universiteit of Amsterdam, Amsterdam, the Netherlands.
Acknowledgment: The authors thank the participants of the Nurses' Health Study II for their continued cooperation.
Grant Support: By the National Institutes of Health (grant CA50385).
Potential Financial Conflicts of Interest: None disclosed.
Corresponding Author: Rob M. van Dam, Department of Nutrition, Harvard School of Public Health, 665 Huntington Avenue, Building II, Boston, MA 02115; e-mail, rvandam{at}hsph.harvard.edu.
Current Author Addresses: Drs. van Dam, Willett, and Hu: Department of Nutrition, Harvard School of Public Health, 665 Huntington Avenue, Building II, Boston, MA 02115.
Dr. Manson: Division of Preventive Medicine, Brigham and Women's Hospital, 900 Commonwealth Avenue East, Third Floor, Boston, MA 02215.
Author Contributions: Conception and design: R.M. van Dam, W.C. Willett, J.E. Manson, F.B. Hu.
Analysis and interpretation of the data: R.M. van Dam, J.E. Manson, F.B. Hu.
Drafting of the article: R.M. van Dam.
Critical revision of the article for important intellectual content: R.M. van Dam, W.C. Willett, J.E. Manson, F.B. Hu.
Final approval of the article: R.M. van Dam, W.C. Willett, J.E. Manson, F.B. Hu.
Statistical expertise: R.M. van Dam, J.E. Manson, F.B. Hu.
Obtaining of funding: W.C. Willett, F.B. Hu.
Administrative, technical, or logistic support: J.E. Manson, F.B. Hu.
Collection and assembly of data: W.C. Willett. ARTICLE
The Relationship between Overweight in Adolescence and Premature Death in Women
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