Obesity in Adulthood and Its Consequences for Life Expectancy: A Life-Table Analysis

Obesity in Adulthood and Its Consequences for Life Expectancy: A Life-Table Analysis

Anna Peeters, PhD;
Jan J. Barendregt, PhD;
Frans Willekens, PhD;
Johan P. Mackenbach, MD, PhD;
Abdullah Al Mamun, BSc(Hons), MSc;
Luc Bonneux, MD, PhD; and
for NEDCOM, the Netherlands Epidemiology and Demography Compression of Morbidity Research Group*

From Erasmus MC, Rotterdam, and University of Groningen, Groningen, the Netherlands.

Abstract

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.

Article and Author Information

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.