Body mass index and mortality in men:

[Guest guest]

when corrected for smoking or existing disease, those

under 22 had the lowest mortality.

ORIGINAL ARTICLE

Body mass index and mortality in men: evaluating the

shape of the association

RP Gelber1, T Kurth1,2,4, JE Manson2,4, JE

Buring1,2,4,5 and JM Gaziano1,2,3

Objective: Controversy regarding the relationship

between body mass index (BMI) and mortality continues

to exist. Most of the

previous studies have not comprehensively accounted

for major sources of bias. We examined the association

between BMI and

all-cause mortality according to pre-existing disease

and smoking status in a large prospective cohort.

Methods: Participants were 99 253 male physicians in

the Physicians’ Health Study enrollment cohort (40–84

years) who

provided self-reported information in 1982. We used

proportional hazards regression to examine the

association between

baseline BMI and mortality.

Results: A total of 5438 men died (median follow-up,

5.7 years). Although a U-shaped association between

BMI and all-cause

mortality was seen among all men, we found a linear

relationship when accounting for potential sources of

bias. In the optimal

model excluding men who died within 2 years, and

adjusting for age, smoking, alcohol consumption,

physical activity, prior

disease and interactions between BMI and prior

disease, and between BMI and smoking, those with BMI

o20.0 kg/m2 had a

relative risk (RR) of death of 0.88 (95% confidence

interval (CI), 0.56–1.40), as compared to men with BMI

22.5–24.9 kg/m2. By

contrast, men with BMI 30.0–34.9 kg/m2 had an RR of

1.45 (95% CI, 1.10–1.91) and those with BMI X35.0

kg/m2 had an RR

of 1.62 (95% CI, 1.12–2.35; P for linear trend,

o0.001). According to WHO categories, men in the

‘overweight’ range (BMI

25.0–29.9 kg/m2) had an RR of 1.20 (95% CI, 1.05–1.38)

as compared to men in the ‘normal’ range (BMI o25.0

kg/m2).

Conclusions: In this large, prospective cohort, we

found a consistent linear association between higher

BMI and increased risk of

mortality after accounting for several potential

sources of bias, even among those within the

‘overweight’ range of BMI. Public

health messages should emphasize the preponderance of

evidence supporting the adverse health effects

associated with higher

body weight.

International Journal of Obesity (2007) 31, 1240–1247;

www.nature.com/ijo

[Guest guest]

Jeff, I'm a little confused by the abstract. Was the conclusion that

men in the BMI range of 20 to 22.5 had the lowest relative risk of

mortality, or was it, as you summarized, those with BMIs under 22?

Did you have access to the full article, and found something

different that what the post below appears to say? Thanks in advance

for clarifying.

--- In , Jeff Novick <chefjeff40@...>

wrote:

>

> when corrected for smoking or existing disease, those

> under 22 had the lowest mortality.

>

>

>

> ORIGINAL ARTICLE

> Body mass index and mortality in men: evaluating the

> shape of the association

> RP Gelber1, T Kurth1,2,4, JE Manson2,4, JE

> Buring1,2,4,5 and JM Gaziano1,2,3

>

> Objective: Controversy regarding the relationship

> between body mass index (BMI) and mortality continues

> to exist. Most of the

> previous studies have not comprehensively accounted

> for major sources of bias. We examined the association

> between BMI and

> all-cause mortality according to pre-existing disease

> and smoking status in a large prospective cohort.

>

> Methods: Participants were 99 253 male physicians in

> the Physicians' Health Study enrollment cohort (40–84

> years) who

> provided self-reported information in 1982. We used

> proportional hazards regression to examine the

> association between

> baseline BMI and mortality.

>

> Results: A total of 5438 men died (median follow-up,

> 5.7 years). Although a U-shaped association between

> BMI and all-cause

> mortality was seen among all men, we found a linear

> relationship when accounting for potential sources of

> bias. In the optimal

> model excluding men who died within 2 years, and

> adjusting for age, smoking, alcohol consumption,

> physical activity, prior

> disease and interactions between BMI and prior

> disease, and between BMI and smoking, those with BMI

> o20.0 kg/m2 had a

> relative risk (RR) of death of 0.88 (95% confidence

> interval (CI), 0.56–1.40), as compared to men with BMI

> 22.5–24.9 kg/m2. By

> contrast, men with BMI 30.0–34.9 kg/m2 had an RR of

> 1.45 (95% CI, 1.10–1.91) and those with BMI X35.0

> kg/m2 had an RR

> of 1.62 (95% CI, 1.12–2.35; P for linear trend,

> o0.001). According to WHO categories, men in the

> `overweight' range (BMI

> 25.0–29.9 kg/m2) had an RR of 1.20 (95% CI, 1.05–1.38)

> as compared to men in the `normal' range (BMI o25.0

> kg/m2).

>

> Conclusions: In this large, prospective cohort, we

> found a consistent linear association between higher

> BMI and increased risk of

> mortality after accounting for several potential

> sources of bias, even among those within the

> `overweight' range of BMI. Public

> health messages should emphasize the preponderance of

> evidence supporting the adverse health effects

> associated with higher

> body weight.

>

> International Journal of Obesity (2007) 31, 1240–1247;

>

> www.nature.com/ijo

>

[Guest guest]

You are correct. I should have clarified. It was the 18.5 to 22 group. I have

the full paper if you want a copy.

jeff

[ ] Re: Body mass index and mortality in men:

Jeff, I'm a little confused by the abstract. Was the conclusion that

men in the BMI range of 20 to 22.5 had the lowest relative risk of

mortality, or was it, as you summarized, those with BMIs under 22?

Did you have access to the full article, and found something

different that what the post below appears to say? Thanks in advance

for clarifying.

--- In , Jeff Novick <chefjeff40@...>

wrote:

>

> when corrected for smoking or existing disease, those

> under 22 had the lowest mortality.

>

>

>

> ORIGINAL ARTICLE

> Body mass index and mortality in men: evaluating the

> shape of the association

> RP Gelber1, T Kurth1,2,4, JE Manson2,4, JE

> Buring1,2,4,5 and JM Gaziano1,2,3

[Guest guest]

You are correct. I should have clarified. It was the 18.5 to 22 group. I have

the full paper if you want a copy.

jeff

[ ] Re: Body mass index and mortality in men:

Jeff, I'm a little confused by the abstract. Was the conclusion that

men in the BMI range of 20 to 22.5 had the lowest relative risk of

mortality, or was it, as you summarized, those with BMIs under 22?

Did you have access to the full article, and found something

different that what the post below appears to say? Thanks in advance

for clarifying.

--- In , Jeff Novick <chefjeff40@...>

wrote:

>

> when corrected for smoking or existing disease, those

> under 22 had the lowest mortality.

>

>

>

> ORIGINAL ARTICLE

> Body mass index and mortality in men: evaluating the

> shape of the association

> RP Gelber1, T Kurth1,2,4, JE Manson2,4, JE

> Buring1,2,4,5 and JM Gaziano1,2,3

[Guest guest]

This correlates with all the studies in our files which say the same thing. This file is also under “CRON SCIENCE” and is called: “Extreme CRON or Moderate CRON?”

From: Novick <chefjeff40@...>

Reply-< >

Date: Fri, 3 Aug 2007 14:54:45 -0400

< >, < >

Subject: RE: [ ] Re: Body mass index and mortality in men:

You are correct. I should have clarified. It was the 18.5 to 22 group. I have the full paper if you want a copy.

jeff

[ ] Re: Body mass index and mortality in men:

Jeff, I'm a little confused by the abstract. Was the conclusion that

men in the BMI range of 20 to 22.5 had the lowest relative risk of

mortality, or was it, as you summarized, those with BMIs under 22?

Did you have access to the full article, and found something

different that what the post below appears to say? Thanks in advance

for clarifying.

--- In <mailto: %40> , Jeff Novick <chefjeff40@...>

wrote:

>

> when corrected for smoking or existing disease, those

> under 22 had the lowest mortality.

>

>

>

> ORIGINAL ARTICLE

> Body mass index and mortality in men: evaluating the

> shape of the association

> RP Gelber1, T Kurth1,2,4, JE Manson2,4, JE

> Buring1,2,4,5 and JM Gaziano1,2,3

[Guest guest]

double oops !! (PS:Note to self: Dont post from your

PDA)

The bottom group was < 20 and 20-22.4.

The < 20 had the lowest mortality but i dont see a

bottom weight/BMI cutoff or discussion.

Maybe we need to write the author.

Jeff

From the paper...

Assessment of BMI

BMI was calculated from self-reported weight (kg)

divided by

height (m) squared. To evaluate BMI over the range of

‘normal’ and ‘overweight,’ we categorized BMI as

o20.0,

20.0–22.4, 22.5–24.9, 25.0–27.4, 27.5–29.9 and X30.0

kg/m2.

We also evaluated BMI according to World Health

Organiza-

tion (WHO) categories (normal, o25.0; overweight,

25.0–

29.9; obese class I, 30.0–34.9; obese class II–III,

X35.0

kg/m2). Self-reports of weight and height have been

validated in other health professional cohorts and

shown

to be highly accurate (Spearman r

1?4 0.97 in the Nurses’

Health Study and r

1?4 0.97 in the Health Professionals Follow-

up Study, as compared to measured weights).18

[Guest guest]

The main problem I see with the optimal model (the one that give linear

results with the lowest BMI having the lowest relative risk) is that the

p = .86.

The other approaches that still have significant results all still

" bottom out " in terms of relative risk in the old 22.5-24.9

range.

Maco

At 12:54 PM 8/3/2007, you wrote:

You are correct. I should have

clarified. It was the 18.5 to 22 group. I have the full paper if you want

a copy.

jeff

[ ] Re: Body mass index and mortality in

men:

Jeff, I'm a little confused by the abstract. Was the conclusion that

men in the BMI range of 20 to 22.5 had the lowest relative risk of

mortality, or was it, as you summarized, those with BMIs under 22?

Did you have access to the full article, and found something

different that what the post below appears to say? Thanks in advance

for clarifying.

--- In

, Jeff Novick <chefjeff40@...>

wrote:

>

> when corrected for smoking or existing disease, those

> under 22 had the lowest mortality.

>

>

>

> ORIGINAL ARTICLE

> Body mass index and mortality in men: evaluating the

> shape of the association

> RP Gelber1, T Kurth1,2,4, JE Manson2,4, JE

> Buring1,2,4,5 and JM Gaziano1,2,3