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Higher obesity increases odds for cardiovascular, cancer, diabetes deaths
Adults with class III obesity are more likely to die from all causes than those within normal weight range, but particularly from heart disease, cancer and diabetes, according to a review published in PLOS Medicine.
The meta-analysis of 20 prospective cohort studies from the United States, Sweden and Australia conducted by Cari M. Kitahara, PhD, with colleagues from the National Cancer Institute in Bethesda, Md., found life expectancy decreased as BMI surpassed 40.
“Our results suggest that otherwise healthy, non-smoking adults with BMI values within the class III obesity range may considerably extend their life expectancy by avoiding additional weight gain,” Kitahara told Endocrine Today.
Cari M. Kitahara
Looking at data from the National Cancer Institute Cohort Consortium, the researchers estimated total and cause-specific mortality rates (deaths per 100,000 persons per year) and multivariable-adjusted hazard ratios over 30 years for adults aged 19 to 83 years at baseline.
Participants were classified as obese class III (BMI 40.0-59.9) or normal weight (BMI 18.5-24.9). Adjustments were made for sex and age. Those who reported ever smoking cigarettes or a history of chronic disease — including heart disease, cancer, stroke or emphysema — through baseline questionnaires were excluded.
In 9,564 participants categorized as class III, mortality rates were 856 for men and 663 for women. In 304,011 participants categorized as normal weight, rates were 346.7 for men and 280.5 for women.
Heart disease deaths were a large contributor for those with class III obesity (men, 238.9 deaths and women, 132.8), followed by cancer (36.7 and 62.3, respectively) and diabetes (51.2 and 29.2, respectively).
Within the class III range, hazard ratios increased for total deaths and deaths due to heart disease, cancer, diabetes, nephritis/nephrotic syndrome/nephrosis, chronic lower respiratory disease and influenza/pneumonia as BMI increased.
Participants lost more years of life as their BMI rose (95% CI for all):
- BMI 40-44.9, approximately 6.5 years (5.7-7.3).
- BMI 45-49.9, approximately 8.9 years (7.4-10.4).
- BMI 50-54.9, approximately 9.8 years (7.4-12.2).
- BMI 55-59.9, approximately 13.7 years (10.5-16.9).
“This loss in life expectancy is similar to what we and others have observed when comparing current vs. never cigarette smokers,” Kitahara said.
The investigators acknowledged self-reported BMI as a limitation to the accuracy of their findings, as well as this being the sole measure of obesity.
Despite having a data-set of mostly white individuals, the researchers said the substantially increased rate of death seen demonstrates the need for action.
“The results of our study highlight the need to develop and implement more effective interventions to combat this growing health problem,” Kitahara said. — by Allegra Tiver
For More Information:
Kitahara can be reached at Division of Cancer Epidemiology and Genetics National Cancer Institute Room, 7E566, MSC 9778, 9609 Medical Center Drive, Bethesda, MD 208792-9778; email: mailto:kitaharac@mail.nih.gov.
Disclosures: The research was supported by the Intramural Research Program of the National Cancer Institute, NIH. One researcher reports being an Editorial Board member for PLOS Medicine.