High body mass index (BMI) has been found to be associated with a multitude of health issues and its longitudinal effect on mortality needs to be further understood due to increasing rates of obesity. The relationship between BMI and mortality is a key public health concern due to the rise in obesity prevalence and advancing knowledge of the impact of BMI on all aspects of health.
In order to expand and further contribute to the understanding of the long-term impact of BMI on mortality, we utilized prospective, longitudinal data from the Veterans Affairs (VA) Normative Aging Study (NAS) to assess the relationship between BMI and 40-year all-cause and cause-specific mortality in men. Cox regression was used to evaluate the relationship between BMI and all-cause and cause-specific (cancer, congenital heart disease (CHD), stroke) mortality.
Of the 1,680 men included in this study, the majority were White (96.7%), born between 1920–1929, were between ages 50–59 years, married, completed some college, identified as an occasional drinker and a current smoker, and worked in a “white-collar” job. This study did not identify any men who had an underweight BMI. 594 men had normal BMI, 910 men were overweight, and 176 men were obese.
After adjusting for confounders, compared to men with normal BMI, overweight men had higher risk for CHD mortality (HR=1.33, 95% CI, 0.95–1.86), lower risk for all-cause and stroke mortality (HR=0.98, 95% CI, 0.87–1.11, HR=0.88, 95% CI, 0.53–1.45, respectively), and no difference in risk for cancer mortality (HR=1.00, 95% CI, 0.82–1.23). Obese men had higher risk for all-cause and stroke mortality (HR=1.19, 95% CI, 0.98–1.45, HR=1.26, 95% CI, 0.57–2.79, respectively) and lower risk for CHD and cancer mortality (HR=0.87, 95% CI, 0.48–1.58, HR=0.95, 95% CI, 0.68–1.33, respectively).
In conclusion, this study found that men categorized as obese had an increased risk of all-cause and stroke mortality, and men categorized as overweight had an increased risk of CHD mortality, compared to those with normal BMI. However, due to all confidence intervals crossing 1.00, there is a suggestion that BMI had an effect on mortality in this sample. These results are limited by selection bias during the NAS screening process which selected for healthy men. This may have skewed our results toward the null, potentially diminishing the association between BMI and mortality.
| Identifer | oai:union.ndltd.org:bu.edu/oai:open.bu.edu:2144/41443 |
| Date | 26 September 2020 |
| Creators | Tyzik, Anna L. |
| Contributors | Spiro, Avron, Aschengrau, Ann |
| Source Sets | Boston University |
| Language | en_US |
| Detected Language | English |
| Type | Thesis/Dissertation |
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