Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2013 Dec 1;178(11):1591-9.
doi: 10.1093/aje/kwt179. Epub 2013 Sep 7.

Obesity and mortality risk: new findings from body mass index trajectories

Hui Zheng, Dmitry Tumin, Zhenchao Qian

Obesity and mortality risk: new findings from body mass index trajectories

Hui Zheng et al. Am J Epidemiol. .

Abstract

Little research has addressed the heterogeneity and mortality risk in body mass index (BMI) trajectories among older populations. Applying latent class trajectory models to 9,538 adults aged 51 to 77 years from the US Health and Retirement Study (1992-2008), we defined 6 latent BMI trajectories: normal weight downward, normal weight upward, overweight stable, overweight obesity, class I obese upward, and class II/III obese upward. Using survival analysis, we found that people in the overweight stable trajectory had the highest survival rate, followed by those in the overweight obesity, normal weight upward, class I obese upward, normal weight downward, and class II/III obese upward trajectories. The results were robust after controlling for baseline demographic and socioeconomic characteristics, smoking status, limitations in activities of daily living, a wide range of chronic illnesses, and self-rated health. Further analysis suggested that BMI trajectories were more predictive of mortality risk than was static BMI status. Using attributable risk analysis, we found that approximately 7.2% of deaths after 51 years of age among the 1931-1941 birth cohort were due to class I and class II/III obese upward trajectories. This suggests that trajectories of increasing obesity past 51 years of age pose a substantive threat to future gains in life expectancy.

Keywords: United States; body mass index trajectories; heterogeneity; mortality; obesity.

PubMed Disclaimer

Figures

Figure 1.
Figure 1.
Six latent body mass index (BMI) trajectories after 51 years of age in the 1931–1941 Health and Retirement Study Cohort, 1992–2008. The BMI trajectories are as follows: +, class II/III obese upwards; solid diamonds, class I obese upwards; dashed line, overweight obesity; solid line, overweight stable; x, normal weight upward; and open diamond, normal weight downward.
Figure 2.
Figure 2.
Kaplan-Meier survival curve among persons in 6 body mass index trajectories in the 1931–1941 Health and Retirement Study Cohort, 1992–2008. The body mass index trajectories are as follows: +, class II/III obese upwards; solid diamonds, class I obese upwards; dashed line, overweight obesity; solid line, overweight stable; x, normal weight upward; and open diamond, normal weight downward.
See this image and copyright information in PMC

References

    1. Flegal KM, Graubard BI, Williamson DF, et al. Excess deaths associated with underweight, overweight, and obesity. JAMA. 2005;293(15):1861–1867. - PubMed
    1. Allison DB, Fontaine KR, Manson JE, et al. Annual deaths attributable to obesity in the United States. JAMA. 1999;282(16):1530–1538. - PubMed
    1. Mokdad AH, Marks JS, Stroup DF, et al. Actual causes of death in the United States, 2000. JAMA. 2004;291(10):1238–1245. - PubMed
    1. Mokdad AH, Marks JS, Stroup DF, et al. Correction: actual causes of death in the United States, 2000. JAMA. 2005;293(3):293–294. - PubMed
    1. Mikkelsen KL, Heitmann BL, Keiding N, et al. Independent effects of stable and changing body weight on total mortality. Epidemiology. 1999;10(6):671–678. - PubMed

Publication types