Mortality and optimal body mass index in a sample of the US population.
In this paper, the authors model the nonmonotonic relation between body mass index (BMI) (weight (kg)/height2 (m2)) and mortality in 13,242 black and white participants in the NHANES I Epidemiologic Follow-up Study in order to estimate the BMI at which minimum mortality occurs. The BMI of minimum mortality was 27.1 for black men (95% confidence interval (CI) 24.8-29.4), 26.8 for black women (95% CI 24.7-28.9), 24.8 for white men (95% CI 23.8-25.9), and 24.3 for white women (95% CI 23.3-25.4). Each confidence interval included the group average. Analyses conducted by smoking status and after exclusion of persons with baseline illness and persons who died during the first 4 years of follow-up led to virtually identical estimates. The authors determined the range of values over which risk of all-cause mortality would increase no more than 20% in comparison with the minimum. This interval was nine BMI units wide, and it included 70% of the population. These results were confirmed by parallel analyses using quantiles. The model used allowed the estimation of parameters in the BMI-mortality relation. The resulting empirical findings from each of four race/sex groups, which are representative of the US population, demonstrate a wide range of BMIs consistent with minimum mortality and do not suggest that the optimal BMI is at the lower end of the distribution for any subgroup.
Durazo-Arvizu
R A
RA
Department of Preventive Medicine and Epidemiology, Stritch School of Medicine, Loyola University, Maywood, IL, USA.
McGee
D L
DL
Cooper
R S
RS
Liao
Y
Y
Luke
A
A
D000328:Adult; D000368:Aged; D044383:Black People; D015992:Body Mass Index; D004812:Epidemiologic Methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009026:Mortality; D009749:Nutrition Surveys; D012907:Smoking / Q000009:adverse effects; D014481:United States; D044465:White People; D001741:Black or African American