title: Lower levels of physical functioning are associated with higher body weight among middle-aged and older women.
abstract: OBJECTIVE
  To compare levels of physical function, across levels of body mass index (BMI), among middle- to older-aged women.
  
  
  METHODS
  Cross-sectional study. Physical function, body weight and other covariates were measured in 1992.
  
  
  METHODS
  56510 women aged 45-71 y, free of cardiovascular disease and cancer, participating in the Nurses' Health Study.
  
  
  METHODS
  The four physical function scores on the Medical Outcomes Study (MOS) Short Form-36 (SF36) Health Survey: physical functioning, vitality, bodily pain and role limitations.
  
  
  RESULTS
  After adjusting for age, race, smoking status, menopausal status, physical activity and alcohol consumption, there was a significant dose-response gradient between increasing levels of BMI in 1992 and reduced function. For example, women with a BMI between 30-34.9 kg/m2 averaged: 9.0 point lower physical functioning score (95% Confidence interval (CI) -9.5, -8.5), 5.6 point lower vitality score (95% CI: -6.1, -5.1), and 7.0 point lower freedom from pain score (95% CI: -7.6, -6.4). These declines represent an approximate 10% loss of function compared to the reference category of women with BMIs ranging from 22.0-23.9 kg/m2. For the same BMI comparison, heavier women were at 66% increased risk of limitations in ability to work or perform other roles (RR = 1.66; 95% odds ratio (OR) CI: 1.56, 1.76). These findings were replicated when the sample was restricted to women who had maintained their BMI over a ten year period.
  
  
  CONCLUSIONS
  In addition to increasing risk of chronic health conditions, greater adiposity is associated with lower every day physical functioning, such as climbing stairs or other moderate activities, as well as lower feelings of well-being and greater burden of pain.
authors.affiliation: The Channing Laboratory, Department of Nutrition, Harvard School of Public Health, Boston, MA 02115, USA.
authors.forename: E H
authors.initials: EH
authors.lastname: Coakley
authors.forename: I
authors.initials: I
authors.lastname: Kawachi
authors.forename: J E
authors.initials: JE
authors.lastname: Manson
authors.forename: F E
authors.initials: FE
authors.lastname: Speizer
authors.forename: W C
authors.initials: WC
authors.lastname: Willet
authors.forename: G A
authors.initials: GA
authors.lastname: Colditz
mesh_terms: D000368:Aged; D000375:Aging; D000428:Alcohol Drinking; D001823:Body Composition; D015992:Body Mass Index; D001835:Body Weight; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D006233:Persons with Disabilities; D015444:Exercise; D005260:Female; D006801:Humans; D008593:Menopause; D008875:Middle Aged; D010146:Pain; D010809:Physical Fitness; D011788:Quality of Life; D012907:Smoking