Obesity in adulthood and its consequences for life expectancy: a life-table analysis.
BACKGROUND
Overweight and obesity in adulthood are linked to an increased risk for death and disease. Their potential effect on life expectancy and premature death has not yet been described.


OBJECTIVE
To analyze reductions in life expectancy and increases in premature death associated with overweight and obesity at 40 years of age.


METHODS
Prospective cohort study.


METHODS
The Framingham Heart Study with follow-up from 1948 to 1990.


METHODS
3457 Framingham Heart Study participants who were 30 to 49 years of age at baseline.


METHODS
Mortality rates specific for age and body mass index group (normal weight, overweight, or obese at baseline) were derived within sex and smoking status strata. Life expectancy and the probability of death before 70 years of age were analyzed by using life tables.


RESULTS
Large decreases in life expectancy were associated with overweight and obesity. Forty-year-old female nonsmokers lost 3.3 years and 40-year-old male nonsmokers lost 3.1 years of life expectancy because of overweight. Forty-year-old female nonsmokers lost 7.1 years and 40-year-old male nonsmokers lost 5.8 years because of obesity. Obese female smokers lost 7.2 years and obese male smokers lost 6.7 years of life expectancy compared with normal-weight smokers. Obese female smokers lost 13.3 years and obese male smokers lost 13.7 years compared with normal-weight nonsmokers. Body mass index at ages 30 to 49 years predicted mortality after ages 50 to 69 years, even after adjustment for body mass index at age 50 to 69 years.


CONCLUSIONS
Obesity and overweight in adulthood are associated with large decreases in life expectancy and increases in early mortality. These decreases are similar to those seen with smoking. Obesity in adulthood is a powerful predictor of death at older ages. Because of the increasing prevalence of obesity, more efficient prevention and treatment should become high priorities in public health.
Peeters
Anna
A
Department of Public Health, Erasmus MC, PO Box 1738, 3000 DR Rotterdam, The Netherlands. peeters@mgz.fgg.eur.nl
Barendregt
Jan J
JJ
Willekens
Frans
F
Mackenbach
Johan P
JP
Al Mamun
Abdullah
A
Bonneux
Luc
L
D000328:Adult; D015992:Body Mass Index; D001835:Body Weight / Q000502:physiology*; D002423:Cause of Death; D048909:Diabetes Complications; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000150:complications; D008017:Life Expectancy; D015993:Life Tables; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications* / Q000503:physiopathology; D012907:Smoking / Q000009:adverse effects; D016019:Survival Analysis