title: Overweight, obesity, and mortality in a large prospective cohort of persons 50 to 71 years old.
abstract: BACKGROUND
  Obesity, defined by a body-mass index (BMI) (the weight in kilograms divided by the square of the height in meters) of 30.0 or more, is associated with an increased risk of death, but the relation between overweight (a BMI of 25.0 to 29.9) and the risk of death has been questioned.
  
  
  METHODS
  We prospectively examined BMI in relation to the risk of death from any cause in 527,265 U.S. men and women in the National Institutes of Health-AARP cohort who were 50 to 71 years old at enrollment in 1995-1996. BMI was calculated from self-reported weight and height. Relative risks and 95 percent confidence intervals were adjusted for age, race or ethnic group, level of education, smoking status, physical activity, and alcohol intake. We also conducted alternative analyses to address potential biases related to preexisting chronic disease and smoking status.
  
  
  RESULTS
  During a maximum follow-up of 10 years through 2005, 61,317 participants (42,173 men and 19,144 women) died. Initial analyses showed an increased risk of death for the highest and lowest categories of BMI among both men and women, in all racial or ethnic groups, and at all ages. When the analysis was restricted to healthy people who had never smoked, the risk of death was associated with both overweight and obesity among men and women. In analyses of BMI during midlife (age of 50 years) among those who had never smoked, the associations became stronger, with the risk of death increasing by 20 to 40 percent among overweight persons and by two to at least three times among obese persons; the risk of death among underweight persons was attenuated.
  
  
  CONCLUSIONS
  Excess body weight during midlife, including overweight, is associated with an increased risk of death.
authors.affiliation: Nutritional Epidemiology Branch, National Cancer Institute, National Institutes of Health, Bethesda, Md, USA. adamske@mail.nih.gov
authors.forename: Kenneth F
authors.initials: KF
authors.lastname: Adams
authors.forename: Arthur
authors.initials: A
authors.lastname: Schatzkin
authors.forename: Tamara B
authors.initials: TB
authors.lastname: Harris
authors.forename: Victor
authors.initials: V
authors.lastname: Kipnis
authors.forename: Traci
authors.initials: T
authors.lastname: Mouw
authors.forename: Rachel
authors.initials: R
authors.lastname: Ballard-Barbash
authors.forename: Albert
authors.initials: A
authors.lastname: Hollenbeck
authors.forename: Michael F
authors.initials: MF
authors.lastname: Leitzmann
mesh_terms: D000368:Aged; D015992:Body Mass Index; D015986:Confounding Factors, Epidemiologic; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009765:Obesity / Q000401:mortality*; D050177:Overweight; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012306:Risk; D012307:Risk Factors; D013851:Thinness / Q000401:mortality; D014481:United States / Q000453:epidemiology