title: Relationship between BMI and all-cause mortality in Japan: NIPPON DATA80.
abstract: As body composition in Asian populations is largely different from Western populations, a healthy BMI could also differ between the two populations. Thus, further study is needed to determine whether a healthy BMI in Asians should be lower than Western populations, as recommended by the World Health Organization (WHO). We investigated the relationship between BMI and mortality in a sample of 8,924 Japanese men and women without stroke or heart disease. During 19 years of follow-up, 1,718 deaths were observed. We found a U-shaped relationship between BMI and fatal events. Risk of total mortality was highest in participants with BMI <18.5 kg/m(2) and lowest in participants with BMI 23.0-24.9 kg/m(2). These findings persisted even after excluding the first 5 years of follow-up with a focus on healthy participants who never smoked, were aged <70 years, and had total cholesterol (TC) levels >or=4.1 mmol/l (N=3712). For both the full sample and healthy participants, all-cause mortality risk did not differ between BMI ranges 21.0-22.9 and 23.0-24.9 kg/m(2). Our findings do not support the recent WHO implications that BMIs <23.0 kg/m(2) is healthy for Asians. Therefore, further studies are needed to identify an optimal BMI range for Asia.
authors.affiliation: Department of Health Science, Shiga University of Medical Science, Otsu, Japan. hozawa-thk@umin.ac.jp
authors.forename: Atsushi
authors.initials: A
authors.lastname: Hozawa
authors.forename: Tomonori
authors.initials: T
authors.lastname: Okamura
authors.forename: Izumi
authors.initials: I
authors.lastname: Oki
authors.forename: Yoshitaka
authors.initials: Y
authors.lastname: Murakami
authors.forename: Takashi
authors.initials: T
authors.lastname: Kadowaki
authors.forename: Koshi
authors.initials: K
authors.lastname: Nakamura
authors.forename: Naomi
authors.initials: N
authors.lastname: Miyamatsu
authors.forename: Takehito
authors.initials: T
authors.lastname: Hayakawa
authors.forename: Yoshikuni
authors.initials: Y
authors.lastname: Kita
authors.forename: Yosikazu
authors.initials: Y
authors.lastname: Nakamura
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Nakamura
authors.forename: Robert D
authors.initials: RD
authors.lastname: Abbott
authors.forename: Akira
authors.initials: A
authors.lastname: Okayama
authors.forename: Hirotsugu
authors.initials: H
authors.lastname: Ueshima
mesh_terms: D000328:Adult; D000368:Aged; D044466:Asian People / Q000706:statistics & numerical data*; D015992:Body Mass Index; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009026:Mortality / Q000208:ethnology; D050177:Overweight / Q000208:ethnology / Q000401:mortality*; D012016:Reference Values; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors