title: Association between body-mass index and risk of death in more than 1 million Asians.
abstract: BACKGROUND
  Most studies that have evaluated the association between the body-mass index (BMI) and the risks of death from any cause and from specific causes have been conducted in populations of European origin.
  
  
  METHODS
  We performed pooled analyses to evaluate the association between BMI and the risk of death among more than 1.1 million persons recruited in 19 cohorts in Asia. The analyses included approximately 120,700 deaths that occurred during a mean follow-up period of 9.2 years. Cox regression models were used to adjust for confounding factors.
  
  
  RESULTS
  In the cohorts of East Asians, including Chinese, Japanese, and Koreans, the lowest risk of death was seen among persons with a BMI (the weight in kilograms divided by the square of the height in meters) in the range of 22.6 to 27.5. The risk was elevated among persons with BMI levels either higher or lower than that range--by a factor of up to 1.5 among those with a BMI of more than 35.0 and by a factor of 2.8 among those with a BMI of 15.0 or less. A similar U-shaped association was seen between BMI and the risks of death from cancer, from cardiovascular diseases, and from other causes. In the cohorts comprising Indians and Bangladeshis, the risks of death from any cause and from causes other than cancer or cardiovascular disease were increased among persons with a BMI of 20.0 or less, as compared with those with a BMI of 22.6 to 25.0, whereas there was no excess risk of either death from any cause or cause-specific death associated with a high BMI.
  
  
  CONCLUSIONS
  Underweight was associated with a substantially increased risk of death in all Asian populations. The excess risk of death associated with a high BMI, however, was seen among East Asians but not among Indians and Bangladeshis.
authors.affiliation: Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt–Ingram Cancer Center, Vanderbilt University, Nashville, TN, USA. wei.zheng@vanderbilt.edu
authors.forename: Wei
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authors.lastname: Zheng
authors.forename: Dale F
authors.initials: DF
authors.lastname: McLerran
authors.forename: Betsy
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authors.lastname: Rolland
authors.forename: Xianglan
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authors.lastname: Zhang
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authors.forename: Yu-Tang
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authors.lastname: Gao
authors.forename: Renwei
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authors.lastname: Wang
authors.forename: Xiao-Ou
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authors.lastname: Shu
authors.forename: Ichiro
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authors.lastname: Tsuji
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authors.forename: Hideo
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authors.lastname: Tanaka
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authors.forename: Chien-Jen
authors.initials: CJ
authors.lastname: Chen
authors.forename: Jian-Min
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authors.lastname: Yuan
authors.forename: Keun-Young
authors.initials: KY
authors.lastname: Yoo
authors.forename: Habibul
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authors.lastname: Ahsan
authors.forename: Wen-Harn
authors.initials: WH
authors.lastname: Pan
authors.forename: Dongfeng
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authors.lastname: Gu
authors.forename: Mangesh Suryakant
authors.initials: MS
authors.lastname: Pednekar
authors.forename: Catherine
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authors.lastname: Sauvaget
authors.forename: Shizuka
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authors.lastname: Sasazuki
authors.forename: Toshimi
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authors.lastname: Sairenchi
authors.forename: Gong
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authors.lastname: Yang
authors.forename: Yong-Bing
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authors.lastname: Xiang
authors.forename: Masato
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authors.lastname: Nagai
authors.forename: Takeshi
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authors.lastname: Suzuki
authors.forename: Yoshikazu
authors.initials: Y
authors.lastname: Nishino
authors.forename: San-Lin
authors.initials: SL
authors.lastname: You
authors.forename: Woon-Puay
authors.initials: WP
authors.lastname: Koh
authors.forename: Sue K
authors.initials: SK
authors.lastname: Park
authors.forename: Yu
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authors.lastname: Chen
authors.forename: Chen-Yang
authors.initials: CY
authors.lastname: Shen
authors.forename: Mark
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authors.lastname: Thornquist
authors.forename: Ziding
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authors.lastname: Feng
authors.forename: Daehee
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authors.lastname: Boffetta
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authors.initials: JD
authors.lastname: Potter
mesh_terms: D001208:Asia / Q000453:epidemiology; D044466:Asian People; D015992:Body Mass Index; D002423:Cause of Death; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D009026:Mortality; D009765:Obesity / Q000208:ethnology*; D050177:Overweight / Q000208:ethnology; D016016:Proportional Hazards Models; D012306:Risk