title: Delineation of body mass index trajectory predicting lowest risk of mortality in U.S. men using generalized additive mixed model.
abstract: Few studies have delineated body mass index (BMI) trajectories that associate with premature mortality, which is defined as death occurring before age 75 years.
  
  
  
  We used generalized additive mixed model to identify BMI trajectories of individuals dying before or after age 75 years among 14,172 U.S. men. We used logistic regression to validate whether the BMI trajectory developed predicted mortality in an independent cohort of 7000 participants.
  
  
  
  Comparing to participants with age at death less than 75 years, the BMI among participants with age at death 75 years or more was lower throughout adulthood, and the mean BMI was 23.98, 24.63, 25.33, and 25.29 kg/m2at age 40, 50, 60, and 70 years. In the validation cohort, participants following the BMI trajectory with age at death less than 75 years had higher risks of total mortality (odds ratio: 1.35; 95% confidence interval: 1.01-1.78) and cardiovascular disease mortality (1.92; 1.10-3.35) compared to participants following the trajectory with age at death 75 years or more. Participants whose BMI trajectories diverged the most from the trajectory with age at death 75 years or more had highest risks of total mortality (1.72; 1.23-2.40) and cardiovascular disease mortality (3.06; 1.49-6.30).
  
  
  
  Individual is suggested to maintain a normal BMI throughout adulthood to have greater longevity.
authors.affiliation: Department of Nutrition, Harvard School of Public Health, Boston, MA; Department of Epidemiology, Harvard School of Public Health, Boston, MA. Electronic address: mid829@mail.harvard.edu.
authors.forename: Ming
authors.initials: M
authors.lastname: Ding
authors.affiliation: Department of Nutrition, Harvard School of Public Health, Boston, MA.
authors.forename: Yang
authors.initials: Y
authors.lastname: Hu
authors.affiliation: Department of Epidemiology, Harvard School of Public Health, Boston, MA; Department of Environmental Health, Harvard School of Public Health, Boston, MA.
authors.forename: Joel
authors.initials: J
authors.lastname: Schwartz
authors.affiliation: Duke-NUS Medical School, Singapore; Saw Swee Hock School of Public Health, National University of Singapore, Singapore.
authors.forename: Woon-Puay
authors.initials: WP
authors.lastname: Koh
authors.affiliation: Division of Cancer Control and Population Sciences, University of Pittsburgh Cancer Institute, Pittsburgh, PA; Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh.
authors.forename: Jian-Min
authors.initials: JM
authors.lastname: Yuan
authors.affiliation: Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA.
authors.forename: Howard D
authors.initials: HD
authors.lastname: Sesso
authors.affiliation: Department of Epidemiology, Harvard School of Public Health, Boston, MA; Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA.
authors.forename: Jing
authors.initials: J
authors.lastname: Ma
authors.affiliation: Department of Nutrition, Harvard School of Public Health, Boston, MA; Department of Epidemiology, Harvard School of Public Health, Boston, MA; Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA.
authors.forename: Jorge
authors.initials: J
authors.lastname: Chavarro
authors.affiliation: Department of Nutrition, Harvard School of Public Health, Boston, MA; Department of Epidemiology, Harvard School of Public Health, Boston, MA; Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA.
authors.forename: Frank B
authors.initials: FB
authors.lastname: Hu
authors.affiliation: Department of Epidemiology and Biostatistics, Ministry of Education Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
authors.forename: An
authors.initials: A
authors.lastname: Pan
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D015992:Body Mass Index; D002423:Cause of Death; D015331:Cohort Studies; D016001:Confidence Intervals; D004812:Epidemiologic Methods; D006801:Humans; D016015:Logistic Models; D008136:Longevity; D008297:Male; D008875:Middle Aged; D061213:Mortality, Premature / Q000639:trends*; D016017:Odds Ratio; D011237:Predictive Value of Tests; D015995:Prevalence; D012189:Retrospective Studies; D018570:Risk Assessment; D014481:United States
keywords: Body mass index; Generalized additive mixed model; Mortality