title: Body mass index as a predictor of healthy and disease-free life expectancy between ages 50 and 75: a multicohort study.
abstract: While many studies have shown associations between obesity and increased risk of morbidity and mortality, little comparable information is available on how body mass index (BMI) impacts health expectancy. We examined associations of BMI with healthy and chronic disease-free life expectancy in four European cohort studies.
  
  
  
  Data were drawn from repeated waves of cohort studies in England, Finland, France and Sweden. BMI was categorized into four groups from normal weight (18.5-24.9 kg m-2) to obesity class II (⩾35 kg m-2). Health expectancy was estimated with two health indicators: sub-optimal self-rated health and having a chronic disease (cardiovascular disease, cancer, respiratory disease and diabetes). Multistate life table models were used to estimate sex-specific healthy life expectancy and chronic disease-free life expectancy from ages 50 to 75 years for each BMI category.
  
  
  
  The proportion of life spent in good perceived health between ages 50 and 75 progressively decreased with increasing BMI from 81% in normal weight men and women to 53% in men and women with class II obesity which corresponds to an average 7-year difference in absolute terms. The proportion of life between ages 50 and 75 years without chronic diseases decreased from 62 and 65% in normal weight men and women and to 29 and 36% in men and women with class II obesity, respectively. This corresponds to an average 9 more years without chronic diseases in normal weight men and 7 more years in normal weight women between ages 50 and 75 years compared to class II obese men and women. No consistent differences were observed between cohorts.
  
  
  
  Excess BMI is associated with substantially shorter healthy and chronic disease-free life expectancy, suggesting that tackling obesity would increase years lived in good health in populations.
authors.affiliation: Department of Public Health, University of Turku and Turku University Hospital, Turku, Finland.
authors.forename: S
authors.identifier: 0000-0001-7560-0930
authors.initials: S
authors.lastname: Stenholm
authors.affiliation: Department of Epidemiology and Public Health, University College London, London, UK.
authors.forename: J
authors.initials: J
authors.lastname: Head
authors.affiliation: Finnish Institute of Occupational Health, Turku, Finland.
authors.forename: V
authors.initials: V
authors.lastname: Aalto
authors.affiliation: Department of Epidemiology and Public Health, University College London, London, UK.|Finnish Institute of Occupational Health, Turku, Finland.|Clinicum, Faculty of Medicine, University of Helsinki, Helsinki, Finland.
authors.forename: M
authors.initials: M
authors.lastname: Kivimäki
authors.affiliation: Department of Social &Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
authors.forename: I
authors.initials: I
authors.lastname: Kawachi
authors.affiliation: Inserm, Population-based Epidemiologic Cohorts Unit-UMS 011, Villejuif, France.|Paris Descartes University, Paris, France.|Inserm, Aging and Chronic Diseases. Epidemiological and Public Health Approaches, Villejuif, France.
authors.forename: M
authors.initials: M
authors.lastname: Zins
authors.affiliation: Inserm, Population-based Epidemiologic Cohorts Unit-UMS 011, Villejuif, France.|Paris Descartes University, Paris, France.
authors.forename: M
authors.initials: M
authors.lastname: Goldberg
authors.affiliation: Stress Research Institute, Stockholm University, Stockholm, Sweden.
authors.forename: L G
authors.initials: LG
authors.lastname: Platts
authors.affiliation: Department of Epidemiology and Public Health, University College London, London, UK.
authors.forename: P
authors.initials: P
authors.lastname: Zaninotto
authors.affiliation: Stress Research Institute, Stockholm University, Stockholm, Sweden.
authors.forename: L L
authors.initials: LL
authors.lastname: Magnusson Hanson
authors.affiliation: Stress Research Institute, Stockholm University, Stockholm, Sweden.
authors.forename: H
authors.initials: H
authors.lastname: Westerlund
authors.affiliation: Department of Public Health, University of Turku and Turku University Hospital, Turku, Finland.
authors.forename: J
authors.initials: J
authors.lastname: Vahtera
mesh_terms: D000368:Aged; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000517:prevention & control; D003920:Diabetes Mellitus / Q000453:epidemiology* / Q000517:prevention & control; D004739:England / Q000453:epidemiology; D005260:Female; D005387:Finland / Q000453:epidemiology; D005602:France / Q000453:epidemiology; D006304:Health Status; D006306:Health Surveys; D006801:Humans; D008017:Life Expectancy; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology* / Q000517:prevention & control; D011446:Prospective Studies; D012307:Risk Factors; D013548:Sweden / Q000453:epidemiology