Time trends of the association of body mass index with mortality in 3.5 million young Swedish adultsDepartment of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, United States.
Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Department of Psychology, University of Southern California, CA, Los Angeles, United States.
Division of Clinical Epidemiology, Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden; Center for Obesity, Academic Specialist Center, Stockholm Health Services, Stockholm, Sweden.
Krefting Research Centre, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Wallenberg Centre for Molecular and Translational Medicine, University of Gothenburg, Gothenburg, Sweden.
Krefting Research Centre, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Respiratory Medicine, Seinäjoki Central Hospital, Seinäjoki, Finland; Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland.
Center for Clinical Research, Region Västmanland, Uppsala University, Uppsala, Sweden.
Center for Clinical Research, Region Västmanland, Uppsala University, Uppsala, Sweden.
Department of Clinical Sciences Lund, Lund University, Lund, Sweden; Department of Surgery, Kristianstad Hospital, Kristianstad, Sweden.
Medical Epidemiology, Department of Surgical Sciences, Uppsala University, Uppsala, Sweden.
Department of Translational Medicine, Lund University, Malmö, Sweden.
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2024 (English)In: Annals of Epidemiology, ISSN 1047-2797, E-ISSN 1873-2585, Vol. 97, p. 23-32Article in journal (Refereed) Published
Abstract [en]
Purpose: We investigated time trends of the obesity-mortality association, accounting for age, sex, and cause-specific deaths.
Methods: We analysed pooled nationwide data in Sweden for 3,472,310 individuals aged 17–39 years at baseline in 1963–2016. Cox regression and flexible parametric survival models investigated BMI-mortality associations in sub-groups of sex and baseline calendar years (men: <1975, 1975–1985, ≥1985 and women: <1985, 1985–1994, ≥1995).
Results: Comparing men with obesity vs. normal weight, all-cause and “other-cause” mortality associations decreased over periods; HR (95% CI) 1.92 (1.83–2.01) and 1.70 (1.58–1.82) for all-cause and 1.72 (1.58–1.87) and 1.40 (1.28–1.53) for “other-cause” mortality in <1975 and ≥1985, but increased for CVD mortality; HR 2.71 (2.51–2.94) and 3.91 (3.37–4.53). Higher age at death before 1975 coincided with more obesity-related deaths at higher ages. Furthermore, the all-cause mortality association for different ages in men showed no clear differences between periods (p-interaction=0.09), suggesting no calendar effect after accounting for attained age. Similar, but less pronounced, results were observed in women. Associations with cancer mortality showed no clear trends in men or in women.
Conclusions: Accounting for differences in age and death causes between calendar periods when investigating BMI-mortality time trends may avoid misinterpreting the risks associated with obesity over time.
Place, publisher, year, edition, pages
Elsevier, 2024. Vol. 97, p. 23-32
Keywords [en]
Body mass index, Mortality, Time trends
National Category
Public Health, Global Health, Social Medicine and Epidemiology Nutrition and Dietetics
Identifiers
URN: urn:nbn:se:umu:diva-228070DOI: 10.1016/j.annepidem.2024.07.043PubMedID: 39019242Scopus ID: 2-s2.0-85199035309OAI: oai:DiVA.org:umu-228070DiVA, id: diva2:1886320
Projects
MONICABiobank SwedenSIMPLER
Funder
Swedish Research Council, 2017–00650Swedish Research Council, 2017–00644Swedish Research Council, 2021–00160Swedish Cancer Society, 23 0633 SIASwedish Research Council, 2021-01934Lund University, STYR 2019/2046Karolinska Institute, 2021–001802024-07-312024-07-312025-02-11Bibliographically approved