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Time trends of the association of body mass index with mortality in 3.5 million young Swedish adults
Department of Translational Medicine, Lund University, Malmö, Sweden.
Department of Translational Medicine, Lund University, Malmö, Sweden; Institute of Medical Statistics and Informatics, Medical University of Innsbruck, Innsbruck, Austria.
Department of Translational Medicine, Lund University, Malmö, 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, 2021–00180Available from: 2024-07-31 Created: 2024-07-31 Last updated: 2025-02-11Bibliographically approved

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Wahlström, JensSöderberg, StefanBackman, HelenaHedman, LinneaHäggström, Christel

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CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • apa-6th-edition.csl
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
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  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
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