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Time trends of the association of body mass index with mortality in 3.5 million young Swedish adults

Mboya, Innocent B LU orcid ; Fritz, Josef LU ; da Silva, Marisa LU orcid ; Sun, Ming LU ; Wahlström, Jens LU orcid ; Magnusson, Patrik K E ; Sandin, Sven ; Yin, Weiyao ; Söderberg, Stefan and Pedersen, Nancy L , et al. (2024) In Annals of Epidemiology 97. p.23-32
Abstract

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... (More)

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.

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organization
publishing date
type
Contribution to journal
publication status
epub
subject
in
Annals of Epidemiology
volume
97
pages
23 - 32
publisher
Elsevier
external identifiers
  • pmid:39019242
ISSN
1047-2797
DOI
10.1016/j.annepidem.2024.07.043
language
English
LU publication?
yes
additional info
Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.
id
a7739e2f-0062-4d6e-810f-14050a8a50fa
date added to LUP
2024-07-23 13:07:58
date last changed
2024-07-24 10:08:22
@article{a7739e2f-0062-4d6e-810f-14050a8a50fa,
  abstract     = {{<p>PURPOSE: We investigated time trends of the obesity-mortality association, accounting for age, sex, and cause-specific deaths.</p><p>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: &lt;1975, 1975-1985, ≥1985 and women: &lt;1985, 1985-1994, ≥1995).</p><p>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 &lt;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.</p><p>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.</p>}},
  author       = {{Mboya, Innocent B and Fritz, Josef and da Silva, Marisa and Sun, Ming and Wahlström, Jens and Magnusson, Patrik K E and Sandin, Sven and Yin, Weiyao and Söderberg, Stefan and Pedersen, Nancy L and Lagerros, Ylva Trolle and Nwaru, Bright I and Kankaanranta, Hannu and Chabok, Abbas and Leppert, Jerzy and Backman, Helena and Hedman, Linnea and Isaksson, Karolin and Michaëlsson, Karl and Häggström, Christel and Stocks, Tanja}},
  issn         = {{1047-2797}},
  language     = {{eng}},
  month        = {{07}},
  pages        = {{23--32}},
  publisher    = {{Elsevier}},
  series       = {{Annals of Epidemiology}},
  title        = {{Time trends of the association of body mass index with mortality in 3.5 million young Swedish adults}},
  url          = {{http://dx.doi.org/10.1016/j.annepidem.2024.07.043}},
  doi          = {{10.1016/j.annepidem.2024.07.043}},
  volume       = {{97}},
  year         = {{2024}},
}