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Obesity’s Final Toll: Influence on Mortality Rate, Attributable Deaths, Years of Life Lost and Population Life Expectancy

  • K. R. Fontaine
  • S. W. Keith
  • J. A. Greenberg
  • S. J. Olshansky
  • D. B. Allison
Reference work entry

Abstract:

 Obesity is recognized as a contributor to health maladies and premature death for millennia and, given the worldwide increase in the prevalence of obesity, is currently one of the greatest public health challenges of the twenty-first century. Apart from obesity’s association with diseases in virtually every major organ system, it also adversely affects quality of life, and appears to have a marked effect on duration of life. That is obesity, herein defined as “excess” of body fat, probabilistically threatens future health and longevity. In this chapter we review the association of obesity to indices of mortality, including: (1) mortality rate (MR), (2) attributable deaths, (3)  years of life lost (YLL) and (4) population life expectancy. Overall, there appears to be a J- or U-shaped association between body weight and mortality rate. The extent to which the elevated mortality rate with low BMIs represents causation or merely association remains the subject of debate and inquiry. The (presumed causal) association of obesity with elevated mortality rate translates into a substantial number of  obesity-attributable deaths and reduced life expectancy. There are several methodological and statistical issues involved in estimating the effect of obesity on indices of longevity. Among these issues are  reverse causation,  confounding, confounding by indication,  regression dilution, secular changes in the true effects of obesity on mortality, accounting for uncertainty, and choosing reference categories and cut-points. We review these issues and offer suggestions for future research.

Keywords

Body Mass Index Reverse Causation Body Mass Index Category Body Mass Index Group Body Mass Index Level 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

List of Abbreviations:

BIA

bioelectric impedance analysis

BMI

 body mass index

CVD

cardiovascular disease

FFM

fat-free mass

FM

fat mass

HRs

 hazard ratios

IOM

Institute of Medicine

MR

mortality rate

NHANES I

First National Health and Nutrition Examination Survey

NHANES II

Second National Health and Nutrition Examination Survey

NHANES III

Third National Health and Nutrition Examination Survey

NH2MS

NHANES II mortality study

NHEFS

NHANES I epidemiological follow-up study

US

United States

WC

waist circumference

WHR

waist-to-hip ratio

YLL

years of life lost

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Copyright information

© Springer Science+Business Media LLC 2010

Authors and Affiliations

  • K. R. Fontaine
  • S. W. Keith
  • J. A. Greenberg
  • S. J. Olshansky
  • D. B. Allison

There are no affiliations available

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