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During 12 years of follow-up, the risk ratio was 1.66 for a BMI of 25.0 to 29.9.
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To examine the relation between adiposity in adolescence and premature death in women, Harvard and Dutch researchers carried out a prospective cohort study in the US involving 102 400 women from the Nurses’ Health Study II who were 24 to 44 years of age and free of cancer at baseline. 90% were of non-Hispanic white ethnicity. In 1989, current weight and height and recalled weight at age 18 years were assessed by using validated questionnaires, and BMI was calculated. Hazard ratios for death were adjusted for potential confounders, including cigarette smoking, alcohol use, and physical activity during adolescence.
They found that during 12 years of follow-up, 710 participants died. Compared with a BMI of 18.5 to 21.9 at age 18 years, the hazard ratio for premature death was 0.98 for a BMI less than 18.5; 1.18 for a BMI of 22.0 to 24.9; 1.66 for a BMI of 25.0 to 29.9; and 2.79 for a BMI of 30 or greater. Among participants who never smoked, a BMI of 22.0 to 24.9 at age 18 years was also associated with increased premature death (hazard ratio, 1.50). Associations between BMI at age 18 years and death could only partly be explained by adult BMI measured in 1989. Limitations were that because of the observational study design, residual confounding by imperfectly measured or unknown confounders may still be present.
The researchers concluded: “Moderately higher adiposity at age 18 years is associated with increased premature death in younger and middle-aged U.S. women.”
This large 12 year US study alerts us to the fact that adiposity at 18 years predicts significantly increased mortality rates in younger and middle-aged white women.
Ann Intern Med 18 July 2006, Volume 145 Issue 2, Pages 91-97.
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