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Body Weight and Mortality Among Men and Women in China

Published on Feb 15, 2006in JAMA51.27
· DOI :10.1001/jama.295.7.776
Dongfeng Gu63
Estimated H-index: 63
,
Jiang He99
Estimated H-index: 99
(Tulane University)
+ 6 AuthorsPaul K. Whelton95
Estimated H-index: 95
Cite
Abstract
ContextThe effect of underweight and obesity on mortality has not been well characterized in Asian populations.ObjectiveTo examine the relationship between body mass index (BMI) and mortality in Chinese adults.Design, Setting, and ParticipantsA prospective cohort study in a nationally representative sample of 169 871 Chinese men and women aged 40 years or older. Data on body weight and covariables were obtained at a baseline examination in 1991 using a standard protocol. Follow-up evaluation was conducted in 1999-2000, with a response rate of 93.4% (n = 158 666).Main Outcome MeasuresBody mass index and all-cause mortality.ResultsAfter excluding those participants with missing body weight or height values, 154 736 adults were included in the analysis. After adjustment for age, sex, cigarette smoking, alcohol consumption, physical activity, education, geographic region (north vs south), and urbanization (urban vs rural), a U-shaped association between BMI and all-cause mortality was observed (P<.001). Using those participants with a BMI of 24.0 to 24.9 as the reference group, the relative risks of all-cause mortality across categories of BMI were 1.65 (95% confidence interval [CI], 1.54-1.77) for BMI less than 18.5, 1.31 (95% CI, 1.22-1.41) for BMI 18.5 to 19.9, 1.20 (95% CI, 1.11-1.29) for BMI 20.0 to 20.9, 1.12 (95% CI, 1.04-1.21) for BMI 21.0 to 21.9, 1.11 (95% CI, 1.03-1.20) for BMI 22.0 to 22.9, 1.09 (95% CI, 1.01-1.19) for BMI 23.0 to 23.9, 1.00 (95% CI, 0.92-1.08) for BMI 25.0 to 26.9, 1.15 (95% CI, 1.06-1.24) for BMI 27.0 to 29.9, and 1.29 (95% CI, 1.16-1.42) for BMI 30.0 or more. The U-shaped association existed even after excluding participants who were current or former smokers, heavy alcohol drinkers, or who had prevalent chronic illness at the baseline examination, or who died during the first 3 years of follow-up. A similar association was observed between BMI and mortality from cardiovascular disease, cancer, and other causes.ConclusionsOur results indicate that both underweight and obesity were associated with increased mortality in the Chinese adult population. Furthermore, our findings support the use of a single common recommendation for defining overweight and obesity among all racial and ethnic groups.
  • References (29)
  • Citations (275)
Cite
References29
Newest
Published on Apr 20, 2005in JAMA51.27
Katherine M. Flegal83
Estimated H-index: 83
(CDC: Centers for Disease Control and Prevention),
Barry I. Graubard75
Estimated H-index: 75
+ 1 AuthorsMitchell H. Gail80
Estimated H-index: 80
Results Relative to the normal weight category (BMI 18.5 to 25), obesity (BMI 30) was associated with 111 909 excess deaths (95% confidence interval [CI], 53 754170 064) and underweight with 33 746 excess deaths (95% CI, 15 726-51 766). Overweight was not associated with excess mortality (�86 094 deaths; 95% CI, �161 223 to �10 966). The relative risks of mortality associated with obesity were lower in NHANES II and NHANES III than in NHANES I. Conclusions Underweight and obesity, particularly h...
Published on Apr 1, 2005in The Lancet59.10
Dongfeng Gu63
Estimated H-index: 63
(Peking Union Medical College),
Kristi Reynolds43
Estimated H-index: 43
(Tulane University)
+ 5 AuthorsJiang He99
Estimated H-index: 99
(Tulane University)
Summary Background The metabolic syndrome and obesity are major risk factors for cardiovascular disease. Little information exists on the prevalence of the metabolic syndrome in China. We aimed to provide up-to-date estimates of the prevalence of the metabolic syndrome and overweight in the general adult population in China. Methods We did a cross-sectional survey in a nationally representative sample of 15 540 Chinese adults aged 35–74 years in 2000–01. Metabolic syndrome was defined according ...
Published on Dec 23, 2004in The New England Journal of Medicine70.67
Frank B. Hu202
Estimated H-index: 202
,
Barry M. Popkin318
Estimated H-index: 318
+ 3 AuthorsJoAnn E. Manson232
Estimated H-index: 232
Background Whether higher levels of physical activity can counteract the elevated risk of death associated with adiposity is controversial. Methods We examined the associations of the body-mass index and physical activity with death among 116,564 women who, in 1976, were 30 to 55 years of age and free of known cardiovascular disease and cancer. Results During 24 years of follow-up, 10,282 deaths occurred — 2370 from cardiovascular disease, 5223 from cancer, and 2689 from other causes. Mortality ...
Published on Nov 1, 2004in The American Journal of Clinical Nutrition6.57
Rachel P. Wildman36
Estimated H-index: 36
,
Dongfeng Gu63
Estimated H-index: 63
+ 2 AuthorsJiang He99
Estimated H-index: 99
Background: Recent data suggest that current overweight and central adiposity guidelines based on Western populations are not appropriate for Asian populations. The published data among Chinese are insufficient to address this issue. Objective: We aimed to identify cutoffs for body mass index (BMI; in kg/m 2 ) and waist circumference that confer increased risk of cardiovascular disease in Chinese adults as would be consistent with overweight and central adiposity. Design: A nationally representa...
Published on Jun 16, 2004in JAMA51.27
Allison A. Hedley2
Estimated H-index: 2
(CDC: Centers for Disease Control and Prevention),
Cynthia L. Ogden55
Estimated H-index: 55
+ 3 AuthorsKatherine M. Flegal83
Estimated H-index: 83
ContextThe prevalence of overweight and obesity has increased markedly in the last 2 decades in the United States.ObjectiveTo update the US prevalence estimates of overweight in children and obesity in adults, using the most recent national data of height and weight measurements.Design, Setting, and ParticipantsAs part of the National Health and Nutrition Examination Survey (NHANES), a complex multistage probability sample of the US noninstitutionalized civilian population, both height and weigh...
Published on Jun 4, 2004in Science41.04
Philip H. Abelson21
Estimated H-index: 21
,
Donald Kennedy37
Estimated H-index: 37
T here is a growing public health crisis that is global in scope, and it isn't another emerging infectious disease. It concerns being overweight and the adverse health consequences of obesity, which include diabetes, heart disease, and cancer. To sketch the extent of this problem, we begin with the United States, an appropriate starting point because U.S. dietary styles and food habits have been exported so widely around the world. In 1998, the National Institutes of Health (NIH) in the United S...
Published on May 1, 2004in Nutrition3.59
Anoop Misra51
Estimated H-index: 51
(AIIMS: All India Institute of Medical Sciences),
Naval K. Vikram25
Estimated H-index: 25
(AIIMS: All India Institute of Medical Sciences)
Abstract Objectives This review describes prevalence, determinants, and possible pathophysiologic mechanisms and suggests management and research directions for insulin resistance syndrome (metabolic syndrome) in Asian Indians. Method We reviewed the topic using the terms Asian Indians, Asians, South Asians, and Indians coupled with the terms insulin resistance, hyperinsulinemia, metabolic syndrome, and obesity from the databases Pubmed (National Library of Medicine, Bethesda, MD, USA) and Curre...
Wichai Aekplakorn29
Estimated H-index: 29
,
Yongyuth Chaiyapong1
Estimated H-index: 1
+ 4 AuthorsPaibul Suriyawongpaisal20
Estimated H-index: 20
To describe the prevalence of overweight and obesity and examine their relationship with sociodemographic factors in Thai adults. Using data from a cross-sectional survey, the National Health Examination Survey II (NHESII), the authors examined the prevalence of overweight (BMI > 25 kg /m2) and obesity (BMI > 30 kg /m2) in 3,220 Thai adults aged 20-59 yr. Univariate analyses and Logistic regression models were used to examine the association of overweight and obesity with socio-demographic and b...
Published on Jan 1, 2004in The American Journal of Clinical Nutrition6.57
Wen-Harn Pan43
Estimated H-index: 43
,
Katherine M. Flegal83
Estimated H-index: 83
+ 3 AuthorsWen-Chung Lee23
Estimated H-index: 23
Background: Recommendations based on scanty data have been made to lower the body mass index (BMI; in kg/m 2 ) cutoff for obesity in Asians. Objective: The goal was to compare relations between BMI and metabolic comorbidity among Asians and US whites and blacks. Methods: We compared the prevalence rate, sensitivity, specificity, predictive values, and impact fraction of comorbidities at each BMI level and the BMI-comorbidity relations across ethnic groups by using data from the third National He...
Published on May 1, 2003in Journal of Epidemiology and Community Health3.87
Tiina Laatikainen52
Estimated H-index: 52
,
L. Manninen1
Estimated H-index: 1
+ 1 AuthorsErkki Vartiainen85
Estimated H-index: 85
Study objective: Although moderate alcohol intake is related to decreased all cause and ischaemic heart disease mortality, intake of large amounts at a time may be harmful. Design: A cohort study, average follow up time was 7.3 years. Setting: Finland. Participants: General population sample of 5092 men, aged from 25 to 64 years, who had consumed alcohol during the 12 months before the baseline examination. Main results: The main outcome measure was death. After excluding cases with previous myo...
Cited By275
Newest
Published on Feb 1, 2020in Chemosphere5.11
Qiang Xie , Duan Gui7
Estimated H-index: 7
+ 1 AuthorsYuping Wu9
Estimated H-index: 9
Abstract Cetaceans and humans shared the same route of exposure to many anthropogenic contaminants via fish consumption. To assess the health risks associated with heavy metal levels in fishes from the Pearl River Estuary (PRE) and the seasonal dynamics, 13 fish species (n = 675) consumed by the Indo-Pacific humpback dolphins (Sousa chinensis) and humans were analyzed for concentrations of nine heavy metals. Heavy metal levels vary significantly by species and by season in the PRE fishes. The tw...
Published on Apr 30, 2019in Analytical Letters1.25
Zhipeng Wang (Ocean University of China), Jie Xu16
Estimated H-index: 16
(Ocean University of China)
+ 4 AuthorsChanghu Xue34
Estimated H-index: 34
(Ocean University of China)
AbstractThis study aimed at developing an accurate method for determining the levels of total arsenic (As) and arsenic species in edible shrimp with the collision/reaction cell (CRC) in the O2 mass-shift mode to remove interferences. The microwave-assisted extraction method demonstrated satisfactory efficiency (86.9%), and As species were separated rapidly within 11 min when the optimized chromatographic conditions were adopted. During the study, the limits of detection, precision, and spike rec...
Published on Jan 15, 2019in Irish Journal of Medical Science1.03
William Newmarch (UL: University of Limerick), Madina Weiler (UL: University of Limerick), Brian Casserly1
Estimated H-index: 1
(University Hospital Limerick)
The negative long-term health consequences of obesity are well known to both the medical profession and general public. Despite this, the number of obese and overweight individuals worldwide continues to steadily rise. Although obesity has long been associated with an increased risk for cardiovascular disease and mortality, the classification of a cardiomyopathy of obesity is a more recent development. Obesity cardiomyopathy is characterized as myocardial dysfunction or heart failure in obese in...
Published on 2019in European Journal of Epidemiology6.53
Li Wu1
Estimated H-index: 1
(Fudan University),
Huandong Lin9
Estimated H-index: 9
(Fudan University)
+ 7 AuthorsNaiqing Zhao9
Estimated H-index: 9
(Fudan University)
To investigate the major causes and predictive factors of death in a middle-aged and elderly Chinese population. A total of 6591 residents aged ≥ 45 years from Shanghai Changfeng community were followed up for an average of 5.4 years. The causes of death were coded according to the 10th Revision of International Classification of Diseases. The mortality rate was calculated by person-years of follow up and age-standardized according to the 2010 Chinese census data. Multivariable-adjusted Cox prop...
Published on Jul 1, 2019in Science of The Total Environment5.59
Wulai Xia1
Estimated H-index: 1
(CAS: Chinese Academy of Sciences),
Liang Chen3
Estimated H-index: 3
(CAS: Chinese Academy of Sciences)
+ 7 AuthorsJun Chen31
Estimated H-index: 31
(CAS: Chinese Academy of Sciences)
Abstract There have been numerous studies on concentrations of trace elements in aquatic ecosystems, but few have been conducted at a large spatial scale. This study collected 410 samples of five wild freshwater fishes at different trophic levels from middle and eastern China. Concentrations of eight trace elements, chromium (Cr), iron (Fe), nickel (Ni), copper (Cu), zinc (Zn), arsenic (As), lead (Pb) and cadmium (Cd) and stable isotope ratios (δ 13 C and δ 15 N) were determined in dorsal muscle...
Published on Jun 18, 2019in Journal of the American Heart Association4.66
Yiqing Wang (UNC: University of North Carolina at Chapel Hill), Huijun Wang14
Estimated H-index: 14
(CCDC: Chinese Center for Disease Control and Prevention)
+ 6 AuthorsPenny Gordon-Larsen57
Estimated H-index: 57
(UNC: University of North Carolina at Chapel Hill)
Background China faces a substantial burden from cardiometabolic diseases, but longitudinal studies on a wide range of cardiometabolic risk factors are limited. We examined the 6‐year incidence of ...
Published on Feb 1, 2019in Chemosphere5.11
Yong Du1
Estimated H-index: 1
(CSU: Central South University),
Lv Chen5
Estimated H-index: 5
(CSU: Central South University)
+ 4 AuthorsYanying Duan1
Estimated H-index: 1
(CSU: Central South University)
Abstract Heavy metal contamination of environmental media in mining area is a global major concern because of its potential threat for human health through food chain. However, the comparison of exposure level and health risk is scarce among people living in the vicinity of mining area with different pollution source. In this study, the concentrations of Mn, Cd, As, Pb, Cu, Zn, Cr and Ni in soil, air, water, rice, vegetable, fish, poultry meat and pork from a Pb-Zn mining area and a Mn mining ar...
Published on Dec 1, 2018in BMC Public Health2.57
Chih-Cheng Hsu19
Estimated H-index: 19
(PRC: China Medical University (PRC)),
C. C. Hsu1
Estimated H-index: 1
(PRC: China Medical University (PRC))
+ 6 AuthorsChao A. Hsiung32
Estimated H-index: 32
(NHRI: National Health Research Institutes)
The effect of cardio-metabolic profile on the relationship of body mass index (BMI) with mortality is unclear. The aim of this study was to explore association between BMI and mortality at all ages, taking account of cardio-metabolic disorders. We followed 377,929 individuals (≥ 20 years), who registered for health checkups in 1996–2007, until 2008 and found 9490 deaths. From multivariable Cox proportional hazards models we estimated mortality hazard ratios (HR) for those in high blood pressure,...
Published on Sep 1, 2018in The Journal of Clinical Endocrinology and Metabolism5.61
Diana Alba4
Estimated H-index: 4
(UCSF: University of California, San Francisco),
Jeffrey A Farooq1
Estimated H-index: 1
(UCSF: University of California, San Francisco)
+ 3 AuthorsSuneil K. Koliwad17
Estimated H-index: 17
(UCSF: University of California, San Francisco)
View next paperMajor Causes of Death among Men and Women in China