Body mass index as a predictor of healthy and disease-free life expectancy between ages 50 and 75: a multicohort study

Abstract

Background:While many studies have shown associations between obesity and increased risk of morbidity and mortality, little comparable information is available on how body mass index (BMI) impacts health expectancy. We examined associations of BMI with healthy and chronic disease-free life expectancy in four European cohort studies.Methods:Data were drawn from repeated waves of cohort studies in England, Finland, France and Sweden. BMI was categorized into four groups from normal weight (18.5–24.9 kg m−2) to obesity class II (⩾35 kg m−2). Health expectancy was estimated with two health indicators: sub-optimal self-rated health and having a chronic disease (cardiovascular disease, cancer, respiratory disease and diabetes). Multistate life table models were used to estimate sex-specific healthy life expectancy and chronic disease-free life expectancy from ages 50 to 75 years for each BMI category.Results:The proportion of life spent in good perceived health between ages 50 and 75 progressively decreased with increasing BMI from 81% in normal weight men and women to 53% in men and women with class II obesity which corresponds to an average 7-year difference in absolute terms. The proportion of life between ages 50 and 75 years without chronic diseases decreased from 62 and 65% in normal weight men and women and to 29 and 36% in men and women with class II obesity, respectively. This corresponds to an average 9 more years without chronic diseases in normal weight men and 7 more years in normal weight women between ages 50 and 75 years compared to class II obese men and women. No consistent differences were observed between cohorts.Conclusions:Excess BMI is associated with substantially shorter healthy and chronic disease-free life expectancy, suggesting that tackling obesity would increase years lived in good health in populations.

Variation in the spatial distribution of erector spinae activity during a lumbar endurance task in people with low back pain

“…No significant anthropometric differences were found between groups for body mass index (BMI), height or weight and the BMI for both groups was within the ‘normal weight’ range (Stenholm et al. ). However, as anticipated, the LBP group presented with higher levels of disability (ODI −13.16%) and lower general and emotional health (RAND 36‐item health survey).…”

Education Level, Monthly Per-Capita Expenditure, and Healthy Aging in the Older Indonesian Population: The Indonesia Family Life Survey 2007 and 2014

“…By contrast, previous studies in developed countries have found that individuals with a higher education level tended to have a lower BMI (Roskam and Kunst 2008;Hermann et al 2011) were less likely to have a chronic disease (Mielck et al 2012), and were more likely to engage in regular vigorous activity (Shaw and Spokane 2008). In addition, normal BMI was associated with healthy life expectancy (Stenholm et al 2017), while participation in moderate or vigorous physical activity was associated with healthy aging (Hamer et al 2014), and not having a chronic disease was associated with a better quality of life (Barile et al 2013;Wijers et al 2019).…”

Body mass index trajectories preceding first report of poor self-rated health: a longitudinal case-control analysis of the English Longitudinal Study of Ageing:

“…Obesity is well known to be associated with shorter healthy life expectancy. 6,8 In light of our results, tackling obesity earlier during the life course is crucial to achieve healthy ageing.…”

“…4,5 Numerous observational studies have investigated whether body mass index (BMI) is associated with self-rated health among middle-aged adults, generally finding that obese persons are more likely to report poor self-rated health and to live more years with poor health than persons of normal weight. [6][7][8] The mechanisms underlying the overall trends between BMI and self-rated health are likely to vary substantially according to age, as conditions contributing to self-rated health change in importance across the lifespan. Developments in overall BMI may be important, because in sedentary populations BMI mainly reflects fat mass, 9 which may affect physical functioning and incidence of disease such as type 2 diabetes.…”