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Abbreviations

Introduction

Globally, the diabetes mellitus epidemic is driven by the increasing burden of overweight and obesity. We conducted a large, population-based cohort study to determine the independent associations of obesity with all-cause mortality and specific causes of death.

Methods

A nationally representative cohort of 1,402,760 persons in the United Kingdom who completed a detailed lifestyle questionnaire was followed up for a mean of 6.5 years (range 2.3–10.7 years). BMI, diabetes and high blood pressure were assessed. Vital status was ascertained. Mortality from specific causes was ascertained by record linkage with the National Health Service Central Registry. Associations with mortality were evaluated using Cox regression.

Results

A total of 9,852 (0.7%) deaths occurred over the follow-up period. In our multivariable analyses, overweight was associated with a significantly increased mortality risk (hazard ratio [HR] 1.17; 95% confidence interval [CI] 1.01–1.36), whereas obesity was associated with a significantly increased mortality risk (HR 1.72; 95% CI 1.56–1.92) compared with normal weight. These associations persisted after adjustment for diabetes and high blood pressure. The relative excess risk due to interaction between BMI and diabetes was 0.32 (95% CI 0.10–0.79), with the greatest excess risk seen for persons with both overweight and diabetes. The relative excess risk due to interaction between BMI and high blood pressure was 0.37 (95% CI 0.16–0.82), with a greater excess risk seen for persons with both obesity and high blood pressure.

Conclusions

Overweight is associated with a modest but significant increased risk of all-cause mortality, 0b46394aab

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