Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Paper
  • Published:

Body mass index and mortality in women: follow-up of the Canadian National Breast Screening Study cohort

International Journal of Obesity volume 29, pages 792–797 (2005)Cite this article

Abstract

OBJECTIVE:

The present study was conducted to examine the relationship between obesity and all-cause mortality in women.

STUDY DESIGN AND SETTINGS:

The subjects were women enrolled from 1980 to 1985 in a Canadian randomized trial, the National Breast Screening Study (NBSS) to evaluate the efficacy of mammographic screening. Mortality was ascertained by record linkage to the Canadian Mortality Data Base. Hazard ratios (HR) for the association between body mass index (BMI) and all-cause mortality were obtained from Cox proportional hazard regression models.

RESULTS:

During an average follow-up period of 16.5 years, 2566 deaths were identified among the 49 165 women, age 40–59 y at enrolment. The risk of all-cause death increased linearly above a BMI of 22 kg/m2 and the trend was statistically significant. The HR (and 95% confidence intervals) in the various categories of BMI (kg/m2) were: BMI<18.5: 1.12 (0.99–1.25); BMI 18.5–21.9: 1.00 (reference); BMI 22–24.9: 1.15 (1.11–1.18); BMI 25.0–27.9: 1.28 (1.24–1.32); BMI 28.0 –29.9: 1.34 (1.29–1.39); BMI 30.0–34.9: 1.30 (1.25,1.35); and BMI ≥35.0: 1.40 (1.33–1.47).

CONCLUSION:

This study confirms the association of high BMI with increased all-cause mortality in women.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Figure 1

Similar content being viewed by others

References

  1. World Health Organization. Joint WHO/FAO Expert Consultation on diet, nutrition and the prevention of chronic diseases, WHO Technical Report Series 916, 2003.

  2. Strychar I . Fighting obesity: a call to arms. Can J Pub Health 2004; 95: 12–14.

    Google Scholar 

  3. Troiano RP, Frongillo EA, Sobal J, Levitsky DA . The relationship between body weight and mortality: a quantitative analysis of combined information from existing studies. Int J Obes 1996; 20: 63–75.

    CAS  Google Scholar 

  4. Seidell JC, Visscher TL, Hoogeveen RT . Overweight and obesity in the mortality rate data: current evidence and research issues. Med Sci Sports Exerc 1999; 31: S597–S601.

    Article  CAS  Google Scholar 

  5. Katzmarzyk PT, Craig C, Bouchard C . Underweight, overweight and obesity: relationships with mortality in the 13-year follow-up of the Canada Fitness Survey. J Clin Epid 2001; 54: 916–920.

    Article  CAS  Google Scholar 

  6. Calle EE, Thun MJ, Petrelli JM, Rodriguez C, Heath CW . Body-mass index and mortality in a prospective cohort of U.S. adults. N Engl J Med 1999; 341: 1097–1105.

    Article  CAS  Google Scholar 

  7. Seidell JC, Verschuren M, van Leer EM, Kromhout D . Overweight, underweight, and mortality: a prospective study of 48 287 men and women. Arch Intern Med 1996; 156: 958–963.

    Article  CAS  Google Scholar 

  8. Sempos CT, Durazo-Arvizu R, McGee DL, Cooper RS, Prewitt TE . The influence of cigarette smoking on the association between body weight and mortality. The Framingham Heart Study revisited. Ann Epidemiol 1998; 8: 289–300.

    Article  CAS  Google Scholar 

  9. National Institute of Health. Clinical guidelines on identification, evaluation, and treatment of overweight and obesity in adults — the evidence report. Obs Res 1998; 6: 51S–209S.

  10. Katzmarzyk PT, Ardern CI . Overweight and obesity mortality trends in Canada, 1985–2000. Can J Pub Health 2004; 95: 16–20.

    Google Scholar 

  11. Dorn JM, Schisterman EF, Winkelstein Jr W, Trevisan M . Body mass index and mortality in a general population sample of men and women. The Buffalo Health Study. Am J Epidemiol 1997; 146: 919–931.

    Article  CAS  Google Scholar 

  12. Bender R, Trautner C, Spraul M, Berger M . Assessment of excess mortality in obesity. Am J Epidemiol 1998; 147: 42–48.

    Article  CAS  Google Scholar 

  13. World Health Organization. Preventing and managing the global epidemic. Report of a WHO consultation on obesity. WHO: Geneva; 2000.

  14. Douketis JD, Feightner JW, Attia J, Feldman WF . Periodic health examination, 1999 update: 1. Detection, prevention and treatment of obesity. Canadian Task Force on Preventive Health Care. Can Med Assoc J 1999; 160: 513–525.

    CAS  Google Scholar 

  15. Health Canada. Canadian community health survey, 2000–01. Health Canada: Ottawa; 2001.

  16. Birmingham CL, Muller JL, Palepu A, Spinelli JJ, Anis AH . The cost of obesity in Canada. Can Med Assoc J 1999; 160: 483–488.

    CAS  Google Scholar 

  17. Miller AB, Howe GR, Wall C . The national study of breast cancer screening: protocol for a Canadian randomized controlled trial of screening for breast cancer in women. Clin Invest Med 1981; 4: 227–258.

    CAS  PubMed  Google Scholar 

  18. Miller AB, Baines CJ, To T, Wall C . Canadian National Breast Screening Study. I. Breast cancer detection and death rates among women aged 40 to 49 years. II. Breast cancer detection and death rates among women aged 50 to 59 years. Can Med Assoc J 1992; 147: 1459–1488.

    CAS  Google Scholar 

  19. Jain M, Harrison L, Howe GR, Miller AB . Evaluation of a self-administered dietary questionnaire for use in a cohort study. Am J Clin Nutr 1982; 36: 931–935.

    Article  CAS  Google Scholar 

  20. Health Canada. Canadian guidelines for body weight classification in adults, Catalogue No- H49-179/2003E. Health Canada: Ottawa; 2003.

  21. Jain M, Howe GR, Rohan T . Dietary assessment in epidemiology: comparison of food frequency and a diet history questionnaire with a 7-day food record. Am J Epidemiol 1996; 143: 953–960.

    Article  CAS  Google Scholar 

  22. Watt BK, Merrill AL . Composition of foods: raw, processed, prepared, Agricultural Handbook No. 8, US Department of Agriculture: Washington, DC; 1972.

    Google Scholar 

  23. Mangels AR, Holden JM, Beecher GR, Forman MR, Lanza E . The carotenoid content of fruits and vegetables: an evaluation of analytical data. J Am Diet Assoc 1993; 93: 284–296.

    Article  CAS  Google Scholar 

  24. Chug-Ahuja JK, Holden JM, Forman MR, Mangels AR, Beecher GR . The development and application of a carotenoid database for fruits, vegetables, and multi-component foods containing fruits and vegetables. J Am Diet Assoc 1993; 93: 318–323.

    Article  CAS  Google Scholar 

  25. Health Canada. Canadian nutrient file. Health Canada: Ottawa; 1997.

  26. Rowland ML . Self-reported weight and height. Am J Clin Nutr 1990; 52: 1125–1133.

    Article  CAS  Google Scholar 

  27. Bouchard C . Genetics of human obesities: introductory notes. In: Bouchard C (ed) The genetics of obesity. CRC Press: Boca Raton, Florida; 1994. pp 1–15.

    Google Scholar 

  28. Durazo-Arvizu RA, McGee DL, Cooper RS, Liao Y, Luke A . Mortality and optimal body mass index in a sample of the US population. Am J Epidemiol 1998; 147: 739–749.

    Article  CAS  Google Scholar 

  29. Canadian Institutes of Health Research. A National Dialogue on Healthy Body Weights, December 2001: Summary of Proceedings, Obesity Canada and the CIHR Institute of Nutrition, Metabolism, and Diabetes. Toronto, Canada.

  30. Chyou PH, Burchfiel CM, Yano K, Sharp DS, Rodriguez BL, Curb JD, Nomura AM . Obesity, alcohol consumption, smoking, and mortality. Ann Epid 1997; 7: 311–317.

    Article  CAS  Google Scholar 

  31. Greenberg JA . Biases in the mortality risk versus body mass index relationships in the NHANES-1 Epidemiologic Follow-up Study. Int J Obesity Relat Metab Disord 2001; 25: 1071–1078.

    Article  CAS  Google Scholar 

  32. Singh PN, Lindsted KD . Body mass and 26-year risk of mortality from specific diseases among women who never smoked. Epidemiology 1998; 9: 246–254.

    Article  CAS  Google Scholar 

Download references

Acknowledgements

This work was supported by Grant no. MA-14469 from the Medical Research Council of Canada.

Author information

Authors and Affiliations

  1. Department of Public Health Sciences, University of Toronto, Toronto, Canada

    M G Jain, A B Miller, J T Rehm, S J Bondy, M J Ashley, J E Cohen & R G Ferrence

  2. Department of Epidemiology and Population Health, Albert Einstein College of Medicine, New York, USA

    T E Rohan

  3. Addiction Research Foundation Division, Centre for Addiction and Mental Health, Toronto, Canada

    J T Rehm & R G Ferrence

  4. Public Health Sciences, University of Applied Sciences, Hamburg, Germany

    J T Rehm

  5. Ontario Tobacco Research Unit, University of Toronto, Canada

    S J Bondy, M J Ashley, J E Cohen & R G Ferrence

  6. Institute for Clinical Evaluative Sciences, Toronto, Canada

    S J Bondy

Authors
  1. M G Jain
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. A B Miller
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. T E Rohan
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. J T Rehm
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. S J Bondy
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. M J Ashley
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. J E Cohen
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. R G Ferrence
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to M G Jain.

Additional information

Supplementary information accompanies the paper on International Journal of Obesity website (http://www.nature.com/ijo)

Supplementary information

Rights and permissions

Reprints and permissions

About this article

Cite this article

Jain, M., Miller, A., Rohan, T. et al. Body mass index and mortality in women: follow-up of the Canadian National Breast Screening Study cohort. Int J Obes 29, 792–797 (2005). https://doi.org/10.1038/sj.ijo.0802952

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/sj.ijo.0802952

Keywords

This article is cited by

Search

Advanced search

Quick links