Association between body mass index and all-cause death in japanese population: Pooled individual participant data analysis of 13 cohort studies

Atsushi Hozawa, Takumi Hirata, Hiroshi Yatsuya, Yoshitaka Murakami, Shinichi Kuriyama, Ichiro Tsuji, Daisuke Sugiyama, Atsushi Satoh, Sachiko Tanaka-Mizuno, Katsuyuki Miura, Hirotsugu Ueshima, Tomonori Okamura

Research output: Contribution to journalArticle

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Abstract

Background: We sought to investigate the optimal values of BMI for the lowest risk of all-cause death and whether the optimal BMI differs according to smoking status in large-scale pooled analysis of 13 Japanese cohorts. Methods: Data from 179,987 participants of 13 well-qualified cohort studies conducted throughout Japan were used for our analysis. A cohort-stratified Cox proportional hazard model was used. P values for interactions were calculated based on the cross product of BMI and age, sex, or smoking status. Results: In the entire study population, all-cause mortality risk was lowest when the BMI was 22.0–24.9 kg=m2. This was also the case for selected healthy participants (never smoked, baseline total cholesterol level ≥4.1 mmol=L; the first 5 years of follow-up data were excluded). No effect modification of age, sex, or smoking status was observed. Regardless of their BMI, never smokers always had a lower all-cause mortality risk than did current smokers even with an ideal BMI in terms of mortality risk. Conclusion: A BMI of 22–24.9 kg=m2 correlated with the lowest risk of mortality, regardless of whether all participants or selected healthy participants were analyzed. The fact that smoking was more strongly associated with mortality than obesity emphasizes the urgency for effective anti-smoking programs.

Original languageEnglish
Pages (from-to)457-463
Number of pages7
JournalJournal of epidemiology
Volume29
Issue number12
DOIs
Publication statusPublished - 01-01-2019

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Cause of Death
Body Mass Index
Cohort Studies
Smoking
Mortality
Population
Healthy Volunteers
Proportional Hazards Models
Japan
Obesity
Cholesterol

All Science Journal Classification (ASJC) codes

  • Epidemiology

Cite this

Hozawa, Atsushi ; Hirata, Takumi ; Yatsuya, Hiroshi ; Murakami, Yoshitaka ; Kuriyama, Shinichi ; Tsuji, Ichiro ; Sugiyama, Daisuke ; Satoh, Atsushi ; Tanaka-Mizuno, Sachiko ; Miura, Katsuyuki ; Ueshima, Hirotsugu ; Okamura, Tomonori. / Association between body mass index and all-cause death in japanese population : Pooled individual participant data analysis of 13 cohort studies. In: Journal of epidemiology. 2019 ; Vol. 29, No. 12. pp. 457-463.
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Hozawa, A, Hirata, T, Yatsuya, H, Murakami, Y, Kuriyama, S, Tsuji, I, Sugiyama, D, Satoh, A, Tanaka-Mizuno, S, Miura, K, Ueshima, H & Okamura, T 2019, 'Association between body mass index and all-cause death in japanese population: Pooled individual participant data analysis of 13 cohort studies', Journal of epidemiology, vol. 29, no. 12, pp. 457-463. https://doi.org/10.2188/jea.JE20180124

Association between body mass index and all-cause death in japanese population : Pooled individual participant data analysis of 13 cohort studies. / Hozawa, Atsushi; Hirata, Takumi; Yatsuya, Hiroshi; Murakami, Yoshitaka; Kuriyama, Shinichi; Tsuji, Ichiro; Sugiyama, Daisuke; Satoh, Atsushi; Tanaka-Mizuno, Sachiko; Miura, Katsuyuki; Ueshima, Hirotsugu; Okamura, Tomonori.

In: Journal of epidemiology, Vol. 29, No. 12, 01.01.2019, p. 457-463.

Research output: Contribution to journalArticle

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T1 - Association between body mass index and all-cause death in japanese population

T2 - Pooled individual participant data analysis of 13 cohort studies

AU - Hozawa, Atsushi

AU - Hirata, Takumi

AU - Yatsuya, Hiroshi

AU - Murakami, Yoshitaka

AU - Kuriyama, Shinichi

AU - Tsuji, Ichiro

AU - Sugiyama, Daisuke

AU - Satoh, Atsushi

AU - Tanaka-Mizuno, Sachiko

AU - Miura, Katsuyuki

AU - Ueshima, Hirotsugu

AU - Okamura, Tomonori

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Background: We sought to investigate the optimal values of BMI for the lowest risk of all-cause death and whether the optimal BMI differs according to smoking status in large-scale pooled analysis of 13 Japanese cohorts. Methods: Data from 179,987 participants of 13 well-qualified cohort studies conducted throughout Japan were used for our analysis. A cohort-stratified Cox proportional hazard model was used. P values for interactions were calculated based on the cross product of BMI and age, sex, or smoking status. Results: In the entire study population, all-cause mortality risk was lowest when the BMI was 22.0–24.9 kg=m2. This was also the case for selected healthy participants (never smoked, baseline total cholesterol level ≥4.1 mmol=L; the first 5 years of follow-up data were excluded). No effect modification of age, sex, or smoking status was observed. Regardless of their BMI, never smokers always had a lower all-cause mortality risk than did current smokers even with an ideal BMI in terms of mortality risk. Conclusion: A BMI of 22–24.9 kg=m2 correlated with the lowest risk of mortality, regardless of whether all participants or selected healthy participants were analyzed. The fact that smoking was more strongly associated with mortality than obesity emphasizes the urgency for effective anti-smoking programs.

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