(18-03-11) Association between body-mass index and risk of death in more than 1 million Asians.

Zheng W, McLerran DF, Rolland B, Zhang X, Inoue M, Matsuo K, He J, Gupta PC,
Ramadas K, Tsugane S, Irie F, Tamakoshi A, Gao YT, Wang R, Shu XO, Tsuji I,
Kuriyama S, Tanaka H, Satoh H, Chen CJ, Yuan JM, Yoo KY, Ahsan H, Pan WH, Gu D,
Pednekar MS, Sauvaget C, Sasazuki S, Sairenchi T, Yang G, Xiang YB, Nagai M,
Suzuki T, Nishino Y, You SL, Koh WP, Park SK, Chen Y, Shen CY, Thornquist M,
Feng Z, Kang D, Boffetta P, Potter JD.

Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology
Center, Vanderbilt?Ingram Cancer Center, Vanderbilt University, Nashville, TN,
USA. [email protected]
Abstract
BACKGROUND: Most studies that have evaluated the association between the body-
mass index (BMI) and the risks of death from any cause and from specific causes
have been conducted in populations of European origin.

METHODS: We performed pooled analyses to evaluate the association between BMI
and the risk of death among more than 1.1 million persons recruited in 19
cohorts in Asia. The analyses included approximately 120,700 deaths that
occurred during a mean follow-up period of 9.2 years. Cox regression models
were used to adjust for confounding factors.

RESULTS: In the cohorts of East Asians, including Chinese, Japanese, and
Koreans, the lowest risk of death was seen among persons with a BMI (the weight
in kilograms divided by the square of the height in meters) in the range of
22.6 to 27.5. The risk was elevated among persons with BMI levels either higher
or lower than that range--by a factor of up to 1.5 among those with a BMI of
more than 35.0 and by a factor of 2.8 among those with a BMI of 15.0 or less. A
similar U-shaped association was seen between BMI and the risks of death from
cancer, from cardiovascular diseases, and from other causes. In the cohorts
comprising Indians and Bangladeshis, the risks of death from any cause and from
causes other than cancer or cardiovascular disease were increased among persons
with a BMI of 20.0 or less, as compared with those with a BMI of 22.6 to 25.0,
whereas there was no excess risk of either death from any cause or cause-
specific death associated with a high BMI.

CONCLUSIONS: Underweight was associated with a substantially increased risk of
death in all Asian populations. The excess risk of death associated with a high
BMI, however, was seen among East Asians but not among Indians and Bangladeshis.

Source: N Engl J Med. 2011 Feb 24;364(8):719-29.

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