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AJPH First Look, published online ahead of print Aug 30, 2005
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American Journal of Public Health, 10.2105/AJPH.2004.045823

Research and Practice

A Semiparametric Analysis of the Body Mass Index's Relationship to Mortality

Jerome Timothy Gronniger 1*

1 Congressional Budget Office

* To whom correspondence should be addressed. E-mail: tim.gronniger{at}cbo.gov.


  Abstract

Objective. To provide a semi-parametric description of the relationship between mortality and the body mass index (BMI).<BR> Methods. This study employs a prospective non-experimental design. Supplements from the National Health Interview Survey (NHIS) in 1987 and 1989 are linked to the 1995 Multiple Cause of Death file. BMI calculated from self-reported height and weight data in 1987 or 1989 is used to predict mortality in 1995. Non-linear estimates of BMI's association with mortality are constructed with a semi-parametric regression technique.<BR> Results. 'Normal' weight men with BMI 20-25 have as high a risk of mortality as men with BMI in the ranges of mild obesity, BMI 30-35. For females, the risk of mortality is smallest in the vicinity of 23-24, and mortality increases steadily with BMI after BMI 27. In each specification the slope of the line is small through BMI 25-35, suggesting negligible risk differences for minor differences in weight for most of the population.<BR> Conclusions. Traditional BMI categories do not conform well to the complexities of the BMI-mortality relationship. In concurrence with some previous literature, this work concludes that definitions of overweight and obesity are over-inclusive as regards mortality.

Key Words: Obesity, Overweight, Underweight, Prevention, Mortality




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