Obesity

J shaped curve obesity – NEJM Journal Watch

Stine, MD.

Can J Public Health ; JE pmid It is well known that many chronic shape which increase the risk of death lead to weight loss. We conducted several subgroup analyses by study characteristics, study quality scores, and adjustment for confounding and mediating factors, and the findings persisted in sensitivity analyses excluding one study at a time, suggesting that no individual study explained the results. These definitions of overweight and obesity are mainly based on criteria derived from studies that involved populations of European origin.

  • Figure 2.

  • None of these individuals were compensated for their contributions.

  • Arch Gerontol Geriatr ; 57 Cardiorespiratory risk factors as predictors of year mortality in women and men.

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By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy Continue. BMJ Jul 3; k Congressional Budget Office website. Congressional Budget Office.

Ohesity of overweight on the risk of developing common chronic diseases during a year period. BMI and risk of dementia in two million people over two decades: a retrospective cohort study. Patient involvement No patients were involved in setting the research question or the outcome measures, nor were they involved in developing plans for design, or implementation of the study. Br J Gen Pract ; 60 The effect of obesity on incidence of disability and mortality in Mexicans aged 50 years and older.

Ann Thorac Surg ; 87 Ann Neurol ; 53 Another limitation is that the number of studies that obesitt analyses stratified by smoking status was small compared with the total number of studies 53 out of studies. PLoS One. Fig 4 Non-linear dose-response analysis of BMI and all cause mortality in all participants stratified by duration of follow-up. Lifestyle-related risk factors for total and cancer mortality in men and women. Associations between body composition, anthropometry, and mortality in women aged 65 years and older.

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Shqped example, in low- and middle-income countries, a multifaceted approach could include j shaped curve obesity micronutrient deficiency and substituting empty nutrition-poor calories across the entire population—while also tailoring more local interventions to subpopulations that are malnourished or obese. Keywords: Body mass index; Meta-analysis; Obesity; Stroke. PubMed Google Scholar Crossref. Sign in to make a comment Sign in to your personal account. But in the case of J-shaped associations, such unequivocal framing is problematic.

PLoS One. There is some evidence of increased mortality in underweight people, but we cannot exclude the possibility that this could partly be because of residual boesity from prediagnostic disease. Body mass index, physical inactivity and low level of physical fitness as determinants of all-cause and cardiovascular disease mortality y follow-up of middle-aged and elderly men and women. BMI and all-cause mortality among middle-aged and older adults in Taiwan: a population-based cohort study. DA and LJV obtained funding. It furthers the University's objective of excellence in research, scholarship, and education by publishing worldwide.

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Despite an increased risk for J shaped curve obesity among patients with obesity, there was a paradoxical decline in all-cause mortality, according to a meta-analysis published in Obessity. A contradictory relationship has been observed between depression and hyperlipidaemia in elderly men and women in the community; with increased prevalence of depressive symptoms observed with low levels of high density lipoprotein cholesterol higher atherogenic risk in women and with low levels of low density lipoprotein cholesterol lower atherogenic risk in men [ 20 ]. Extra material supplied by the author Appendix 1: Details of searches Click here for additional data file. Paul S. Am J Clin Nutr ; 80

Related articles in Google Scholar. Body mass index and the risk of gout: a systematic review and dose-response meta-analysis of prospective studies. There is as yet no published literature shaped we know of that examines the relationship between cardiovascular risk factors and depressive symptoms in those with cardiometabolic disease. Published Online: September 21, When we restricted the analysis to never smokers there was evidence of increased mortality in the overweight range with more substantial increases in risk in the obese and morbidly obese range. Cox regression analysis was performed to determine the significance of the association of BMI with all-cause mortality. Reverse causality can result in J-shaped associations in observational studies.

Back to top Article Information. As illustrated by the case of blood pressure, obesity nature of interventions may matter as much as risk factor distributions. Farmington, New Mexico. Framing and Public Health Communication. In the face of these uncertainties, public health policy makers must act and communicate in a way that is understandable and resonant with individuals.

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Patient Characteristics Baseline characteristics of all patients are presented in Table 1. In never smokers and healthy never smokers, there was a J shaped association between BMI and mortality, and the lowest risk was observed at BMI andrespectively. Haslam D. Adiposity and mortality in men.

Create a personal account to register for email alerts with links to free full-text articles. For example, j shaped curve obesity overall prevalence shapee alcohol use in the United States has not changed substantially between and —but the prevalence of heavy drinking and binge drinking has increased in Citation s : Lee DH et al. Then conversations might focus more on what is epidemiologically important, such as curbing excessive intake, rather than on theoretical risks to small subpopulations. BMJ Jul 3; k Health consequences of smoking cigarettes per day.

  • Data sources PubMed and Embase databases searched up to 23 September Janssen I.

  • As illustrated by the case of blood pressure, the nature of interventions may matter as much as risk factor distributions. Further characterization should include the causal mechanisms underlying the J-shaped trajectory.

  • Firstly, our participants were all middle-aged or elderly hypertensives; therefore, the result of this study cannot be generalized to all populations.

  • View Metrics. Impact of achieved blood pressures on mortality risk and end-stage renal disease among a large, diverse hypertension population.

Further stratified analyses by subgroups including sex, age, center, smoking and alcohol drinking status, education, stress and albumin levels were obesity explored by Cox proportional-hazards regression models to test for consistency of results. Lancet Diabetes Endocrinol ; 3 Chung W. Men had a lower of BMI Int J Obes Lond. Studies that reported only a continuous linear risk estimate were excluded as there is evidence that the association between BMI and mortality is non-linear.

A critique and re-analysis. Body mass index, dementia, and mortality in the elderly. Body mass index and chronic obstructive pulmonary disease-related mortality: a shapsd representative prospective study ofmen in China. This article has been cited by other articles in PMC. R: A language and environment for statistical computing. The assessment included detailed history taking, various physical examinations and blood tests. However, when data were adjusted for multiple variables, a linear relation was observed between predicted fat mass and all-cause death and with deaths caused by cardiovascular disease, respiratory disease, and cancer.

Associated Data

It is well known that many chronic diseases which increase the risk of death lead to weight loss. Int J Epidemiol ; 36 No of studies risk estimates by geographical location:.

Eur Heart J ; 20 No significant differences were seen across the other BMI groups. Some studies might have over-adjusted the analysis by including some intermediate factors such as diabetes, blood pressure, hypertension, and serum cholesterol in the multivariate models. Estimating the number of deaths due to obesity: can the divergent findings be reconciled? The current analysis provides strong evidence that overweight and obesity increases the risk of all cause mortality and therefore reinforces previous concerns regarding the adverse health effects of excess weight. Bias in meta-analysis detected by a simple, graphical test. It is well known that smoking strongly increases risk of mortality and many specific causes of death, and there is therefore a great potential for residual confounding by smoking as it is typically also associated with lower weight.

Health Professionals Follow-up Study to determine associations between predicted fat and lean body mass and death in 38, men age range, 40— Sign in to save your search Sign in to your personal account. New York. Presentation of the risk curve could be paired with information about what proportion of the population lies an unhealthy distance away from the nadir. In contrast, a U-shaped relation was noted between predicted lean body mass and all-cause death and deaths caused by cardiovascular disease and cancer. Hospitalist Medical Director in Texas.

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Clin Endocrinol Oxf ; 79 Bjartveit K, Tverdal A. Methodological issues further limit understanding of these fundamental epidemiologic relationships.

Linearization refers to the idea that j shaped curve obesity subcomponents of complex risk obesify like BMI may be characterized by a more straightforward relationship between exposures and health effects. Abstract Background and aim: Many studies have shown increased risk of stroke with greater adiposity as measured by body mass index BMIbut questions remain about the shape of the dose-response relation. Complex risk factors such as blood pressure and BMI raise questions around how to meaningfully interpret associations with disease. J Am Coll Cardiol. For instance, a primary determinant of BMI is caloric intake, which also has a J-shaped association with mortality—with the left lip of the curve representing calorie malnutrition. Results: patients died during follow-up.

Environ Health Prev Med ; 5 Sign In or Create an Account. As the study was based on cross-sectional analysis, it is not possible to make causal inferences from the findings of this study. Cudve publications reported on or included data from more than one study which were analysed shqped one combined dataset ; one publication included data from nine studies, and another publication included eight cohort studies that were combined in one analysis, 16 one publication reported results from six studies that were combined, 95 five publications reported results from three studies that were combined, 74 four publications reported results from two studies, which were included in the analysis. Compared to middle-aged adults, some previous studies found that the optimal BMI among the elderly shifted upwards [ 1718 ]. In the NCI Cohort Consortium the effect of exclusion of participants with prevalent disease on the association between BMI and mortality was more pronounced in men and for heart disease rather than for cancer, stroke, or respiratory disease.

EDITOR DISCLOSURES AT TIME OF PUBLICATION

Ultimately, successful approaches will depend on more robust and precise mapping of the inflections of shapev important J-shaped relationships as well as understanding how many people actually are distributed along different points on the curve. July 16, Recent controversies around sodium intake thresholds, for instance, revealed the missed opportunities for clear public health strategies when the true contours of the exposure-outcome curve are not firmly established.

J Affect Disord. Our meta-analysis has some limitations that need to be mentioned. Body mass index, change in body mass index, and survival in old and very old persons. Ann Epidemiol ; 3

Get free access to newly published articles Create a personal account or sign shaped to: Register for email alerts with links to free full-text articles Access PDFs of free articles Manage shapfd interests Save searches and receive search alerts. Publication types Multicenter Study Observational Study. All rights reserved. Framing and Public Health Communication. As illustrated by the case of blood pressure, the nature of interventions may matter as much as risk factor distributions. The prognostic significance of BMI in patients with severe aortic stenosis AoS undergoing TAVI is a matter of current debate, as published studies are scarce and their results conflicting.

Increased risk of mortality from overweight and obesity shapwd middle-aged individuals from six communities in Taiwan. Open in a separate window. All Participants. Taxes and regulations on sugar-sweetened beverages can be interpreted in a similar way. Relation between body mass index and mortality in an unusually slim cohort. Purchase access Subscribe now.

Data sharing: No additional data available. Psychiatry Res. This post-hoc analysis utilizes data from the China Stroke Primary Prevention Trial CSPPTwhich enrolled 20, subjects with primary hypertension in a multi-community, randomized, double-blind, controlled trial to assess whether enalapril maleate and folic acid supplementation was more effective in reducing risk of stroke than enalapril maleate supplementation alone. Body mass index, weight change and mortality risk in a prospective study in India.

Farmington, New Mexico. Three public health strategies may help make the challenges surrounding J-shaped curves cudve soluble. Drinking patterns in US counties from to Views 56, Eur J Clin Nutr ; 55 The distributions of the five cardiovascular risk factors in the study sample such as sample mean, standard deviation, missing values and the observations outside the plausible range considered and observed nadirs are described in Table 2. Google Scholar.

Please try again later. Figure 1 shows the Kaplan-Meier curves of the cumulative hazards of all-cause j shaped curve obesity stratified by BMI categories. Repeated measures of body mass index and risk of health related outcomes. Bjartveit K, Tverdal A. Scand J Public Health ; 33 National Center for Biotechnology InformationU.

Background

Firstly, reverse causality is a major problem in observational studies. Weight change, j shaped curve obesity weight and mortality: the impact of smoking and ill health. This finding is similar to what has been observed in other Asian regions such as Taiwan [ 19 ], Hong Kong [ 20 ], India and Bangladesh [ 8 ], among others [ 457 ].

Such further investigation is necessary in order to determine whether the lower obesityy risk factors are merely markers of other disease processes for example, low total cholesterol levels associated with malnutrition, liver diseases and haematological diseases [ 44 — 46 ] that may make patients more vulnerable to experiencing depressive symptoms or whether it could be attributed to a potential side-effect of aggressive cardiovascular risk factor management [ 47 — 50 ]. Bias in meta-analysis detected by a simple, graphical test. J Insur Med ; 33 Citation s : Lee DH et al. Am J Public Health.

Int J Obes Lond ; 29 Eur J Epidemiol ; 30 Age Dordr ; 33 There are no plans to disseminate the results of the research to study participants or the relevant patient community.

FSM is the guarantor and the lead author for this manuscript. Body mass index, weight loss, and mortality in community-dwelling older adults. Fellowship-trained Rheumatologists. There is some evidence of increased mortality in underweight people, but we cannot exclude the possibility that this could partly be because of residual confounding from prediagnostic disease. Web Extra.

In the analysis of all participants obesitty was j shaped curve obesity evidence of heterogeneity when we stratified studies by adjustment for age, education, socioeconomic status, alcohol, smoking status, pack years, years since quitting, physical activity, height, dietary pattern, fat intake, or fruit and vegetable intake. BMC Public Health ; 7 Body mass index, weight loss, and mortality in community-dwelling older adults. DA and LJV obtained funding.

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Framing and Public Health Communication. Gov't Systematic Review. Indeed, while tobacco excise taxes have steadily increased over the past 2 decades, alcohol tax rates have not shped increased since and are far lower than historical levels when adjusted for inflation. However, when data were adjusted for multiple variables, a linear relation was observed between predicted fat mass and all-cause death and with deaths caused by cardiovascular disease, respiratory disease, and cancer. Tobacco taxes are an example of such population-based approaches to disease prevention. Sign in to customize your interests Sign in to your personal account.

Association between body-mass index and risk of death in more than 1 million Asians. In addition, evidence from longitudinal studies show that depression may have a bi-directional relationship with obesity [ 18 ]. Lancet Diabetes Endocrinol ; 3 The results were slightly stronger when we restricted the analysis to healthy never smokers without prevalent disease at baselinebut the increased risk in the participants with a low BMI persisted in these analyses. J Clin Epidemiol ; 60

  • Swiss National Cohort Study Group. Hosegood V, Campbell OM.

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  • Lancet ; The distributions of the five cardiovascular risk factors in the study sample such as sample mean, standard deviation, missing values and the observations outside the plausible range considered and observed nadirs are described in Table 2.

  • Modification of the relationship between the Quetelet index and mortality by weight-loss history among older women.

  • Random-effects generalized least-squares regression models were used to estimate study-specific dose-response association, and restricted cubic splines were used to model the association.

J Am Coll Cardiol. Int J Obes Lond ; 35 Figures are relative risk estimates from non-linear curve obesity analysis. Obewity size image. The observed nadir for HbA1c in patients with diabetes was 6. The summary relative risk for a 5 unit increment in BMI was 1. This would then offer a mechanism for targeting of depression screening in those with cardiometabolic disease.

However, j shaped curve obesity data were adjusted for multiple variables, a linear relation was observed between predicted fat mass and all-cause death and with deaths caused by cardiovascular disease, respiratory disease, and cancer. Citation s : Lee DH et al. Family Medicine Curvf. Body-mass index and mortality among 1. For example, one possibility is that the lip of the J-shaped curve for BMI may result from premortality cachexia in individuals with chronic disease. Background and aim: Many studies have shown increased risk of stroke with greater adiposity as measured by body mass index BMIbut questions remain about the shape of the dose-response relation. Three examples—alcohol consumption, body mass index BMIand blood pressure—help elucidate the challenges posed by J-shaped curves.

1. Introduction

There was no heterogeneity in the analyses among never smokers when we stratified by sex, and, although there was heterogeneity when we stratified analyses of all participants by sex, this seemed to be due to no association among the studies of men and women combined, and when analysis was restricted to studies in either men or women there was no heterogeneity tables C, D, and F in appendix 2, fig I in appendix 3. Increased risk of mortality from overweight and obesity in middle-aged individuals from six communities in Taiwan. As preclinical weight loss can precede the diagnosis of disease by many years, stratification by duration of follow-up can allow for assessments of the longer term impact of confounding by undiagnosed disease. Article PubMed Google Scholar 3. Some publications reported on or included data from more than one study which were analysed as one combined dataset ; one publication included data from nine studies, and another publication included eight cohort studies that were combined in one analysis, 16 one publication reported results from six studies that were combined, 95 five publications reported results from three studies that were combined, 74 four publications reported results from two studies, which were included in the analysis.

WHO Expert Consultation Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies. BMC Curve obesity Pract. Health Professionals Follow-up Study to determine associations between predicted fat and lean body mass and death in 38, men age range, 40— Sex-age-specific association of body mass index with all-cause mortality among It has been shown that weight loss associated with disease before baseline is associated with increased risk of mortality and that in people with stable BMI there was a linear increase in risk of mortality with higher BMI, while in those who previously experienced weight loss likely because of chronic illness there was a more U shaped association between BMI and mortality. Joint association of adiposity and smoking with mortality among U.

A reversed J-shaped relationship was observed between BMI and all-cause mortality. The U-shaped association between body mass index and mortality: relationship with weight gain in a Native American population. In addition, hypertensive participants are relatively less healthy compared to the general population, although in our study we excluded patients with stroke and MI. Article Navigation.

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Appendix 2: Supplementary tables A-L. DerSimonian R, Laird N. Effect of positive health factors and all-cause mortality in men.

  • Diabetes Care ; 35

  • New York.

  • Zheng W.

  • For instance, a primary determinant of BMI is caloric intake, which also has a J-shaped association with mortality—with the left lip of the curve representing calorie malnutrition.

Ann Oncol ; 23 Such further investigation is necessary in order to determine whether the lower cardiovascular risk factors are merely markers of other disease processes for example, low total cholesterol levels associated with malnutrition, liver diseases and haematological diseases [ 44 — 46 ] that may make patients more vulnerable to experiencing depressive symptoms or whether it could be attributed to a potential side-effect of aggressive cardiovascular risk factor management [ 47 — 50 ]. Body mass index and mortality: results of a cohort ofadults in Austria. Association of all-cause mortality with overweight and obesity using standard body mass index categories: A systematic review and meta-analysis.

A prospective study of 1. Am J Public Health. In countries with concurrent epidemics of malnutrition and obesity, efforts to curb either could result in harmful unintended consequences. Create a free personal account to access your subscriptions, sign up for alerts, and more.

Studies that reported only a continuous linear risk estimate were excluded as there is evidence that the association between BMI and mortality is non-linear. Body mass index and mortality: results of a cohort ofadults in Austria. This would then offer a mechanism for targeting of depression screening in those with cardiometabolic disease. Body mass index and mortality in a middle-aged Japanese cohort. Secular declines in the association between obesity and mortality in the United States.

Body size and physical activity in relation to incidence of chronic obstructive pulmonary disease. BMC Public Health obesity 11 Read more about weight loss. Support Center Support Center. These studies also reported on the impact of weight loss after bariatric surgery on myocardial function and cardiac structure among patients with obesity.

Publication types Multicenter Study Observational J shaped curve obesity. Dave A. Paul S. Ccurve Engl J Med. First, health communication should emphasize the nadir of a J-shaped curve as a healthy range for the general population. Back to top Article Information. Create a free personal account to access your subscriptions, sign up for alerts, and more.

Keywords: Body mass index; Meta-analysis; Obesity; Stroke. All rights reserved. Stine, MD 1,2. During mean follow-up of 21 years, 12, deaths occurred. Health consequences of smoking cigarettes per day.

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Powdered alcohol, for instance—or very sugary alcoholic beverages appealing to adolescents—are cases for which regulation would address a specific health harm that does not have a countervailing benefit. Keywords: Aortic stenosis; Body mass index; Mortality; Obesity paradox; Transcatheter aortic valve implantation. Accessed July 22,

Model 1: crude; Model 2: adjustment for sex, age, center, baseline and on-treatment BP, smoking status, alcohol drinking, education, stress, fasting blood glucose, total cholesterol, triglycerides, serum creatinine, homocysteine, albumin. This relationship also remained significant after adjusting for age, sex, number of comorbid conditions and socio-economic status. R: A language and environment for statistical computing. Sign In or Create an Account. Facilitating meta-analyses by deriving relative effect and precision estimates for alternative comparisons from a set of estimates presented by exposure level or disease category. Body mass index category as a risk factor for colorectal adenomas: a systematic review and meta-analysis. Smoking is a strong risk factor for premature mortality and several specific causes of death.

We found large differences in the shape of the dose-response relation with different durations of follow-up, with more U shaped associations with shorter follow-up and J shaped associations with longer follow-up. Those with cardiometabolic disease who have suffered from depression have been reported to experience increased adverse clinical outcomes and mortality, and poorer functional abilities [ 46 — 8 ]. Materials and Methods 2. Supplementary and sensitivity analyses The screened population was a subset of the whole dataset and the majority of the patients eligible for depression screening did not have HADS-D recorded due to poor uptake of depression screening. Hazard ratios for all-cause mortality according to narrower BMI categories.

Dave A. By continuing to use our site, you accept the use of these cookies. Stine, MD 1,2. Meanwhile, theoretical perceived harms u subpopulations may make any population-based approach considerably more difficult to implement. Arch Intern Med. Fellowship-trained Rheumatologists. For example, while overall fat intake likely follows a J-shaped curve, there is no safe level of trans fat consumption; therefore, more aggressive regulation of trans fats may be justified and more feasible.

The screened population was a subset of the whole dataset and the majority of the patients eligible for depression screening did not have HADS-D recorded due to poor uptake of depression screening. Barrett-Connor et al. Obesity Silver Spring ; 16 BMC Public Health ; 11

  • Find articles by Xi-Ping Xu. J Nutr Health Aging ; 19

  • Random-effects generalized least-squares regression models were used to estimate study-specific dose-response association, and restricted cubic splines were used to model the association. Methodological issues further limit understanding of these fundamental epidemiologic relationships.

  • Weight histories and mortality among finnish adults: the role of duration and peak body mass index. Janssen et al.

  • All authors interpreted the findings and contributed to the drafting of curve obesity paper. In conclusion, both overweight and obesity increases the risk of all cause mortality with a J shaped dose-response relation, and the nadir of the dose-response curve seems to be in the BMI range of among never smokers and among healthy never smokers.

  • Global, regional, and national prevalence of overweight and obesity in children and adults during a systematic analysis for the Global Burden of Disease Study Knoxville, Tennessee.

  • Congressional Budget Office.

Background: Obesity in patients with established cardiovascular disease has previously been obssity as an indicator of good prognosis, a phenomenon known as the "obesity paradox". View Large Download. Create a free personal account to download free article PDFs, sign up for alerts, customize your interests, and more. For example, some evidence suggests that supplementary feeding programs in Chile intended to treat malnutrition may have contributed to an increase in overweight and obesity among children of higher socioeconomic position. Impact of achieved blood pressures on mortality risk and end-stage renal disease among a large, diverse hypertension population.

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Secondly, socioeconomic status could confound the association between BMI and the risk of death, as people from less well-developed countries with a high BMI are more likely to have a higher socioeconomic status, allowing them better access to health care than those with a lower BMI [ 8 ]. Article PubMed Google Scholar 2. The objective of this paper is to study the association between cardiovascular risk factors and concurrent depressive symptoms in patients with three common cardiometabolic conditions: coronary heart disease CHDstroke and diabetes. WHO Expert Consultation Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies. Click Here to Manage Email Alerts.

By continuing to use our site, you accept the use of these obesity. As illustrated by the case of blood pressure, the nature of interventions may matter as much as risk factor distributions. Gov't Systematic Review. Published by Elsevier B. Get free access to newly published articles Create a personal account or sign in to: Register for email alerts with links to free full-text articles Access PDFs of free articles Manage your interests Save searches and receive search alerts. Accessed July 22,

J-Shaped Curves and Public Health. Paul S. Accessed July 22, Ultimately, successful approaches will depend on more robust and precise mapping of the inflections of epidemiologically important J-shaped relationships as well as understanding how many people actually are distributed along different points on the curve. Arch Intern Med.

View Large Download. All rights reserved. Age-specific relevance of usual blood pressure to vascular mortality. Reverse causality can result in J-shaped associations in observational studies. Purchase access Subscribe to the journal.

It is therefore unclear whether the observed shsped association of cardiovascular risk factors with prevalent depressive symptoms is due to cause or effect. Tob Control. Int J Epidemiol ; 30 Volume 5. Ethical approval: Not required. The prognostic role of body mass index on mortality amongst the middle-aged and elderly: a competing risk analysis. Prev Med ; 15

For example, while overall fat intake likely follows a J-shaped curve, there is no shapde level of trans fat consumption; therefore, more aggressive regulation of trans fats may be justified and more feasible. Int J Obes Lond. The relation of body mass index, cardiorespiratory fitness, and all-cause mortality in women. Figure 1.

Arch Intern Med. Stine, MD 1,2. View Large Download. Body-mass index and mortality among 1. Health Policy and J-Shaped Curves. Coronavirus Resource Center. Alcohol dosing and total mortality in men and women.

Rent this article from DeepDyve. View Metrics. The J-shaped curve complicates matters in 2 principal ways: 1 the potential for real, unintended adverse consequences for certain subpopulations and 2 magnification of potential adverse consequences by opponents of public health interventions. Disclaimer: The views in this article are those of the authors and do not necessarily reflect the policies or views of the New York City Health and Hospitals Corporation. Taxes and regulations on sugar-sweetened beverages can be interpreted in a similar way. Health consequences of smoking cigarettes per day. BMI is a simple, if imperfect, proxy for energy metabolism—and therefore the current standard for representing healthy weight.

Sign in to save your search Sign in to your personal account. PubMed Google Scholar Crossref. Importantly, even for exposures that follow a J-shaped curve, there may be situations in which similar public health tactics are warranted.

BMJ ; BMI and risk of dementia in two million people obesity two decades: a retrospective cohort study. Finally, the overall accuracy of depression screening in our study was reliant on HADS-D which is a self-reported measure and it is not a gold standard measure for assessing depressive symptoms in patients with cardiometabolic disease in a primary care setting [ 115758 ]. Article PubMed Google Scholar If you continue to have this issue please contact customerservice slackinc. Ann Oncol ; 23 Alcohol dosing and total mortality in men and women.

To learn more, please visit our Cookie Information page. A J-shaped curve was observed for BMI and all-cause death. In countries with concurrent epidemics of malnutrition and obesity, efforts to curb either could result in harmful unintended consequences. Purchase access Subscribe to the journal.

Does the Mediterranean diet predict longevity in the elderly? The association of body mass index BMI with all-cause mortality in older Taiwanese: results of a national cohort study. Obesity and cancer. Int J Epidemiol ; 44

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