U-shaped association between body mass index and all-cause mortality in both Austrian men and women
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Body mass index (BMI) is the most widely used surrogate for overall adiposity. BMI however does not discriminate subjects according to body composition, i.e. lean (e.g. skeletal muscle) vs fat mass. As a result, the role of BMI as risk factor for all-cause mortality is still a matter of debate. This study investigated the association between BMI and all-cause and cause-specific mortality in a cohort of 184,697 Austrian men and women. During a mean follow-up of 15.1 years, 6077 deaths from cardiovascular disease, 4443 deaths from cancer and 606 deaths from respiratory disease occurred. In both men and women, a U-shaped association between BMI and all-cause mortality was noted: high-risks were found both in the highest and in the lowest BMI categories when compared to subjects with BMI in the reference category (22.5-24.9 kg/m2). Cardiovascular disease and to a lesser extent cancers were the driving factors of increased mortality with increasing BMI while respiratory diseases contributed to mortality in the lowest BMI category, independently from smoking status. Thus, underweight and obesity were both associated with higher all-cause mortality in this Austrian cohort study.
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