Friday, November 17, 2006

Obesity, physical activity and mortality

Obesity and physical inactivity are major public health problems in the United States. Persuasive evidence indicates that both obesity and physical inactivity are risk factors for the development of major chronic diseases and premature death. However, the optimal weight and levels of physical activity for longevity continue to be controversial, and few studies have examined adiposity and physical activity at the same time in relation to mortality. It has been suggested that higher levels of physical fitness can eliminate the effect of excess weight and obesity on morbidity and mortality, and that obesity may be a less important determinant of mortality than is fitness. A study in the New England Journal of Medicine extended their previous analyses of BMI and mortality in the Nurses' Health Study to 24 years of follow-up to address the long-term relationship between BMI and mortality and to examine whether higher levels of physical activity attenuate the association between BMI and mortality.

The study included 116,564 women, who in 1976, were 30 years to 55 years of age and free of known cardiovascular disease and cancer. In 1980 and 1982, the women were asked to report the average number of hours they had spent each week during the previous year engaging in moderate physical activity (that is, brisk walking) and in vigorous activity (that is, strenuous sports and jogging). In 1980, 1982, 1988, 1992, 1996 and 1998, women were asked to complete an eight-item questionnaire regarding the average time they spent per week walking, jogging, running, bicycling, swimming laps, playing tennis or squash, and participating in calisthenics. Self-reported weights helped to determine BMI and in 1986 the women reported direct measurements of their waists and hips.


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