0
December 15, 1993, Vol 270, No. 23 >
ARTICLE | December 15, 1993

Body Weight and Mortality: Title and subTitle BreakA 27-Year Follow-up of Middle-aged Men FREE

I-Min Lee, MBBS, ScD; JoAnn E. Manson, MD, DrPH; Charles H. Hennekens, MD, DrPH; Ralph S. Paffenbarger, Jr, MD, DrPH
[+] Author Affiliations

This is report No. LVI in a series on chronic disease in former college students.

Reprint requests to Department of Epidemiology, Harvard School of Public Health, 677 Huntington Ave, Boston, MA 02115 (Dr Lee).


JAMA. 1993;270(23):2823-2828. doi:10.1001/jama.1993.03510230061036
Text Size: A A A
Published online
Article
References

Objective.  —To investigate the nature of the relation between body weight and all-cause mortality.

Design.  —Prospective cohort study, following up men from 1962 or 1966 (1962/1966) through 1988.

Setting/Participants.  —Harvard University alumni with a mean age of 46.6 years in 1962/1966 and without self-reported, physician-diagnosed coronary heart disease, stroke, or cancer, who completed questionnaires on weight, height, cigarette smoking habit, and physical activity (n=19297). We calculated body mass index (weight in kilograms divided by the square of height in meters) using self-reported measures.

Main Outcome Measure.  —All-cause mortality (4370 deaths).

Results.  —In multivariate analysis adjusting for age, cigarette smoking habit, and physical activity, we found a J-shaped relation between body mass index and mortality. Relative risks of dying for men with a body mass index of less than 22.5, 22.5 to less than 23.5, 23.5 to less than 24.5, 24.5 to less than 26.0, and 26.0 or greater were 1.00 (referent), 0.99 (95% confidence interval, 0.89 to 1.20), 0.95 (0.87 to 1.05), 1.01 (0.91 to 1.10), and 1.18 (1.08 to 1.28), respectively (P for linear trend=.0008). Among current smokers, the relation between body mass index and mortality was U-shaped, with lowest risk of death at a body mass index of 23.5 to less than 24.5. During early follow-up (1962/1966 through 1974), we also observed a U-shaped curve, this time with lowest mortality risk at a body mass index of 24.5 to less than 26.0. To minimize confounding by cigarette smoking and bias from antecedent disease and early mortality, we conducted analysis only among never smokers and omitted the first 5 years of follow-up (510 deaths). The corresponding relative risks from this analysis, adjusted for age and physical activity, were 1.00, 1.23 (95% confidence interval, 0.90 to 1.67), 1.06 (0.80 to 1.42), 1.27 (0.96 to 1.68), and 1.67 (1.29 to 2.17), respectively (P for linear trend=.0001).

Conclusions.  —In these prospective data, body weight and mortality were directly related. After accounting for confounding by cigarette smoking and bias resulting from illness-related weight loss or inappropriate control for the biologic effects of obesity, we found no evidence of excess mortality among lean men. Indeed, lowest mortality was observed among men weighing, on average, 20% below the US average for men of comparable age and height.(JAMA. 1993;270:2823-2828)

REFERENCES

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References 2, 6, 7, 9, 12,18,19, 22, 26, 27, 29, and 31.
2 +
References 6, 7, 9, 12, 18, 19, 26, 27, 29, and 31.
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References 4, 8, 12, 15, 16, 18, 22, 23, 26, 29, 30, and 33.
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References 4, 7, 9-11, 13-17, 21, 24-26, 29-31, and 43-49.
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References 2, 3, 5, 8-10, 22, 23, 27,28, 45, 48, and 50-52.
6 +
National Institutes of Health Consensus Development Panel on the Health Implications of Obesity.  Health implications of obesity: National Institutes of Health consensus development conference statement. Ann Intern Med . 1985;;103:1073-1077.
7 +
Borhani NO, Hechter HH, Breslow L.  Report of a ten-year follow-up study of the San Francisco longshoremen. J Chronic Dis . 1963;;16:1251-1266.
8 +
Tibblin G, Wilhelmsen L, Werkö L.  Risk factors for myocardial infarction and death due to ischemic heart disease and other causes. Am J Cardiol . 1975;; 35:514-522.
9 +
Pyörälä K, Savolainen E, Lehtovirta E, Punsar S, Siltanen P.  Glucose intolerance and coronary heart disease: Helsinki Policeman Study. J Chronic Dis . 1979;;32:729-745.
10 +
Schroll M.  A longitudinal epidemiological survey of relative weight at age 25, 50 and 60 in the Glostrup population of men and women born in 1914. Dan Med Bull . 1981;;28:106-116.
11 +
Vandenbroucke JP, Mauritz BJ, de Bruin A, Verheesen JHH, van der Heide-Wessel C, van der Heide RM.  Weight, smoking, and mortality. JAMA . 1984;; 252:2859-2860.
12 +
Tuomilehto J, Salonen JT, Marti B, et al.  Body weight and risk of myocardial infarction and death in the adult population of eastern Finland. BMJ . 1987;;295:623-627.
13 +
Keys A.  Longevity of man: relative weight and fatness in middle age. Ann Med 1989;;21:163-168.
14 +
Stevens J, Keil JE, Rust PF, et al.  Body mass index and body girths as predictors of mortality in black and white men. Am J Epidemiol . 1992;;135: 1137-1146.
15 +
Stevens J, Keil JE, Rust PF, Tyroler HA, Davis CE, Gazes PC.  Body mass index and body girths as predictors of mortality in black and white women. Arch Intern Med . 1992;;152:1257-1262.
16 +
Build and Blood Pressure Study, 1959 . Chicago, Ill: Society of Actuaries; 1959;.
17 +
Garrison RJ, Feinleib M, Castelli WP, McNamara PM.  Cigarette smoking as a confounder of the relationship between relative weight and long-term mortality: the Framingham Heart Study. JAMA . 1983;;249:2199-2203.
18 +
Linsted K, Tonstad S, Kuzma JW.  Body mass index and patterns of mortality among Seventh-Day Adventist men. Int J Obes . 1991;;15:397-406.
19 +
Comstock GW, Kendrick MA, Livesay VT.  Subcutaneous fat and mortality. Am J Epidemiol . 1966;; 83:548-563.
20 +
Westlund K, Nicolaysen R.  Ten-year mortality and morbidity related to serum cholesterol: a follow-up of 3751 men aged 40-49. Scand J Clin Lab Invest . 1972;;30( (suppl 127) ):3-24.
21 +
Lew EA, Garfinkel L.  Variations in mortality by weight among 750 000 men and women. J Chronic Dis . 1979;;32:563-576.
22 +
Build Study, 1979 . Chicago, Ill: Society of Actuaries and Association of Life Insurance Medical Directors of America; 1980;.
23 +
Sidney S, Friedman GD, Siegelaub AB.  Thinness and mortality. Am J Public Health . 1987;;77: 317-322.
24 +
Gordon T, Doyle JT.  Weight and mortality in men: the Albany Study. Int J Epidemiol . 1988;;17: 77-81.
25 +
Hoffmans MDAF, Kromhout D, de Lezenne Coulander C.  The impact of body mass index of 78 612 18-year old Dutch men on 32-year mortality from all causes. J Clin Epidemiol . 1988;;41:749-756.
26 +
Folsom AR, Kaye SA, Sellers TA, et al.  Body fat distribution and 5-year risk of death in older women. JAMA . 1993;;269:483-487.
27 +
Dyer AR, Stamler J, Berkson DM, Lindberg HA.  Relationship of relative weight and body mass index to 14-year mortality in the Chicago Peoples Gas Company Study. J Chronic Dis . 1975;;28:109-123.
28 +
Keys A. Seven Countries: A Multivariate Analysis of Death and Coronary Heart Disease . Cambridge, Mass: Harvard University Press; 1980;.
29 +
Rhoads GG, Kagan A.  The relation of coronary disease, stroke, and mortality to weight in youth and in middle age. Lancet . 1983;;1:492-495.
30 +
Waaler HT.  Height, weight and mortality: the Norwegian experience. Acta Med Scand Suppl . 1984;; 679:1-56.
31 +
Garfinkel L, Stellman SD.  Mortality by relative weight and exercise. Cancer . 1988;;62:1844-1850.
32 +
Harris T, Cook EF, Garrison R, Higgins M, Kannel W, Goldman L.  Body mass index and mortality among nonsmoking older persons: the Framingham Heart Study. JAMA . 1988;;259:1520-1524.
33 +
Wannamethee G, Shaper AG.  Body weight and mortality in middle aged British men: impact of smoking. BMJ . 1989;;299:1497-1502.
34 +
Rissanen A, Heliövaara M, Knekt P, Aromaa A, Reunanen A, Maatela J.  Weight and mortality in Finnish men. J Clin Epidemiol . 1989;;42:781-789.
35 +
Noppa H, Bengtsson C, Wedel H, Wilhelmsen L.  Obesity in relation to morbidity and mortality from cardiovascular disease. Am J Epidemiol . 1980;;111: 682-692.
36 +
Garn SM, Hawthorne VM, Pilkington JJ, Pesick SD.  Fatness and mortality in the West of Scotland. Am J Clin Nutr . 1983;;38:313-319.
37 +
Campbell AJ, Spears GFS, Brown JS, Busby WJ, Borrie MJ.  Anthropometric measurements as predictors of mortality in a community population aged 70 years and over. Age Ageing . 1990;;19:131-135.
38 +
Wilcosky T, Hyde J, Anderson JJB, Bangdiwala S, Duncan B.  Obesity and mortality in the Lipid Research Clinics Program Follow-up Study. J Clin Epidemiol . 1990;;43:743-752.
39 +
Manson JE, Stampfer MJ, Hennekens CH, Willett WC.  Body weight and longevity: a reassessment. JAMA . 1987;;257:353-358.
40 +
 New weight standards for men and women. Stat Bull Metropolitan Life Insur Co . (November-December) 1959;;40:1-4.
41 +
 1983 Metropolitan height and weight tables. Stat Bull Metropolitan Life Insur Co . (January-June) 1983;; 64:2-9.
42 +
US Dept of Agriculture, US Dept of Health and Human Services. Nutrition and Your Health: Dietary Guidelines for Americans . 3rd ed. Washington, DC: US Dept of Agriculture; 1990;.
43 +
Willett WC, Stampfer M, Manson J, Van Itallie T.  New guidelines for Americans: justified or injudicious? Am J Clin Nutr . 1991;;53:1102-1103.
44 +
Lee I-M, Paffenbarger RS Jr, Hsieh C-C.  Time trends in physical activity among college alumni, 1962-1988. Am J Epidemiol . 1992;;135:915-925.
45 +
Paffenbarger RS Jr, Wing AL, Hyde RT.  Physical activity as an index of heart attack risk in college alumni. Am J Epidemiol . 1978;;108:161-175.
46 +
Cox DR.  Regression models and life tables. J Roy Stat Soc (B) . 1972;;34:187-220.
47 +
National Center for Health Statistics.  Weight by height and age of adults, United States, 1960-1962. Vital Health Stat 11 . 1966;;No. (14) .
48 +
Paul O, Lepper MH, Phelan WH, et al.  A longitudinal study of coronary heart disease. Circulation . 1963;;28:20-31.
49 +
Rosenman RH, Brand RJ, Sholtz RI, Friedman M.  Multivariate prediction of coronary heart disease during 8.5 year follow-up in the Western Collaborative Group Study. Am J Cardiol . 1976;;37: 903-910.
50 +
Kozarević D, Pirc B, Racić Z, Dawber TR, Gordon T, Zukel WJ.  The Yugoslavia Cardiovascular Disease Study, II: factors in the incidence of coronary heart disease. Am J Epidemiol . 1976;;104:133-140.
51 +
Rabkin SW, Matthewson FAL, Hsu P-H.  Relation of body weight to development of ischemic heart disease in a cohort of young North American men after a 26 year observation period: the Manitoba Study. Am J Cardiol . 1977;;39:452-458.
52 +
The Pooling Project Research Group.  Relationship of blood pressure, serum cholesterol, smoking habit, relative weight and ECG abnormalities to incidence of major coronary events: final report of the Pooling Project. J Chronic Dis . 1978;;31:201-306.
53 +
Fitzgerald AP, Jarett RJ.  Body weight and coronary heart disease mortality: an analysis in relation to age and smoking habit: 15 year follow-up data from the Whitehall Study. Int J Obes . 1992;;16:119-123.
54 +
Hubert HB, Feinleib M, McNamara PM, Castelli WP.  Obesity as an independent risk factor for cardiovascular disease: a 26-year follow-up of participants in the Framingham Heart Study. Circulation . 1983;;67:968-977.
55 +
Chapman JM, Massey FJ Jr.  The interrelationship of serum cholesterol, hypertension, body weight, and risk of coronary disease: results of the first ten years' follow-up in the Los Angeles Heart Study. J Chronic Dis . 1964;;17:933-949.
56 +
Keys A, Taylor HL, Blackburn H, Brozek J, Anderson JT, Simonson E.  Mortality and coronary heart disease among men studied for 23 years. Arch Intern Med . 1971;;128:201-214.
57 +
Böttiger L-E, Carlson LA.  Risk factors for ischaemic vascular death for men in the Stockholm Prospective Study. Atherosclerosis . 1980;;36:389-408.
58 +
Stunkard AJ, Albaum JM.  The accuracy of self-reported weights. Am J Clin Nutr . 1981;;34:1593-1599.
59 +
Palta M, Prineas RJ, Berman R, Hannan P.  Comparison of self-reported and 20 measured height and weight. Am J Epidemiol . 1982;;115:223-230.
60 +
Stewart AW,Jackson RT, Ford MA, Beaglehole R.  Underestimation of relative weight by use of self-reported height and weight. Am J Epidemiol . 1987;;125:122-126.
61 +
Williamson DF, Madans J, Anda RF, Kleinman JC, Giovino GA, Byers T.  Smoking cessation and severity of weight gain in a national cohort. N Engl J Med . 1991;;324:739-745.
62 +
Hamm P, Shekelle RB, Stamler J.  Large fluctuations in body weight during young adulthood and twenty-five-year risk of coronary death in men. Am J Epidemiol . 1989;;129:312-318.
63 +
Lissner L, Bengtsson C, Lapidus L, Larsson B, Bengtsson B, Brownell K.  Body weight variability and mortality in the Gothenburg prospective studies of men and women.  In: Björntorp P, Rossner S, eds. Obesity in Europe 88: Proceeding of the First European Congress on Obesity . London, England: Libbey; 1989;:55-60.
64 +
Lissner L, Odell PM, D'Agostino RB, et al.  Variability of body weight and health outcomes in the Framingham population. N Engl J Med . 1991;;324: 1839-1844.
65 +
Lee I-M, Paffenbarger RS Jr.  Change in body weight and longevity. JAMA . 1992;;268:2045-2049.]

Figures

Tables

Interactive Graphics

Video

Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

1 +
References 2, 6, 7, 9, 12,18,19, 22, 26, 27, 29, and 31.
2 +
References 6, 7, 9, 12, 18, 19, 26, 27, 29, and 31.
3 +
References 4, 8, 12, 15, 16, 18, 22, 23, 26, 29, 30, and 33.
4 +
References 4, 7, 9-11, 13-17, 21, 24-26, 29-31, and 43-49.
5 +
References 2, 3, 5, 8-10, 22, 23, 27,28, 45, 48, and 50-52.
6 +
National Institutes of Health Consensus Development Panel on the Health Implications of Obesity.  Health implications of obesity: National Institutes of Health consensus development conference statement. Ann Intern Med . 1985;;103:1073-1077.
7 +
Borhani NO, Hechter HH, Breslow L.  Report of a ten-year follow-up study of the San Francisco longshoremen. J Chronic Dis . 1963;;16:1251-1266.
8 +
Tibblin G, Wilhelmsen L, Werkö L.  Risk factors for myocardial infarction and death due to ischemic heart disease and other causes. Am J Cardiol . 1975;; 35:514-522.
9 +
Pyörälä K, Savolainen E, Lehtovirta E, Punsar S, Siltanen P.  Glucose intolerance and coronary heart disease: Helsinki Policeman Study. J Chronic Dis . 1979;;32:729-745.
10 +
Schroll M.  A longitudinal epidemiological survey of relative weight at age 25, 50 and 60 in the Glostrup population of men and women born in 1914. Dan Med Bull . 1981;;28:106-116.
11 +
Vandenbroucke JP, Mauritz BJ, de Bruin A, Verheesen JHH, van der Heide-Wessel C, van der Heide RM.  Weight, smoking, and mortality. JAMA . 1984;; 252:2859-2860.
12 +
Tuomilehto J, Salonen JT, Marti B, et al.  Body weight and risk of myocardial infarction and death in the adult population of eastern Finland. BMJ . 1987;;295:623-627.
13 +
Keys A.  Longevity of man: relative weight and fatness in middle age. Ann Med 1989;;21:163-168.
14 +
Stevens J, Keil JE, Rust PF, et al.  Body mass index and body girths as predictors of mortality in black and white men. Am J Epidemiol . 1992;;135: 1137-1146.
15 +
Stevens J, Keil JE, Rust PF, Tyroler HA, Davis CE, Gazes PC.  Body mass index and body girths as predictors of mortality in black and white women. Arch Intern Med . 1992;;152:1257-1262.
16 +
Build and Blood Pressure Study, 1959 . Chicago, Ill: Society of Actuaries; 1959;.
17 +
Garrison RJ, Feinleib M, Castelli WP, McNamara PM.  Cigarette smoking as a confounder of the relationship between relative weight and long-term mortality: the Framingham Heart Study. JAMA . 1983;;249:2199-2203.
18 +
Linsted K, Tonstad S, Kuzma JW.  Body mass index and patterns of mortality among Seventh-Day Adventist men. Int J Obes . 1991;;15:397-406.
19 +
Comstock GW, Kendrick MA, Livesay VT.  Subcutaneous fat and mortality. Am J Epidemiol . 1966;; 83:548-563.
20 +
Westlund K, Nicolaysen R.  Ten-year mortality and morbidity related to serum cholesterol: a follow-up of 3751 men aged 40-49. Scand J Clin Lab Invest . 1972;;30( (suppl 127) ):3-24.
21 +
Lew EA, Garfinkel L.  Variations in mortality by weight among 750 000 men and women. J Chronic Dis . 1979;;32:563-576.
22 +
Build Study, 1979 . Chicago, Ill: Society of Actuaries and Association of Life Insurance Medical Directors of America; 1980;.
23 +
Sidney S, Friedman GD, Siegelaub AB.  Thinness and mortality. Am J Public Health . 1987;;77: 317-322.
24 +
Gordon T, Doyle JT.  Weight and mortality in men: the Albany Study. Int J Epidemiol . 1988;;17: 77-81.
25 +
Hoffmans MDAF, Kromhout D, de Lezenne Coulander C.  The impact of body mass index of 78 612 18-year old Dutch men on 32-year mortality from all causes. J Clin Epidemiol . 1988;;41:749-756.
26 +
Folsom AR, Kaye SA, Sellers TA, et al.  Body fat distribution and 5-year risk of death in older women. JAMA . 1993;;269:483-487.
27 +
Dyer AR, Stamler J, Berkson DM, Lindberg HA.  Relationship of relative weight and body mass index to 14-year mortality in the Chicago Peoples Gas Company Study. J Chronic Dis . 1975;;28:109-123.
28 +
Keys A. Seven Countries: A Multivariate Analysis of Death and Coronary Heart Disease . Cambridge, Mass: Harvard University Press; 1980;.
29 +
Rhoads GG, Kagan A.  The relation of coronary disease, stroke, and mortality to weight in youth and in middle age. Lancet . 1983;;1:492-495.
30 +
Waaler HT.  Height, weight and mortality: the Norwegian experience. Acta Med Scand Suppl . 1984;; 679:1-56.
31 +
Garfinkel L, Stellman SD.  Mortality by relative weight and exercise. Cancer . 1988;;62:1844-1850.
32 +
Harris T, Cook EF, Garrison R, Higgins M, Kannel W, Goldman L.  Body mass index and mortality among nonsmoking older persons: the Framingham Heart Study. JAMA . 1988;;259:1520-1524.
33 +
Wannamethee G, Shaper AG.  Body weight and mortality in middle aged British men: impact of smoking. BMJ . 1989;;299:1497-1502.
34 +
Rissanen A, Heliövaara M, Knekt P, Aromaa A, Reunanen A, Maatela J.  Weight and mortality in Finnish men. J Clin Epidemiol . 1989;;42:781-789.
35 +
Noppa H, Bengtsson C, Wedel H, Wilhelmsen L.  Obesity in relation to morbidity and mortality from cardiovascular disease. Am J Epidemiol . 1980;;111: 682-692.
36 +
Garn SM, Hawthorne VM, Pilkington JJ, Pesick SD.  Fatness and mortality in the West of Scotland. Am J Clin Nutr . 1983;;38:313-319.
37 +
Campbell AJ, Spears GFS, Brown JS, Busby WJ, Borrie MJ.  Anthropometric measurements as predictors of mortality in a community population aged 70 years and over. Age Ageing . 1990;;19:131-135.
38 +
Wilcosky T, Hyde J, Anderson JJB, Bangdiwala S, Duncan B.  Obesity and mortality in the Lipid Research Clinics Program Follow-up Study. J Clin Epidemiol . 1990;;43:743-752.
39 +
Manson JE, Stampfer MJ, Hennekens CH, Willett WC.  Body weight and longevity: a reassessment. JAMA . 1987;;257:353-358.
40 +
 New weight standards for men and women. Stat Bull Metropolitan Life Insur Co . (November-December) 1959;;40:1-4.
41 +
 1983 Metropolitan height and weight tables. Stat Bull Metropolitan Life Insur Co . (January-June) 1983;; 64:2-9.
42 +
US Dept of Agriculture, US Dept of Health and Human Services. Nutrition and Your Health: Dietary Guidelines for Americans . 3rd ed. Washington, DC: US Dept of Agriculture; 1990;.
43 +
Willett WC, Stampfer M, Manson J, Van Itallie T.  New guidelines for Americans: justified or injudicious? Am J Clin Nutr . 1991;;53:1102-1103.
44 +
Lee I-M, Paffenbarger RS Jr, Hsieh C-C.  Time trends in physical activity among college alumni, 1962-1988. Am J Epidemiol . 1992;;135:915-925.
45 +
Paffenbarger RS Jr, Wing AL, Hyde RT.  Physical activity as an index of heart attack risk in college alumni. Am J Epidemiol . 1978;;108:161-175.
46 +
Cox DR.  Regression models and life tables. J Roy Stat Soc (B) . 1972;;34:187-220.
47 +
National Center for Health Statistics.  Weight by height and age of adults, United States, 1960-1962. Vital Health Stat 11 . 1966;;No. (14) .
48 +
Paul O, Lepper MH, Phelan WH, et al.  A longitudinal study of coronary heart disease. Circulation . 1963;;28:20-31.
49 +
Rosenman RH, Brand RJ, Sholtz RI, Friedman M.  Multivariate prediction of coronary heart disease during 8.5 year follow-up in the Western Collaborative Group Study. Am J Cardiol . 1976;;37: 903-910.
50 +
Kozarević D, Pirc B, Racić Z, Dawber TR, Gordon T, Zukel WJ.  The Yugoslavia Cardiovascular Disease Study, II: factors in the incidence of coronary heart disease. Am J Epidemiol . 1976;;104:133-140.
51 +
Rabkin SW, Matthewson FAL, Hsu P-H.  Relation of body weight to development of ischemic heart disease in a cohort of young North American men after a 26 year observation period: the Manitoba Study. Am J Cardiol . 1977;;39:452-458.
52 +
The Pooling Project Research Group.  Relationship of blood pressure, serum cholesterol, smoking habit, relative weight and ECG abnormalities to incidence of major coronary events: final report of the Pooling Project. J Chronic Dis . 1978;;31:201-306.
53 +
Fitzgerald AP, Jarett RJ.  Body weight and coronary heart disease mortality: an analysis in relation to age and smoking habit: 15 year follow-up data from the Whitehall Study. Int J Obes . 1992;;16:119-123.
54 +
Hubert HB, Feinleib M, McNamara PM, Castelli WP.  Obesity as an independent risk factor for cardiovascular disease: a 26-year follow-up of participants in the Framingham Heart Study. Circulation . 1983;;67:968-977.
55 +
Chapman JM, Massey FJ Jr.  The interrelationship of serum cholesterol, hypertension, body weight, and risk of coronary disease: results of the first ten years' follow-up in the Los Angeles Heart Study. J Chronic Dis . 1964;;17:933-949.
56 +
Keys A, Taylor HL, Blackburn H, Brozek J, Anderson JT, Simonson E.  Mortality and coronary heart disease among men studied for 23 years. Arch Intern Med . 1971;;128:201-214.
57 +
Böttiger L-E, Carlson LA.  Risk factors for ischaemic vascular death for men in the Stockholm Prospective Study. Atherosclerosis . 1980;;36:389-408.
58 +
Stunkard AJ, Albaum JM.  The accuracy of self-reported weights. Am J Clin Nutr . 1981;;34:1593-1599.
59 +
Palta M, Prineas RJ, Berman R, Hannan P.  Comparison of self-reported and 20 measured height and weight. Am J Epidemiol . 1982;;115:223-230.
60 +
Stewart AW,Jackson RT, Ford MA, Beaglehole R.  Underestimation of relative weight by use of self-reported height and weight. Am J Epidemiol . 1987;;125:122-126.
61 +
Williamson DF, Madans J, Anda RF, Kleinman JC, Giovino GA, Byers T.  Smoking cessation and severity of weight gain in a national cohort. N Engl J Med . 1991;;324:739-745.
62 +
Hamm P, Shekelle RB, Stamler J.  Large fluctuations in body weight during young adulthood and twenty-five-year risk of coronary death in men. Am J Epidemiol . 1989;;129:312-318.
63 +
Lissner L, Bengtsson C, Lapidus L, Larsson B, Bengtsson B, Brownell K.  Body weight variability and mortality in the Gothenburg prospective studies of men and women.  In: Björntorp P, Rossner S, eds. Obesity in Europe 88: Proceeding of the First European Congress on Obesity . London, England: Libbey; 1989;:55-60.
64 +
Lissner L, Odell PM, D'Agostino RB, et al.  Variability of body weight and health outcomes in the Framingham population. N Engl J Med . 1991;;324: 1839-1844.
65 +
Lee I-M, Paffenbarger RS Jr.  Change in body weight and longevity. JAMA . 1992;;268:2045-2049.]

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