Comparing life expectancy and health-adjusted life expectancy by body mass index category in adult Canadians: a descriptive study

Population Health Metrics

Sylvie Martel²  Chris Waters³  Bernard Choi³  Ernest Lo²  Heather Orpana³  Lidia Loukine³  Colin Steensma¹ 

[1] Public Health Agency of Canada, 200, boulevard René-Lévesque Ouest, Montréal, QC H2Z 1X4, Canada;Institut national de santé publique du Québec, 190, boulevard Crémazie Est, Montréal, QC H2P 1E2, Canada;Public Health Agency of Canada, 785 Carling, Ottawa, ON K1A 0K9, Canada

关键词: Health-related quality of life;    Mortality;    Health expectancy;    Life expectancy;    Body mass index;    Underweight;    Obesity;    Overweight;   

Others  :  804002
DOI  :  10.1186/1478-7954-11-21

 received in 2013-03-04, accepted in 2013-11-11,  发布年份 2013

【 摘 要 】

Background

While many studies have examined differences between body mass index (BMI) categories in terms of mortality risk and health-related quality of life (HRQL), little is known about the effect of body weight on health expectancy. We examined life expectancy (LE), health-adjusted life expectancy (HALE), and proportion of LE spent in nonoptimal (or poor) health by BMI category for the Canadian adult population (age ≥ 20).

Methods

Respondents to the National Population Health Survey (NPHS) were followed for mortality outcomes from 1994 to 2009. Our study population at baseline (n=12,478) was 20 to 100 years old with an average age of 47. LE was produced by building abridged life tables by sex and BMI category using data from the NPHS and the Canadian Chronic Disease Surveillance System. HALE was estimated using the Health Utilities Index from the Canadian Community Health Survey as a measure of HRQL. The contribution of HRQL to loss of healthy life years for each BMI category was also assessed using two methods: by calculating differences between LE and HALE proportional to LE and by using a decomposition technique to separate out mortality and HRQL contributions to loss of HALE.

Results

At age 20, for both sexes, LE is significantly lower in the underweight and obesity class 2+ categories, but significantly higher in the overweight category when compared to normal weight (obesity class 1 was nonsignificant). HALE at age 20 follows these same associations and is significantly lower for class 1 obesity in women. Proportion of life spent in nonoptimal health and decomposition of HALE demonstrate progressively higher losses of healthy life associated with lowered HRQL for BMI categories in excess of normal weight.

Conclusions

Although being in the overweight category for adults may be associated with a gain in life expectancy as compared to normal weight adults, overweight individuals also experience a higher proportion of these years of life in poorer health. Due to the descriptive nature of this study, further research is needed to explore the causal mechanisms which explain these results, including the important differences we observed between sexes and within obesity subcategories.

【 授权许可】

   
2013 Steensma et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

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