Impact of Obesity on Life Expectancy Among Different European Countries: Secondary Analysis of Population-level Data over the 1975-2012 Period

Overview

Journal BMJ Open

Specialty General Medicine

Date 2019 Aug 3

PMID 31371290

Citations 23

Authors

Nikoletta Vidra

Sergi Trias-Llimos

Fanny Janssen

Affiliations

Soon will be listed here.

Abstract

Objective: This study assesses the impact of obesity on life expectancy for 26 European national populations and the USA over the 1975-2012 period.

Design: Secondary analysis of population-level obesity and mortality data.

Setting: European countries, namely Austria, Belarus, Belgium, the Czech Republic, Denmark, Estonia, Finland, France, Hungary, Iceland, Ireland, Italy, Latvia, Lithuania, Luxembourg, the Netherlands, Norway, Poland, Portugal, the Russian Federation, Slovakia, Spain, Sweden, Switzerland, Ukraine and the UK; and the USA.

Participants: National populations aged 18-100 years, by sex.

Measurements: Using data by age and sex, we calculated obesity-attributable mortality by multiplying all-cause mortality (Human Mortality Database) with obesity-attributable mortality fractions (OAMFs). OAMFs were obtained by applying the weighted sum method to obesity prevalence data (non-communicable diseases (NCD) Risk Factor Collaboration) and European relative risks (Dynamic Modeling for Health Impact Assessment (DYNAMO- HIA)). We estimated potential gains in life expectancy (PGLE) at birth by eliminating obesity-attributable mortality from all-cause mortality using associated single-decrement life tables.

Results: In the 26 European countries in 2012, PGLE due to obesity ranged from 0.86 to 1.67 years among men, and from 0.66 to 1.54 years among women. In all countries, PGLE increased over time, with an average annual increase of 2.68% among men and 1.33% among women. Among women in Denmark, Switzerland, and Central and Eastern European countries, the increase in PGLE levelled off after 1995. Without obesity, the average increase in life expectancy between 1975 and 2012 would have been 0.78 years higher among men and 0.30 years higher among women.

Conclusions: Obesity was proven to have an impact on both life expectancy levels and trends in Europe. The differences found in this impact between countries and the sexes can be linked to contextual factors, as well as to differences in people's ability and capacity to adopt healthier lifestyles.

Citing Articles

Trends in educational inequalities in obesity-attributable mortality in England and Wales, Finland, and Italy.

Janssen F, Gonzales Martinez R, Zengarini N, Martikainen P, Kunst A Obesity (Silver Spring). 2025; 33(3):578-588.

PMID: 39962991 PMC: 11897850. DOI: 10.1002/oby.24225.

Ultra-processed foods intake in relation to metabolic health status, serum brain-derived neurotrophic factor and adropin levels in adults.

Poursalehi D, Tirani S, Shahdadian F, Hajhashemy Z, Rouhani P, Saneei P Nutr J. 2024; 23(1):121.

PMID: 39385201 PMC: 11462761. DOI: 10.1186/s12937-024-01024-1.

The contribution of avoidable mortality to life expectancy differences and lifespan disparities in the European Union: a population-based study.

Hrzic R, Vogt T Lancet Reg Health Eur. 2024; 46:101042.

PMID: 39286330 PMC: 11402299. DOI: 10.1016/j.lanepe.2024.101042.

The COVID-19 Pandemic: Lessons for Financially Fragile and Aging Societies.

van Dalen H, Henkens K Work Aging Retire. 2024; :waaa011.

PMID: 38626235 PMC: 7454871. DOI: 10.1093/workar/waaa011.

Metabolically 'extremely unhealthy' obese and non-obese patients with diabetes and the risk of cardiovascular events: a French nationwide cohort study.

Nabrdalik K, Bisson A, Irlik K, Fauchier G, Ducluzeau P, Lip G Clin Res Cardiol. 2023; 113(11):1534-1543.

PMID: 38047924 PMC: 11493818. DOI: 10.1007/s00392-023-02344-8.

References

Malik V, Willett W, Hu F . Global obesity: trends, risk factors and policy implications. Nat Rev Endocrinol. 2012; 9(1):13-27. DOI: 10.1038/nrendo.2012.199. View

Finucane M, Stevens G, Cowan M, Danaei G, Lin J, Paciorek C . National, regional, and global trends in body-mass index since 1980: systematic analysis of health examination surveys and epidemiological studies with 960 country-years and 9·1 million participants. Lancet. 2011; 377(9765):557-67. PMC: 4472365. DOI: 10.1016/S0140-6736(10)62037-5. View

Rockhill B, Newman B, WEINBERG C . Use and misuse of population attributable fractions. Am J Public Health. 1998; 88(1):15-9. PMC: 1508384. DOI: 10.2105/ajph.88.1.15. View

Yu Y . The Changing Body Mass-Mortality Association in the United States: Evidence of Sex-Specific Cohort Trends from Three National Health and Nutrition Examination Surveys. Biodemography Soc Biol. 2016; 62(2):143-63. DOI: 10.1080/19485565.2015.1108835. View

Doak C, Wijnhoven T, Schokker D, Visscher T, Seidell J . Age standardization in mapping adult overweight and obesity trends in the WHO European Region. Obes Rev. 2011; 13(2):174-91. DOI: 10.1111/j.1467-789X.2011.00943.x. View

Flegal K, Panagiotou O, Graubard B . Estimating population attributable fractions to quantify the health burden of obesity. Ann Epidemiol. 2014; 25(3):201-7. PMC: 4383168. DOI: 10.1016/j.annepidem.2014.11.010. View

. Trends in adult body-mass index in 200 countries from 1975 to 2014: a pooled analysis of 1698 population-based measurement studies with 19·2 million participants. Lancet. 2016; 387(10026):1377-1396. PMC: 7615134. DOI: 10.1016/S0140-6736(16)30054-X. View

Monteiro C, Conde W, Lu B, Popkin B . Obesity and inequities in health in the developing world. Int J Obes Relat Metab Disord. 2004; 28(9):1181-6. DOI: 10.1038/sj.ijo.0802716. View

Olshansky S, Passaro D, Hershow R, Layden J, Carnes B, Brody J . A potential decline in life expectancy in the United States in the 21st century. N Engl J Med. 2005; 352(11):1138-45. DOI: 10.1056/NEJMsr043743. View

10.

Global BMI Mortality Collaboration , Di Angelantonio E, Bhupathiraju S, Wormser D, Gao P, Kaptoge S . Body-mass index and all-cause mortality: individual-participant-data meta-analysis of 239 prospective studies in four continents. Lancet. 2016; 388(10046):776-86. PMC: 4995441. DOI: 10.1016/S0140-6736(16)30175-1. View

11.

Silventoinen K, Sans S, Tolonen H, Monterde D, Kuulasmaa K, Kesteloot H . Trends in obesity and energy supply in the WHO MONICA Project. Int J Obes Relat Metab Disord. 2004; 28(5):710-8. DOI: 10.1038/sj.ijo.0802614. View

12.

. Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks for 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of.... Lancet. 2018; 392(10159):1923-1994. PMC: 6227755. DOI: 10.1016/S0140-6736(18)32225-6. View

13.

Seidell J . Prevalence and time trends of obesity in Europe. J Endocrinol Invest. 2003; 25(10):816-22. DOI: 10.1007/BF03344045. View

14.

Trias-Llimos S, Kunst A, Jasilionis D, Janssen F . The contribution of alcohol to the East-West life expectancy gap in Europe from 1990 onward. Int J Epidemiol. 2017; 47(3):731-739. DOI: 10.1093/ije/dyx244. View

15.

Allison D, Fontaine K, Manson J, Stevens J, VANITALLIE T . Annual deaths attributable to obesity in the United States. JAMA. 1999; 282(16):1530-8. DOI: 10.1001/jama.282.16.1530. View

16.

Mehta N, Chang V . Secular declines in the association between obesity and mortality in the United States. Popul Dev Rev. 2011; 37(3):435-51. PMC: 3220918. DOI: 10.1111/j.1728-4457.2011.00429.x. View

17.

Fagerli R, Wandel M . Gender differences in opinions and practices with regard to a "healthy diet". Appetite. 1999; 32(2):171-90. DOI: 10.1006/appe.1998.0188. View

18.

Flegal K, Graubard B, Williamson D, Gail M . Excess deaths associated with underweight, overweight, and obesity. JAMA. 2005; 293(15):1861-7. DOI: 10.1001/jama.293.15.1861. View

19.

Psaltopoulou T, Hatzis G, Papageorgiou N, Androulakis E, Briasoulis A, Tousoulis D . Socioeconomic status and risk factors for cardiovascular disease: Impact of dietary mediators. Hellenic J Cardiol. 2017; 58(1):32-42. DOI: 10.1016/j.hjc.2017.01.022. View

20.

Leon D . Trends in European life expectancy: a salutary view. Int J Epidemiol. 2011; 40(2):271-7. DOI: 10.1093/ije/dyr061. View