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BMJ 2010; 341 doi: (Published 07 December 2010) Cite this as: BMJ 2010;341:c7019

Higher body mass index, higher mortality

A fresh look at published data from nearly one and a half million adults has confirmed that being overweight or obese can significantly shorten your life. Researchers found an association shaped like a flattened J between body mass index and death from any cause. Adults with a body mass index between 22.5 and 24.9 had the lowest risk of death over 10 years of follow-up. Both bigger and smaller adults had a higher risk, although the link was strongest for increasing rather than decreasing body mass.

The researchers focused on men and women who were without cancer or heart disease at baseline and had never smoked. The ideal body mass index for this subgroup was 20-24.9. Risk of death rose by around 30% (hazard ratio 1.31, 95% CI 1.29 to 1.33) for every 5 unit increase in body mass index over the range 25-49.9. Even moderately overweight adults (body mass index 25-29.9) were significantly more likely to die than those in the ideal category. The excess risk for women was 13% (1.13, 1.09 to 1.17) and similar for men. The main analyses were adjusted for age, alcohol consumption, physical activity, educational level, and marital status.

The data came from 19 cohort studies of 1.46 million white adults aged 19-84. Researchers had enough statistical power to fine tune previous estimates of the association between body mass index and mortality. Overweight and obesity were linked to death from both cardiovascular disease and cancer. Cardiovascular disease looked the bigger hazard.

Taxanes for node negative breast cancer?

Chemotherapy that includes a taxane is already standard for women with node positive breast cancer. Women with node negative disease may also benefit, according to a new trial. Chemotherapy with doxorubicin and cyclophosphamide plus the taxane docetaxel (TAC) significantly prolonged disease-free survival in women with early breast cancer and …

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