Impact of body size and physical activity during adolescence and adult life on overall and cause-specific mortality in a large cohort study from Iran

We conducted this study to examine life-course body size and physical activity in relation to total and cause-specific mortality, which has not previously been studied in the low and middle-income countries in Asia. The Golestan Cohort Study is a population-based cohort in northeastern Iran in which...

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Published in:	European journal of epidemiology Vol. 29; no. 2; pp. 95 - 109
Main Authors:	Etemadi, Arash, Abnet, Christian C., Kamangar, Farin, Islami, Farhad, Khademi, Hooman, Pourshams, Akram, Poustchi, Hossein, Bagheri, Mohammad, Sohrabpour, Amir Ali, Aliasgar, Ali, Khoshnia, Masoud, Wacholder, Sholom, Matthews, Charles C., Pharoah, Paul D., Brennan, Paul, Boffetta, Paolo, Malekzadeh, Reza, Dawsey, Sanford M.
Format:	Journal Article
Language:	English
Published:	Dordrecht Springer 01-02-2014 Springer Netherlands Springer Nature B.V
Subjects:	Adolescent Adolescents Adult Adults Age Biological and medical sciences Body Mass Index Body Size Cancer Cardiology Cardiovascular disease Cardiovascular Diseases - complications Cardiovascular Diseases - mortality Cause of Death Cohort Studies Epidemiology Exercise Female General aspects Health Surveys Humans Infectious Diseases Iran - epidemiology Male Medical sciences Medicine Medicine & Public Health Metabolic diseases Miscellaneous Mortality Motor Activity Multiple tumors. Solid tumors. Tumors in childhood (general aspects) Neoplasms - complications Neoplasms - mortality Obesity Obesity - complications Obesity - mortality Oncology Overweight Pediatric obesity Population Surveillance Proportional Hazards Models Public Health Public health. Hygiene Public health. Hygiene-occupational medicine Risk Factors Social Class Socioeconomic Factors Socioeconomics Teenagers Tumors Young Adult Iran Asia Obesity Adolescence Cardiovascular disease Physical activity Mortality Cancer Human Physical exercise Nutrition disorder Corporal biometry Malignant tumor Epidemiology Cohort study Body size Adolescent Cause Adult Nutritional status Public health
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Summary:	We conducted this study to examine life-course body size and physical activity in relation to total and cause-specific mortality, which has not previously been studied in the low and middle-income countries in Asia. The Golestan Cohort Study is a population-based cohort in northeastern Iran in which 50,045 people above the age of 40 have been followed since 2004. Participants were shown a validated pictogram to assess body size at ages 15, 30, and the time of recruitment. Information on occupational physical activity at these ages was also collected. Subjects were followed up annually, and cause of death was determined. Cox regression models were adjusted for age at cohort start, smoking, socioeconomic status, ethnicity, place of residence, education, and opium use. Models for body size were also adjusted for physical activity at the same age, and vice versa. During a total of 252,740 person-years of follow-up (mean follow-up duration 5.1 ± 1.3 years) through December 2011, 2,529 of the cohort participants died. Larger body sizes at ages 15 or 30 in both sexes were associated with increased overall mortality. Cancer mortality was more strongly associated with adolescent obesity, and cardiovascular mortality with early adulthood body size. Weight gain between these ages was associated with cardiovascular mortality. Obese adolescents who lost weight still had increased mortality from all medical causes in both sexes. Physical activity during adolescence and early adulthood had no association with mortality, but at cohort baseline higher levels of activity were associated with reduced mortality. Mortality in this Middle-Eastern population was associated with obesity both during adolescence and early adult life.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0393-2990 1573-7284
DOI:	10.1007/s10654-014-9883-6