Age-Specific Associations Between Adiposity and Mortality in U.S. Adults, 1999-2018
Authors' conclusion
Age significantly modifies the relationship between adiposity and mortality. Younger adults experience greater mortality risks from both obesity and underweight
Study context
- Population
- US adults aged 18 to 79 years, NHANES 1999–20185,019 deaths (1,186 CV)
- Participants
- 44,041 adults
- Exposure
- Adiposity–mortality associations by age group
- Outcome
- Interaction between age and adiposity (BMI, waist circumference, weight, waist-to-height ratio) on all-cause and CV mortality
- Follow-up
- Median 10.1 years
Methodological detailsnationally representative sample, NHANES 1999-2018 linked to mortality data
- Nationally representative sample
- NHANES 1999-2018 linked to mortality data
Main finding
As reported in the abstract
CV mortality per 1-SD increase in BMI, by age
Hazard ratio (95% CI)
18 to 49 years
1.49(1.27–1.77)
70 to 79 years
1.15(0.99–1.32)
Per 1-SD increase in BMI, as printed
- Significant interactions between age and all 4 adiposity measures
- P < 0.05
Observational data: associations, not effects.
Further findings
CV mortality with class 3 obesity (younger adults)
| HR (95% CI) | ||
|---|---|---|
| Class 3 obesityYounger adults | 4.37 (2.01–9.50) | |
| 0.10.31310Hazard ratio (log scale) |
All-cause mortality with underweight status (younger individuals)
| HR (95% CI) | ||
|---|---|---|
| UnderweightParticularly among younger individuals | 2.04 (1.24–3.36) | |
| 0.20.5125Hazard ratio (log scale) |
Original publication
Age-Specific Associations Between Adiposity and Mortality in U.S. Adults, 1999-2018. JACC Adv. Published 7 November 2025. doi:10.
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