Esther Zimmermann - Academia.edu (original) (raw)
Papers by Esther Zimmermann
Background: The FTO gene harbors the strongest known susceptibility locus for obesity. While many... more Background: The FTO gene harbors the strongest known susceptibility locus for obesity. While many individual studies have suggested that physical activity (PA) may attenuate the effect of FTO on obesity risk, other studies have not been able to confirm this interaction. To confirm or refute unambiguously whether PA attenuates the association of FTO with obesity risk, we meta-analyzed data from 45 studies of adults (n = 218,166) and nine studies of children and adolescents (n = 19,268).
Background: The FTO gene harbors the strongest known susceptibility locus for obesity. While many... more Background: The FTO gene harbors the strongest known susceptibility locus for obesity. While many individual studies have suggested that physical activity (PA) may attenuate the effect of FTO on obesity risk, other studies have not been able to confirm this interaction. To confirm or refute unambiguously whether PA attenuates the association of FTO with obesity risk, we meta-analyzed data from 45 studies of adults (n = 218,166) and nine studies of children and adolescents (n = 19,268). Methods and Findings: All studies identified to have data on the FTO rs9939609 variant (or any proxy [r.0.8]) and PA were invited to participate, regardless of ethnicity or age of the participants. PA was standardized by categorizing it into a dichotomous variable (physically inactive versus active) in each study. Overall, 25% of adults and 13% of children were categorized as inactive. Interaction analyses were performed within each study by including the FTO6PA interaction term in an additive model, ...
Expert Opinion on Pharmacotherapy, 2018
Diabetes, 2018
Machine learning allows extensive analysis of big complex data. This study had two aims: 1) chara... more Machine learning allows extensive analysis of big complex data. This study had two aims: 1) characterize patients on BI who add a GLP-1RA and 2) identify predictors of ≥1% decline in A1C. Patients with T2D who were prescribed BI for ≥90 days but not GLP-1RA for 180 days beforehand (in the U.S. IBM Explorys database between 2010 and 2016) were included (N=80,019). For the A1C analysis, A1C readings ≤180 days before, and 180-360 days after initiating GLP-1RA were required (N=8731). Logistic regression with 23 pre-specified variables, and subsequent hypothesis-free machine learning models, with 155000 additional variables covering clinical, claims and billing data addressed both aims. GLP-1RA initiators were characterized by a BI duration of >180 days (vs. ≤180 days) estimated odds ratio (OR) 5.87 (95% CI: 5.49-6.27), receiving oral antidiabetic drugs(s) OR 1.70 (1.64-1.77) and co-medication(s) (both vs. none) OR 3.22 (2.96-3.50), a BMI >30 kg/m2 (vs. <30 kg/m2) OR 1.93 (1.84-...
Primary Care Diabetes, 2019
Please cite this article in press as: S. Ramtoola, et al., Characteristics of newly diagnosed adu... more Please cite this article in press as: S. Ramtoola, et al., Characteristics of newly diagnosed adults with type 1 diabetes in the UK and evolution of glycaemic control, body mass index and Charlson comorbidity index over the first 5 years after diagnosis, Prim. Care Diab.
Diabetes, 2019
ReFLeCT, a multicenter, prospective, observational study evaluated the safety and effectiveness o... more ReFLeCT, a multicenter, prospective, observational study evaluated the safety and effectiveness of switching from other basal insulins to insulin degludec (degludec) in patients with type 1 (T1D) or type 2 diabetes (T2D) in routine clinical practice. ReFLeCT comprised a 4-week baseline period (pre-switch basal insulin) and 12-month follow-up period (degludec). The primary endpoint of overall hypoglycemia reported in patient diaries was reduced during the 12-month follow-up period vs. baseline, without compromising glycemic control. In pre-specified subgroup analyses of the primary endpoint, we assessed if the overall result was robust in different subgroups, characterized according to baseline A1C (<7.5, ≥7.5-<8.5, ≥8.5-<9.5, ≥9.5%), diabetes duration (quartiles) and physician’s reason for initiating degludec (hypoglycemia [Yes/No]). The estimated rate ratios of hypoglycemia were similar within subgroups (no significant interactions), and demonstrated overall lower rates (t...
Diabetes, 2019
ReFLeCT was a multicenter, prospective, observational study designed to investigate the safety an... more ReFLeCT was a multicenter, prospective, observational study designed to investigate the safety and effectiveness of switching to degludec from other basal insulins in patients with type 1 (T1D) or type 2 diabetes (T2D). ReFLeCT comprised a 4-week baseline period (pre-switch basal insulin) and 12-month follow-up period (degludec). The primary endpoint of overall hypoglycemia reported in patient diaries was reduced during follow-up vs. baseline in T1D and T2D without compromising glycemic control. As different hypoglycemia definitions can impact study outcomes, the previous (pre-specified) and updated (post hoc) American Diabetes Association (ADA) hypoglycemia definitions were analyzed and presented here (Figure). Definitions consisted of, documented asymptomatic and symptomatic, pseudo, probable symptomatic, and Level 1, 2 and 3 (severe) (Figure). Hypoglycemic events were analyzed using fully adjusted, negative binomial regression models. In T1D (n=556) and T2D (n=611), the estimated...
Lancet (London, England), Jan 10, 2017
Underweight, overweight, and obesity in childhood and adolescence are associated with adverse hea... more Underweight, overweight, and obesity in childhood and adolescence are associated with adverse health consequences throughout the life-course. Our aim was to estimate worldwide trends in mean body-mass index (BMI) and a comprehensive set of BMI categories that cover underweight to obesity in children and adolescents, and to compare trends with those of adults. We pooled 2416 population-based studies with measurements of height and weight on 128·9 million participants aged 5 years and older, including 31·5 million aged 5-19 years. We used a Bayesian hierarchical model to estimate trends from 1975 to 2016 in 200 countries for mean BMI and for prevalence of BMI in the following categories for children and adolescents aged 5-19 years: more than 2 SD below the median of the WHO growth reference for children and adolescents (referred to as moderate and severe underweight hereafter), 2 SD to more than 1 SD below the median (mild underweight), 1 SD below the median to 1 SD above the median (...
Obesity, 2016
ObjectiveThe U‐shaped association between body mass index (BMI) and mortality may depend on other... more ObjectiveThe U‐shaped association between body mass index (BMI) and mortality may depend on other traits with permanent health effects. Whether the association between BMI and mortality depends on levels of health‐related traits known to be inversely associated with mortality throughout adult life such as height, intelligence, and education was investigated.MethodsThe study was based on a cohort of young men with data on weight, height, intelligence test score, and education from the Danish Conscription Database. In total, 346,500 men born 1939 to 1959 were followed until December 2013. The association between BMI and mortality was analyzed using Cox‐regression models including interactions between BMI and height, intelligence, and education, respectively.ResultsBMI and mortality showed the U‐shaped association from the start of the follow‐up period, and it persisted through the subsequent 56 years. As expected, the mortality was inversely associated with height, intelligence, and e...
Obesity (Silver Spring, Md.), May 27, 2017
This study investigated how a wide spectrum of body mass index (BMI) values at ages 7 to 13 years... more This study investigated how a wide spectrum of body mass index (BMI) values at ages 7 to 13 years are associated with type 2 diabetes throughout adulthood, including potential modifying effects of sex and birth weight. From the Copenhagen School Health Records Register, 292,827 individuals, born between 1930 and 1989, were followed in national registers for type 2 diabetes (women, n = 7,472; men, n = 11,548). Heights and weights were measured at ages 7 to 13 years. Below-average BMIs, with few exceptions, were not associated with type 2 diabetes. Above-average BMIs had positive associations that were stronger in women than men, stronger in younger birth cohorts, and weaker with older age at diagnosis. Women born 1930-1947, 1948-1965, and 1966-1983 with above-average BMIs at 13 years (≥18.2 kg/m(2) ) had hazard ratios (95% confidence intervals) ranging from 2.12 (1.91-2.36) to 2.84 (2.31-3.49) per z score when diagnosed at 30 to 47 years. Birth weight did not modify these association...
Lancet (London, England), Jan 7, 2017
Raised blood pressure is an important risk factor for cardiovascular diseases and chronic kidney ... more Raised blood pressure is an important risk factor for cardiovascular diseases and chronic kidney disease. We estimated worldwide trends in mean systolic and mean diastolic blood pressure, and the prevalence of, and number of people with, raised blood pressure, defined as systolic blood pressure of 140 mm Hg or higher or diastolic blood pressure of 90 mm Hg or higher. For this analysis, we pooled national, subnational, or community population-based studies that had measured blood pressure in adults aged 18 years and older. We used a Bayesian hierarchical model to estimate trends from 1975 to 2015 in mean systolic and mean diastolic blood pressure, and the prevalence of raised blood pressure for 200 countries. We calculated the contributions of changes in prevalence versus population growth and ageing to the increase in the number of adults with raised blood pressure. We pooled 1479 studies that had measured the blood pressures of 19·1 million adults. Global age-standardised mean syst...
eLife, Jul 26, 2016
Being taller is associated with enhanced longevity, and higher education and earnings. We reanaly... more Being taller is associated with enhanced longevity, and higher education and earnings. We reanalysed 1472 population-based studies, with measurement of height on more than 18.6 million participants to estimate mean height for people born between 1896 and 1996 in 200 countries. The largest gain in adult height over the past century has occurred in South Korean women and Iranian men, who became 20.2 cm (95% credible interval 17.5-22.7) and 16.5 cm (13.3-19.7) taller, respectively. In contrast, there was little change in adult height in some sub-Saharan African countries and in South Asia over the century of analysis. The tallest people over these 100 years are men born in the Netherlands in the last quarter of 20th century, whose average heights surpassed 182.5 cm, and the shortest were women born in Guatemala in 1896 (140.3 cm; 135.8-144.8). The height differential between the tallest and shortest populations was 19-20 cm a century ago, and has remained the same for women and increas...
Lancet (London, England), Jan 2, 2016
Underweight and severe and morbid obesity are associated with highly elevated risks of adverse he... more Underweight and severe and morbid obesity are associated with highly elevated risks of adverse health outcomes. We estimated trends in mean body-mass index (BMI), which characterises its population distribution, and in the prevalences of a complete set of BMI categories for adults in all countries. We analysed, with use of a consistent protocol, population-based studies that had measured height and weight in adults aged 18 years and older. We applied a Bayesian hierarchical model to these data to estimate trends from 1975 to 2014 in mean BMI and in the prevalences of BMI categories (<18·5 kg/m(2) [underweight], 18·5 kg/m(2) to <20 kg/m(2), 20 kg/m(2) to <25 kg/m(2), 25 kg/m(2) to…
Ugeskrift for laeger, Jan 9, 2006
The prevalence of overweight and obesity is escalating globally, and in Denmark more than 10% of ... more The prevalence of overweight and obesity is escalating globally, and in Denmark more than 10% of the population are now severely overweight. The aim of this study was to estimate the short-term health effects of 15 weeks of intensive lifestyle intervention composed of physical activity, dietary changes and personal development in severely obese subjects of both sexes. The 27 subjects were weighed weekly. Fat percentage, abdominal circumference, maximum oxygen uptake, heart rate, oral glucose tolerance and blood lipids were measured at baseline and in week 15. The intensive lifestyle intervention was completed under supervision at a stay at Ebeltoft Kurcenter, and the goal was a weight loss of approximately 1% per week. At baseline, the participants' average body mass index (BMI: kg/m2) was 44 +- 1; the BMI was reduced by 11% after the stay (p<0.001). Body weight was reduced by 14 +- 4 kg (p<0.001), corresponding to 76% of the desired weight loss. The subjects' fat mass...
BACKGROUND: Although the expectation is that weight gain increases mortality and weight loss amon... more BACKGROUND: Although the expectation is that weight gain increases mortality and weight loss among those overweight reduces mortality, results on weight gain and mortality in young adults are conflicting, and weight loss is less explored. We investigated the association between long-term weight change and all-cause mortality in a broad range of body mass index (BMI) in young men. METHODS: Among 362200 Danish draftees, examined between 1943 and 1977, all obese (BMI X31.0 kg m À 2 ; n ¼ 1930), and a random 1% sample of the others (n ¼ 3601) were identified at a mean age of 20 years (range: 18-25 years). All the obese and half the controls were reexamined between 4 and 40 years later (mean age 35 years). Weight changes were defined as: weight loss o À 0.1 kg m À 2 per year, weight stability within ±0.1 kg m À 2 per year and weight gain 40.1 kg m À 2 per year. Hazard ratios (HR) and 95% confidence intervals (CI) were estimated using Cox regression. RESULTS: Among the 908 obese and 1073 controls followed for 30 years after re-examination 220 and 232 died. HR of the weight stable obese was 2.32 (CI: 1.56-3.44) compared with the weight stable controls. In the obese cohort there was no association between weight loss, adjusted for initial BMI, and mortality (HR: 0.99; CI: 0.68-1.45) compared with weight stable obese. Too few controls lost weight to allow assessment of weight loss. Weight gain was associated with increased mortality in the obese (HR: 1.50; CI: 1.07-2.10) and controls (HR: 1.54; CI: 1.14-2.09) compared with weight stable obese and controls, respectively. Neither the time between the two examinations, lifestyle factors nor exclusion of diseased individuals influenced the results. CONCLUSIONS: Although there were increased mortality of the weight-stable obese compared with controls, there was no association between weight loss and mortality in the obese. Weight gain increased mortality regardless of the initial weight.
et al. Do rapid BMI growth in childhood and early-onset obesity offer cardiometabolic protection ... more et al. Do rapid BMI growth in childhood and early-onset obesity offer cardiometabolic protection to obese adults in mid-life? Analysis of a longitudinal cohort study of Danish men. BMJ Open 2014;4:e004827.
Scandinavian Journal of Public Health, 2008
Aim: To investigate predictors of changes in physical activity, in a prospective population-based... more Aim: To investigate predictors of changes in physical activity, in a prospective population-based study. Methods: Data were from the Danish Health Interview Surveys in 1994 and 2000, and included persons between 16 and 64 years of age who answered the questions on physical activity and various covariates in 1994, and who were re-interviewed in 2000. In total 2,957 subjects participated (62% of the original sample). Data were analysed using logistic regression. Results: Predictors of physical inactivity were, for men and women respectively, heavy smoking (odds ratio (OR) 2.07, 95% confidence interval (CI) 1.24—3.48, and OR 2.23, 95% CI 1.34—3.71), poor self-rated health (OR 2.11, 95% CI 1.25—3.58, and OR 1.75, 95% CI 1.10—2.80), and believing that one's own effort has no effect on health (OR 1.86, 95% CI 1.20—2.88, and OR 1.63, 95% CI 1.00—2.65). For men, further predictors for physical inactivity were obesity as compared to normal weight (OR 2.10, 95% CI 1.11—3.98), and being un...
PLoS ONE, 2009
Background: The A-allele of the single nucleotide polymorphism (SNP), rs9939609, in the FTO gene ... more Background: The A-allele of the single nucleotide polymorphism (SNP), rs9939609, in the FTO gene is associated with increased fatness. We hypothesized that the SNP is associated with morbidity and mortality through the effect on fatness. Methodology/Principal Findings: In a population of 362,200 Danish young men, examined for military service between 1943 and 1977, all obese (BMI$31.0 kg/m 2) and a random 1% sample of the others were identified. In 1992-94, at an average age of 46 years, 752 of the obese and 876 of the others were reexamined , including measurements of weight, fat mass, height, and waist circumference, and DNA sampling. Hospitalization and death occurring during the following median 13.5 years were ascertained by linkage to national registers. Cox regression analyses were performed using a dominant effect model (TT vs. TA or AA). In total 205 men died. Mortality was 42% lower (p = 0.001) with the TT genotype than in Aallele carriers. This phenomenon was observed in both the obese and the randomly sampled cohort when analysed separately. Adjustment for fatness covariates attenuated the association only slightly. Exploratory analyses of cause-specific mortality and morbidity prior to death suggested a general protective effect of the TT genotype, whereas there were only weak associations with disease incidence, except for diseases of the nervous system. Conclusion: Independent of fatness, the A-allele of the FTO SNP appears to increase mortality of a magnitude similar to smoking, but without a particular underlying disease pattern barring an increase in the risk of diseases of the nervous system.
PLoS medicine, 2011
The FTO gene harbors the strongest known susceptibility locus for obesity. While many individual ... more The FTO gene harbors the strongest known susceptibility locus for obesity. While many individual studies have suggested that physical activity (PA) may attenuate the effect of FTO on obesity risk, other studies have not been able to confirm this interaction. To confirm or refute unambiguously whether PA attenuates the association of FTO with obesity risk, we meta-analyzed data from 45 studies of adults (n = 218,166) and nine studies of children and adolescents (n = 19,268).
Background: The FTO gene harbors the strongest known susceptibility locus for obesity. While many... more Background: The FTO gene harbors the strongest known susceptibility locus for obesity. While many individual studies have suggested that physical activity (PA) may attenuate the effect of FTO on obesity risk, other studies have not been able to confirm this interaction. To confirm or refute unambiguously whether PA attenuates the association of FTO with obesity risk, we meta-analyzed data from 45 studies of adults (n = 218,166) and nine studies of children and adolescents (n = 19,268).
Background: The FTO gene harbors the strongest known susceptibility locus for obesity. While many... more Background: The FTO gene harbors the strongest known susceptibility locus for obesity. While many individual studies have suggested that physical activity (PA) may attenuate the effect of FTO on obesity risk, other studies have not been able to confirm this interaction. To confirm or refute unambiguously whether PA attenuates the association of FTO with obesity risk, we meta-analyzed data from 45 studies of adults (n = 218,166) and nine studies of children and adolescents (n = 19,268). Methods and Findings: All studies identified to have data on the FTO rs9939609 variant (or any proxy [r.0.8]) and PA were invited to participate, regardless of ethnicity or age of the participants. PA was standardized by categorizing it into a dichotomous variable (physically inactive versus active) in each study. Overall, 25% of adults and 13% of children were categorized as inactive. Interaction analyses were performed within each study by including the FTO6PA interaction term in an additive model, ...
Expert Opinion on Pharmacotherapy, 2018
Diabetes, 2018
Machine learning allows extensive analysis of big complex data. This study had two aims: 1) chara... more Machine learning allows extensive analysis of big complex data. This study had two aims: 1) characterize patients on BI who add a GLP-1RA and 2) identify predictors of ≥1% decline in A1C. Patients with T2D who were prescribed BI for ≥90 days but not GLP-1RA for 180 days beforehand (in the U.S. IBM Explorys database between 2010 and 2016) were included (N=80,019). For the A1C analysis, A1C readings ≤180 days before, and 180-360 days after initiating GLP-1RA were required (N=8731). Logistic regression with 23 pre-specified variables, and subsequent hypothesis-free machine learning models, with 155000 additional variables covering clinical, claims and billing data addressed both aims. GLP-1RA initiators were characterized by a BI duration of >180 days (vs. ≤180 days) estimated odds ratio (OR) 5.87 (95% CI: 5.49-6.27), receiving oral antidiabetic drugs(s) OR 1.70 (1.64-1.77) and co-medication(s) (both vs. none) OR 3.22 (2.96-3.50), a BMI >30 kg/m2 (vs. <30 kg/m2) OR 1.93 (1.84-...
Primary Care Diabetes, 2019
Please cite this article in press as: S. Ramtoola, et al., Characteristics of newly diagnosed adu... more Please cite this article in press as: S. Ramtoola, et al., Characteristics of newly diagnosed adults with type 1 diabetes in the UK and evolution of glycaemic control, body mass index and Charlson comorbidity index over the first 5 years after diagnosis, Prim. Care Diab.
Diabetes, 2019
ReFLeCT, a multicenter, prospective, observational study evaluated the safety and effectiveness o... more ReFLeCT, a multicenter, prospective, observational study evaluated the safety and effectiveness of switching from other basal insulins to insulin degludec (degludec) in patients with type 1 (T1D) or type 2 diabetes (T2D) in routine clinical practice. ReFLeCT comprised a 4-week baseline period (pre-switch basal insulin) and 12-month follow-up period (degludec). The primary endpoint of overall hypoglycemia reported in patient diaries was reduced during the 12-month follow-up period vs. baseline, without compromising glycemic control. In pre-specified subgroup analyses of the primary endpoint, we assessed if the overall result was robust in different subgroups, characterized according to baseline A1C (<7.5, ≥7.5-<8.5, ≥8.5-<9.5, ≥9.5%), diabetes duration (quartiles) and physician’s reason for initiating degludec (hypoglycemia [Yes/No]). The estimated rate ratios of hypoglycemia were similar within subgroups (no significant interactions), and demonstrated overall lower rates (t...
Diabetes, 2019
ReFLeCT was a multicenter, prospective, observational study designed to investigate the safety an... more ReFLeCT was a multicenter, prospective, observational study designed to investigate the safety and effectiveness of switching to degludec from other basal insulins in patients with type 1 (T1D) or type 2 diabetes (T2D). ReFLeCT comprised a 4-week baseline period (pre-switch basal insulin) and 12-month follow-up period (degludec). The primary endpoint of overall hypoglycemia reported in patient diaries was reduced during follow-up vs. baseline in T1D and T2D without compromising glycemic control. As different hypoglycemia definitions can impact study outcomes, the previous (pre-specified) and updated (post hoc) American Diabetes Association (ADA) hypoglycemia definitions were analyzed and presented here (Figure). Definitions consisted of, documented asymptomatic and symptomatic, pseudo, probable symptomatic, and Level 1, 2 and 3 (severe) (Figure). Hypoglycemic events were analyzed using fully adjusted, negative binomial regression models. In T1D (n=556) and T2D (n=611), the estimated...
Lancet (London, England), Jan 10, 2017
Underweight, overweight, and obesity in childhood and adolescence are associated with adverse hea... more Underweight, overweight, and obesity in childhood and adolescence are associated with adverse health consequences throughout the life-course. Our aim was to estimate worldwide trends in mean body-mass index (BMI) and a comprehensive set of BMI categories that cover underweight to obesity in children and adolescents, and to compare trends with those of adults. We pooled 2416 population-based studies with measurements of height and weight on 128·9 million participants aged 5 years and older, including 31·5 million aged 5-19 years. We used a Bayesian hierarchical model to estimate trends from 1975 to 2016 in 200 countries for mean BMI and for prevalence of BMI in the following categories for children and adolescents aged 5-19 years: more than 2 SD below the median of the WHO growth reference for children and adolescents (referred to as moderate and severe underweight hereafter), 2 SD to more than 1 SD below the median (mild underweight), 1 SD below the median to 1 SD above the median (...
Obesity, 2016
ObjectiveThe U‐shaped association between body mass index (BMI) and mortality may depend on other... more ObjectiveThe U‐shaped association between body mass index (BMI) and mortality may depend on other traits with permanent health effects. Whether the association between BMI and mortality depends on levels of health‐related traits known to be inversely associated with mortality throughout adult life such as height, intelligence, and education was investigated.MethodsThe study was based on a cohort of young men with data on weight, height, intelligence test score, and education from the Danish Conscription Database. In total, 346,500 men born 1939 to 1959 were followed until December 2013. The association between BMI and mortality was analyzed using Cox‐regression models including interactions between BMI and height, intelligence, and education, respectively.ResultsBMI and mortality showed the U‐shaped association from the start of the follow‐up period, and it persisted through the subsequent 56 years. As expected, the mortality was inversely associated with height, intelligence, and e...
Obesity (Silver Spring, Md.), May 27, 2017
This study investigated how a wide spectrum of body mass index (BMI) values at ages 7 to 13 years... more This study investigated how a wide spectrum of body mass index (BMI) values at ages 7 to 13 years are associated with type 2 diabetes throughout adulthood, including potential modifying effects of sex and birth weight. From the Copenhagen School Health Records Register, 292,827 individuals, born between 1930 and 1989, were followed in national registers for type 2 diabetes (women, n = 7,472; men, n = 11,548). Heights and weights were measured at ages 7 to 13 years. Below-average BMIs, with few exceptions, were not associated with type 2 diabetes. Above-average BMIs had positive associations that were stronger in women than men, stronger in younger birth cohorts, and weaker with older age at diagnosis. Women born 1930-1947, 1948-1965, and 1966-1983 with above-average BMIs at 13 years (≥18.2 kg/m(2) ) had hazard ratios (95% confidence intervals) ranging from 2.12 (1.91-2.36) to 2.84 (2.31-3.49) per z score when diagnosed at 30 to 47 years. Birth weight did not modify these association...
Lancet (London, England), Jan 7, 2017
Raised blood pressure is an important risk factor for cardiovascular diseases and chronic kidney ... more Raised blood pressure is an important risk factor for cardiovascular diseases and chronic kidney disease. We estimated worldwide trends in mean systolic and mean diastolic blood pressure, and the prevalence of, and number of people with, raised blood pressure, defined as systolic blood pressure of 140 mm Hg or higher or diastolic blood pressure of 90 mm Hg or higher. For this analysis, we pooled national, subnational, or community population-based studies that had measured blood pressure in adults aged 18 years and older. We used a Bayesian hierarchical model to estimate trends from 1975 to 2015 in mean systolic and mean diastolic blood pressure, and the prevalence of raised blood pressure for 200 countries. We calculated the contributions of changes in prevalence versus population growth and ageing to the increase in the number of adults with raised blood pressure. We pooled 1479 studies that had measured the blood pressures of 19·1 million adults. Global age-standardised mean syst...
eLife, Jul 26, 2016
Being taller is associated with enhanced longevity, and higher education and earnings. We reanaly... more Being taller is associated with enhanced longevity, and higher education and earnings. We reanalysed 1472 population-based studies, with measurement of height on more than 18.6 million participants to estimate mean height for people born between 1896 and 1996 in 200 countries. The largest gain in adult height over the past century has occurred in South Korean women and Iranian men, who became 20.2 cm (95% credible interval 17.5-22.7) and 16.5 cm (13.3-19.7) taller, respectively. In contrast, there was little change in adult height in some sub-Saharan African countries and in South Asia over the century of analysis. The tallest people over these 100 years are men born in the Netherlands in the last quarter of 20th century, whose average heights surpassed 182.5 cm, and the shortest were women born in Guatemala in 1896 (140.3 cm; 135.8-144.8). The height differential between the tallest and shortest populations was 19-20 cm a century ago, and has remained the same for women and increas...
Lancet (London, England), Jan 2, 2016
Underweight and severe and morbid obesity are associated with highly elevated risks of adverse he... more Underweight and severe and morbid obesity are associated with highly elevated risks of adverse health outcomes. We estimated trends in mean body-mass index (BMI), which characterises its population distribution, and in the prevalences of a complete set of BMI categories for adults in all countries. We analysed, with use of a consistent protocol, population-based studies that had measured height and weight in adults aged 18 years and older. We applied a Bayesian hierarchical model to these data to estimate trends from 1975 to 2014 in mean BMI and in the prevalences of BMI categories (<18·5 kg/m(2) [underweight], 18·5 kg/m(2) to <20 kg/m(2), 20 kg/m(2) to <25 kg/m(2), 25 kg/m(2) to…
Ugeskrift for laeger, Jan 9, 2006
The prevalence of overweight and obesity is escalating globally, and in Denmark more than 10% of ... more The prevalence of overweight and obesity is escalating globally, and in Denmark more than 10% of the population are now severely overweight. The aim of this study was to estimate the short-term health effects of 15 weeks of intensive lifestyle intervention composed of physical activity, dietary changes and personal development in severely obese subjects of both sexes. The 27 subjects were weighed weekly. Fat percentage, abdominal circumference, maximum oxygen uptake, heart rate, oral glucose tolerance and blood lipids were measured at baseline and in week 15. The intensive lifestyle intervention was completed under supervision at a stay at Ebeltoft Kurcenter, and the goal was a weight loss of approximately 1% per week. At baseline, the participants' average body mass index (BMI: kg/m2) was 44 +- 1; the BMI was reduced by 11% after the stay (p<0.001). Body weight was reduced by 14 +- 4 kg (p<0.001), corresponding to 76% of the desired weight loss. The subjects' fat mass...
BACKGROUND: Although the expectation is that weight gain increases mortality and weight loss amon... more BACKGROUND: Although the expectation is that weight gain increases mortality and weight loss among those overweight reduces mortality, results on weight gain and mortality in young adults are conflicting, and weight loss is less explored. We investigated the association between long-term weight change and all-cause mortality in a broad range of body mass index (BMI) in young men. METHODS: Among 362200 Danish draftees, examined between 1943 and 1977, all obese (BMI X31.0 kg m À 2 ; n ¼ 1930), and a random 1% sample of the others (n ¼ 3601) were identified at a mean age of 20 years (range: 18-25 years). All the obese and half the controls were reexamined between 4 and 40 years later (mean age 35 years). Weight changes were defined as: weight loss o À 0.1 kg m À 2 per year, weight stability within ±0.1 kg m À 2 per year and weight gain 40.1 kg m À 2 per year. Hazard ratios (HR) and 95% confidence intervals (CI) were estimated using Cox regression. RESULTS: Among the 908 obese and 1073 controls followed for 30 years after re-examination 220 and 232 died. HR of the weight stable obese was 2.32 (CI: 1.56-3.44) compared with the weight stable controls. In the obese cohort there was no association between weight loss, adjusted for initial BMI, and mortality (HR: 0.99; CI: 0.68-1.45) compared with weight stable obese. Too few controls lost weight to allow assessment of weight loss. Weight gain was associated with increased mortality in the obese (HR: 1.50; CI: 1.07-2.10) and controls (HR: 1.54; CI: 1.14-2.09) compared with weight stable obese and controls, respectively. Neither the time between the two examinations, lifestyle factors nor exclusion of diseased individuals influenced the results. CONCLUSIONS: Although there were increased mortality of the weight-stable obese compared with controls, there was no association between weight loss and mortality in the obese. Weight gain increased mortality regardless of the initial weight.
et al. Do rapid BMI growth in childhood and early-onset obesity offer cardiometabolic protection ... more et al. Do rapid BMI growth in childhood and early-onset obesity offer cardiometabolic protection to obese adults in mid-life? Analysis of a longitudinal cohort study of Danish men. BMJ Open 2014;4:e004827.
Scandinavian Journal of Public Health, 2008
Aim: To investigate predictors of changes in physical activity, in a prospective population-based... more Aim: To investigate predictors of changes in physical activity, in a prospective population-based study. Methods: Data were from the Danish Health Interview Surveys in 1994 and 2000, and included persons between 16 and 64 years of age who answered the questions on physical activity and various covariates in 1994, and who were re-interviewed in 2000. In total 2,957 subjects participated (62% of the original sample). Data were analysed using logistic regression. Results: Predictors of physical inactivity were, for men and women respectively, heavy smoking (odds ratio (OR) 2.07, 95% confidence interval (CI) 1.24—3.48, and OR 2.23, 95% CI 1.34—3.71), poor self-rated health (OR 2.11, 95% CI 1.25—3.58, and OR 1.75, 95% CI 1.10—2.80), and believing that one's own effort has no effect on health (OR 1.86, 95% CI 1.20—2.88, and OR 1.63, 95% CI 1.00—2.65). For men, further predictors for physical inactivity were obesity as compared to normal weight (OR 2.10, 95% CI 1.11—3.98), and being un...
PLoS ONE, 2009
Background: The A-allele of the single nucleotide polymorphism (SNP), rs9939609, in the FTO gene ... more Background: The A-allele of the single nucleotide polymorphism (SNP), rs9939609, in the FTO gene is associated with increased fatness. We hypothesized that the SNP is associated with morbidity and mortality through the effect on fatness. Methodology/Principal Findings: In a population of 362,200 Danish young men, examined for military service between 1943 and 1977, all obese (BMI$31.0 kg/m 2) and a random 1% sample of the others were identified. In 1992-94, at an average age of 46 years, 752 of the obese and 876 of the others were reexamined , including measurements of weight, fat mass, height, and waist circumference, and DNA sampling. Hospitalization and death occurring during the following median 13.5 years were ascertained by linkage to national registers. Cox regression analyses were performed using a dominant effect model (TT vs. TA or AA). In total 205 men died. Mortality was 42% lower (p = 0.001) with the TT genotype than in Aallele carriers. This phenomenon was observed in both the obese and the randomly sampled cohort when analysed separately. Adjustment for fatness covariates attenuated the association only slightly. Exploratory analyses of cause-specific mortality and morbidity prior to death suggested a general protective effect of the TT genotype, whereas there were only weak associations with disease incidence, except for diseases of the nervous system. Conclusion: Independent of fatness, the A-allele of the FTO SNP appears to increase mortality of a magnitude similar to smoking, but without a particular underlying disease pattern barring an increase in the risk of diseases of the nervous system.
PLoS medicine, 2011
The FTO gene harbors the strongest known susceptibility locus for obesity. While many individual ... more The FTO gene harbors the strongest known susceptibility locus for obesity. While many individual studies have suggested that physical activity (PA) may attenuate the effect of FTO on obesity risk, other studies have not been able to confirm this interaction. To confirm or refute unambiguously whether PA attenuates the association of FTO with obesity risk, we meta-analyzed data from 45 studies of adults (n = 218,166) and nine studies of children and adolescents (n = 19,268).