Sprawl and Health

Kannel 1996 - "Effect of Weight on Cardiovascular Disease"

Kannel, Wiliam B; Agostino, D; et al
"Effect of Weight on Cardiovascular Disease"
American Journal of Clinical Nutrition
March 1996; v.63, n.3; p.419S-422S
On the Web
Relevance: low

Using the Framingham Heart Study, the authors find that the optimal BMI to avoid cardiovascular disease is 22.6 for men and 21.1 for women.  Each SD (???) increment in relative weight increased risk of cardiovascular events by 15% for men and 22% for women.  The authors estimate that if everyone was their optimal BMI, there would be 1) 25% less coronary heart disease and 2) 35% fewer strokes or episodes of cardiac failure.

Xiang 2005 - "Obesity and Risk of Nonfatal Unintentional Injuries"

Xiang, Huiyun; Smith, Gary A; et al
"Obesity and Risk of Nonfatal Unintentional Injuries"
American Journal of Preventive Medicine
July 2005; v.29, n.1; pp.41-45
On the Web
Relevance: low

The authors used a survey of adults in 1999-2000 to estimate the likelihood of injuries for persons in different weight categories.  The found that injuries increase linearly with BMI category among women and that both men and women with BMI>35 had the highest likelihood of injury.

Pratt 2000 - "Higher Direct Medical Costs Associated with Physical Inactivity"

Pratt, Michael; Macera, Caroline A; Wang, Guijing
"Higher Direct Medical Costs Associated with Physical Inactivity"
The Physician and Sportsmedicine
October 2000; v.28, n.10; pp.63-70
On the Web
Relevance: medium

Using the 1987 National Medical Expenditures Survey, the authors estimate the costs of physical activity in the US. They conclude:

"The mean net annual benefit of physical activity [among people with no physical limitations] was $330 per person in 1987 dollars.  Our results suggest that increasing participation in regular moderate physical activity among the more than 88 million inactive Americans over the age of 15 might reduce annual national medical costs by as much as $29.2 billion in 1987 dollars--$76.6 billion in 2000 dollars."

Finkelstein 2004 - "State-Level Estimates of Annual Medical Expenditures Attributable to Obesity"

Finkelstein, Eric A; Fiebelkorn, Ian C; Wang, Guijing
"State-Level Estimates of Annual Medical Expenditures Attributable to Obesity"
Obesity Research
January 2004; v.12, n.1; pp.18-24
On the Web
Relevance: high

Beginning with their earlier estimates of the national medical expenditures on obesity, the authors use BRFSS data from 1998-2000 to estimate the state-level expenditures.  Idaho spent $227 million; Oregon, $781 million; and Washington, $1330 million.  In the first study, they found: "Annual U.S. obesity-attributable medical expenditures are estimated at $75 billion in 2003 dollars, and approximately one-half of these expenditures are financed by Medicare and Medicaid.

Finkelstein 2003 - "National Medical Spending Attributable to Overweight and Obesity: How Much, and Who's Paying?"

Finkelstein, Eric A; Fiebelkorn, Ian C; Wang, Guijing
"National Medical Spending Attributable to Overweight and Obesity: How Much, and Who's Paying?"
Health Affairs - web exclusive
May 2003; web published
On the Web
Relevance: high

Using the 1998 Medical Expenditure Panel Survey (MEPS) and the 1996 and 1997 National Health Interview Survey, the authors estimate that aggregate medical expenditures for obesity and overweight in 1998 were 9.1% of total US medical expenditures: $78.5 billion ($92.6 billion in 2002 dollars).  The also found that Medicare and Medicaid paid for about half of these costs.

Fontaine 2003 - "Years of Life Lost Due to Obesity"

Fontaine, Kevin R; Redden, David T; et al
"Years of Life Lost Due to Obesity"
Journal of the American Medical Association
January 8, 2003; v.289, n.2; pp.187-193
On the Web
Relevance: medium

Using data from NHANES I, II, and III, the authors calculated that a BMI of 23-25 for whites and 23-30 for black was associated with the longest life.  The estimated that years of life lost (YLL) increases with BMI in a J or U shaped curved among whites. Overweight and obesity cut more years off life for younger adults than for older adults.   Overweight had less effect on blacks, especially black women and elderly blacks.

Hu 2004 - "Adiposity as Compared with Physical Activity in Predicting Mortality among Women"

Hu, Frank B; Willet, Walter C; et al
"Adiposity as Compared with Physical Activity in Predictiong Mortality among Women"
New England Journal of Medicine
December 23, 2004; v.351, n.26' pp.2694-2703
On the Web
Relevance: high

Using the Nurse's Health Study (1976-1998?), the authors studied how both adiposity (obesity) and physical activity affect mortality risk. They found that obesity predicted a higher risk of death regardless of physical activity level, and physical inactivity predicted a higher risk of death regardless of BMI.

Gregg 2005 - "Secular Trends in Cardiovascular Disease Risk Factors According to Body Mass Index in US Adults"

Gregg, Edward W.; Cheng, Yiling J; et al
"Secular Trends in Cardiovascular Disease Risk Factors According to Body Mass Index in US Adults"
Journal of the American Medical Association
April 20, 2005; v.293, n.15; pp.1868-1875
On the Web
Relevance: high

Using data from NHES (1960-1962), NHANES I (1971-1975), II (1976-1980), and II (1988-1994) and NHANES 1999-2000, the authors looked at trends in high cholesterol, high blood pressure, and diabetes. They found that the prevalence of high cholesterol and high blood pressure have declined, and that they declined most in overweight and obese groups; however, the decline was smaller when the authors looked at the prevalence of both the conditions and treatments for the conditions. The prevalence of diabetes increased in all groups, most dramatically among the overweight and obese.

• "The net result of these phenomena may be a population that is, paradoxically, more obese, diabetic, arthritic, disabled, and medicated, but with lower overall CVD risk."

Manson 1995 - "Body Weight and Mortality Among Women"

Manson, Joann E; Willett, Walter C; Stampfer, Meir J; et al
"Body Weight and Mortality Among Women"
New England Journal of Medicine
September 14, 1995; v.333, n.11; pp.677-685
On the Web
Relevance: medium

Using data from the Nurses Health Study (1976-1992), the authors calculated the risk of mortality at various BMI levels for women of smoking and non-smoking status.  They found that among non-smoking women, mortality increases with BMI at all levels of BMI.  Smoking affects the association by raising the mortality risk for the leanest group (lowest BMI).

Stevens 1998 - "The Effect of Age on the Association Between Body-Mass Index and Mortality"

Stevens, June; Cai, Jianwen; et al
"The Effect of Age on the Association Between Body-Mass Index and Mortality"
New England Journal of Medicine
January 1, 1998; v.338, n.1; pp.1-7
On the Web
Relevance: medium

Using data from the American Cancer Society's Cancer Prevention Study I (1960-1972), the authors found that: "Excess body weight increases the risk of death from any cause and from cardiovascular disease in adults between 30 and 74 years of age.  The relative risk associated with greater body weight is higher among younger subjects."  In short, the older you are, the less detrimental obesity and overweight are for mortality.