Abstract
Background:
Smoking and obesity are two of the most important risk factors for chronic disease today. Their combined effect on the risk of disability pension is not known.
Methods:
A nationwide cohort of 45 920 Swedish men (18.7±0.5years) were followed for 38 years. The body mass index (BMI), based on measured height and weight, was used to define underweight (<18.5), normal weight (18.5–24.9), overweight (25.0–29.9) and obesity (⩾30.0). The hazard ratios (HRs) associated with BMI and smoking status at baseline for receiving disability pension were adjusted for socio-economic index (SEI), muscular strength, geographic region and place of residence.
Results:
During 1.6 million person-years, 4631 disability pensions and 2897 deaths occurred. After adjustment, overweight (HR 1.34, 95% CI 1.19–1.51) and obesity (HR 1.55, 1.18–2.05) were associated with an increased risk of disability pension, independent of smoking, whereas underweight (18.5; HR 1.07, 0.97–1.17) was not compared with normal weight. Similarly, smoking 1–10 (HR 1.37, 1.27–1.49) or >10 cigarettes per day (HR 2.01, 1.86–2.17) showed independent risk increases versus non-smoking. Although obese individuals smoking >10 daily cigarettes were at greatly increased risk (HR 2.98, 1.98–4.47), no evidence of interaction between the two risk factors could be detected.
Conclusions:
Both increased adiposity and smoking are strong and independent predictors of disability pension, but they do not act synergistically.
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Neovius, K., Neovius, M. & Rasmussen, F. The combined effects of overweight and smoking in late adolescence on subsequent disability pension: a nationwide cohort study. Int J Obes 34, 75–82 (2010). https://doi.org/10.1038/ijo.2009.178
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DOI: https://doi.org/10.1038/ijo.2009.178
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