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Cited by 111Nutrition and Health in AgingObesity, Physical Activity, DietCancer Risks and Factors

Obesity and muscle strength as long-term determinants of all-cause mortality—a 33-year follow-up of the Mini-Finland Health Examination Survey

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Stenholm, S, Mehta, N K, Elo, I T, Heliövaara, M, Koskinen, S, Aromaa, A·2014·International Journal of Obesity
DOI 10.1038/ijo.2013.214PMC PMC4022712
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Abstract

Objective To examine the independent and combined associations of obesity and muscle strength with mortality in adult men and women.Design Follow-up study with 33 years of mortality follow-up.Subjects A total of 3594 men and women aged 50-91 years at baseline with 3043 deaths during the follow-up.Measurement Body mass index (BMI) and handgrip strength were measured at baseline.Results Based on Cox models adjusted for age, sex, education, smoking, alcohol use, physical activity and chronic conditions, baseline obesity (BMI ≥30 kg m(-2)) was associated with mortality among participants aged 50-69 years (hazard ratio (HR) 1.14, 95% confidence interval (CI), 1.01-1.28). Among participants aged 70 years and older, overweight and obesity were protective (HR 0.77, 95% CI, 0.66-0.89 and HR 0.76, 95% CI, 0.62-0.92). High handgrip strength was inversely associated with mortality among participants aged 50-69 (HR 0.89, 95% CI, 0.80-1.00) and 70 years and older (HR 0.78, 95% CI, 0.66-0.93). Compared to normal-weight participants with high handgrip strength, the highest mortality risk was observed among obese participants with low handgrip strength (HR 1.23, 95% CI, 1.04-1.46) in the 50-69 age group and among normal-weight participants with low handgrip strength (HR 1.30, 95% CI, 1.09-1.54) among participants aged 70+ years. In addition, in the old age group, overweight and obese participants with high handgrip strength had significantly lower mortality than normal-weight participants with high handgrip strength (HR 0.79, 95% CI, 0.67-0.92 and HR 0.77, 95% CI, 0.63-0.94).Conclusion Both obesity and low handgrip strength, independent of each other, predict the risk of death in adult men and women with additive pattern. The predictive value of obesity varies by age, whereas low muscle strength predicts mortality in all age groups aged>50 years and across all BMI categories. When promoting health among older adults, more attention should be paid to physical fitness in addition to body weight and adiposity.

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  • Reduced muscle strength is associated with increased mortality (HR 1.30, 95% CI 1.09-1.54) in the MiniFinland Health Examination Study.

    “reduced muscle strength is associated with increased mortality (HR 1.30, 95% CI 1.09–1.54)228”

    From Sarcopenic obesity in older adults: aetiology, epidemiology and treatment strategies (2018) · cites this paper as [228]

    The Abstract Results report HR 1.30 (95% CI 1.09–1.54), but specifically for participants aged 70 or older with normal weight and low handgrip strength, compared with normal-weight participants with high handgrip strength. The citing sentence omits those age, weight, and comparator qualifications and presents the estimate as applying to reduced strength generally. (LLM, conf=0.90)

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  • In the Mini-Finland Health Examination Survey, among participants aged ≥70 years, the risk of mortality was higher in participants with dynapenic obesity (HR 1.23) and dynapenia alone (HR 1.30) than in participants without dynapenia or obesity.

    “In this study, among participants aged ≥70 years, the risk of mortality was higher in participants with dynapenic obesity (defined using grip strength and BMI) (HR: 1.23, 95% CI: 1.04–1.46) and dynapenia alone (HR: 1.30, 95% CI: 1.09–1.54) than in participants without dynapenia or obesity (69).”

    From Health Consequences of Sarcopenic Obesity: A Narrative Review (2020) · cites this paper as [69]

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Authors
Stenholm, S., Mehta, N. K., Elo, I. T., Heliövaara, M., Koskinen, S., & Aromaa, A.
Affiliations
  • University of Turku (FI)
  • Emory University (US)
  • University of Pennsylvania (US)
  • Finnish Institute for Health and Welfare (FI)
Corresponding author
Stenholm, S
ORCID
Venue
International Journal of Obesity
Publisher
Springer Science and Business Media LLC
Published
2013-11-15
Volume
38
Issue
8
Pages
1126-1132
ISSN
  • 0307-0565 (ISSN-L)
  • 1476-5497
DOI
10.1038/ijo.2013.214
PMC
PMC4022712
OpenAlex
W2069702946
Cited by
111
References
47
Citations by year
2026: 5 · 2025: 11 · 2024: 6 · 2023: 8 · 2022: 7 · 2021: 7 · 2020: 8 · 2019: 4 · 2018: 12 · 2017: 14 · 2016: 11 · 2015: 12 · 2014: 6
FWCI
6.71
Type
journal article
Language
en
Open access
Licence
Locations
  • International Journal of Obesity (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
  • STM:n Hallinnonalan avoin julkaisuarkisto (Julkari) (submittedVersion)
Funders
  • National Institutes of Health (5p30ag012836-30)
  • National Institute on Aging (P30-AG-012836, R01 #AG040212-01, R01AG040212)
Topics
  • Health Sciences › Medicine › Physiology › Nutrition and Health in Aging
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
  • Health Sciences › Medicine › Oncology › Cancer Risks and Factors
Keywords
obesity, muscle strength, grip strength, all-cause mortality, body mass index, overweight, older adults, mortality risk, chronic comorbidities, smoking, alcohol consumption, physical activity, chronic disease, sex differences, socioeconomic status
MeSH terms
Aged, Aged, 80 and over, Cardiovascular Diseases, Female, Finland, Follow-Up Studies, Health Status Indicators, Health Surveys, Humans, Male, Middle Aged, Obesity, Physical Fitness, Predictive Value of Tests, Risk Factors, Comorbidity, Body Mass Index, Proportional Hazards Models, Risk Assessment, Hand Strength, Muscle Strength

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