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Obesity and muscle strength as long-term determinants of all-cause mortality—a 33-year follow-up of the Mini-Finland Health Examination Survey
Open accessAbstract
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)228”
From Sarcopenic obesity in older adults: aetiology, epidemiology and treatment strategies (2018) · cites this paper as [228]
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“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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- Aromaa A, Heliövaara M, Impivaara O, Knekt P, Maatela J, Joukamaa M et al Health, Functional Limitations and Need for Care in Finland. Basic Results from the Mini-Finland Health Survey. Publications of the Social Insurance Institution AL:32 (In Finnish with an English summary: 525–554): Helsinki and Turku, 1989. p 793.
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Sarcopenic obesity in older adults: aetiology, epidemiology and treatment strategies
Batsis, J. A., & Villareal, D. T. (2018) · Nature Reviews Endocrinology · doi:10.1038/s41574-018-0062-9 · Cited by 1,382
Aune, D., Sen, A., Prasad, M., Norat, T., Janszky, I., Tonstad, S., Romundstad, P., & Vatten, L. J. (2016) · BMJ · doi:10.1136/bmj.i2156 · Cited by 996
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García-Hermoso, A., Cavero-Redondo, I., Ramírez-Vélez, R., Ruiz, J. R., Ortega, F. B., Lee, D.-C., & Martínez-Vizcaíno, V. (2018) · Archives of Physical Medicine and Rehabilitation · doi:10.1016/j.apmr.2018.01.008 · Cited by 609
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Metadata
- 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
- Venue
- International Journal of Obesity
- Published
- 2013-11-15
- Volume
- 38
- Issue
- 8
- Pages
- 1126-1132
- ISSN
- 0307-0565 (ISSN-L)
- 1476-5497
- 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
- green
- www.ncbi.nlm.nih.gov
- 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 (medical) › 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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