Obesity in late teens 'as hazardous as heavy smoking' Obesity in late adolescence carries the same risk of premature death as smoking more than 10 cigarettes a day, according to new Swedish research published in the British Medical Journal (BMJ) on 24 February. Meanwhile, those who are overweight in their late teens have a simila... Obesity in late adolescence carries the same risk of premature death as smoking more than 10 cigarettes a day, according to new Swedish research published in the British Medical Journal (BMJ) on 24 February. Meanwhile, those who are overweight in their late teens have a similar risk of dying early as a light smoker. The researchers conclude that public-health initiatives should continue to target smoking and obesity among adolescents. Smoking and obesity are two of the biggest risk factors for premature death in the western world. In the developing world, smoking is already a major problem and obesity is on the rise across the globe except in the very poorest areas. Adults who are obese (i.e. have a body mass index, or BMI, of over 30) in middle age have a mortality risk two to three times greater than adults whose weight falls in the 'normal' range (BMI between 18.5 and 24.9). Worryingly, overweight and obesity are rising faster among children and adolescents than among adults, yet until now, few studies have investigated the link between overweight and obesity in adolescence and premature death. This latest study sought to address this issue and also investigate whether obesity and smoking have a synergistic effect on mortality risk. The researchers, from the Karolinska Institute and Uppsala University, analysed data on the cause of death of over 45,000 men who had undergone a medical test in 1969 and 1970 when they were around 18 years old as part of the military conscription process. At that time, only the severely handicapped were exempt from military service, so the data effectively covers all Swedish men in that age cohort. The men were followed up for an average of 38 years; during that time, 2,897 died. The analysis revealed that for those who were overweight at the time of the test, the risk of premature death compared to that for normal weight subjects was increased by a third, while being obese more than doubled the risk. The researchers underline that these risks are comparable in magnitude to those associated with smoking. 'In late adolescence, overweight was as hazardous as smoking 1 to 10 cigarettes a day, while obesity was as hazardous as smoking over 10 cigarettes a day,' the scientists write. Being underweight had no apparent effects on mortality risk, but those who were severely underweight (BMI under 17) had the same risk of early death as the overweight subjects. Regarding the reasons behind these increased risks, the researchers note that overweight and obesity are associated with a greater risk of developing type-2 diabetes, cardiovascular disease and certain types of cancer. For the underweight, they speculate that these people could be more susceptible to infections. Unsurprisingly, the risk of an early death was also closely linked to the number of cigarettes smoked, with heavy smokers being more than twice as likely to die early as non-smokers. However, the study did not reveal an interaction between smoking and weight. In other words, smoking did not appear to exacerbate the risks associated with being overweight or obese. Nevertheless, those who were both obese and heavy smokers were almost five times more likely to die young than non-smokers of normal weight. 'In summary, we found that overweight and obesity in late adolescence is associated with premature death, regardless of smoking status,' the researchers state. 'The global obesity epidemic and smoking among adolescents remain important targets for intensified public health initiatives.' Countries Sweden
