{"doi":"10.1016/j.jacadv.2025.102234","title":"Age-Specific Associations Between Adiposity and Mortality in U.S. Adults, 1999-2018","abstract":"BACKGROUND: Obesity is a leading risk factor for increased mortality. However, it remains unclear how this relationship varies across different age groups. OBJECTIVES: The purpose of this study was to evaluate whether the associations between adiposity and mortality are modified by age in a nationally representative sample of U.S. adults. METHODS: We analyzed data from 44,041 U.S. adults aged 18 to 79 years from the National Health and Nutrition Examination Survey (1999-2018), linked to mortality data through 2019. Anthropometric measures included body mass index, waist circumference, weight, and waist-to-height ratio. Cox proportional hazards models were used to assess the interaction between age and adiposity on all-cause and cardiovascular mortality, adjusting for demographic, behavioral, and clinical covariates. RESULTS: Over a median follow-up of 10.1 years, there were 5,019 deaths (1,186 cardiovascular). Significant interactions between age and all 4 adiposity measures were observed (P < 0.05). Associations between adiposity and mortality were strongest among younger adults. For example, each 1-SD increase in body mass index was associated with a cardiovascular mortality HR of 1.49 (95% CI: 1.27-1.77) in adults aged 18 to 49 years, vs 1.15 (95% CI: 0.99-1.32) in those aged 70 to 79 years. Class 3 obesity was associated with a cardiovascular mortality HR of 4.37 (95% CI: 2.01-9.50) in younger adults. Underweight status was also associated with elevated all-cause mortality, particularly among younger individuals (HR: 2.04; 95% CI: 1.24-3.36). CONCLUSIONS: Age significantly modifies the relationship between adiposity and mortality. Younger adults experience greater mortality risks from both obesity and underweight, underscoring the need for early, age-tailored interventions.","journal":"JACC Advances","year":2025,"id":580466,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":0.0,"corpus_rank":10062,"citation_count":0,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":true,"is_dataset_confidence":0.5772,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2025-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1491692,"name":"Yunhan Mou","orcid":null,"position":1,"is_corresponding":false},{"id":829353,"name":"Yuntian Liu","orcid":"0000-0001-6571-6112","position":2,"is_corresponding":false},{"id":1304302,"name":"Alissa S. Chen","orcid":"0000-0003-1049-9274","position":3,"is_corresponding":false},{"id":305644,"name":"Jeph Herrin","orcid":"0000-0002-3671-3622","position":4,"is_corresponding":false},{"id":391160,"name":"Erica S. Spatz","orcid":"0000-0002-1557-7713","position":5,"is_corresponding":false},{"id":413218,"name":"Mona Sharifi","orcid":"0000-0002-1632-7038","position":6,"is_corresponding":false},{"id":648510,"name":"Ania M. Jastreboff","orcid":"0000-0003-1446-0991","position":7,"is_corresponding":false},{"id":1077,"name":"Harlan M. Krumholz","orcid":"0000-0003-2046-127X","position":8,"is_corresponding":false},{"id":27757,"name":"Yuan Lu","orcid":"0000-0001-5264-2169","position":0,"is_corresponding":true}],"reference_count":33,"raw_metadata":null,"created_at":"2026-07-19T02:58:38.868285Z","pmid":"41205545","pmcid":"PMC12639814","fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}