Body Mass Index and Mortality Among Hospitalized Patients

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Abstract
THE GRAPHED relationship of body weight to mortality throughout the range of body mass index (weight in kilograms divided by the square of the height in meters [BMI]) has been described as J-shaped, U-shaped, inverse, positive, and even absent.1-6 In most population studies, the association between BMI and mortality is described by a U-shaped curve, with augmented risk in the lowest and highest percentiles of the distribution, even when controlling for comorbid disease, age, and smoking.7 However, the association between body weight and mortality remains controversial.8 In particular, important questions remain about the impact of age on the relationship between overweight conditions and mortality.9-11 The third edition of the Dietary Guidelines for Americans12 has recommended a higher BMI with increasing age. On the contrary, the last edition of analogous weight guidelines13 did not include age-specific recommendations.