Most prospective studies identify an increased mortality risk for adults of high body mass index (> 27 kg/m2) that is commonly attributed to the effects of excess body fat, and also identify an increased mortality risk for adults of low body mass index (< 21 kg/m2), an association that, if causal among healthy adults, is without adequate pathophysiologic support.
In this dissertation, I have conducted three studies that continue the investigation of adiposity in relation to mortality among never-smoking adults of the California Seventh-day Adventist population. Among never-smoking adults of the Adventist Mortality Study (1960-1985), the relation between body mass index (BMI) and all-cause mortality has been examined and the investigators found a direct positive relation among middle-aged men, older men, and middle-aged women, and a J-shaped relation among older women.
In the first study, I found that among 12,576 never-smoking women of the Adventist Mortality Study, the risk due to high BMI (> 27 kg/m2) was primarily due to cardiovascular disease and the risk due to low BMI (< 21 kg/m2) among older women was primarily due to cardiovascular and respiratory diseases. In the second study, I examined the relation between BMI and mortality among 20,346 never-smoking adults of the Adventist Health Study (1976-1988) and found a direct positive relation among middle-aged men, older men, middle-aged women, and a J-shaped relation among older women. Further study of the older women indicated that increased risk due to the lowest BMI (13.4-20.6 kg/m2) was only evident among those who had not used hormone replacement therapy, and that this risk was primarily due to cardiovascular and respiratory disease. In the third study, I related weight gain over a 17-year interval to all cause mortality among 6,030 never-smoking members of the 1960 and 1976 cohorts and found evidence implicating weight gain (> 10 kg) as a risk factor and that this risk remained evident for weight gains recorded at the sixth, seventh, and eighth decade.
The findings from these studies implicate obesity as a risk factor throughout adulthood and raise the possibility that lean older women can experience an increased mortality risk that may be due to their lower levels of adipose tissue-derived estrogens.
","abstract_html":"<p>Most prospective studies identify an increased mortality risk for adults of high body mass index (> 27 kg/m<sup>2</sup>) that is commonly attributed to the effects of excess body fat, and also identify an increased mortality risk for adults of low body mass index (< 21 kg/m<sup>2</sup>), an association that, if causal among healthy adults, is without adequate pathophysiologic support.</p> <p>In this dissertation, I have conducted three studies that continue the investigation of adiposity in relation to mortality among never-smoking adults of the California Seventh-day Adventist population. Among never-smoking adults of the Adventist Mortality Study (1960-1985), the relation between body mass index (BMI) and all-cause mortality has been examined and the investigators found a direct positive relation among middle-aged men, older men, and middle-aged women, and a J-shaped relation among older women.</p> <p>In the first study, I found that among 12,576 never-smoking women of the Adventist Mortality Study, the risk due to high BMI (> 27 kg/m2) was primarily due to cardiovascular disease and the risk due to low BMI (< 21 kg/m2) among older women was primarily due to cardiovascular and respiratory diseases. In the second study, I examined the relation between BMI and mortality among 20,346 never-smoking adults of the Adventist Health Study (1976-1988) and found a direct positive relation among middle-aged men, older men, middle-aged women, and a J-shaped relation among older women. Further study of the older women indicated that increased risk due to the lowest BMI (13.4-20.6 kg/m2) was only evident among those who had not used hormone replacement therapy, and that this risk was primarily due to cardiovascular and respiratory disease. In the third study, I related weight gain over a 17-year interval to all cause mortality among 6,030 never-smoking members of the 1960 and 1976 cohorts and found evidence implicating weight gain (> 10 kg) as a risk factor and that this risk remained evident for weight gains recorded at the sixth, seventh, and eighth decade.</p> <p>The findings from these studies implicate obesity as a risk factor throughout adulthood and raise the possibility that lean older women can experience an increased mortality risk that may be due to their lower levels of adipose tissue-derived estrogens.</p>","abstract_has_math":false,"creators":["Singh, Pramil N."],"institution":null,"degree_name":"Doctor of Public Health (DrPH)","degree_level":"Dissertation","degree_discipline":"Epidemiology and Biostatistics","degree_department":null,"school":null,"contributors":["Kristian D. Lindsted","Gary E. Fraser","Ella Haddad"],"advisors":[],"committee_chairs":[],"committee_members":[],"year":1999,"date_issued":"1999-01-01T08:00:00Z","date_published":"1999-01-01T08:00:00Z","updated_at":"2026-07-24T02:53:20Z","subjects":["Biostatistics","Epidemiology","Vital and Health Statistics","Body Weight; Obesity -- mortality; Smoking; Health Status Indicators; Health Surveys; Mortality."],"languages":["English"],"rights":["This title appears here courtesy of the author, who has granted Loma Linda University a limited, non-exclusive right to make this publication available to the public. The author retains all other copyrights."],"rights_urls":[],"identifier_entries":[]},"links":{"outbound_url":"https://scholarsrepository.llu.edu/etd/776","outbound_label":"Repository record","outbound_source":"dc:identifier"},"metadata_groups":[{"id":"people","label":"People","entries":[{"key":"dc:contributor","label":"Contributor","values":["Kristian D. Lindsted","Gary E. 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The author retains all other copyrights."]}]},{"id":"identifiers","label":"Identifiers","entries":[{"key":"dc:identifier","label":"Identifier","values":["https://scholarsrepository.llu.edu/etd/776"]}]},{"id":"additional","label":"Additional Metadata","entries":[{"key":"dc:description.abstract","label":"Abstract","values":["Most prospective studies identify an increased mortality risk for adults of high body mass index (> 27 kg/m2) that is commonly attributed to the effects of excess body fat, and also identify an increased mortality risk for adults of low body mass index (< 21 kg/m2), an association that, if causal among healthy adults, is without adequate pathophysiologic support.
In this dissertation, I have conducted three studies that continue the investigation of adiposity in relation to mortality among never-smoking adults of the California Seventh-day Adventist population. Among never-smoking adults of the Adventist Mortality Study (1960-1985), the relation between body mass index (BMI) and all-cause mortality has been examined and the investigators found a direct positive relation among middle-aged men, older men, and middle-aged women, and a J-shaped relation among older women.
In the first study, I found that among 12,576 never-smoking women of the Adventist Mortality Study, the risk due to high BMI (> 27 kg/m2) was primarily due to cardiovascular disease and the risk due to low BMI (< 21 kg/m2) among older women was primarily due to cardiovascular and respiratory diseases. In the second study, I examined the relation between BMI and mortality among 20,346 never-smoking adults of the Adventist Health Study (1976-1988) and found a direct positive relation among middle-aged men, older men, middle-aged women, and a J-shaped relation among older women. Further study of the older women indicated that increased risk due to the lowest BMI (13.4-20.6 kg/m2) was only evident among those who had not used hormone replacement therapy, and that this risk was primarily due to cardiovascular and respiratory disease. In the third study, I related weight gain over a 17-year interval to all cause mortality among 6,030 never-smoking members of the 1960 and 1976 cohorts and found evidence implicating weight gain (> 10 kg) as a risk factor and that this risk remained evident for weight gains recorded at the sixth, seventh, and eighth decade.
The findings from these studies implicate obesity as a risk factor throughout adulthood and raise the possibility that lean older women can experience an increased mortality risk that may be due to their lower levels of adipose tissue-derived estrogens.
"]},{"key":"dc:title","label":"Title","values":["Body Weight and Mortality Among Adults Who Never Smoked"]}]}],"canonical_facts":{"dc:contributor":["Kristian D. Lindsted","Gary E. Fraser","Ella Haddad"],"dc:creator":["Singh, Pramil N."],"dc:description.abstract":["Most prospective studies identify an increased mortality risk for adults of high body mass index (> 27 kg/m2) that is commonly attributed to the effects of excess body fat, and also identify an increased mortality risk for adults of low body mass index (< 21 kg/m2), an association that, if causal among healthy adults, is without adequate pathophysiologic support.
In this dissertation, I have conducted three studies that continue the investigation of adiposity in relation to mortality among never-smoking adults of the California Seventh-day Adventist population. Among never-smoking adults of the Adventist Mortality Study (1960-1985), the relation between body mass index (BMI) and all-cause mortality has been examined and the investigators found a direct positive relation among middle-aged men, older men, and middle-aged women, and a J-shaped relation among older women.
In the first study, I found that among 12,576 never-smoking women of the Adventist Mortality Study, the risk due to high BMI (> 27 kg/m2) was primarily due to cardiovascular disease and the risk due to low BMI (< 21 kg/m2) among older women was primarily due to cardiovascular and respiratory diseases. In the second study, I examined the relation between BMI and mortality among 20,346 never-smoking adults of the Adventist Health Study (1976-1988) and found a direct positive relation among middle-aged men, older men, middle-aged women, and a J-shaped relation among older women. Further study of the older women indicated that increased risk due to the lowest BMI (13.4-20.6 kg/m2) was only evident among those who had not used hormone replacement therapy, and that this risk was primarily due to cardiovascular and respiratory disease. In the third study, I related weight gain over a 17-year interval to all cause mortality among 6,030 never-smoking members of the 1960 and 1976 cohorts and found evidence implicating weight gain (> 10 kg) as a risk factor and that this risk remained evident for weight gains recorded at the sixth, seventh, and eighth decade.
The findings from these studies implicate obesity as a risk factor throughout adulthood and raise the possibility that lean older women can experience an increased mortality risk that may be due to their lower levels of adipose tissue-derived estrogens.
"],"dc:identifier":["https://scholarsrepository.llu.edu/etd/776"],"dc:language":["English"],"dc:rights":["This title appears here courtesy of the author, who has granted Loma Linda University a limited, non-exclusive right to make this publication available to the public. The author retains all other copyrights."],"dc:subject":["Biostatistics","Epidemiology","Vital and Health Statistics","Body Weight; Obesity -- mortality; Smoking; Health Status Indicators; Health Surveys; Mortality."],"dc:title":["Body Weight and Mortality Among Adults Who Never Smoked"],"thesis:degree_discipline":["Epidemiology and Biostatistics"],"thesis:degree_level":["Dissertation"],"thesis:degree_name":["Doctor of Public Health (DrPH)"]},"updated_at":"2026-07-24T02:53:20Z"}