BODY-WEIGHT, PREEXISTING DISEASE, AND ALL-CAUSE MORTALITY IN A COHORTOF MALE EMPLOYEES IN THE GERMAN CONSTRUCTION-INDUSTRY

The impact of body weight on all-cause mortality is subject to ongoing debate. We assessed the relation between body mass index (BMI) and al l-cause mortality in a cohort of 8043 male employees in the German con struction industry who underwent detailed occupational health examinat ions at ages 25-64 and who were followed for all cause mortality over an average period of 4.5 years. Overall, there was a negative, graded relation between BMI and all-cause mortality, which persisted after co ntrolling for multiple covariates including age and cigarette smoking, and after excluding the initial two years of follow-up. There was a s trong positive cross-sectional relationship between BMI and a medical diagnosis of diabetes, hypertension, and ischemic heart disease at the baseline examination. While BMI showed a strong negative relation wit h all-cause mortality among men with such diseases, the association wa s much weaker and non-monotonic for men free of these diseases. Our re sults underline the importance of preexisting diseases for the prognos tic value of body weight. (C) 1997 Elsevier Science Inc.