This site is intended for UK healthcare professionals
Medscape UK Univadis Logo
Medscape UK Univadis Logo
News

Obesity May Have Overtaken Smoking as a Contributor to Death in Older People

Obesity and excess body fat may have contributed to more deaths among middle aged and older people in England and Scotland than smoking, a study suggested.

Between 2003 and 2017 the percentage of deaths attributable to adiposity increased from 17.9% to 23.1%.

During the same time, the percentage of deaths from smoking decreased from 23.1% to 19.4%.

The crossover was likely to have occurred in 2013, researchers from the University of Glasgow believe.

Dr Frederick Ho PhD, who co-led the investigation, told Medscape News UK: "We think that obesity is now the biggest problem in public health, and we should allocate proportionate resources to tackle that problem."

Data From Health Surveys

The comparative risk assessment study, published in the open access journal BMC Public Health, drew on data from Health Surveys for England and Scottish Health Surveys involving 192,239 adults aged 16 and over.

Participants reported whether they had ever regularly smoked, and their height and weight were measured by trained interviewers or nurses.

The researchers combined their data with estimates of the risk of mortality from smoking or adiposity.

Variations by Age, Gender, and Country

Differences in the relative risk were observed according to age and gender.

Among those aged 65 and over, adiposity contributed to 3.5% more estimated deaths than smoking in 2017. The figure was 3.4% more estimated deaths for those aged between 45 and 64 years.

For those in the younger 16 to 44 age group, smoking accounted for 2.4% more deaths than adiposity.

"Older people are more likely to be obese," said Dr Ho, who is a public health research associate. "That's why we found that among younger people – those younger than 45 – smoking is still the top contributor compared to obesity."

Adiposity may have accounted for 5.2% more deaths in 2017 than smoking in men, compared to 2.2% more deaths in women, the study suggested.

Estimated deaths due to adiposity are thought to have increased by 25.9% for women and 31% for men between 2003 and 2017, while deaths due to smoking are thought to have decreased by 18.1% for women and 14.9% for men.

Minor differences in the pattern of adiposity and smoking were seen between England and Scotland. "Basically, Scottish people are a little bit more likely to be obese and more likely to be smoking currently, but in terms of trend they're quite similar," said Dr Ho.

The authors caution that the number of deaths attributed to smoking and adiposity were estimates only and that factors influencing mortality require further investigation.

Public Health Interventions

Dr Ho said the findings suggested that public health initiatives should replicate the successful interventions used to reduce smoking rates in past years.

A ban on fast food adverts "could be a good start", he suggested. Also, consumers could be 'nudged' towards making healthier choices, with initiatives such as changing the default option in fast food outlets from 'chips' to 'vegetables'.

More "affordable, healthy choices" in food could boost consumption, as "we know that the people living in deprived areas are more likely to be obese, quite likely because healthy foods like fruit and vegetables are quite expensive".

Safe cycling routes and discounted gyms could boost physical activity, Dr Ho added.

Ho, F.K., Celis-Morales, C., Petermann-Rocha, F. et al. Changes over 15 years in the contribution of adiposity and smoking to deaths in England and Scotland. BMC Public Health 21, 169 (2021). https://doi.org/10.1186/s12889-021-10167-3. Article

YOU MAY ALSO LIKE