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Obese Non-smoking Women At An Increased Risk Of Premature Death

May 11, 2017

In a clinical study published on bmj (British Medical Journal) today, research has shown that obesity leads women who have never smoked to die prematurely. This was found to be more frequent in obese women who belonged to lower socioeconomic groups.

The authors argue that although there is conclusive scientific evidence that smoking leads to premature death and inequalities of health status, it is not clear which factors that increase the risk of death are linked to the social status of non-smoking women.

To answer this important health related question, Dr Laurence Gruer from NHS Health Scotland studied the cases of 3,613 women who had been non-smokers throughout their lives. These women were study subjects in a large study that recruited 15,000 adults in Scotland between 1972 and 1976. The subjects were 45-64 years of age when they were recruited and were then followed up until death occurred.

The study subjects were grouped by Dr Gruer and his co-researchers by their occupation (1 & 2, 3 non-manual, 3 manual, and 4 & 5) and by how much they weighed (normal weight, overweight, moderately obese and severely obese).

Half the women who were followed during the follow-up period of 28 years died. 916 (51%) women died due to cardiovascular disease and 487 (27%) died from cancer.

It was found by the researchers that women who died from cardiovascular disease were more likely to be associated with a lower socioeconomic group. These women also had a higher likelihood of being obese, and the more obese a woman was the more were her chances of premature death. Interestingly, the women belonging to lower occupational group were less likely to die from cancer as compared to other groups.

Data from this study has shown that women who never smoked had higher chances of being overweight or obese in comparison to women who smoked. The authors argue that the higher prevalence of smoking 35 years ago masked the real magnitude of obesity in women who didn't smoke, and that the decrease in smoking rates over the years may have led to a higher prevalence of increased weight and obesity in women.

"The findings of this research have far reaching implications", says Dr Gruer. While chronic smoking is an established risk factor for much higher mortality rates in women, severe obesity has significantly contributed to premature mortality in women who never smoked. Researchers of the study stated that obesity in women who belong to the lower socioeconomic groups leads to inequalities of health status and an increased load on local health and social services.

Another finding of the study that is encouraging is that women who are not obese and have never smoked are relatively well protected with low mortality rates irrespective of their social status.

In the editorial that accompanies the published study, Professor Johan Mackenbach from the Erasmus Medical Center Rotterdam, says the study is welcome "but it is important not to forget that smoking is a much stronger risk factor for mortality than most other risk factors, including obesity."

He draws a conclusion that "inequalities in mortality persist among those who have never smoked, partly because obesity takes over the role of smoking, but they persist at a much lower level, and that is good news for whoever wants to reduce health inequalities."

Link to Abstract in BMJ

Barry Windsor