BMI

Declining BMI was associated with higher mortality in the Level 3 slope analysis. Level 3 estimated a U-shaped mortality risk curve for current BMI value with the minimum near BMI 27. Relative to BMI 27, BMI 20 and BMI 40 were associated with higher mortality under the Level 3 model. A 1% annual relative BMI decrease had higher estimated mortality risk than stable weight, while a 1% annual increase had lower estimated risk. Among patients with valid BMI, overweight was the most common BMI category, followed by normal weight, obesity, and underweight. BMI does not distinguish visceral fat from subcutaneous fat, lean mass, or fat distribution. BMI was strongly correlated with waist-to-height ratio and moderately to strongly correlated with visceral fat overall. Women had significantly higher average BMI than men in the sample. Cumulative breast cancer incidence was higher among overweight or obese women than among underweight or acceptable-weight women. Athletes with high muscle development may register as overweight or obese on BMI despite low health risk. The linear Level 1 model missed the U-shaped BMI pattern and estimated lower risk at BMI 40. Patients with overweight and obesi…