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Some studies have shown lower mortality among middle-aged and older people who are overweight or mildly obese compared with those who are normal-weight — a finding termed the obesity paradox. To clarify the contributions of body-mass index (BMI) and adiposity to all-cause mortality, researchers in Manitoba, Canada, examined data from a study of bone density in 49,500 women (mean age, 63) and 5000 men (mean age, 65); dual-energy x-ray absorptiometry (DEXA) scans were used to estimate percent body fat. Mean follow-up was 6.7 years in women and 4.5 years in men.
Participants were divided into quintiles based on BMI and DEXA-derived percent adiposity, with the middle quintile serving as the reference. In fully adjusted models where BMI and adipo…