A team from the Karolinska Institute in Sweden reviewed data on cause of the death of 45,920 men who underwent national mandatory military conscription tests.
BMI and smoking status were recorded at outset and the men were followed up for an average of 38 years, during which 2,897 died.
The incidence of death was lowest for people with normal weight and highest in obese subjects. Being overweight at the age of 18 increased the risk of premature death by just over a third, while being obese more than doubled the risk.
This risk of early death also increased the more participants smoked, with heavy smokers at more than double the risk of premature death compared to non-smokers.
Lead author Dr Martin Neovius, a post-doctorate fellow at the institute, said: ‘The findings indicate that from a mortality perspective targets for young men should be within the non-smoking, normal weight range, and that overweight, obesity, and smoking among adolescents might be good targets for intensified public health initiatives.’
BMJ 2009;338:b496 doi:10.1136/bmj.b496
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