Dataset Information

Association of current and former smoking with body mass index: A study of smoking discordant twin pairs from 21 twin cohorts.

ABSTRACT:

Background

Smokers tend to weigh less than never smokers, while successful quitting leads to an increase in body weight. Because smokers and non-smokers may differ in genetic and environmental family background, we analysed data from twin pairs in which the co-twins differed by their smoking behaviour to evaluate if the association between smoking and body mass index (BMI) remains after controlling for family background.

Methods and findings

The international CODATwins database includes information on smoking and BMI measured between 1960 and 2012 from 156,593 twin individuals 18-69 years of age. Individual-based data (230,378 measurements) and data of smoking discordant twin pairs (altogether 30,014 pairwise measurements, 36% from monozygotic [MZ] pairs) were analysed with linear fixed-effects regression models by 10-year periods. In MZ pairs, the smoking co-twin had, on average, 0.57 kg/m2 lower BMI in men (95% confidence interval (CI): 0.49, 0.70) and 0.65 kg/m2 lower BMI in women (95% CI: 0.52, 0.79) than the never smoking co-twin. Former smokers had 0.70 kg/m2 higher BMI among men (95% CI: 0.63, 0.78) and 0.62 kg/m2 higher BMI among women (95% CI: 0.51, 0.73) than their currently smoking MZ co-twins. Little difference in BMI was observed when comparing former smoking co-twins with their never smoking MZ co-twins (0.13 kg/m2, 95% CI 0.04, 0.23 among men; -0.04 kg/m2, 95% CI -0.16, 0.09 among women). The associations were similar within dizygotic pairs and when analysing twins as individuals. The observed series of cross-sectional associations were independent of sex, age, and measurement decade.

Conclusions

Smoking is associated with lower BMI and smoking cessation with higher BMI. However, the net effect of smoking and subsequent cessation on weight development appears to be minimal, i.e. never more than an average of 0.7 kg/m2.

SUBMITTER: Piirtola M

PROVIDER: S-EPMC6042712 | biostudies-literature | 2018

REPOSITORIES: biostudies-literature

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Publications

Association of current and former smoking with body mass index: A study of smoking discordant twin pairs from 21 twin cohorts.

Piirtola Maarit M Jelenkovic Aline A Latvala Antti A Sund Reijo R Honda Chika C Inui Fujio F Watanabe Mikio M Tomizawa Rie R Iwatani Yoshinori Y Ordoñana Juan R JR Sánchez-Romera Juan F JF Colodro-Conde Lucia L Tarnoki Adam D AD Tarnoki David L DL Martin Nicholas G NG Montgomery Grant W GW Medland Sarah E SE Rasmussen Finn F Tynelius Per P Tan Qihua Q Zhang Dongfeng D Pang Zengchang Z Rebato Esther E Stazi Maria A MA Fagnani Corrado C Brescianini Sonia S Busjahn Andreas A Harris Jennifer R JR Brandt Ingunn I Nilsen Thomas Sevenius TS Cutler Tessa L TL Hopper John L JL Corley Robin P RP Huibregtse Brooke M BM Sung Joohon J Kim Jina J Lee Jooyeon J Lee Sooji S Gatz Margaret M Butler David A DA Franz Carol E CE Kremen William S WS Lyons Michael J MJ Magnusson Patrik K E PKE Pedersen Nancy L NL Dahl Aslan Anna K AK Öncel Sevgi Y SY Aliev Fazil F Derom Catherine A CA Vlietinck Robert F RF Loos Ruth J F RJF Silberg Judy L JL Maes Hermine H HH Boomsma Dorret I DI Sørensen Thorkild I A TIA Korhonen Tellervo T Kaprio Jaakko J Silventoinen Karri K

PloS one 20180712 7

<h4>Background</h4>Smokers tend to weigh less than never smokers, while successful quitting leads to an increase in body weight. Because smokers and non-smokers may differ in genetic and environmental family background, we analysed data from twin pairs in which the co-twins differed by their smoking behaviour to evaluate if the association between smoking and body mass index (BMI) remains after controlling for family background.<h4>Methods and findings</h4>The international CODATwins database in ...[more]

PMID: 30001359

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Project description:Although obesity has been directly linked to the development of many cancers, many epidemiological studies have found that body mass index (BMI)--a surrogate marker of obesity--is inversely associated with the risk of lung cancer. These studies are difficult to interpret because of potential confounding by cigarette smoking, a major risk factor for lung cancer that is associated with lower BMI.We prospectively examined the association between BMI and the risk of lung cancer among 448?732 men and women aged 50-71 years who were recruited during 1995-1996 for the National Institutes of Health-AARP Diet and Health Study. BMI was calculated based on the participant's self-reported height and weight on the baseline questionnaire. We identified 9437 incident lung carcinomas (including 415 in never smokers) during a mean follow-up of 9.7 years through 2006. Multivariable Cox proportional hazards regression models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) with adjustment for lung cancer risk factors, including smoking status. To address potential bias due to preexisting undiagnosed disease, we excluded potentially unhealthy participants in sensitivity analyses. All statistical tests were two-sided.The crude incidence rate of lung cancer over the study follow-up period was 233 per 100?000 person-years among men and 192 per 100?000 person-years among women. BMI was inversely associated with the risk of lung cancer among both men and women (BMI ?35 vs 22.5-24.99 kg/m(2): HR = 0.81, 95% CI = 0.70 to 0.94 and HR = 0.73, 95% CI = 0.61 to 0.87, respectively). The inverse association was restricted to current and former smokers and was stronger after adjustment for smoking. Among smokers, the inverse association persisted even after finely stratifying on smoking status, time since quitting smoking, and number of cigarettes smoked per day. Sensitivity analyses did not support the possibility that the inverse association was due to prevalent undiagnosed disease.Our results suggest that a higher BMI is associated with a reduced risk of lung cancer in current and former smokers. Our inability to attribute the inverse association between BMI and the risk of lung cancer to residual confounding by smoking or to bias suggests the need for considering other explanations.

Dataset Information

Association of current and former smoking with body mass index: A study of smoking discordant twin pairs from 21 twin cohorts.

Background

Methods and findings

Conclusions

Publications

Association of current and former smoking with body mass index: A study of smoking discordant twin pairs from 21 twin cohorts.

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