Adiposity in Adults and Life Expectancy with and without Cardiovascular Disease. The Doetinchem Cohort Study

Silvia Juliana Trujillo-Cáceres; Annelot P. Smit; Vicente Artola Arita; Marilyne Menassa; H. Susan J. Picavet; Klodian Dhana; Oscar H. Franco; W. M. Monique Verschuren

doi:10.5334/gh.1558

Adiposity in Adults and Life Expectancy with and without Cardiovascular Disease. The Doetinchem Cohort Study

Volume 21 (2026): Issue 1

By: Silvia Juliana Trujillo-Cáceres , Annelot P. Smit , Vicente Artola Arita , Marilyne Menassa , H. Susan J. Picavet , Klodian Dhana , Oscar H. Franco and W. M. Monique Verschuren

Open Access

|May 2026

CBS. What is the average lifespan in the Netherlands? – The Netherlands in numbers 2022 [Internet]. September 2022. [cited 2025 July 14]. Available from: https://longreads.cbs.nl/the-netherlands-in-numbers-2022/what-is-the-average-lifespan-in-the-netherlands/.
Search in Google Scholar Back to article
Statista. Netherlands: life expectancy at birth by gender 2022 [Internet]. Nov 28, 2025. [cited 2024 January 14]. Available from: https://www.statista.com/statistics/520408/netherlands-life-expectancy-at-birth-by-gender/.
Search in Google Scholar Back to article
Westendorp RGJ, van Bodegom D, Engelaer FM. Sex differences in healthy life expectancy in the Netherlands. Annu Rev Gerontol Geriatr. 2013;33(1):361–371. DOI: 10.1891/0198-8794.33.361
Open DOI Search in Google Scholar Back to article
Wang X, Ma H, Li X, Heianza Y, Manson JE, Franco OH, et al. Association of cardiovascular health with life expectancy free of cardiovascular disease, diabetes, cancer, and dementia in UK adults. JAMA Intern Med. 2023;183(4):340–349. DOI: 10.1001/JAMAINTERNMED.2023.0015
Open DOI Search in Google Scholar Back to article
Li Y, Schoufour J, Wang DD, Dhana K, Pan A, Liu X, et al. Healthy lifestyle and life expectancy free of cancer, cardiovascular disease, and type 2 diabetes: prospective cohort study. BMJ. 2020;368. DOI: 10.1136/BMJ.L6669
Open DOI Search in Google Scholar Back to article
GBD 2021 Europe Life Expectancy Collaborators. Changing life expectancy in European countries 1990–2021: a subanalysis of causes and risk factors from the Global Burden of Disease Study 2021. Lancet Public Health. 2025;10(3):e172–e188. DOI: 10.1016/S2468-2667(25)00009-X
Open DOI Search in Google Scholar Back to article
Koliaki C, Dalamaga M, Liatis S. Update on the obesity epidemic: after the sudden rise, is the upward trajectory beginning to flatten? Curr Obes Rep. 2023;12:514–527. DOI: 10.1007/s13679-023-00527-y
Open DOI Search in Google Scholar Back to article
Lobstein T, Jackson-Leach R, Powis J, Brinsden H, Gray M. World Obesity Atlas 2023. 2023. https://data.worldobesity.org/publications/?cat=19, https://data.worldobesity.org/publications/WOF-Obesity-Atlas-V5.pdf.
Search in Google Scholar Back to article
CBS. Health Survey Netherlands 2024. Height and weight of persons, underweight and overweight; since 1981. [cited 2025 July 10]. Available from: https://opendata.cbs.nl/statline/#/CBS/nl/dataset/81565NED/table?ts=1620225801465.
Search in Google Scholar Back to article
Peeters A, Barendregt JJ, Willekens F, Mackenbach JP, Al Mamun A, Bonneux L, et al. Obesity in adulthood and its consequences for life expectancy: a life-table analysis. Ann Intern Med. 2003;138(1):24–32. DOI: 10.7326/0003-4819-138-1-200301070-00008
Open DOI Search in Google Scholar Back to article
Fontaine KR, Redden DT, Wang C, Westfall AO, Allison DB. Years of life lost due to obesity. JAMA. 2003;289(2):187–193. DOI: 10.1001/JAMA.289.2.187
Open DOI Search in Google Scholar Back to article
Stenholm S, Head J, Aalto V, Kivimäki M, Kawachi I, Zins M, et al. Body mass index as a predictor of healthy and disease-free life expectancy between ages 50 and 75: a multicohort study. Int J Obes. 2017;41:769–775. DOI: 10.1038/ijo.2017.29
Open DOI Search in Google Scholar Back to article
Pardo Silva MC, De Laet C, Nusselder WJ, Mamun AA, Peeters A. Adult obesity and number of years lived with and without cardiovascular disease. Obesity. 2006;14(7):1264–1273. DOI: 10.1038/OBY.2006.144
Open DOI Search in Google Scholar Back to article
Nusselder WJ, Franco OH, Peeters A, MacKenbach JP. Living healthier for longer: comparative effects of three heart-healthy behaviors on life expectancy with and without cardiovascular disease. BMC Public Health. 2009;9:1–9. DOI: 10.1186/1471-2458-9-487
Open DOI Search in Google Scholar Back to article
Grover SA, Kaouache M, Rempel P, Joseph L, Dawes M, Lau DCW, et al. Years of life lost and healthy life-years lost from diabetes and cardiovascular disease in overweight and obese people: a modelling study. Lancet Diabetes Endocrinol. 2015;3(2):114–122. DOI: 10.1016/S2213-8587(14)70229-3
Open DOI Search in Google Scholar Back to article
O’Doherty MG, Cairns K, O’Neill V, Lamrock F, Jørgensen T, Brenner H, et al. Effect of major lifestyle risk factors, independent and jointly, on life expectancy with and without cardiovascular disease: results from the Consortium on Health and Ageing Network of Cohorts in Europe and the United States (CHANCES). Eur J Epidemiol. 2016;31:455–468. DOI: 10.1007/s10654-015-0112-8
Open DOI Search in Google Scholar Back to article
Dhana K, Berghout MA, Peeters A, Ikram MA, Tiemeier H, Hofman A, et al. Obesity in older adults and life expectancy with and without cardiovascular disease. Int J Obes. 2016;40:1535–1540. DOI: 10.1038/ijo.2016.94
Open DOI Search in Google Scholar Back to article
Khan SS, Ning H, Wilkins JT, Allen N, Carnethon M, Berry JD, et al. Association of body mass index with lifetime risk of cardiovascular disease and compression of morbidity. JAMA Cardiol. 2018;3(4):280–287. DOI: 10.1001/JAMACARDIO.2018.0022
Open DOI Search in Google Scholar Back to article
Fekri N, Khaloo P, Ramezankhani A, Mansournia MA, Azizi F, Hadaegh F. Association of body mass index with life expectancy with and without cardiovascular disease. Int J Obes. 2019;44:195–203. DOI: 10.1038/S41366-019-0464-3
Open DOI Search in Google Scholar Back to article
Khaleghi AA, Salari N, Darvishi N, Bokaee S, Jafari S, Hemmati M, et al. Global prevalence of obesity in the older adults: a meta-analysis. Public Health in Practice. 2025;9:100585. DOI: 10.1016/J.PUHIP.2025.100585
Open DOI Search in Google Scholar Back to article
Villareal DT, Apovian CM, Kushner RF, Klein S. Obesity in older adults: technical review and position statement of the American Society for Nutrition and NAASO, The Obesity Society. Am J Clin Nutr. 2005;82(5):923–934. DOI: 10.1093/AJCN/82.5.923
Open DOI Search in Google Scholar Back to article
Koskinas KC, Van Craenenbroeck EM, Antoniades C, Blüher M, Gorter TM, Hanssen H, et al. Obesity and cardiovascular disease: an ESC clinical consensus statement. Eur J Prev Cardiol. 2024;32(3):184–220. DOI: 10.1093/eurjpc/zwae279
Open DOI Search in Google Scholar Back to article
Rubino F, Cummings DE, Eckel RH, Cohen R V, Wilding JPH, Brown WA, et al. Definition and diagnostic criteria of clinical obesity. Lancet Diabetes Endocrinol. 2025;13(3):221–262. DOI: 10.1016/S2213-8587(24)00316-4
Open DOI Search in Google Scholar Back to article
Powell-Wiley TM, Poirier P, Burke LE, Després JP, Gordon-Larsen P, Lavie CJ, et al. Obesity and cardiovascular disease: a scientific statement from the American Heart Association. Circulation. 2021;143:E984–E1010. DOI: 10.1161/CIR.0000000000000973
Open DOI Search in Google Scholar Back to article
Abdullah A, Amin F, Stoelwinder J, Tanamas SK, Wolfe R, Barendregt J, et al. Estimating the risk of cardiovascular disease using an obese-years metric. BMJ Open. 2014;4:e005629. DOI: 10.1136/bmjopen-2014-005629
Open DOI Search in Google Scholar Back to article
Cerhan JR, Moore SC, Jacobs EJ, Kitahara CM, Rosenberg PS, Adami HO, et al. A pooled analysis of waist circumference and mortality in 650,000 adults. Mayo Clin Proc. 2014;89(3):335–345. DOI: 10.1016/j.mayocp.2013.11.011
Open DOI Search in Google Scholar Back to article
De Koning L, Merchant AT, Pogue J, Anand SS. Waist circumference and waist-to-hip ratio as predictors of cardiovascular events: meta-regression analysis of prospective studies. Eur Heart J. 2007;28(7):850–856. DOI: 10.1093/eurheartj/ehm026
Open DOI Search in Google Scholar Back to article
Verschuren WMM, Blokstra A, Picavet HSJ, Smit HA. Cohort profile: The Doetinchem Cohort Study. Int J Epidemiol. 2008;37(6):1236–1241. DOI: 10.1093/IJE/DYM292
Open DOI Search in Google Scholar Back to article
Picavet HSJ, Blokstra A, Spijkerman AMW, Verschuren WMM. Cohort profile update: The Doetinchem Cohort Study 1987–2017: lifestyle, health and chronic diseases in a life course and ageing perspective. Int J Epidemiol. 2017;46(6):1751–1751g. DOI: 10.1093/IJE/DYX103
Open DOI Search in Google Scholar Back to article
Garvey WT, Mechanick JI, Brett EM, Garber AJ, Hurley DL, Jastreboff AM, et al. American Association of Clinical Endocrinologists and American College of Endocrinology comprehensive clinical practice guidelines for medical care of patients with obesity. Endocr Pract. 2016;22(Suppl 3):1–203. DOI: 10.4158/EP161365.GL
Open DOI Search in Google Scholar Back to article
World Health Organization. Obesity: Preventing and Managing the Global Epidemic: Report on a WHO Consultation (WHO Technical Report Series 894). Geneva, Switzerland: 2000.
Search in Google Scholar Back to article
Eveleth PB. Physical status: the use and interpretation of anthropometry. Report of a WHO Expert Committee. Am J Hum Biol. 1996;8(6):786–787. DOI: 10.1002/(SICI)1520-6300(1996)8:6<;786::AID-AJHB11>3.0.CO;2-I
Open DOI Search in Google Scholar Back to article
Visseren F, Mach F, Smulders YM, Carballo D, Koskinas KC, Bäck M, et al. 2021 ESC Guidelines on cardiovascular disease prevention in clinical practice. Eur Heart J. 2021;42(34):3227–3337. DOI: 10.1093/EURHEARTJ/EHAB484
Open DOI Search in Google Scholar Back to article
Hulsegge G, Looman M, Smit HA, Daviglus ML, van der Schouw YT, Monique Verschuren WM. Lifestyle changes in young adulthood and middle age and risk of cardiovascular disease and all-cause mortality: the Doetinchem Cohort Study. J Am Heart Assoc. 2016;5(1). DOI: 10.1161/JAHA.115.002432
Open DOI Search in Google Scholar Back to article
World Health Organization. International Classification of Diseases, 10th Revision (ICD-10). Second edition. Geneva, Switzerland: World Health Organization; 2004.
Search in Google Scholar Back to article
World Health Organization. International Classification of Diseases, 9th Revision (ICD-9). Geneva, Switzerland: World Health Organization; 1977.
Search in Google Scholar Back to article
Wareham NJ, Jakes RW, Rennie KL, Schuit J, Mitchell J, Hennings S, et al. Validity and repeatability of a simple index derived from the short physical activity questionnaire used in the European Prospective Investigation into Cancer and Nutrition (EPIC) study. Public Health Nutr. 2003;6(4):407–413. DOI: 10.1079/phn2002439
Open DOI Search in Google Scholar Back to article
Looman M, Feskens EJM, De Rijk M, Meijboom S, Biesbroek S, Temme EHM, et al. Development and evaluation of the Dutch Healthy Diet index 2015. Public Health Nutr. 2017;20(13):2289–2299. DOI: 10.1017/S136898001700091X
Open DOI Search in Google Scholar Back to article
Chalmers J, MacMahon S, Mancia G, Whitworth J, Beilin L, Hansson L, et al. 1999 World Health Organization-International Society of Hypertension Guidelines for the management of hypertension. Guidelines sub-committee of the World Health Organization. Clin Exp Hypertens. 1999;21(5–6):1009–1060. DOI: 10.3109/10641969909061028
Open DOI Search in Google Scholar Back to article
National Cholesterol Education Program (NCEP): Expert Panel on Detection and Treatment of High Blood Cholesterol in Adults. Third report of the National Cholesterol Education Program (NCEP) Expert Panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III) final report. Circulation. 2002;106(25):3143–3421. DOI: 10.1161/circ.106.25.3143
Open DOI Search in Google Scholar Back to article
Llopis-Cardona F, Armero C, Sanfélix-Gimeno G. Reflection on modern methods: competing risks versus multi-state models 2021. arXiv:2104.03671. DOI: 10.48550/arXiv.2104.03671
Open DOI Search in Google Scholar Back to article
Cleves M, Gould W, Gutierrez R, Marchenko Y. Chapter 13, Section 13.3 (Gompertz regression – PH metric. In: College Station, editor. An introduction to survival analysis using Stata. 2nd ed. Texas: Stata Press; 2008. pp. 310–312.
Search in Google Scholar Back to article
Franco OH, De Laet C, Peeters A, Jonker J, Mackenbach J, Nusselder W. Effects of physical activity on life expectancy with cardiovascular disease. Arch Intern Med. 2005;165(20):2355–2360. DOI: 10.1001/ARCHINTE.165.20.2355
Open DOI Search in Google Scholar Back to article
Ma H, Wang X, Xue Q, Li X, Liang Z, Heianza Y, et al. Cardiovascular health and life expectancy among adults in the United States. Circulation. 2023;147(15):1137–1146. DOI: 10.1161/CIRCULATIONAHA.122.062457
Open DOI Search in Google Scholar Back to article
Dhana K, Nano J, Ligthart S, Peeters A, Hofman A, Nusselder W, et al. Obesity and life expectancy with and without diabetes in adults aged 55 years and older in the Netherlands: a prospective cohort study. PLoS Med. 2016;13(7):e1002086. DOI: 10.1371/JOURNAL.PMED.1002086
Open DOI Search in Google Scholar Back to article
Chaudhary AK, Sapkota LP, Kumar V. Poisson Gompertz Distribution with properties and applications. Int J Appl Eng Res. 2021;16:75–84. DOI: 10.37622/IJAER/16.1.2021.75-84
Open DOI Search in Google Scholar Back to article
Suthahar N, Bergman RN, de Boer RA. Replacing body mass index with relative fat mass to accurately estimate adiposity. Nat Rev Endocrinol. 2025;21:393–394. DOI: 10.1038/s41574-025-01120-0
Open DOI Search in Google Scholar Back to article
Abildgaard J, Ploug T, Al-Saoudi E, Wagner T, Thomsen C, Ewertsen C, et al. Changes in abdominal subcutaneous adipose tissue phenotype following menopause is associated with increased visceral fat mass. Sci Rep. 2021;11. DOI: 10.1038/s41598-021-94189-2
Open DOI Search in Google Scholar Back to article
Palmer BF, Clegg DJ. The sexual dimorphism of obesity. Mol Cell Endocrinol. 2015;402:113–119. DOI: 10.1016/j.mce.2014.11.029
Open DOI Search in Google Scholar Back to article
Fontana L, Eagon JC, Trujillo ME, Scherer PE, Klein S. Visceral fat adipokine secretion is associated with systemic inflammation in obese humans. Diabetes. 2007;56(4):1010–1013. DOI: 10.2337/db06-1656
Open DOI Search in Google Scholar Back to article
Zarulli V, Salinari G. Gender differences in survival across the ages of life: an introduction. Genus. 2024;80. DOI: 10.1186/s41118-024-00216-1
Open DOI Search in Google Scholar Back to article
Flegal KM, Graubard BI, Williamson DF, Gail MH. Sources of differences in estimates of obesity-associated deaths from first National Health and Nutrition Examination Survey (NHANES I) hazard ratios. Am J Clin Nutr. 2010;91(3):519–527. DOI: 10.3945/ajcn.2009.28222
Open DOI Search in Google Scholar Back to article

Authors

Additional files

Metrics

Articles in this issue

DOI: https://doi.org/10.5334/gh.1558 | Journal eISSN: 2211-8179

Journal RSS Feed

Language: English

Page range: 43 - 43

Submitted on: Oct 20, 2025

Accepted on: May 7, 2026

Published on: May 26, 2026

Published by: Ubiquity Press

In partnership with: Paradigm Publishing Services

Publication frequency: 1 issue per year

Keywords:

adiposity,

life expectancy,

life tables,

cardiovascular diseases

© 2026 Silvia Juliana Trujillo-Cáceres, Annelot P. Smit, Vicente Artola Arita, Marilyne Menassa, H. Susan J. Picavet, Klodian Dhana, Oscar H. Franco, W. M. Monique Verschuren, published by Ubiquity Press
This work is licensed under the Creative Commons Attribution 4.0 License.

Volume 21 (2026): Issue 1