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Highlights We examined a large middle-aged population-based cohort, excluding participants with prevalent cancer, endocrine and metabolic conditions, and severe illnesses. Body mass index (BMI) was associated positively with platelet count in women (strongest in pre-menopausal women) and inversely in men (strongest in older men), but inversely with platelet size in pre-menopausal women and positively in post-menopausal women and men. Alcohol consumption and smoking shifted the association of BMI with platelet count towards the null for women and towards a stronger inverse association for men, but did not affect the associations with waist or hip size. Waist size was associated positively with platelet count in women and men, with only a weak inverse association for hip size. Waist size was associated inversely and hip size positively with platelet size, mainly in women.