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Body-mass index and mortality risk in U.S. blacks compared to whites.

ABSTRACT: To compare body-mass index (BMI)-related mortality risk in U.S. Blacks vs. Whites as the relationship appears to differ across race/ethnicity groups.Cross-sectional surveys of nationally representative samples of 11,934 Blacks and 59,741 Whites aged 35-75 in the National Health Interview Survey from 1997 to 2002 with no history of cardiovascular disease (CVD) or cancer were pooled. Mortality follow-up was available through 2006. BMI was calculated from self-reported height and weight. We used adjusted Cox regression analysis to adjust for potential confounders.Over 9 years of follow-up, there were 4303 deaths (1205 among never smokers). Age-adjusted mortality rates were higher in Blacks compared to Whites at BMI < 25 kg/m2 and showed no increase at higher levels of BMI. In men, adjusted hazard ratios for all-cause death rose in a similar fashion across upper BMI quintiles in Blacks and Whites; in women, however, BMI was positively associated with mortality risk in Whites, but inversely associated in Blacks (P interaction = 0.01). Racial disparities were amplified in subsidiary analyses that introduced a 12-month lag for mortality or focused on CVD mortality.The relationship of elevated BMI to mortality appeared weaker in US Blacks than in Whites, especially among women.

SUBMITTER: Jackson CL

PROVIDER: S-EPMC3844096 | biostudies-literature | 2014 Mar

REPOSITORIES: biostudies-literature

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Body-mass index and mortality risk in U.S. blacks compared to whites.

Jackson Chandra L CL Wang Nae-Yuh NY Yeh Hsin-Chieh HC Szklo Moyses M Dray-Spira Rosemary R Brancati Frederick L FL

Obesity (Silver Spring, Md.) 20140211 3

<h4>Objective</h4>To compare body-mass index (BMI)-related mortality risk in U.S. Blacks vs. Whites as the relationship appears to differ across race/ethnicity groups.<h4>Methods</h4>Cross-sectional surveys of nationally representative samples of 11,934 Blacks and 59,741 Whites aged 35-75 in the National Health Interview Survey from 1997 to 2002 with no history of cardiovascular disease (CVD) or cancer were pooled. Mortality follow-up was available through 2006. BMI was calculated from self-repo ...[more]

PMID: 23554375

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Project description:BACKGROUND:Obesity, typically quantified in terms of Body Mass Index (BMI) exceeding threshold values, is considered a leading cause of premature death worldwide. For given body size (BMI), it is recognized that risk is also affected by body shape, particularly as a marker of abdominal fat deposits. Waist circumference (WC) is used as a risk indicator supplementary to BMI, but the high correlation of WC with BMI makes it hard to isolate the added value of WC. METHODS AND FINDINGS:We considered a USA population sample of 14,105 non-pregnant adults (age ? 18) from the National Health and Nutrition Examination Survey (NHANES) 1999-2004 with follow-up for mortality averaging 5 yr (828 deaths). We developed A Body Shape Index (ABSI) based on WC adjusted for height and weight: ABSI ? WC/(BMI(2/3)height(1/2)). ABSI had little correlation with height, weight, or BMI. Death rates increased approximately exponentially with above average baseline ABSI (overall regression coefficient of +33% per standard deviation of ABSI [95% confidence interval: +20%-+48%), whereas elevated death rates were found for both high and low values of BMI and WC. 22% (8%-41%) of the population mortality hazard was attributable to high ABSI, compared to 15% (3%-30%) for BMI and 15% (4%-29%) for WC. The association of death rate with ABSI held even when adjusted for other known risk factors including smoking, diabetes, blood pressure, and serum cholesterol. ABSI correlation with mortality hazard held across the range of age, sex, and BMI, and for both white and black ethnicities (but not for Mexican ethnicity), and was not weakened by excluding deaths from the first 3 yr of follow-up. CONCLUSIONS:Body shape, as measured by ABSI, appears to be a substantial risk factor for premature mortality in the general population derivable from basic clinical measurements. ABSI expresses the excess risk from high WC in a convenient form that is complementary to BMI and to other known risk factors.

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Body-mass index and mortality risk in U.S. blacks compared to whites.

Publications

Body-mass index and mortality risk in U.S. blacks compared to whites.

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