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Obesity and overall mortality: findings from the Jackson Heart Study
- Source :
- BMC Public Health, BMC Public Health, Vol 21, Iss 1, Pp 1-10 (2021)
- Publication Year :
- 2021
- Publisher :
- BioMed Central, 2021.
-
Abstract
- Background Overall mortality has been reported to be lower among individuals classified as overweight/obese when compared with their normal weight counterparts (“obesity paradox”) when obesity classification is based on the body mass index (BMI). One possible reason for this apparent paradox is that BMI is not a reliable measure of obesity-related risk as it does not differentiate fat mass from lean muscle mass or fat mass phenotypes. Waist circumference (WC), as a measure of central adiposity, may be a better indicator of obesity-related risk. We examined the association of overall mortality with BMI and with WC measures, including WC, waist-to-height ratio (WHtR) and waist-to-hip ratio (WHR). Methods Data from 3976 African American participants (551 deaths) in the Jackson Heart Study (JHS) were analyzed. Cox regression models were used to perform survival analysis. Obesity measures were analyzed as dichotomous (obese/non-obese) and continuous variables. Baseline covariates included age, sex and smoking status. Results Comparing obese to non-obese participants, adjusted hazard ratios (95% CI) for overall mortality were 1.14 (0.96, 1.35), 1.30 (1.07, 1.59), 1.02 (0.73, 1.41) and 1.45 (1.18, 1.79) when using BMI, WC, WHtR and WHR, respectively. For BMI, WC and WHtR, a J-shaped relationship was observed with overall mortality. For WHR, a monotonic increasing relationship was observed with overall mortality. Conclusions In the JHS, we found that obesity as defined by WC and WHR was associated with an increased risk of overall and CVD mortality, while obesity defined by BMI was associated only with an increased risk of CVD mortality. WHR was the only obesity measure that showed a monotonic increasing relationship with overall and CVD mortality.
- Subjects :
- Waist
Cardiovascular mortality
030209 endocrinology & metabolism
Cancer mortality
Overweight
Waist-to-height ratio
Body Mass Index
03 medical and health sciences
0302 clinical medicine
Waist–hip ratio
Classification of obesity
Risk Factors
medicine
Overall mortality
Humans
030212 general & internal medicine
Obesity
Longitudinal Studies
Mortality
business.industry
Waist-Hip Ratio
lcsh:Public aspects of medicine
Waist-to-hip ratio
Public Health, Environmental and Occupational Health
nutritional and metabolic diseases
lcsh:RA1-1270
medicine.disease
Waist circumference
medicine.symptom
business
Body mass index
Obesity paradox
Demography
Research Article
Subjects
Details
- Language :
- English
- ISSN :
- 14712458
- Volume :
- 21
- Database :
- OpenAIRE
- Journal :
- BMC Public Health
- Accession number :
- edsair.doi.dedup.....308b9b3b92123cd7255e1257fac147ac