General and dbdominal adiposity and mortality in Mexico City: prospective study of 150 000 adults

BACKGROUND: Some reports suggest that body mass index (BMI) is not strongly associated with mortality in Hispanic populations. OBJECTIVE: To assess the causal relevance of adiposity to mortality in Mexican adults, avoiding reverse causality biases. DESIGN: Prospective study. SETTING: 2 Mexico City districts. PARTICIPANTS: 159 755 adults aged 35 years and older at recruitment, followed for up to 14 years. Participants with a hemoglobin A(1c) level of 7% or greater, diabetes, or other chronic diseases were excluded. MEASUREMENTS: BMI, waist-to-hip ratio, waist circumference, and cause-specific mortality. Cox regression, adjusted for confounders, yielded mortality hazard ratios (HRs) after at least 5 years of follow-up and before age 75 years. RESULTS: Among 115 400 participants aged 35 to