Obesity and overall mortality: findings from the Jackson Heart Study
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 parado...
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| Language: | English |
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BMC
2021-01-01
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| Series: | BMC Public Health |
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| Online Access: | https://doi.org/10.1186/s12889-020-10040-9 |
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| author | Yuan-I Min Yan Gao Pramod Anugu Anshul Anugu Adolfo Correa |
| author_facet | Yuan-I Min Yan Gao Pramod Anugu Anshul Anugu Adolfo Correa |
| author_sort | Yuan-I Min |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-12-17T00:28:27Z |
| format | Article |
| id | doaj.art-bf8cbe627320415ba080362bd1b1006f |
| institution | Directory Open Access Journal |
| issn | 1471-2458 |
| language | English |
| last_indexed | 2024-12-17T00:28:27Z |
| publishDate | 2021-01-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Public Health |
| spelling | doaj.art-bf8cbe627320415ba080362bd1b1006f2022-12-21T22:10:24ZengBMCBMC Public Health1471-24582021-01-0121111010.1186/s12889-020-10040-9Obesity and overall mortality: findings from the Jackson Heart StudyYuan-I Min0Yan Gao1Pramod Anugu2Anshul Anugu3Adolfo Correa4The Jackson Heart Study, University of Mississippi Medical CenterThe Jackson Heart Study, University of Mississippi Medical CenterThe Jackson Heart Study, University of Mississippi Medical CenterThe Jackson Heart Study, University of Mississippi Medical CenterThe Jackson Heart Study, University of Mississippi Medical CenterAbstract 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.https://doi.org/10.1186/s12889-020-10040-9ObesityBody mass indexWaist circumferenceWaist-to-height ratioWaist-to-hip ratioMortality |
| spellingShingle | Yuan-I Min Yan Gao Pramod Anugu Anshul Anugu Adolfo Correa Obesity and overall mortality: findings from the Jackson Heart Study BMC Public Health Obesity Body mass index Waist circumference Waist-to-height ratio Waist-to-hip ratio Mortality |
| title | Obesity and overall mortality: findings from the Jackson Heart Study |
| title_full | Obesity and overall mortality: findings from the Jackson Heart Study |
| title_fullStr | Obesity and overall mortality: findings from the Jackson Heart Study |
| title_full_unstemmed | Obesity and overall mortality: findings from the Jackson Heart Study |
| title_short | Obesity and overall mortality: findings from the Jackson Heart Study |
| title_sort | obesity and overall mortality findings from the jackson heart study |
| topic | Obesity Body mass index Waist circumference Waist-to-height ratio Waist-to-hip ratio Mortality |
| url | https://doi.org/10.1186/s12889-020-10040-9 |
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