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Waist circumference, BMI, smoking, and mortality in middle-aged men and women.
Obes Res 2003; 11(7):895-903OR

Abstract

OBJECTIVE

Measurement of waist circumference alone as a proxy of abdominal fat mass has been suggested as a simple clinical alternative to BMI for detecting adults with possible health risks due to obesity.

RESEARCH METHODS AND PROCEDURES

From 1993 to 1997, 27,178 men and 29,875 women, born in Denmark, 50 to 64 years of age, were recruited in the Danish prospective study Diet, Cancer and Health. By the end of the year 2000, 1465 deaths had occurred. We evaluated the relationship between waist circumference and BMI (simultaneously included in the model) and all-cause mortality. We used Cox regression models to estimate the mortality-rate ratios and to consider possible confounding from smoking.

RESULTS

Waist circumference among both men and women showed a strong dose-response type of relationship with mortality when adjusted for BMI, whereas the low range of BMI was inversely associated with mortality when adjusted for waist circumference. A 10% larger waist circumference corresponded to a 1.48 (95% confidence interval: 1.36 to 1.61) times higher mortality over the whole range of waist circumference. The associations were independent of age and time since baseline examination. Restriction to never smokers showed a similar pattern, but a weakening of the associations.

DISCUSSION

Despite the high correlation between waist circumference and BMI, the combination may be very relevant in clinical practice because waist circumference for given BMI was a strong predictor of all-cause mortality. The inverse association between BMI and mortality for given waist circumference was diminished in never smokers, particularly for high values of BMI.

Authors+Show Affiliations

Institute of Cancer Epidemiology, The Danish Cancer Society, Copenhagen, Denmark. janne@cancer.dkNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

12855760

Citation

Bigaard, Janne, et al. "Waist Circumference, BMI, Smoking, and Mortality in Middle-aged Men and Women." Obesity Research, vol. 11, no. 7, 2003, pp. 895-903.
Bigaard J, Tjønneland A, Thomsen BL, et al. Waist circumference, BMI, smoking, and mortality in middle-aged men and women. Obes Res. 2003;11(7):895-903.
Bigaard, J., Tjønneland, A., Thomsen, B. L., Overvad, K., Heitmann, B. L., & Sørensen, T. I. (2003). Waist circumference, BMI, smoking, and mortality in middle-aged men and women. Obesity Research, 11(7), pp. 895-903.
Bigaard J, et al. Waist Circumference, BMI, Smoking, and Mortality in Middle-aged Men and Women. Obes Res. 2003;11(7):895-903. PubMed PMID: 12855760.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Waist circumference, BMI, smoking, and mortality in middle-aged men and women. AU - Bigaard,Janne, AU - Tjønneland,Anne, AU - Thomsen,Birthe Lykke, AU - Overvad,Kim, AU - Heitmann,Berit Lilienthal, AU - Sørensen,Thorkild I A, PY - 2003/7/12/pubmed PY - 2003/10/28/medline PY - 2003/7/12/entrez SP - 895 EP - 903 JF - Obesity research JO - Obes. Res. VL - 11 IS - 7 N2 - OBJECTIVE: Measurement of waist circumference alone as a proxy of abdominal fat mass has been suggested as a simple clinical alternative to BMI for detecting adults with possible health risks due to obesity. RESEARCH METHODS AND PROCEDURES: From 1993 to 1997, 27,178 men and 29,875 women, born in Denmark, 50 to 64 years of age, were recruited in the Danish prospective study Diet, Cancer and Health. By the end of the year 2000, 1465 deaths had occurred. We evaluated the relationship between waist circumference and BMI (simultaneously included in the model) and all-cause mortality. We used Cox regression models to estimate the mortality-rate ratios and to consider possible confounding from smoking. RESULTS: Waist circumference among both men and women showed a strong dose-response type of relationship with mortality when adjusted for BMI, whereas the low range of BMI was inversely associated with mortality when adjusted for waist circumference. A 10% larger waist circumference corresponded to a 1.48 (95% confidence interval: 1.36 to 1.61) times higher mortality over the whole range of waist circumference. The associations were independent of age and time since baseline examination. Restriction to never smokers showed a similar pattern, but a weakening of the associations. DISCUSSION: Despite the high correlation between waist circumference and BMI, the combination may be very relevant in clinical practice because waist circumference for given BMI was a strong predictor of all-cause mortality. The inverse association between BMI and mortality for given waist circumference was diminished in never smokers, particularly for high values of BMI. SN - 1071-7323 UR - https://www.unboundmedicine.com/medline/citation/12855760/Waist_circumference_BMI_smoking_and_mortality_in_middle_aged_men_and_women_ L2 - https://doi.org/10.1038/oby.2003.123 DB - PRIME DP - Unbound Medicine ER -