Weight, shape and mortality risk in older persons: elevated Waist Hip Ratio, not high Body Mass Index, is associated with a greater risk of death

Price, Gill M., Uauy, Ricardo, Breeze, Elizabeth, Bulpitt, Christopher J. and Fletcher, Astrid E. (2006) Weight, shape and mortality risk in older persons: elevated Waist Hip Ratio, not high Body Mass Index, is associated with a greater risk of death. American Journal of Clinical Nutrition, 84 (2). pp. 449-460. ISSN 1938-3207

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Abstract

Background: Guidelines for optimal weight in older persons are limited by uncertainty about the ideal body mass index (BMI) or the usefulness of alternative anthropometric measures. Objective: We investigated the association of BMI (in kg/m2), waist circumference, and waist-hip ratio (WHR) with mortality and cause-specific mortality. Design: Subjects aged ≥75 y (n = 14 833) from 53 family practices in the United Kingdom underwent a health assessment that included measurement of BMI and waist and hip circumferences; they also were followed up for mortality. Results: During a median follow-up of 5.9 y, 6649 subjects died (46% of circulatory causes). In nonsmoking men and women (90% of the cohort), compared with the lowest quintile of BMI (<23 in men and <22.3 in women), adjusted hazard ratios (HRs) for mortality were <1 for all other quintiles of BMI (P for trend = 0.0003 and 0.0001 in men and women, respectively). Increasing WHR was associated with increasing HRs in men and women (P for trend = 0.008 and 0.0002, respectively). BMI was not associated with circulatory mortality in men (P for trend = 0.667) and was negatively associated in women (P for trend = 0.004). WHR was positively related to circulatory mortality in both men and women (P for trend = 0.001 and 0.005, respectively). Waist circumference was not associated with all-cause or circulatory mortality. Conclusions: Current guidelines for BMI-based risk categories overestimate risks due to excess weight in persons aged ≥75 y. Increased mortality risk is more clearly indicated for relative abdominal obesity as measured by high WHR.

Item Type:	Article
Faculty \ School:	Faculty of Medicine and Health Sciences > Norwich Medical School
UEA Research Groups:	Faculty of Medicine and Health Sciences > Research Groups > Health Services and Primary Care Faculty of Medicine and Health Sciences > Research Groups > Public Health and Health Services Research (former - to 2023) Faculty of Medicine and Health Sciences > Research Groups > Epidemiology and Public Health
Depositing User:	EPrints Services
Date Deposited:	25 Nov 2010 11:10
Last Modified:	12 Jun 2023 12:35
URI:	https://ueaeprints.uea.ac.uk/id/eprint/13482
DOI:	10.1093/ajcn/84.2.449

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