A pooled analysis of waist circumference and mortality in 650,000 adults

James R Cerhan, Steven C. Moore, Eric J. Jacobs, Cari M. Kitahara, Philip S. Rosenberg, Hans Olov Adami, Jon Owen Ebbert, Dallas R. English, Susan M. Gapstur, Graham G. Giles, Pamela L. Horn-Ross, Yikyung Park, Alpa V. Patel, Kim Robien, Elisabete Weiderpass, Walter C. Willett, Alicja Wolk, Anne Zeleniuch-Jacquotte, Patricia Hartge, Leslie Bernstein & 1 others Amy Berrington De Gonzalez

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Abstract

Objectives: To assess the independent effect of waist circumference on mortality across the entire body mass index (BMI) range and to estimate the loss in life expectancy related to a higher waist circumference. Patients and Methods: We pooled data from 11 prospective cohort studies with 650,386 white adults aged 20 to 83 years and enrolled from January 1, 1986, through December 31, 2000. We used proportional hazards regression to estimate hazard ratios (HRs) and 95% CIs for the association of waist circumference with mortality. Results: During a median follow-up of 9 years (maximum, 21 years), 78,268 participants died. After accounting for age, study, BMI, smoking status, alcohol consumption, and physical activity, a strong positive linear association of waist circumference with all-cause mortality was observed for men (HR, 1.52 for waist circumferences of ≥110 vs <90 cm; 95% CI, 1.45-1.59; HR, 1.07 per 5-cm increment in waist circumference; 95% CI, 1.06-1.08) and women (HR, 1.80 for waist circumferences of ≥95 vs <70 cm; 95% CI, 1.70-1.89; HR, 1.09 per 5-cm increment in waist circumference; 95% CI, 1.08-1.09). The estimated decrease in life expectancy for highest vs lowest waist circumference was approximately 3 years for men and approximately 5 years for women. The HR per 5-cm increment in waist circumference was similar for both sexes at all BMI levels from 20 to 50 kg/m2, but it was higher at younger ages, higher for longer follow-up, and lower among male current smokers. The associations were stronger for heart and respiratory disease mortality than for cancer. Conclusions: In white adults, higher waist circumference was positively associated with higher mortality at all levels of BMI from 20 to 50 kg/m 2. Waist circumference should be assessed in combination with BMI, even for those in the normal BMI range, as part of risk assessment for obesity-related premature mortality.

Original languageEnglish (US)
Pages (from-to)335-345
Number of pages11
JournalMayo Clinic Proceedings
Volume89
Issue number3
DOIs
StatePublished - 2014

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Waist Circumference
Mortality
Body Mass Index
Life Expectancy
Premature Mortality
Alcohol Drinking
Heart Diseases
Cohort Studies
Obesity
Smoking
Prospective Studies
Exercise

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Cerhan, J. R., Moore, S. C., Jacobs, E. J., Kitahara, C. M., Rosenberg, P. S., Adami, H. O., ... De Gonzalez, A. B. (2014). A pooled analysis of waist circumference and mortality in 650,000 adults. Mayo Clinic Proceedings, 89(3), 335-345. https://doi.org/10.1016/j.mayocp.2013.11.011

A pooled analysis of waist circumference and mortality in 650,000 adults. / Cerhan, James R; Moore, Steven C.; Jacobs, Eric J.; Kitahara, Cari M.; Rosenberg, Philip S.; Adami, Hans Olov; Ebbert, Jon Owen; English, Dallas R.; Gapstur, Susan M.; Giles, Graham G.; Horn-Ross, Pamela L.; Park, Yikyung; Patel, Alpa V.; Robien, Kim; Weiderpass, Elisabete; Willett, Walter C.; Wolk, Alicja; Zeleniuch-Jacquotte, Anne; Hartge, Patricia; Bernstein, Leslie; De Gonzalez, Amy Berrington.

In: Mayo Clinic Proceedings, Vol. 89, No. 3, 2014, p. 335-345.

Research output: Contribution to journalArticle

Cerhan, JR, Moore, SC, Jacobs, EJ, Kitahara, CM, Rosenberg, PS, Adami, HO, Ebbert, JO, English, DR, Gapstur, SM, Giles, GG, Horn-Ross, PL, Park, Y, Patel, AV, Robien, K, Weiderpass, E, Willett, WC, Wolk, A, Zeleniuch-Jacquotte, A, Hartge, P, Bernstein, L & De Gonzalez, AB 2014, 'A pooled analysis of waist circumference and mortality in 650,000 adults', Mayo Clinic Proceedings, vol. 89, no. 3, pp. 335-345. https://doi.org/10.1016/j.mayocp.2013.11.011
Cerhan, James R ; Moore, Steven C. ; Jacobs, Eric J. ; Kitahara, Cari M. ; Rosenberg, Philip S. ; Adami, Hans Olov ; Ebbert, Jon Owen ; English, Dallas R. ; Gapstur, Susan M. ; Giles, Graham G. ; Horn-Ross, Pamela L. ; Park, Yikyung ; Patel, Alpa V. ; Robien, Kim ; Weiderpass, Elisabete ; Willett, Walter C. ; Wolk, Alicja ; Zeleniuch-Jacquotte, Anne ; Hartge, Patricia ; Bernstein, Leslie ; De Gonzalez, Amy Berrington. / A pooled analysis of waist circumference and mortality in 650,000 adults. In: Mayo Clinic Proceedings. 2014 ; Vol. 89, No. 3. pp. 335-345.
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abstract = "Objectives: To assess the independent effect of waist circumference on mortality across the entire body mass index (BMI) range and to estimate the loss in life expectancy related to a higher waist circumference. Patients and Methods: We pooled data from 11 prospective cohort studies with 650,386 white adults aged 20 to 83 years and enrolled from January 1, 1986, through December 31, 2000. We used proportional hazards regression to estimate hazard ratios (HRs) and 95{\%} CIs for the association of waist circumference with mortality. Results: During a median follow-up of 9 years (maximum, 21 years), 78,268 participants died. After accounting for age, study, BMI, smoking status, alcohol consumption, and physical activity, a strong positive linear association of waist circumference with all-cause mortality was observed for men (HR, 1.52 for waist circumferences of ≥110 vs <90 cm; 95{\%} CI, 1.45-1.59; HR, 1.07 per 5-cm increment in waist circumference; 95{\%} CI, 1.06-1.08) and women (HR, 1.80 for waist circumferences of ≥95 vs <70 cm; 95{\%} CI, 1.70-1.89; HR, 1.09 per 5-cm increment in waist circumference; 95{\%} CI, 1.08-1.09). The estimated decrease in life expectancy for highest vs lowest waist circumference was approximately 3 years for men and approximately 5 years for women. The HR per 5-cm increment in waist circumference was similar for both sexes at all BMI levels from 20 to 50 kg/m2, but it was higher at younger ages, higher for longer follow-up, and lower among male current smokers. The associations were stronger for heart and respiratory disease mortality than for cancer. Conclusions: In white adults, higher waist circumference was positively associated with higher mortality at all levels of BMI from 20 to 50 kg/m 2. Waist circumference should be assessed in combination with BMI, even for those in the normal BMI range, as part of risk assessment for obesity-related premature mortality.",
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AU - Cerhan, James R

AU - Moore, Steven C.

AU - Jacobs, Eric J.

AU - Kitahara, Cari M.

AU - Rosenberg, Philip S.

AU - Adami, Hans Olov

AU - Ebbert, Jon Owen

AU - English, Dallas R.

AU - Gapstur, Susan M.

AU - Giles, Graham G.

AU - Horn-Ross, Pamela L.

AU - Park, Yikyung

AU - Patel, Alpa V.

AU - Robien, Kim

AU - Weiderpass, Elisabete

AU - Willett, Walter C.

AU - Wolk, Alicja

AU - Zeleniuch-Jacquotte, Anne

AU - Hartge, Patricia

AU - Bernstein, Leslie

AU - De Gonzalez, Amy Berrington

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N2 - Objectives: To assess the independent effect of waist circumference on mortality across the entire body mass index (BMI) range and to estimate the loss in life expectancy related to a higher waist circumference. Patients and Methods: We pooled data from 11 prospective cohort studies with 650,386 white adults aged 20 to 83 years and enrolled from January 1, 1986, through December 31, 2000. We used proportional hazards regression to estimate hazard ratios (HRs) and 95% CIs for the association of waist circumference with mortality. Results: During a median follow-up of 9 years (maximum, 21 years), 78,268 participants died. After accounting for age, study, BMI, smoking status, alcohol consumption, and physical activity, a strong positive linear association of waist circumference with all-cause mortality was observed for men (HR, 1.52 for waist circumferences of ≥110 vs <90 cm; 95% CI, 1.45-1.59; HR, 1.07 per 5-cm increment in waist circumference; 95% CI, 1.06-1.08) and women (HR, 1.80 for waist circumferences of ≥95 vs <70 cm; 95% CI, 1.70-1.89; HR, 1.09 per 5-cm increment in waist circumference; 95% CI, 1.08-1.09). The estimated decrease in life expectancy for highest vs lowest waist circumference was approximately 3 years for men and approximately 5 years for women. The HR per 5-cm increment in waist circumference was similar for both sexes at all BMI levels from 20 to 50 kg/m2, but it was higher at younger ages, higher for longer follow-up, and lower among male current smokers. The associations were stronger for heart and respiratory disease mortality than for cancer. Conclusions: In white adults, higher waist circumference was positively associated with higher mortality at all levels of BMI from 20 to 50 kg/m 2. Waist circumference should be assessed in combination with BMI, even for those in the normal BMI range, as part of risk assessment for obesity-related premature mortality.

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