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Increasing obesity raises risk for death among black women

Boggs DA. N Engl J Med. 2011;365:901-908.

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Black women with a BMI of more than 25 or a waist circumference of more than 35 inches have a higher risk for dying from any cause, researchers found.

Data collected from 1995 to 2008 on 51,695 black women aged 21 to 69 years who participated in the Black Women’s Health Study suggest that high BMI correlates with increased risk for death. During the study, 1,773 deaths occurred among 33,916 nonsmokers. The researchers determined that, among nonsmokers, black women with BMIs between 20 and 24.9 had the lowest risk for death from any cause.

However, results linked a 5-unit increase in BMI to an 18% increase in risk for death among black women with a BMI of at least 20, according to the study results. Compared with a BMI between 22.5 and 24.9, multivariable-adjusted HRs were:

• 1.12 (95% CI, 0.87-1.44) for a BMI between 25 and 27.4.
• 1.31 (95% CI, 1.01-1.72) for a BMI between 27.5 and 29.9.
• 1.27 (95% CI, 0.99-1.64) for a BMI between 30 and 34.9.
• 1.51 (95% CI, 1.13-2.02) for a BMI between 35 and 39.9.
• 2.19 (95% CI, 1.62-2.95) for a BMI between 40 and 49.9.

After adjusting for all covariates except BMI, the researchers noted a connection between larger waist circumference and increased risk for death among nonsmoking black women. For example, compared with a waist circumference of 26 to 27 inches, HRs were 1.05 (95% CI, 0.74-1.49) for a waist circumference ranging from 28 to 29 inches and 1.75 (95% CI, 1.17-2.61) for a waist circumference between 40 and 47 inches. Adjusting for BMI altered these numbers, the researchers said, with the HR for the highest waist circumference category then decreasing to 1.4 (95% CI, 0.9-2.19). Excluding women with waist circumferences of less than 26 inches and after again adjusting for BMI, a 5-unit increase correlated with a 12% increase in risk for death, according to the study results.

The researchers also noted, however, that waist circumference of at least 35 inches raised the risk for death from any cause in women with BMIs less than 30 (HR=1.55; 95% CI, 1.17-2.06), but not among women with BMIs of more than 30 (HR=1.07; 95% CI, 0.82-1.4).

Disclosure: The researchers report no relevant financial disclosures.

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