This article is more than 5 years old. Information may no longer be current.
Mortality risk related to high BMI similar for blacks, whites
Increased likelihood of dying early due to high BMI is similar across black and white races, contrary to previous research suggesting the association could be lower for blacks, according to research published in PLOS ONE.
The BMI–mortality relationship differs for smokers and people with prevalent disease compared with healthy people who never smoked, with overweight and obesity strongly associated with higher risk across both races in the latter category.
“For the vast majority of the population that does not smoke, maintaining a healthy body weight is one of the most important things they can do for overall health and longevity,” Alpa V. Patel, PhD, of the American Cancer Society, told Endocrine Today.
Patel and colleagues used data from the society’s prospective Cancer Prevention Study II, which has more than 28 years of follow-up and 891,572 white and 38,119 black men and women enrolled.
“This is the largest study to date to examine the relationship between BMI and mortality in blacks,” Patel said. “While the relationship between obesity and premature mortality has been well documented in whites and Asians, it has not been well characterized for blacks, who have disproportionately higher rates of overweight and obesity.”
The researchers analyzed subgroups defined by smoking, prevalent disease and age, based on height, weight and other information gathered at enrollment. Cox regression was used to estimate multivariable-adjusted RRs and 95% CIs.
During 28 years, there were 434,400 deaths in whites and 18,702 deaths in blacks. Across both races, smoking and prevalent disease status significantly altered BMI–mortality relationship; higher BMI was strongly associated with higher mortality risk among never-smokers without prevalent disease.
At all levels of overweight and obesity, a significantly higher risk for mortality was observed vs. the reference category (BMI, 22.5-24.9 kg/m2), except for black women who had elevated risk without statistical significance in the lower end of overweight.
Absolute mortality rates were higher in blacks than whites within each BMI category, and RRs were similar between race groups for men (P=.20) and women (P=.23).
BMI showed the strongest association with mortality when reported before age 70 years.
“For clinicians, results from this study should reinforce messaging for individuals at any level of overweight or obesity, regardless of race, to lose weight and maintain a healthy body weight, as risk of premature death is higher beginning at any level of overweight and continues to increase as BMI increases,” Patel said. — by Allegra Tiver
Disclosure: The researchers report no relevant financial disclosures.