Among white adults, larger waist is associated with increased mortality at all levels of body mass index (BMI), according to research published in Mayo Clinic Proceedings (2014;89:335-345).
James R. Cerhan, MD, PhD, of the Mayo Clinic in Rochester, Minn., and colleagues analyzed pooled data from 11 prospective cohort studies for 650,386 white adults, aged 20 to 83 years, to assess the association between waist circumference and mortality.
After multivariable adjustment, men with a waist circumference of 110 cm or more had a 52% increased risk of all-cause mortality than men with a waist circumference less than 90 cm. Each 5 cm increment in waist circumference was associated with a 7% increased risk of all-cause mortality.
Women with a waist circumference of 95 cm or more had an 80% increased risk of all-cause mortality compared with women with a waist circumference less than 70 cm. Each 5 cm increment in waist circumference was associated with a 9% increased risk of all-cause mortality.
Among those with the highest compared with the lowest waist circumference, the estimated decrease in life expectancy was approximately 3 years for men and 5 years for women. The increased risk of mortality per 5-cm increment in waist circumference was similar for both sexes at all body mass index (BMI) levels from 20 to 50 kg/m².
“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,” the authors wrote.