Article

Body mass index and mortality rate among Hispanic adults: a pooled analysis of multiple epidemiologic data sets.

Division of Rheumatology, Johns Hopkins University School of Medicine, Baltimore, MD 21224, USA.
International journal of obesity (2005) (Impact Factor: 5.39). 10/2011; 36(8):1121-6. DOI: 10.1038/ijo.2011.194
Source: PubMed

ABSTRACT To evaluate the association between body mass index (BMI, kg m⁻²) and mortality rate among Hispanic adults.
Analysis of five data sets (total N=16,798) identified after searching for publicly available, prospective cohort data sets containing relevant information for at least 500 Hispanic respondents (≥18 years at baseline), at least 5 years of mortality follow-up, and measured height and weight. Data sets included the third National Health and Nutrition Examination Survey, the Puerto Rico Heart Health Program (PRHHP), the Hispanic Established Population for Epidemiologic Studies of the Elderly (HEPESE), the San Antonio Heart Study (SAHS) and the Sacramento Area Latino Study on Aging.
Cox proportional hazards regression models, adjusting for sex and smoking, were fit within three attained-age strata (18 to younger than 60 years, 60 to younger than 70 years, and 70 years and older). We found that underweight was associated with elevated mortality rate for all age groups in the PRHHP (hazard ratios [HRs]=1.38-1.60) and the SAHS (HRs=1.88-2.51). Overweight (HRs=0.38 and 0.84) and obesity grade 2-3 (HRs=0.75 and 0.60) associated with reduced mortality rate in the HEPESE dataset for those in the 60 to younger than 70 years, and 70 years and older attained-age strata. Weighted estimates combining the HRs across the data sets revealed a similar pattern.
Among Hispanic adults, there was no clear evidence that overweight and obesity associate with elevated mortality rate.

0 Followers
 · 
112 Views
  • [Show abstract] [Hide abstract]
    ABSTRACT: Objective It is debatable if the strength of obesity–mortality association depends on age. The objective of this study was to investigate the influence of age on the obesity–mortality association in men and women, and to assess if adjusting for major confounding factors altered the age-dependent trend of the obesity–mortality association. Design and methods Articles were identified by searches of PubMed through 15 August 2013. Twenty studies which reported two or more age-specific effect estimates were identified. A random-effect approach was applied to estimate pooled effect sizes for different age groups. Results There was a significant heterogeneity among studies within each age group in the effect estimates for the association between obesity and mortality. The pooled hazard ratio estimates decreased with increasing age from 1.59 (95% confidence interval, 1.46–1.72) for men and 1.60 (1.49–1.72) for women under 35 years to 1.11 (1.08–1.15) for men and 1.11 (1.09–1.14) for women 75 years or older. On average, the effect estimate was decreased by about 10% with every 10 years increase in age. Conclusions Adjusting for known confounding factors of smoking, pre-existing illness, hypertension and diabetes has little impact on the age-dependent decline trend of the obesity–mortality association. Therefore, the strength of the association between obesity and mortality weakens with increasing age.
    Obesity Research & Clinical Practice 03/2014; 9(1). DOI:10.1016/j.orcp.2014.01.006 · 0.70 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Objective Abdominal obesity is considered to be a risk factor for mortality. However, recent studies indicate that overweight may be negatively associated with mortality (“obesity paradox”). The relationships between mortality and various obesity markers in an elderly Asian cohort were evaluated.Methods Subjects of the Korean Longitudinal Study on Health and Aging (KLoSHA) (n = 1000, age ≥65 years) were included. The visceral fat area (VFA) and subcutaneous fat area (SFA) were measured using computed tomography.ResultsA total of 222 deaths occurred during the 6-year follow-up (median = 5.2 [range 0.1–6.3] years). Body mass index (BMI), VFA, SFA, and total fat mass were negatively associated with all-cause mortality in the univariable analyses (hazard ratio [HR] 0.67 per 1 SD [95% CI 0.57-0.77], 0.66 [0.55-0.79], 0.73 [0.61-0.86], and 0.74 [0.63-0.87], respectively). BMI and VFA were significantly associated with all-cause mortality in the multivariable analyses (HR 0.85 per 1 SD [95% CI 0.73-0.99] and 0.64 [0.47-0.87], respectively). When stratified by quartiles, the HR associated with VFA was the lowest in the third quartile.Conclusions In this observational study with a short follow-up of elderly Asian people, higher amounts of visceral fat, a marker for central obesity, were associated with decreased all-cause mortality.
    Obesity 01/2015; 23(1). DOI:10.1002/oby.20914 · 4.39 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: We present three considerations in analysing the association between weight and mortality, as well as other relations that might be non-linear in nature. First, authors must graphically plot their independent and dependent variables in a continuous manner. Second, authors should assess the shape of that relation, and note its shape. If it is non-linear, and specifically, J-shaped or U-shaped, careful consideration should be given to using the 'best' statistical model, of which multivariate fractional polynomial regression is a reasonable choice. Authors should also refrain from truncating their data to avoid dealing with non-linear relations.
    Journal of epidemiology and community health 03/2014; 68(7). DOI:10.1136/jech-2013-203439 · 3.29 Impact Factor