Obesity (Silver Spring). 2013 Mar 30. doi: 10.1002/oby.20471. [Epub ahead of print]
Body-mass index and mortality risk in US blacks compared to whites.
Source
Department of Nutrition, Harvard School of Public Health, Boston, MA, USA.
Abstract
Objective: To compare body-mass index (BMI)-related mortality risk in US Blacks vs. Whites as the relationship appears to differ across race/ethnicity groups. Design and Methods: We pooled cross-sectional surveys of nationally representative samples of 11,934 Blacks and 59,741 Whites aged 35-75 in the National Health Interview Survey from 1997-2002 with no history of cardiovascular disease or cancer. Mortality follow-up was available through 2006. BMI was calculated from self-reported height and weight. We used adjusted Cox regression analysis to adjust for potential confounders. Results: Over 9 years of follow-up, there were 4,303 deaths (1,205 among never smokers). Age-adjusted mortality rates were higher in Blacks compared to Whites at BMI < 25 kg/m2 and showed no increase at higher levels of BMI. In men, adjusted hazard ratios for all-cause death rose in a similar fashion across upper BMI quintiles in Blacks and Whites; in women, however, BMI was positively associated with mortality risk in Whites, but inversely associated in Blacks (p interaction = 0.01). Racial disparities were amplified in subsidiary analyses that introduced a 12-month lag for mortality or focused on CVD mortality. Conclusions: The relationship of elevated BMI to mortality appears weaker in US Blacks than in Whites, especially among women.
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