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Abstract
Aim. To study the association between anthropometric measures: body mass index (BMI), percent body fat, waist circumference (WC), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR), waist-to-hip-to-height ratio (WHHR), and A Body Shape Index (ABSI); to see if individuals in the lowest 5 percentiles for these measures have an increased risk of mortality.
Methods. A population-based prospective cohort study (10,304 men and 16,549 women), the Malmö Diet and Cancer study (MDC), aged 45–73 years.
Results. During a mean follow-up of 14 ± 3 years, 2,224 men and 1,983 women died. There was a significant increased mortality risk after adjustments for potential confounders in the group with the 5% lowest BMI (referent 25%–75%); hazard ratios (HR) with 95% confidence intervals were 1.33 (1.10–1.61) for women and 1.27 (1.07–1.52) for men. A similar significant increased mortality risk was seen with the 5% lowest percent body fat, HR 1.31 (1.07–1.60) for women and 1.25 (1.04–1.50) for men. Women with an ABSI in the lowest 5 percentiles had a lower mortality risk HR 0.64 (0.48–0.85).
Conclusion. These results imply that BMI or percent body fat could be used to identify lean individuals at increased mortality risk.
Funding: The Malmö Diet and Cancer study was supported by grants from the Swedish Medical Research Council, the Swedish Heart and Lung Foundation, and by funds from the Region Skåne, Skåne University Hospital, Malmö, and Lundströms Foundation.
Declaration of interest: The study was investigator-initiated and -driven. The authors report no conflicts of interests in connection with this study. I.W. is employed by Executive Health AB.