Low anthropometric measures and mortality—results from the Malmö Diet and Cancer Study

Figures & data

Table I. Baseline characteristics.

BMI	Lowest 5%	> 5%–10%	> 10%–25%	> 25%–75%	> 75%
Women (n = 16549)	825	834	2480	8270	4140
BMI	18.7 ± 1.0	20.3 ± 0.3	21.7 ± 0.5	24.8 ± 1.4	31.1 ± 3.3
% Body fat	22.1 ± 3.7	24.7 ± 3.0	26.7 ± 2.9	30.7 ± 3.1	36.1 ± 3.0
WHR	0.76 ± 0.04	0.77 ± 0.04	0.78 ± 0.04	0.79 ± 0.05	0.83 ± 0.06
WC (cm)	64.5 ± 3.9	67.0 ± 3.8	69.7 ± 4.2	76.3 ± 5.8	90.4 ± 9.7
WHHR (m^−1)	0.46 ± 0.03	0.47 ± 0.03	0.47 ± 0.03	0.48 ± 0.03	0.51 ± 0.04
WHtR	0.39 ± 0.02	0.41 ± 0.02	0.42 ± 0.02	0.47 ± 0.04	0.56 ± 0.06
ABSI (m^11/6 kg^−2/3)	0.0714 ± 0.0040	0.0701 ± 0.0037	0.699 ± 0.0038	0.0701 ± 0.0043	0.0717 ± 0.0051
Age	56.1 ± 7.7	55.1 ± 7.4	55.5 ± 7.6	57.5 ± 7.8	59.1 ± 7.8
Low education level (%)	30.2	26.6	29.7	38.5	50.0
Smoking (%)	48.1	34.3	33.4	26.8	21.9
High alcohol intake (%)	1.8	3.0	2.7	2.6	1.9
Low physical activity (%)	24.8	20.3	21.9	22.8	31.5
Married (%)	53.0	57.9	59.4	61.8	61.5
Foreign-born (%)	7.4	9.4	9.7	15.6	11.2
Comorbidities at baseline (%)	17.3	14.6	16.7	19.8	16.4
Men (n = 10304)	513	514	1544	5156	2577
BMI	19.9 ± 1.0	21.6 ± 0.3	23.1 ± 0.5	26.0 ± 1.2	30.7 ± 2.5
% Body fat	15.1 ± 3.7	17.2 ± 3.8	18.2 ± 3.9	20.4 ± 4.0	24.5 ± 5.0
WHR	0.87 ± 0.04	0.89 ± 0.04	0.91 ± 0.05	0.94 ± 0.05	0.99 ± 0.05
WC (cm)	77.5 ± 5.1	82.4 ± 4.4	85.9 ± 4.8	92.8 ± 5.7	105.1 ± 8.0
WHHR (m^−1)	0.49 ± 0.03	0.50 ± 0.03	0.51 ± 0.03	0.53 ± 0.03	0.56 ± 0.04
WHtR	0.44 ± 0.03	0.47 ± 0.02	0.49 ± 0.03	0.53 ± 0.03	0.60 ± 0.04
ABSI (m^11/6 kg^−2/3)	0.079 ± 0.0040	0.080 ± 0.0040	0.080 ± 0.0039	0.080 ± 0.0038	0.081 ± 0.0036
Age	58.5 ± 6.9	58.2 ± 6.9	58.5 ± 7.1	59.2 ± 7.0	59.4 ± 6.9
Low education level (%)	43.7	38.7	40.5	45.5	49.1
Smoking (%)	51.6	39.5	34.5	26.9	22.6
High alcohol intake (%)	8.0	7.6	5.8	7.1	9.0
Low physical activity (%)	27.9	25.1	21.6	24.5	29.0
Married (%)	63.2	68.7	70.2	75.2	71.6
Foreign-born (%)	9.4	8.8	9.1	15.5	11.8
Comorbidities at baseline (%)	9.4	7.8	6.7	12.9	8.5

Values are mean± standard deviation, unless stated otherwise.

ABSI = A Body Shape Index; BMI = body mass index; WC = waist circumference; WHHR = waist-hip-height ratio; WHR = waist-hip ratio; WHtR = waist-height ratio.

Table II. The age-adjusted total mortality risk associated with anthropometric measures.

Cox regression models	Lowest 5% HR (95% CI)	> 5%–10% HR (95% CI)	> 10%–25% HR (95% CI)	> 25%–75% referent	> 75% HR (95% CI)
Women
BMI	1.70 (1.41–2.04)***	1.16 (0.93–1.44)	1.07 (0.93–1.24)	1	1.24 (1.12–1.38)***
% Body fat	1.48 (1.21–1.81)***	1.25 (1.00–1.55)	0.91 (0.78–1.06)	1	1.25 (1.13–1.39)**
WHR	0.85 (0.68–1.06)	0.84 (0.67–1.05)	0.78 (0.68–0.91)**	1	1.37 (1.24–1.51)***
WC	1.20 (0.98–1.48)	0.88 (0.68–1.13)	1.05 (0.91–1.20)	1	1.37 (1.24–1.51)***
WHHR	0.93 (0.73–1.18)	0.91 (0.72–1.16)	0.88 (0.76–1.02)	1	1.42 (1.28–1.56)***
WHtR	1.14 (0.90–1.43)	0.93 (0.72–1.19)	0.88 (0.76–1.03)	1	1.29 (1.17–1.42)***
ABSI	0.67 (0.50–0.89)**	0.81 (0.63–1.04)	0.92 (0.80–1.07)	1	1.59 (1.45–1.76)***
Men
BMI	1.63 (1.37–1.95)***	1.36 (1.13–1.65)**	1.13 (1.00–1.28)	1	1.25 (1.13–1.39)***
% Body fat	1.29 (1.08–1.54)**	1.13 (0.90–1.42)	0.94 (0.83–1.06)	1	1.31 (1.19–1.44)***
WHR	1.01 (0.83–1.22)	0.98 (0.80–1.20)	0.96 (0.84–1.09)	1	1.40 (1.27–1.54)***
WC	1.23 (1.02–1.48)*	1.07 (0.86–1.32)	0.95 (0.83–1.09)	1	1.36 (1.24–1.50)***
WHHR	0.92 (0.75–1.13)	1.08 (0.88–1.30)	0.92 (0.81–1.05)	1	1.30 (1.18–1.44)***
WHtR	1.19 (0.97–1.46)	1.04 (0.85–1.28)	0.95 (0.83–1.08)	1	1.35 (1.23–1.49)***
ABSI	0.78 (0.62–0.98)*	0.74 (0.58–0.93)*	0.82 (0.71–0.94)**	1	1.44 (1.31–1.58)***

The two-sided significance levels are indicated as follows: *P < 0.05, **P < 0.01, and ***P < 0.001.

ABSI = A Body Shape Index; BMI = body mass index; WC = waist circumference; WHR = waist–hip ratio; WHHR = waist–hip–height ratio; WHtR = waist–height ratio.

Table III. Multivariable^a models of the association between anthropometric measures and total mortality.

Cox regression models	Lowest 5% HR (95% CI)	> 5%–10% HR (95% CI)	> 10%–25% HR (95% CI)	> 25%–75% referent	> 75% HR (95% CI)
Women
BMI	1.33 (1.10–1.61)**	1.03 (0.79–1.23)	0.97 (0.84–1.11)	1	1.29 (1.16–1.43)***
% Body fat	1.31 (1.07–1.60)**	1.03 (0.82–1.28)	0.83 (0.71–0.97)*	1	1.31 (1.18–1.45)**
WHR	0.89 (0.71–1.11)	0.89 (0.71–1.19)	0.80 (0.69–0.93)*	1	1.35 (1.22–1.49)***
WC	0.99 (0.81–1.22)	0.77 (0.60–0.99)*	0.98 (0.85–1.12)	1	1.43 (1.29–1.58)***
WHHR	0.91 (0.72–1.16)	0.87 (0.68–1.11)	0.84 (0.73–0.98)*	1	1.48 (1.34–1.63)***
WHtR	0.91 (0.72–1.15)	0.78 (0.60–1.00)	0.78 (0.67–0.90)*	1	1.40 (1.27–1.55)***
ABSI	0.64 (0.48–0.85)*	0.77 (0.60–0.99)*	0.90 (0.78–1.05)	1	1.61 (1.46–1.78)***
Men
BMI	1.27 (1.07–1.52)**	1.18 (0.98–1.43)	1.06 (0.94–1.20)	1	1.19 (1.08–1.32)***
% Body fat	1.25 (1.04–1.50)**	1.09 (0.87–1.38)	0.93 (0.82–1.05)	1	1.26 (1.14–1.39)***
WHR	1.20 (0.99–1.45)	1.05 (0.86–1.28)	0.99 (0.88–1.13)	1	1.24 (1.12–1.37)***
WC	1.11 (0.92–1.34)	0.91 (0.76–1.17)	0.91 (0.79–1.04)	1	1.31 (1.19–1.44)***
WHHR	0.99 (0.81–1.23)	1.13 (0.93–1.37)	0.98 (0.86–1.11)	1	1.25 (1.13–1.37)***
WHtR	0.99 (0.81–1.21)	0.99 (0.81–1.22)	0.93 (0.81–1.06)	1	1.35 (1.23–1.49)***
ABSI	0.83 (0.68–1.07)	0.82 (0.65–1.03)	0.85 (0.72–0.95)*	1	1.45 (1.32–1.59)***

The two-sided significance levels are indicated as follows: *P < 0.05, **P < 0.01, and ***P < 0.001.

ABSI = A Body Shape Index; BMI = body mass index; WC = waist circumference; WHHR = waist–hip–height ratio; WHR = waist–hip ratio; WHtR = waist–height ratio.

^aHRs were adjusted for age, education level, marital status, immigrant status, smoking status, alcohol intake, physical activity level, and comorbidities at baseline.

Table IV. Anthropometric measures BMI, body fat% and cancer, CVD, and other mortality in women.

Women Cox regression models	Lowest 5% HR (95% CI)	> 5%–10% HR (95% CI)	> 10%–25% HR (95% CI)	> 25%–75% referent	> 75% HR (95% CI)
Cancer mortality
BMI Model 1	1.24 (0.93–1.65)	1.10 (0.81–1.49)	1.03 (0.85–1.25)	1	1.12 (0.96–1.29)
BMI Model 2	1.01 (0.76–1.35)	1.02 (0.76–1.39)	0.97 (0.80–1.18)	1	1.13 (0.98–1.32)
% Body fat Model 1	1.45 (1.11–1.89)**	1.04 (0.76–1.42)	0.83 (0.67–1.03)	1	1.05 (0.90–1.22)
% Body fat Model 2	1.27 (0.97–1.66)	0.94 (0.69–1.29)	0.79 (0.64–0.97)	1	1.07 (0.92–1.24)
CVD mortality
BMI Model 1	1.25 (0.82–1.90)	0.83 (0.49–1.39)	0.95 (0.71–1.27)	1	1.37 (1.13–1.65)**
BMI Model 2	0.98 (0.64–1.50)	0.77 (0.46–1.30)	0.90 (0.67–1.20)	1	1.32 (1.09–1.61)**
% Body fat Model 1	0.79 (0.46–1.36)	0.99 (0.59–1.64)	0.92 (0.68–1.24)	1	1.48 (1.12–1.78)***
% Body fat Model 2	0.71 (0.42–1.22)	0.89 (0.53–1.47)	0.89 (0.66–1.21)	1	1.44 (1.19–1.75)***
Other mortality
BMI Model 1	0.99 (0.92–1.07)	0.97 (0.90–1.04)	0.99 (0.95–1.04)	1	1.06 (1.01–1.10)**
BMI Model 2	0.96 (0.88–1.03)	0.95 (0.88–1.02)	0.97 (0.93–1.02)	1	1.08 (1.03–1.12)***
% Body fat Model 1	1.33 (1.23–1.43)***	1.23 (1.15–1.23)***	1.07 (1.02–1.12)**	1	0.99 (0.95–1.04)
% Body fat Model 2	1.28 (1.18–1.37)***	1.20 (1.11–1.29)***	1.05 (1.01–1.11)*	1	1.01 (0.97–1.05)

Model 1: Adjusted for age. Model 2: Adjusted for age, education level, marital status, immigrant status, smoking status, alcohol intake, physical activity level, and comorbidities at baseline.

The two-sided significance levels are indicated as follows: *P < 0.05, **P < 0.01, and ***P < 0.001.

BMI = body mass index.

Table V. Anthropometric measures BMI, body fat% and cancer, CVD, and other mortality in men.

Men	Lowest 5%	> 5%–10%	> 10%–25%	> 25%–75%	> 75%
Cancer mortality
BMI Model 1	1.52 (1.16–1.98)**	1.21 (0.90–1.62)	1.09 (0.91–1.32)	1	1.09 (0.94–1.28)
BMI Model 2	1.21 (0.93–1.59)	1.12 (0.83–1.50)	1.04 (0.86–1.26)	1	1.05 (0.87–1.26)
% Body fat Model 1	1.43 (1.11–1.84)*	1.10 (0.78–1.55)	0.92 (0.76–1.11)	1	1.10 (0.94–1.28)
% Body fat Model 2	1.34 (1.04–1.74)*	1.10 (0.78–1.55)	0.90 (0.75–1.09)	1	1.06 (0.91–1.24)
CVD mortality
BMI Model 1	1.18 (0.83–1.63)	1.28 (0.92–1.78)	1.01 (0.81–1.27)	1	1.42 (1.21–1.67)***
BMI Model 2	0.93 (0.65–1.32)	1.19 (0.85–1.65)	0.95 (0.76–1.19)	1	1.34 (1.13–1.58)***
% Body fat Model 1	1.14 (0.82–1.58)	1.13 (0.76–1.68)	0.88 (0.71–1.10)	1	1.55 (1.32–1.82)***
% Body fat Model 2	1.06 (0.76–1.47)	1.16 (0.78–1.73)	0.88 (0.70–1.09)	1	1.43 (1.22–1.69)***
Other mortality
BMI Model 1	1.10 (1.00–1.22)	1.03 (0.93–1.14)	1.05 (0.98–1.11)	1	1.06 (1.01–1.12)*
BMI Model 2	1.06 (0.96–1.17)	1.01 (0.92–1.12)	1.04 (0.97–1.10)	1	1.04 (0.99–1.10)
% Body fat Model 1	1.23 (1.12–1.36)***	1.07 (0.96–1.21)	1.03 (0.97–1.09)	1	1.03 (0.96–1.06)
% Body fat Model 2	1.22 (1.11–1.34)***	1.08 (0.96–1.21)	1.04 (0.98–1.10)	1	1.00 (0.95–1.05)

Model 1: Adjusted for age. Model 2: Adjusted for age, education level, marital status, immigrant status, smoking status, alcohol intake, physical activity level, and comorbidities at baseline.

The two-sided significance levels are indicated as follows: *P < 0.05, **P < 0.01, and ***P < 0.001.

BMI = body mass index.