Body Mass Index (BMI) has been used as an indicator of various health conditions for many decades.1 However, a multitude of other factors may affect health risks but are not typically utilized when assessing for mortality risk associated with various BMI categories. 2,3
The article, “Body Mass Index, Waist Circumference, and Mortality in a Large Multiethnic Postmenopausal Cohort-Results from the Women’s Health Initiative,” was recently published in the Journal of Geriatrics Society, discussed the need to include age, race, and ethnicity in conjunction with BMI ranges in postmenopausal women in order to more accurately predict health outcomes and mortality risk.4
Excess weight is associated with an increase in mortality but how that affects different age groups, races and ethnicity is not fully understood. BMI, or the ratio of height to weight, is a common measurement used to indirectly assess body composition. Another indirect assessment is waist circumference (WC) measurement and it may be a better predictor of health concerns, as central adiposity has been shown to be associated with greater disease risk.
Dr. Zhao Chen and researchers from the University of Arizona and Ohio State University, analyzed data from the Women’s Health Initiative (WHI), an observational study and set of clinical trials involving 161,808 generally healthy postmenopausal women. Chen et al, evaluated a cohort of women for BMI, waist circumference, age, race and ethnicity and associations with mortality risk.
While BMI has long been used to assess for and predict health outcomes and mortality risk associated with body composition, this analysis indicates that other factors should also be considered. Physicians should factor in WC and patient ethnicity as well as BMI when assessing mortality risk in their under and overweight patients. 3,4
Why is this clinically important?
- WC, age, race, and ethnicity along with BMI may be more accurate factors when assessing mortality risk in under and overweight patients3.4
- Underweight and high central obesity were seen to be significant risk factors for mortality in older women4
- Assessing Your Weight and Health Risk. NHLBI.NIH.gov. 2017. Available at: https://www.nhlbi.nih.gov/health/educational/lose_wt/risk.htm. Accessed March 13, 2017.
- Body Mass Index (BMI) | Healthy Weight | CDC. CCD.gov. 2017. Available at: https://www.cdc.gov/healthyweight/assessing/bmi/. Accessed March 13, 2017.
- Ethnic Differences in BMI and Disease Risk. Obesity Prevention Source. 2017. Available at: https://www.hsph.harvard.edu/obesity-prevention-source/ethnic-differences-in-bmi-and-disease-risk/. Accessed March 13, 2017.
- Chen Z, Klimentidis Y, Bea J et al. Body Mass Index, Waist Circumference, and Mortality in a Large Multiethnic Postmenopausal Cohort-Results from the Women’s Health Initiative. Journal of the American Geriatrics Society. 2017. doi:10.1111/jgs.14790.