In the Journals

Obesity linked to increased mortality risk in Hispanic adults

General adiposity and abdominal adiposity were strongly linked to premature death in Mexican adults, according to a study published in the Annals of Internal Medicine.

The findings contrast previous studies that found overweight and obesity were not linked to an increased risk for all-cause mortality among Hispanic adults, known as the Hispanic obesity paradox, according to study authors.

“Studies limiting the effects of reverse causality are needed to clarify the causal relevance of overweight and obesity to mortality in Hispanic populations, and to investigate whether, given BMI, indices of abdominal obesity, such as waist-to-hip ratio, have substantial further relevance to mortality,” Louisa Gnatiuc, MSc, of the University of Oxford, United Kingdom, and Jesus Alegre-Diaz, MD, of the National Autonomous University of Mexico, Mexico City, and colleagues wrote.

Researchers reviewed data from those who participated in the Mexico City Prospective Study between 1998 and 2004 from two of the city’s districts. In addition to basic characteristics, researchers also reviewed participants’ weight, height, and waist circumference and and waist-to-hip ratio and calculated their BMIs.

The Mexican electronic death registry was used to monitor participant mortality through January 1, 2016.

Those who had HbA1c levels of 7% or higher or had been previously diagnosed with diabetes, renal disease and other conditions were excluded from the study.

A total of 115,400 patients aged 35 to less than 75 years were included in the study. The mean BMI was 28 kg/m2 among men and 29.6 kg/m2 among women.

For BMIs more than 25 kg/m2, each 5-kg/m2 increase was tied to a 30% increase in risk for all-cause mortality (HR = 1.3; 95% CI, 1.24-1.36). The link was stronger in those aged 40 to 59 years (HR = 1.4; 95% CI, 1.3-1.49) than in those aged 60 to 74 years (HR = 1.24; 95% CI, 1.17-1.31). The association between mortality and BMI was not affected by sex, smoking status, education, physical activity or alcohol intake.

Researchers found that the link between mortality and waist-to-hip ratio was similar to that between mortality and BMI. The associations were only slightly decreased after adjusting each for the other, suggesting that they were mostly independent of each other.

Waist circumference was strongly associated with mortality, even after adjusting for BMI and hip circumference.

“Although we assessed only mortality, our ndings suggest that even a moderate population-wide reduction in average adiposity levels might substantially reduce both morbidity and mortality in middle age,” Gnatiuc, Alegre-Diaz and colleagues wrote. “In addition to their relevance to Mexico's population, these ndings are likely to be relevant to other Hispanic groups, including millions of Mexican Americans (because they refute earlier suggestions of a Hispanic obesity paradox).” – by Erin Michael

Disclosures: Gnatiuc and Alegre-Diaz report no relevant financial disclosures. Please see study for all other authors’ relevant financial disclosures.

General adiposity and abdominal adiposity were strongly linked to premature death in Mexican adults, according to a study published in the Annals of Internal Medicine.

The findings contrast previous studies that found overweight and obesity were not linked to an increased risk for all-cause mortality among Hispanic adults, known as the Hispanic obesity paradox, according to study authors.

“Studies limiting the effects of reverse causality are needed to clarify the causal relevance of overweight and obesity to mortality in Hispanic populations, and to investigate whether, given BMI, indices of abdominal obesity, such as waist-to-hip ratio, have substantial further relevance to mortality,” Louisa Gnatiuc, MSc, of the University of Oxford, United Kingdom, and Jesus Alegre-Diaz, MD, of the National Autonomous University of Mexico, Mexico City, and colleagues wrote.

Researchers reviewed data from those who participated in the Mexico City Prospective Study between 1998 and 2004 from two of the city’s districts. In addition to basic characteristics, researchers also reviewed participants’ weight, height, and waist circumference and and waist-to-hip ratio and calculated their BMIs.

The Mexican electronic death registry was used to monitor participant mortality through January 1, 2016.

Those who had HbA1c levels of 7% or higher or had been previously diagnosed with diabetes, renal disease and other conditions were excluded from the study.

A total of 115,400 patients aged 35 to less than 75 years were included in the study. The mean BMI was 28 kg/m2 among men and 29.6 kg/m2 among women.

For BMIs more than 25 kg/m2, each 5-kg/m2 increase was tied to a 30% increase in risk for all-cause mortality (HR = 1.3; 95% CI, 1.24-1.36). The link was stronger in those aged 40 to 59 years (HR = 1.4; 95% CI, 1.3-1.49) than in those aged 60 to 74 years (HR = 1.24; 95% CI, 1.17-1.31). The association between mortality and BMI was not affected by sex, smoking status, education, physical activity or alcohol intake.

Researchers found that the link between mortality and waist-to-hip ratio was similar to that between mortality and BMI. The associations were only slightly decreased after adjusting each for the other, suggesting that they were mostly independent of each other.

Waist circumference was strongly associated with mortality, even after adjusting for BMI and hip circumference.

“Although we assessed only mortality, our ndings suggest that even a moderate population-wide reduction in average adiposity levels might substantially reduce both morbidity and mortality in middle age,” Gnatiuc, Alegre-Diaz and colleagues wrote. “In addition to their relevance to Mexico's population, these ndings are likely to be relevant to other Hispanic groups, including millions of Mexican Americans (because they refute earlier suggestions of a Hispanic obesity paradox).” – by Erin Michael

Disclosures: Gnatiuc and Alegre-Diaz report no relevant financial disclosures. Please see study for all other authors’ relevant financial disclosures.