title: Body fat percentage, body mass index and waist-to-hip ratio as predictors of mortality and cardiovascular disease.
abstract: OBJECTIVE
  To study the utility of body fat percentage in predicting health outcomes when other obesity indices are considered.
  
  
  METHODS
  We conducted a prospective cohort study to evaluate the independent utility of body fat percentage and other obesity indices in predicting mortality and cardiovascular disease (CVD).
  
  
  RESULTS
  We prospectively followed 15 062 European Prospective Investigation into Cancer (EPIC)-Norfolk participants who attended a health examination during 1997–2000 for all-cause mortality and incidence of CVD up to end of December 2011 and end of March 2009, respectively. During the follow-up, 2420 died and 4665 had incident CVD. After exclusion of prior stroke, myocardial infarction and cancer and adjusting for potential confounders, body mass index (BMI) and waist-to- hip ratio (WHR), the HR of mortality for men were 0.86 (0.68 to 1.09), 0.81 (0.61 to 1.07) and 0.76 (0.55 to 1.05) and for women were 0.91 (0.70 to 1.17), 0.75 (0.55 to 1.02) and 0.87 (0.61 to 1.23) for second, third and fourth quartile compared with the first (bottom) quartile of body fat percentage. The respective HRs for incident CVD were 0.99 (0.83 to 1.19), 0.85 (0.69 to 1.04) and 0.81 (0.64 to 1.03) for men and 0.98 (0.82 to 1.17), 0.89 (0.73 to 1.10) and 1.02 (0.81 to 1.29) for women. In contrast, higher BMI and WHR were associated with an increased risk of both outcomes and WHR appeared to have the best predictive value among three indices.
  
  
  CONCLUSIONS
  Once BMI and WHR are taken into account, fat percentage does not add to prediction of mortality or CVD in middle-aged and older-aged adults.
authors: Division of Applied Health Sciences, School of Medicine & Dentistry, University of Aberdeen, Aberdeen, UK.
authors: Phyo Kyaw
authors: PK
authors: Myint
authors: Chun Shing
authors: CS
authors: Kwok
authors: Robert N
authors: RN
authors: Luben
authors: Nicholas J
authors: NJ
authors: Wareham
authors: Kay-Tee
authors: KT
authors: Khaw
mesh_terms: D050154:Adiposity; D000368:Aged; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000401:mortality*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D049629:Waist-Hip Ratio