A pooled analysis of body mass index and mortality among African Americans.
Pooled analyses among whites and East Asians have demonstrated positive associations between all-cause mortality and body mass index (BMI), but studies of African Americans have yielded less consistent results. We examined the association between BMI and all-cause mortality in a sample of African Americans pooled from seven prospective cohort studies: NIH-AARP, 1995-2009; Adventist Health Study 2, 2002-2008; Black Women's Health Study, 1995-2009; Cancer Prevention Study II, 1982-2008; Multiethnic Cohort Study, 1993-2007; Prostate, Lung, Colorectal and Ovarian Screening Trial, 1993-2009; Southern Community Cohort Study, 2002-2009. 239,526 African Americans (including 100,175 never smokers without baseline heart disease, stroke, or cancer), age 30-104 (mean 52) and 71% female, were followed up to 26.5 years (mean 11.7). Hazard ratios (HR) and 95% confidence intervals (CI) for mortality were derived from multivariate Cox proportional hazards models. Among healthy, never smokers (11,386 deaths), HRs (CI) for BMI 25-27.4, 27.5-29.9, 30-34.9, 35-39.9, 40-49.9, and 50-60 kg/m(2) were 1.02 (0.92-1.12), 1.06 (0.95-1.18), 1.32 (1.18-1.47), 1.54 (1.29-1.83), 1.93 (1.46-2.56), and 1.93 (0.80-4.69), respectively among men and 1.06 (0.99-1.15), 1.15 (1.06-1.25), 1.24 (1.15-1.34), 1.58 (1.43-1.74), 1.80 (1.60-2.02), and 2.31 (1.74-3.07) respectively among women (reference category 22.5-24.9). HRs were highest among those with the highest educational attainment, longest follow-up, and for cardiovascular disease mortality. Obesity was associated with a higher risk of mortality in African Americans, similar to that observed in pooled analyses of whites and East Asians. This study provides compelling evidence to support public health efforts to prevent excess weight gain and obesity in African Americans.
International Epidemiology Institute, Rockville, Maryland, United States of America; EpidStat Institute, Ann Arbor, Michigan, United States of America.
Sarah S
SS
Cohen
Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, United States of America.
Yikyung
Y
Park
Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts, United States of America.
Lisa B
LB
Signorello
Epidemiology Research Program, American Cancer Society, Atlanta, Georgia, United States of America.
Alpa V
AV
Patel
Slone Epidemiology Center at Boston University, Boston, Massachusetts, United States of America.
Deborah A
DA
Boggs
Cancer Epidemiology Program, University of Hawaii Cancer Center, Honolulu, Hawaii, United States of America.
Laurence N
LN
Kolonel
Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, United States of America.
Cari M
CM
Kitahara
Center for Nutrition, Healthy Lifestyle and Disease Prevention, School of Public Health, Loma Linda University, Loma Linda, California, United States of America.
Synnove F
SF
Knutsen
Division of Cancer Control and Population Sciences, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, United States of America.
Elizabeth
E
Gillanders
Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California, United States of America.
Kristine R
KR
Monroe
Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, United States of America.
Amy
A
Berrington de Gonzalez
Slone Epidemiology Center at Boston University, Boston, Massachusetts, United States of America.
Traci N
TN
Bethea
Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, United States of America.
Amanda
A
Black
Center for Nutrition, Healthy Lifestyle and Disease Prevention, School of Public Health, Loma Linda University, Loma Linda, California, United States of America.
Gary
G
Fraser
Epidemiology Research Program, American Cancer Society, Atlanta, Georgia, United States of America.
Susan
S
Gapstur
Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, United States of America.
Patricia
P
Hartge
Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, United States of America.
Charles E
CE
Matthews
Cancer Epidemiology Program, University of Hawaii Cancer Center, Honolulu, Hawaii, United States of America.
Song-Yi
SY
Park
Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, United States of America.
Mark P
MP
Purdue
Center for Health Research, School of Public Health, Loma Linda University, Loma Linda, California, United States of America.
Pramil
P
Singh
Epidemiology and Genomics Research Program, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, United States of America.
Chinonye
C
Harvey
International Epidemiology Institute, Rockville, Maryland, United States of America; Division of Epidemiology, Department of Medicine, Vanderbilt University Medical Center and Vanderbilt-Ingram Cancer Center, Nashville, Tennessee, United States of America.
William J
WJ
Blot
Slone Epidemiology Center at Boston University, Boston, Massachusetts, United States of America.
Julie R
JR
Palmer
D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data*; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D002423:Cause of Death; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009026:Mortality; D009765:Obesity / Q000453:epidemiology; D016016:Proportional Hazards Models; D011446:Prospective Studies; D062486:Public Health Surveillance; D012307:Risk Factors; D055815:Young Adult