Body fat percentage, body mass index and waist-to-hip ratio as predictors of mortality and cardiovascular disease

Phyo Kyaw Myint, Chun Shing Kwok, Robert N Luben, Nicholas J Wareham, Kay-Tee Khaw

Research output: Contribution to journalArticle

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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.

Original languageEnglish
Pages (from-to)1613-1619
Number of pages7
JournalHeart
Volume100
Issue number20
Early online date24 Jun 2014
DOIs
Publication statusPublished - Oct 2014

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Waist-Hip Ratio
Adipose Tissue
Body Mass Index
Cardiovascular Diseases
Mortality
Obesity
Health
Neoplasms
Cohort Studies
Stroke
Fats
Myocardial Infarction
Prospective Studies
Incidence

Keywords

  • Adiposity
  • Aged
  • Body Mass Index
  • Cardiovascular Diseases
  • Female
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Prognosis
  • Prospective Studies
  • Waist-Hip Ratio

Cite this

Body fat percentage, body mass index and waist-to-hip ratio as predictors of mortality and cardiovascular disease. / Myint, Phyo Kyaw; Kwok, Chun Shing; Luben, Robert N; Wareham, Nicholas J; Khaw, Kay-Tee.

In: Heart, Vol. 100, No. 20, 10.2014, p. 1613-1619.

Research output: Contribution to journalArticle

Myint, Phyo Kyaw ; Kwok, Chun Shing ; Luben, Robert N ; Wareham, Nicholas J ; Khaw, Kay-Tee. / Body fat percentage, body mass index and waist-to-hip ratio as predictors of mortality and cardiovascular disease. In: Heart. 2014 ; Vol. 100, No. 20. pp. 1613-1619.
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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.",
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TY - JOUR

T1 - Body fat percentage, body mass index and waist-to-hip ratio as predictors of mortality and cardiovascular disease

AU - Myint, Phyo Kyaw

AU - Kwok, Chun Shing

AU - Luben, Robert N

AU - Wareham, Nicholas J

AU - Khaw, Kay-Tee

PY - 2014/10

Y1 - 2014/10

N2 - 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.

AB - 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.

KW - Adiposity

KW - Aged

KW - Body Mass Index

KW - Cardiovascular Diseases

KW - Female

KW - Humans

KW - Incidence

KW - Male

KW - Middle Aged

KW - Prognosis

KW - Prospective Studies

KW - Waist-Hip Ratio

U2 - 10.1136/heartjnl-2014-305816

DO - 10.1136/heartjnl-2014-305816

M3 - Article

VL - 100

SP - 1613

EP - 1619

JO - Heart

JF - Heart

SN - 1355-6037

IS - 20

ER -