A pooled analysis of body mass index and mortality among African Americans

Sarah S. Cohen, Yikyung Park, Lisa B. Signorello, Alpa V. Patel, Deborah A. Boggs, Laurence N. Kolonel, Cari M. Kitahara, Synnove F. Knutsen, Elizabeth Gillers, Kristine R. Monroe, Amy Berrington De Gonzalez, Traci N. Bethea, Ama Black, Gary Fraser, Susan Gapstur, Patricia Hartge, Charles E. Matthews, Song Yi Park, Mark P. Purdue, Pramil SinghChinonye Harvey, William J. Blot, Julie R. Palmer

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Abstract

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: NIHAARP, 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/m2 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.

Original languageEnglish
Article numbere111980
JournalPloS one
Volume9
Issue number11
DOIs
StatePublished - Nov 17 2014

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    Cohen, S. S., Park, Y., Signorello, L. B., Patel, A. V., Boggs, D. A., Kolonel, L. N., Kitahara, C. M., Knutsen, S. F., Gillers, E., Monroe, K. R., De Gonzalez, A. B., Bethea, T. N., Black, A., Fraser, G., Gapstur, S., Hartge, P., Matthews, C. E., Park, S. Y., Purdue, M. P., ... Palmer, J. R. (2014). A pooled analysis of body mass index and mortality among African Americans. PloS one, 9(11), [e111980]. https://doi.org/10.1371/journal.pone.0111980