General or Central Obesity and Mortality Among US Hispanic and Latino Adults
Authors' conclusion
In this cohort of US Hispanic and Latino adults, WHR was independently associated with higher all-cause mortality regardless of BMI and prevalent comorbidities. These findings suggest that prioritizing clinical screening and intervention for WHR in this population may be an important public health strategy, with sex-specific strategies potentially being needed.
Study context
- Population
- US Hispanic and Latino adults aged 18 to 74 years, HCHS/SOL, baseline 2008–2011; mean age 40.9 years, 52.8% female686 deaths
- Participants
- 15,773 participants
- Exposure
- Obesity categories by body mass index (BMI), body fat percentage, waist circumference (WC) and waist to hip ratio (WHR)
- Outcome
- Deaths, ascertained via death certificates, the National Death Index and active follow-up
Methodological detailsmulticenter, ongoing, multistage probability sampling, complex survey design and sampling weights
- Multicenter
- Ongoing
- Multistage probability sampling
- Complex survey design and sampling weights
Main finding
As reported in the abstract
All-cause mortality, adjusted for sociodemographic, lifestyle and family history covariates
Hazard ratio (95% CI)
BMI ≥35.0vs BMI 18.5–24.9
1.55(1.08–2.22)
Highest body fat %vs Lowest body fat %
1.22(0.92–1.64)
High WCvs Low WC
1.35(0.98–1.85)
High WHRvs Low WHR
1.91(1.28–2.86)
Observational data: associations, not effects.
Further findings
Mortality with additional adjustment for major comorbidities
- Only WHR was associated with mortality with additional adjustment for major comorbidities
- HR 1.75 (95% CI 1.17-2.62)
Mortality by sex (interaction)
- Association of WHR with mortality stronger among women vs men (P for interaction)
- P = 0.03
- Association between BMI and mortality stronger among men (P for interaction)
- P = 0.02
Severe obesity (BMI ≥35.0) and mortality by WHR (interaction)
- Positive association observed only with WHR ≥0.90 (men) or ≥0.85 (women), not with WHR below these (who had greater hip circumference) (P for interaction)
- P = 0.005
Original publication
General or Central Obesity and Mortality Among US Hispanic and Latino Adults. JAMA Netw Open. Published 2 January 2024. doi:10.
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