(HealthDay News) — Among white adults, larger waist is associated with increased mortality at all levels of body mass index (BMI), according to research published in the March issue of the Mayo Clinic Proceedings.

James R. Cerhan, MD, PhD, of the Mayo Clinic in Rochester, MN, and colleagues analyzed pooled data from 11 prospective cohort studies for 650,386 white adults, aged 20–83 years, to assess the association between waist circumference and mortality.

The researchers found that, after multivariable adjustment, waist circumference had a strong positive linear association with all-cause mortality for men with waist circumferences of ≥110 versus <90 cm (hazard ratio [HR], 1.52; 95% confidence interval [CI], 1.45–1.59; HR, 1.07 per 5-cm increment in waist circumference; 95% CI, 1.06–1.08) and for women with waist circumferences of ≥95 vs. <70 cm (HR, 1.80; 95% CI, 1.70–1.89; HR, 1.09 per 5-cm increment in waist circumference; 95% CI, 1.08–1.09). Among those with the highest compared with the lowest waist circumference, the estimated decrease in life expectancy was approximately three years for men and five years for women. The increased risk of mortality per 5-cm increment in waist circumference was similar for both sexes at all BMI levels from 20 to 50 kg/m².

“Waist circumference should be assessed in combination with BMI, even for those in the normal BMI range, as part of risk assessment for obesity-related premature mortality,” the authors write.

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