Normal-Weight Central Obesity: Implications for Total and Cardiovascular Mortality

Area of Science:

• Cardiovascular Health
• Obesity Research
• Public Health

Background:

• The association between central obesity and survival in normal body mass index (BMI) adults remains unclear.
• Central obesity, characterized by excess abdominal fat, is a growing public health concern.
• Understanding its impact on mortality is crucial for targeted health interventions.

Purpose of the Study:

• To investigate the risks of total and cardiovascular mortality linked to central obesity in individuals with a normal BMI.
• To compare mortality risks between normal-weight central obesity and obesity defined solely by BMI.
• To elucidate the role of body fat distribution in predicting survival outcomes.

Main Methods:

• Utilized data from the Third National Health and Nutrition Examination Survey (NHANES III).
• Employed a stratified multistage probability sampling design for a representative adult cohort (n=15,184).
• Applied multivariable Cox proportional hazards models to assess mortality risks associated with BMI and waist-to-hip ratio (WHR).

Main Results:

• Normal-weight individuals with central obesity exhibited the poorest long-term survival rates.
• Men with normal BMI and central obesity had significantly higher total mortality risk (HR, 1.87) compared to normal BMI without central obesity.
• Women with normal-weight central obesity also showed increased mortality risk (HR, 1.48) compared to normal BMI without central obesity.

Conclusions:

• Body fat distribution, specifically central obesity identified by WHR, is a critical predictor of mortality, independent of BMI.
• Normal-weight central obesity is associated with higher mortality risks than BMI-defined obesity.
• These findings underscore the importance of assessing body fat distribution in clinical practice for accurate risk stratification.