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A comparison of body mass index, waist–hip ratio and waist circumference as predictors of all-cause mortality among the elderly: the Rotterdam study

International Journal of Obesity volume 25, pages 1730–1735 (2001)Cite this article

Abstract

OBJECTIVE: To compare body mass index (BMI), waist–hip ratio (WHR) and waist circumference as predictors of all-cause mortality among the elderly.

DESIGN: Population-based cohort study; mean follow-up was 5.4 y.

SETTING: The Rotterdam Study.

PARTICIPANTS: A total of 6296 men and women; baseline age 55–102 y.

MEASUREMENTS: Sex-specific all-cause mortality was compared between quintiles of BMI, WHR and waist circumference and between predefined categories of BMI and waist circumference, stratified for smoking category.

RESULTS: High quintiles of waist circumference, but not high quintiles of BMI and WHR were related to increased mortality among never smoking men, without reaching statistical significance. Only the highest category of BMI (BMI>30 kg/m2) among never smoking men was related to increased mortality, compared to normal BMI (hazard ratio 2.6 (95% confidence interval: 1.3–5.3)). Waist circumference between 94 and 102 cm and waist circumference 102 cm and larger were related to increased mortality, compared to normal waist circumference (hazard ratios 1.7 (95% confidence interval 1.1–2.8) and 1.6 (95% confidence interval 1.0–2.8), respectively). The proportion of mortality attributable to large waist circumference among never smoking men was three-fold the proportion attributable to high BMI. Among never smoking women and ex- and current smokers, categories of large body fatness did not predict increased mortality.

CONCLUSION: Among never smoking elderly men waist circumference may have more potential for detecting overweight than the BMI.

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Acknowledgements

The Rotterdam study is supported in part by the NESTOR program for geriatric research (Ministry of Health and Ministry of Education), The Netherlands Heart Foundation, The Netherlands Organisation for Scientific Research (NWO), and the municipality of Rotterdam.

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Authors and Affiliations

  1. Department of Epidemiology and Biostatistics, Erasmus University Medical School, Rotterdam, The Netherlands

    TLS Visscher, D van der Kuip, A Hofman & JCM Witteman

  2. The Netherlands Institute for Health Sciences, Erasmus University Medical School, Rotterdam, The Netherlands

    TLS Visscher, A Molarius & A Hofman

  3. Department of Chronic Diseases Epidemiology, National Institute of Public Health and the Environment, Bilthoven, The Netherlands

    TLS Visscher & JC Seidell

  4. Institute for Research in Extramural Medicine, Free University Amsterdam, Amsterdam, The Netherlands

    JC Seidell

  5. Centre for Public Health Research, Karlstad University, Karlstad, Sweden

    A Molarius

Authors
  1. TLS Visscher
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  2. JC Seidell
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  4. D van der Kuip
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  5. A Hofman
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Correspondence to TLS Visscher.

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Visscher, T., Seidell, J., Molarius, A. et al. A comparison of body mass index, waist–hip ratio and waist circumference as predictors of all-cause mortality among the elderly: the Rotterdam study. Int J Obes 25, 1730–1735 (2001). https://doi.org/10.1038/sj.ijo.0801787

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  • DOI: https://doi.org/10.1038/sj.ijo.0801787

Keywords

  • aged
  • body mass index
  • follow-up studies
  • mortality
  • overweight
  • waist circumference
  • waist–hip ratio

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