Pulse lineResearch With Heart Logo

The effect of decision rules on the choice of a body mass index cutoff for obesity: examples from African American and white women.

TitleThe effect of decision rules on the choice of a body mass index cutoff for obesity: examples from African American and white women.
Publication TypeJournal Article
Year of Publication2002
AuthorsStevens J, Cai J, Jones DW
JournalAm J Clin Nutr
Volume75
Issue6
Pagination986-92
Date Published2002 Jun
ISSN0002-9165
KeywordsAfrican Continental Ancestry Group, Alcohol Drinking, Arteriosclerosis, Body Mass Index, Cohort Studies, Diabetes Mellitus, European Continental Ancestry Group, Exercise, Female, Humans, Hypertension, Hypertriglyceridemia, Incidence, Middle Aged, Neoplasms, Obesity, Reference Standards, Regression Analysis, Risk Factors
Abstract

BACKGROUND: Ethnic differences in the relation of body mass index (BMI; in kg/m2) to morbidity and mortality have led investigators to question whether a single cutoff for obesity should be applied to all ethnic groups.

OBJECTIVE: The effects of using 4 different outcomes and 3 different measures of effect as criteria for comparing BMI cutoffs were shown with the use of data from 45- to 64-y-old African American and white women.

DESIGN: Data were from the Cancer Prevention Study I (CPS-I) and the Atherosclerosis Risk in Communities (ARIC) Study. The outcomes were mortality (9211 deaths), diabetes (757 cases), hypertension (1518 cases), and hypertriglyceridemia (1264 cases). The measures of effect were incidence rate, rate ratio, and rate difference. The BMI in African American women that was associated with a risk equivalent to that of white women with a BMI of 30 was estimated.

RESULTS: There was no significant association between BMI and mortality in African American women. The BMI in African American women that was associated with a risk of diabetes equivalent to that of white women with a BMI of 30 was 28.0-34.5, depending on the measure of effect. For hypertension, the equivalent risk in African American women occurred at a BMI of

CONCLUSION: BMI cutoffs associated with equivalent risk across ethnic groups differ widely depending on the outcome and the risk estimate.

DOI10.1093/ajcn/75.6.986
Alternate JournalAm J Clin Nutr
PubMed ID12036803