This prospective cohort study by Koster et al. examined the association between waist circumference and all-cause mortality in the National Institutes of Health-American Association of Retired Persons (NIH-AARP) Diet and Health Study among 154,776 men and 90,757 women. During 9 years of follow-up, 18,282 men and 6,538 women died. In the total study population, persons in the highest quintile of waist circumference had an approximately 50% higher risk of mortality than individuals in the second quintile of waist circumference [men: hazard ratio (HR): 1.51, (95% CI, 1.44-1.57) women: HR: 1.56, (95% CI, 1.44-1.68)]. After adjusting for body mass index (BMI), persons with a large waist circumference still had a significantly higher risk of death [men: HR: 1.22, (95% CI, 1.15-1.29) women: HR: 1.28, (95% CI, 1.16-1.41)]. The combined associations of BMI and waist circumference showed that having a large waist circumference while being in the normal BMI range is an important risk factor for mortality. Study results suggest that an increased waist circumference should be considered a risk factor for mortality, in addition to BMI.
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