The objective of this study was to investigate the association between waist circumference and risk of mortality in the Cancer Prevention Study II Nutrition Cohort. Among 48,500 men and 56,343 women (50 years and older), a total of 9,315 men and 5,332 women died during a 9-year follow-up. Results showed that an increased waist circumference was associated with higher risk of mortality independent of body mass index (BMI) in men and women. Moreover, the adjustment for BMI increased the strength of the association between waist circumference and mortality. The waist circumference was also associated with higher risk of mortality within all categories of BMI. The relative risk associated with a 10-cm increase in waist circumference ranged from approximately 15% to 25% within various categories of BMI. Among women, the association between waist circumference and mortality was strongest in those with a normal BMI. In addition, associations with waist circumference were strongest for mortality caused by respiratory disease, followed by cardiovascular disease and then cancer. Thus, these results suggest that regardless of the BMI, a higher waist circumference is associated with higher risk of mortality and must be considered as a risk factor in older adults.
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