Aim: To study the association between anthropometric measures: body mass index (BMI), percent body fat, waist circumference (WC), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR), waist-to-hip-to-height ratio (WHHR), and A Body Shape Index (ABSI); to see if individuals in the lowest 5 percentiles for these measures have an increased risk of mortality.
Methods: A population-based prospective cohort study (10,304 men and 16,549 women), the Malmö Diet and Cancer study (MDC), aged 45-73 years.
Results: During a mean follow-up of 14 ± 3 years, 2,224 men and 1,983 women died. There was a significant increased mortality risk after adjustments for potential confounders in the group with the 5% lowest BMI (referent 25%-75%); hazard ratios (HR) with 95% confidence intervals were 1.33 (1.10-1.61) for women and 1.27 (1.07-1.52) for men. A similar significant increased mortality risk was seen with the 5% lowest percent body fat, HR 1.31 (1.07-1.60) for women and 1.25 (1.04-1.50) for men. Women with an ABSI in the lowest 5 percentiles had a lower mortality risk HR 0.64 (0.48-0.85).
Conclusion: These results imply that BMI or percent body fat could be used to identify lean individuals at increased mortality risk.
Keywords: Obesity; underweight; waist–hip ratio (WHR); waist–hip–height ratio (WHHR).