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Pramil N. Singh, Ralph W. Clark, Patti Herring, Joan Sabaté, David Shavlik, Gary E. Fraser, Obesity and Life Expectancy Among Long-Lived Black Adults, The Journals of Gerontology: Series A, Volume 69, Issue 1, January 2014, Pages 63–72, https://doi.org/10.1093/gerona/glt049
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Abstract
In samples of African Americans and the elderly adults, obesity is often not found to be a risk factor for mortality. These data contradict the evidence linking obesity to chronic disease in these groups. Our objective was to determine whether obesity remains a risk factor for mortality among long-lived black adults.
The Adventist Health Study 2 is a large prospective cohort study of Seventh-day Adventist church members who are encouraged by faith-based principles to avoid tobacco, alcohol, and meat consumption. We conducted an attained age survival analysis of 22,884 U.S. blacks of the cohort—half of whom attained an age of 58–108 years during the follow-up (adult life expectancy of 84 years in men, 89 years in women).
Women in the highest body mass index quintile (>33.8) experienced a significant 61% increase (hazard ratio [95% CI] = 1.62 [1.23, 2.11] relative to the middle quintile) in mortality risk and a 6.2-year (95% CI = 2.8–10.2 years) decrease in life expectancy. Men in the highest body mass index quintile (>30.8) experienced a significant 87% increase (hazard ratio [95% CI] = 1.87 [1.28, 2.73] relative to the middle quintile) in mortality risk and 5.9-year (95% CI = 2.1– 9.5 years) decrease in life expectancy. Obesity (>30) was a significant risk factor relative to normal weight (18.5–24.9) in never-smokers. Instantaneous hazards indicated excess risk from obesity was evident through at least age 85 years. The nonobese tended to follow plant-based diets and exercise vigorously.
Avoiding obesity promotes gains in life expectancy through at least the eighth decade of life in black adults. Evidence for weight control through plant-based diets and active living was found in long-lived nonobese blacks.
