Article Figures & Tables
Tables
- Table 1:
Age-standardized* baseline characteristics by body mass index, waist circumference, hip circumference, waist–hip ratio and vigorous physical activity (NIH-AARP Diet and Health Study, 1995–1996)
Variable Levels within recommended guidelines, %† BMI Waist circumference‡ Hip circumference§ Waist–hip ratio¶ Vigorous physical activity** < 18.5 (No) 18.5–24.9 (Yes) ≥ 25.0 (No) No Yes < Median ≥ Median No Yes No Yes No. of participants 887 46 669 65 723 33 570 79 709 58 706 54 573 48 365 64 914 54 685 58 594 Age at baseline, mean, yr 63 63 62 63 62 62 62 62 63 62 63 Sex Female 69 53 34 46 40 42 42 72 20 45 39 Male 31 47 66 54 60 58 58 28 80 55 61 Marital status Married or common law 55 67 75 69 73 71 72 61 80 69 74 Not married 45 33 25 31 27 29 28 39 20 31 26 Postgraduate education No 72 72 76 77 73 73 75 75 73 77 71 Yes 28 28 24 23 27 27 25 25 27 23 29 Ethnicity White 96 95 94 95 94 94 95 94 95 94 95 Nonwhite 4 5 6 5 6 6 5 6 5 6 5 BMI < 18.5 (not recommended) — — — 0 1 1 0 1 0 1 1 18.5–24.9 (recommended) — — — 7 56 65 16 58 28 36 46 ≥ 25.0 (not recommended) — — — 93 43 34 84 41 72 63 53 Waist circumference within recommended guideline‡ No 5 5 47 — — 7 54 13 42 37 23 Yes 95 95 53 — — 93 46 87 58 63 77 Hip circumference§ < Median 87 82 30 12 69 — — 55 50 46 57 ≥ Median 13 18 70 88 31 — — 45 50 54 43 Waist–hip ratio within recommended guideline¶ No 74 60 30 19 53 45 40 — — 40 45 Yes 26 40 70 81 47 55 60 — — 60 55 Physical activity level within recommended guideline** No 42 42 53 59 44 43 54 46 50 — — Yes 58 58 47 41 56 57 46 54 50 — — Smoking status Never 47 46 40 39 43 43 42 49 38 43 43 Distant past†† 30 35 42 40 39 38 40 33 42 36 42 Recent past‡‡ 7 8 11 13 9 9 11 9 11 10 9 Current 16 11 7 8 9 10 7 9 9 11 6 Alcohol intake, g/d, mean 12 12 14 13 13 13 13 9 16 13 13 History of type 2 diabetes mellitus No 97 97 93 92 96 96 94 97 93 95 95 Yes 3 3 7 8 4 4 6 3 7 5 5 BMI = body mass index, NIH = National Institutes of Health.
↵* Using direct standardization to the baseline age distribution of the cohort.
↵† Unless stated otherwise.
↵‡ Recommended guideline for waist circumference was defined as less than 88 cm (women) or less than 102 cm (men).
↵§ There is no World Health Organization recommendation for hip circumference. Thus, the dichotomous cut-off was defined by the sex-specific median. The median hip circumference was 102 cm in men and in women.
↵¶ Recommended guideline for waist–hip ratio was defined as < 0.85 (women) or < 0.90 (men).
↵** Vigorous physical activity was defined as ≥ 20 minutes of exercise that was sufficient to increase breathing, increase heart rate or work up a sweat. Recommended guideline was defined as engaging in vigorous physical activity ≥ 3 times per week.
↵†† Distant past defined as ≥ 10 years ago.
↵‡‡ Recent past defined as < 10 years ago.
- Table 2:
Relative risk of chronic obstructive pulmonary disease in relation to body mass index, waist circumference, hip circumference, waist–hip ratio and physical activity (NIH-AARP Diet and Health Study, 1996–2006)
Variable COPD cases N Relative risk (95% CI)* Adjusted for age and sex† Model 1‡ Model 1 plus BMI§ Model 1 plus waist circumference¶ Model 1 plus BMI and hip circumference** BMI < 18.5 54 887 1.76 (1.33–2.33) 1.50 (1.12–2.03) — 1.56 (1.15–2.11) — 18.5–24.9 1 552 46 669 1.00 (ref) 1.00 (ref) — 1.00 (ref) — 25.0–29.9 1 393 47 856 0.95 (0.88–1.02) 0.94 (0.87–1.02) — 0.83 (0.76–0.91) — 30.0–34.9 505 14 386 1.14 (1.03–1.26) 1.11 (1.00–1.24) — 0.87 (0.76–0.99) — ≥ 35.0 144 3 481 1.30 (1.09–1.55) 1.36 (1.13–1.63) — 1.00 (0.80–1.24) — ptrend 0.04 0.03 — 0.04 — Waist circumference, cm < 64 (women)
< 80 (men)35 1 110 1.09 (0.78–1.54) 1.13 (0.79–1.61) 1.03 (0.72–1.47) — 0.99 (0.69–1.42) 64–79 (women)
80–93 (men)1 330 47 815 1.00 (ref) 1.00 (ref) 1.00 (ref) — 1.00 (ref) 80–87 (women)
94–101 (men)937 30 784 1.08 (0.99–1.18) 1.02 (0.93–1.11) 1.10 (1.00–1.20) — 1.14 (1.03–1.26) 88–109 (women)
102–117 (men)1 185 30 188 1.36 (1.26–1.48) 1.22 (1.12–1.33) 1.36 (1.22–1.52) — 1.44 (1.28–1.63) ≥ 110 (women)
≥ 118 (men)161 3 382 1.76 (1.48–2.08) 1.47 (1.23–1.75) 1.55 (1.25–1.92) — 1.72 (1.37–2.16) ptrend < 0.001 < 0.001 < 0.001 — < 0.001 Hip circumference, cm < 86 (women)
< 87 (men)55 1 254 1.53 (1.16–2.02) 1.24 (0.93–1.66) — 1.27 (0.95–1.70) — 86–99 (women)
87–100 (men)1 511 46 622 1.00 (ref) 1.00 (ref) — 1.00 (ref) — 100–105 (women)
101–106 (men)876 31 334 0.88 (0.81–0.96) 0.94 (0.86–1.03) — 0.85 (0.77–0.94) — 106–124 (women)
107–119 (men)1 081 30 486 1.05 (0.97–1.14) 1.10 (1.01–1.20) — 0.86 (0.77–0.97) — ≥ 125 (women)
≥ 120 (men)125 3 583 1.09 (0.90–1.31) 1.16 (0.96–1.41) — 0.78 (0.62–0.98) — ptrend 0.6 0.04 — 0.001 — Waist–hip ratio < 0.67 (women)
< 0.82 (men)28 1 271 0.89 (0.61–1.29) 0.85 (0.58–1.25) — — — 0.67–0.78 (women)
0.82–0.92 (men)1 201 47 687 1.00 (ref) 1.00 (ref) — — — 0.79–0.83 (women)
0.93–0.96 (men)944 28 581 1.32 (1.21–1.43) 1.18 (1.08–1.30) — — — 0.84–0.95 (women)
0.97–1.06 (men)1 303 32 397 1.59 (1.47–1.72) 1.29 (1.18–1.40) — — — ≥ 0.96 (women)
≥ 1.07 (men)172 3 343 2.12 (1.80–2.49) 1.46 (1.23–1.73) — — — ptrend < 0.001 < 0.001 — — — Physical activity, times/wk 0 757 14 442 1.00 (ref) 1.00 (ref) 1.00 (ref) 1.00 (ref) — < 1 564 14 731 0.76 (0.68–0.85) 0.84 (0.75–0.95) 0.85 (0.76–0.95) 0.85 (0.76–0.96) — 1–2 829 25 512 0.64 (0.58–0.71) 0.79 (0.71–0.88) 0.80 (0.72–0.89) 0.81 (0.73–0.90) — 3–4 900 33 969 0.51 (0.46–0.56) 0.71 (0.64–0.79) 0.73 (0.65–0.80) 0.74 (0.66–0.82) — ≥ 5 598 24 625 0.47 (0.42–0.52) 0.67 (0.60–0.75) 0.68 (0.61–0.77) 0.71 (0.63–0.79) — ptrend < 0.001 < 0.001 < 0.001 < 0.001 — BMI = body mass index, CI = confidence interval, COPD = chronic obstructive pulmonary disease, NIH = National Institutes of Health.
↵* Unless stated otherwise.
↵† Adjusted for age (5-year groups) and sex (female, male).
↵‡ Adjusted for age (5-year groups), sex (female, male), marital status (married or common law, never married, separated, divorced, widowed), education (high school or less than high school, vocational training or some college, college education, postgraduate education), ethnicity (non-Hispanic white, non-Hispanic black, Hispanic, Asian, other ethnic background), alcohol intake (0, 0.1–14.9, 15.0–29.9, 30.0–59.9, ≥ 60 g/d), 31 combinations of smoking status (currently smoking, stopped smoking within the last 12 months, stopped smoking 1–4 years ago, stopped smoking 5–9 years ago, stopped smoking ≥ 10 years ago, never smoked) and smoking intensity (never smoked: 0 cigarettes/d; ever smoked: 1–10, 11–20, 21–30, 31–40, 41–60, ≥ 61 cigarettes/d), history of type 2 diabetes mellitus (no, yes) and height (sex-specific quintiles). The BMI, waist circumference and waist–hip ratio analyses were additionally adjusted for physical activity (0, < 1, 1–2, 3–4,
↵≥ 5 times/wk).
↵§ Additionally adjusted for BMI (< 18.5, 18.5–24.9, 25.0–29.9, 30.0–34.9, ≥ 35.0).
↵¶ Additionally adjusted for waist circumference (women: < 64, 64–79, 80–87, 88–109, ≥ 110 cm; men: < 80, 80–93, 94–101, 102–117, ≥ 118 cm).
↵** Additionally adjusted for BMI (< 18.5, 18.5–24.9, 25.0–29.9, 30.0–34.9, ≥ 35.0) and hip circumference (women: < 86, 86–99, 100–105, 106–124, ≥ 125 cm; men: < 87, 87–100, 101–106, 107–119, ≥ 120 cm).
- Table 3:
Multivariate-adjusted* relative risk of chronic obstructive pulmonary disease in relation to body mass index, waist circumference, hip circumference, waist–hip ratio and physical activity, stratified by smoking status (NIH-AARP Diet and Health Study, 1996–2006)
Variable Smoking status Never n = 47 874 Distant past†n = 44 228 Recent past‡n = 11 207 Current n = 9 970 COPD cases RR (95% CI)§ COPD cases RR (95% CI)§ COPD cases RR (95% CI)§ COPD cases RR (95% CI)§ BMI analysis 1¶ < 18.5 11 2.17 (1.17–4.02) 8 1.34 (0.65–2.74) 4 1.00 (0.35–2.82) 31 1.50 (0.99–2.28) 18.5–24.9 220 1.00 (ref) 344 1.00 (ref) 266 1.00 (ref) 722 1.00 (ref) 25.0–29.9 250 1.41 (1.17–1.70) 427 1.00 (0.86–1.16) 313 0.85 (0.71–1.02) 403 0.76 (0.66–0.87) 30.0–34.9 91 1.55 (1.21–2.00) 176 1.26 (1.04–1.53) 103 0.80 (0.62–1.02) 135 1.00 (0.81–1.23) ≥ 35.0 31 1.75 (1.18–2.58) 44 1.35 (0.97–1.87) 35 1.06 (0.72–1.56) 34 1.49 (1.01–2.21) ptrend < 0.001 0.02 0.3 0.4 pinteraction < 0.001 BMI analysis 2** < 18.5 11 2.30 (1.22–4.32) 8 1.28 (0.62–2.65) 4 1.15 (0.40–3.27) 31 1.54 (1.01–2.35) 18.5–24.9 220 1.00 (ref) 344 1.00 (ref) 266 1.00 (ref) 722 1.00 (ref) 25.0–29.9 250 1.28 (1.03–1.60) 427 0.88 (0.74–1.04) 313 0.65 (0.53–0.80) 403 0.72 (0.62–0.85) 30.0–34.9 91 1.26 (0.92–1.74) 176 0.99 (0.77–1.26) 103 0.51 (0.37–0.68) 135 0.87 (0.67–1.13) ≥ 35.0 31 1.36 (0.86–2.17) 44 1.00 (0.68–1.49) 35 0.62 (0.39–0.98) 34 1.19 (0.75–1.86) ptrend 0.3 0.9 <0.001 0.08 pinteraction < 0.001 Waist circumference analysis 1, cm†† < 64 (women)
< 80 (men)5 0.84 (0.35–2.06) 11 2.08 (1.12–3.86) 2 0.56 (0.13–2.30) 17 1.00 (0.59–1.68) 64–79 (women)
80–93 (men)214 1.00 (ref) 314 1.00 (ref) 200 1.00 (ref) 602 1.00 (ref) 80–87 (women)
94–101 (men)146 1.07 (0.87–1.33) 274 1.16 (0.98–1.37) 187 1.03 (0.83–1.27) 330 0.90 (0.78–1.05) 88–110 (women)
102–117 (men)215 1.49 (1.22–1.81) 349 1.35 (1.15–1.58) 289 1.30 (1.07–1.59) 332 0.95 (0.82–1.11) ≥ 110 (women)
≥ 118 (men)23 1.69 (1.08–2.63) 51 1.58 (1.16–2.16) 43 1.32 (0.92–1.89) 44 1.48 (1.04–2.11) ptrend < 0.001 < 0.001 0.002 0.5 pinteraction = 0.004 Waist circumference analysis 2, cm‡‡ < 64 (women)
< 80 (men)5 0.74 (0.30–1.83) 11 1.84 (0.98–3.45) 2 0.45 (0.11–1.92) 17 0.89 (0.53–1.52) 64–79 (women)
80–93 (men)214 1.00 (ref) 314 1.00 (ref) 200 1.00 (ref) 602 1.00 (ref) 80–87 (women)
94–101 (men)146 1.00 (0.78–1.28) 274 1.25 (1.04–1.51) 187 1.34 (1.06–1.69) 330 1.04 (0.89–1.23) 88–109 (women)
102–117 (men)215 1.30 (0.98–1.73) 349 1.45 (1.15–1.82) 289 2.12 (1.62–2.78) 332 1.22 (0.98–1.51) ≥ 110 (women)
≥ 118 (men)23 1.56 (0.90–2.72) 51 1.64 (1.10–2.47) 43 2.49 (1.55–3.99) 44 1.73 (1.12–2.68) ptrend 0.04 0.007 < 0.001 0.007 pinteraction = 0.007 Hip circumference, cm§§ < 86 (women)
< 87 (men)5 1.32 (0.53–3.25) 15 1.77 (1.04–3.01) 8 1.17 (0.56–2.45) 27 1.03 (0.67–1.56) 86–99 (women)
87–100 (men)212 1.00 (ref) 345 1.00 (ref) 257 1.00 (ref) 697 1.00 (ref) 100–105 (women)
101–106 (men)145 0.99 (0.78–1.25) 261 0.89 (0.74–1.07) 185 0.73 (0.59–0.91) 285 0.82 (0.70–0.97) 106–124 (women)
107–119 (men)219 1.08 (0.83–1.40) 335 0.99 (0.81–1.22) 240 0.66 (0.52–0.85) 287 0.77 (0.63–0.95) ≥ 125 (women)
≥ 120 (men)22 0.81 (0.48–1.39) 43 0.95 (0.64–1.40) 31 0.57 (0.35–0.91) 29 0.76 (0.48–1.21) ptrend 0.7 0.4 0.001 0.02 pinteraction = 0.01 Waist–hip ratio¶¶ < 0.67 (women)
< 0.82 (men)5 0.78 (0.32–1.90) 8 1.07 (0.52–2.17) 1 0.19 (0.03–1.37) 14 1.02 (0.57–1.80) 0.67–0.78 (women)
0.82–0.92 (men)230 1.00 (ref) 317 1.00 (ref) 186 1.00 (ref) 468 1.00 (ref) 0.79–0.83 (women)
0.93–0.96 (men)148 1.14 (0.92–1.40) 255 1.20 (1.02–1.42) 181 1.34 (1.08–1.65) 360 1.22 (1.05–1.41) 0.84–0.95 (women)
0.97–1.06 (men)202 1.39 (1.15–1.69) 376 1.50 (1.28–1.74) 316 1.68 (1.39–2.03) 409 1.07 (0.92–1.23) ≥ 0.96 (women)
≥ 1.07 (men)18 1.36 (0.84–2.22) 43 1.65 (1.19–2.29) 37 1.68 (1.16–2.44) 74 1.52 (1.15–2.00) ptrend 0.002 < 0.001 < 0.001 0.02 pinteraction < 0.001 Physical activity analysis 1, times/wk 0 105 1.00 (ref) 146 1.00 (ref) 135 1.00 (ref) 371 1.00 (ref) < 1 74 0.80 (0.59–1.09) 135 0.93 (0.73–1.18) 116 0.94 (0.72–1.22) 239 0.77 (0.65–0.93) 1–2 151 0.93 (0.72–1.20) 212 0.84 (0.67–1.04) 167 0.83 (0.65–1.06) 299 0.69 (0.59–0.82) 3–4 152 0.72 (0.56–0.92) 300 0.78 (0.64–0.96) 188 0.73 (0.58–0.93) 260 0.67 (0.56–0.80) ≥ 5 121 0.81 (0.62–1.06) 206 0.68 (0.55–0.85) 115 0.64 (0.49–0.83) 156 0.65 (0.53–0.80) ptrend 0.07 < 0.001 < 0.001 < 0.001 pinteraction = 0.7 Physical activity analysis 2, times/wk*** 0 105 1.00 (ref) 146 1.00 (ref) 135 1.00 (ref) 371 1.00 (ref) < 1 74 0.82 (0.60–1.11) 135 0.94 (0.74–1.19) 116 0.95 (0.73–1.23) 239 0.78 (0.65–0.93) 1–2 151 0.97 (0.75–1.25) 212 0.86 (0.69–1.07) 167 0.85 (0.67–1.08) 299 0.70 (0.59–0.82) 3–4 152 0.77 (0.60–0.99) 300 0.82 (0.67–1.01) 188 0.77 (0.60–0.97) 260 0.67 (0.56–0.80) ≥ 5 121 0.89 (0.68–1.17) 206 0.73 (0.59–0.91) 115 0.68 (0.52–0.88) 156 0.65 (0.53–0.80) ptrend 0.3 0.004 0.001 < 0.001 pinteraction = 0.7 Note: BMI = body mass index, CI = confidence interval, COPD = chronic obstructive pulmonary disease, NIH = National Institutes of Health, RR = relative risk.
↵* Adjusted for age (5-year groups), sex (female, male), marital status (married or common law, never married, separated, divorced, widowed), education (high school or less than high school, vocational training or some college, college education, postgraduate education), ethnicity (non-Hispanic white, non-Hispanic black, Hispanic, Asian, other ethnic background), alcohol intake (0, 0.1–14.9, 15.0–29.9, 30.0–59.9, ≥ 60 g/d), history of type 2 diabetes mellitus (no, yes) and height (sex-specific quintiles). Analyses involving participants who formerly and currently smoked were additionally adjusted for those of the 30 combinations of smoking status (currently smoking, stopped smoking within the last 12 months, stopped smoking 1–4 years ago, stopped smoking 5–9 years ago, stopped smoking ≥ 10 years ago, never smoked) and smoking intensity (never smoked: 0 cigarettes per day; ever smoked: 1–10, 11–20, 21–30, 31–40, 41–60, ≥ 61 cigarettes/d) applicable to the smoking stratum.
See footnotes ¶ to *** for additional exposure-specific adjustment factors.
↵† Distant past defined as ≥ 10 years ago.
↵‡ Recent past defined as < 10 years ago.
↵§ Unless stated otherwise.
↵¶ BMI analysis 1 was additionally adjusted for physical activity (0, < 1, 1–2, 3–4, ≥ 5 times/wk).
↵** BMI analysis 2 was additionally adjusted for physical activity (0, < 1, 1–2, 3–4, ≥ 5 times/wk) and waist circumference (women: < 64, 64–79, 80–87, 88–109,
↵≥ 110 cm; men: < 79, 79–93, 94–101, 102–116, ≥ 117 cm).
↵†† Waist circumference analysis 1 was additionally adjusted for physical activity (0, < 1, 1–2, 3–4, ≥ 5 times/wk).
↵‡‡ Waist circumference analysis 2 was additionally adjusted for physical activity (0, < 1, 1–2, 3–4, ≥ 5 times/wk), hip circumference (women: < 86,86–99,100–105, 106–124, = 125 cm; men: < 87, 87–100, 101–106, 107–119, = 120 cm) and BMI (< 18.5, 18.5–24.9, 25.0–29.9, 30.0–34.9, ≥ 35.0).
↵§§ The hip circumference analysis was additionally adjusted for waist circumference (women: < 64, 64–79, 80–87, 88–107, ≥ 108 cm; men: < 79, 79–93, 94–101, 102–116, ≥ 117 cm).
↵¶¶ The waist–hip–ratio analysis was additionally adjusted for physical activity (0, < 1, 1–2, 3–4, ≥ 5 times/wk).
↵*** Physical activity analysis 2 was additionally adjusted for waist circumference (women: < 64, 64–79, 80–87, 88–107, ≥ 108 cm; men: < 79, 79–93, 94–101, 102–116, ≥ 117 cm).
- Table 4:
Multivariate-adjusted* relative risk of chronic obstructive pulmonary disease in relation to combinations of body mass index, waist circumference and physical activity in the entire analytic cohort and stratified by smoking status (NIH-AARP Diet and Health Study, 1996–2006)
Combination† of BMI, waist circumference and physical activity RR (95% CI) for entire analytic cohort Smoking status; RR (95% CI) pinteraction Never Distant past‡ Recent past§ Current Entire analytic cohort¶ < 0.001 BMI 18.5–24.9 Small waist circumference** 1.00 (ref) 1.00 (ref) 1.00 (ref) 1.00 (ref) 1.00 (ref) Large waist circumference†† 1.13 (0.93–1.38) 1.17 (0.70–1.95) 1.48 (1.01–2.16) 1.15 (0.76–1.73) 0.91 (0.66–1.26) BMI 25.0–29.9 Small waist circumference** 0.84 (0.76–0.92) 1.11 (0.90–1.38) 0.91 (0.77–1.07) 0.72 (0.58–0.89) 0.75 (0.64–0.87) Large waist circumference†† 1.12 (1.01–1.23) 1.60 (1.27–2.01) 1.19 (0.99–1.43) 1.15 (0.94–1.42) 0.83 (0.69–0.99) BMI ≥ 30.0 Small waist circumference** 0.87 (0.70–1.10) 1.29 (0.78–2.12) 1.13 (0.78–1.63) 0.54 (0.31–0.94) 0.72 (0.47–1.11) Large waist circumference†† 1.21 (1.09–1.34) 1.65 (1.32–2.08) 1.33 (1.11–1.60) 0.93 (0.74–1.17) 1.12 (0.93–1.36) Participants with a high level of physical activity‡‡ 0.004 BMI 18.5–24.9 Small waist circumference** 1.00 (ref) 1.00 (ref) 1.00 (ref) 1.00 (ref) 1.00 (ref) Large waist circumference†† 1.05 (0.75–1.46) 1.33 (0.61– 2.87) 1.18 (0.63–2.19) 1.35 (0.72–2.54) 0.65 (0.34–1.23) BMI 25.0–29.9 Small waist circumference** 0.91 (0.80–1.04) 1.17 (0.86–1.58) 0.99 (0.79–1.23) 0.81 (0.59–1.09) 0.78 (0.60–1.01) Large waist circumference†† 1.17 (1.00–1.36) 1.78 (1.27–2.50) 1.24 (0.95–1.62) 1.27 (0.92–1.74) 0.65 (0.45–0.93) BMI ≥ 30.0 Small waist circumference** 0.84 (0.59–1.21) 1.31 (0.61–2.83) 1.12 (0.66–1.92) 0.44 (0.16–1.22) 0.60 (0.27–1.32) Large waist circumference†† 1.33 (1.12–1.58) 1.50 (1.01–2.23) 1.73 (1.33–2.24) 1.00 (0.69–1.47) 1.03 (0.69–1.54) Participants with a low level of physical activity§§ 0.06 BMI 18.5–24.9 Small waist circumference** 1.00 (ref) 1.00 (ref) 1.00 (ref) 1.00 (ref) 1.00 (ref) Large waist circumference†† 1.18 (0.93–1.51) 1.07 (0.54–2.13) 1.70 (1.05–2.76) 1.02 (0.59–1.75) 1.07 (0.73–1.55) BMI 25.0–29.9 Small waist circumference** 0.78 (0.69–0.88) 1.06 (0.78–1.44) 0.82 (0.64–1.05) 0.64 (0.48–0.86) 0.73 (0.60–0.89) Large waist circumference†† 1.09 (0.96–1.23) 1.50 (1.10–2.04) 1.13 (0.87–1.46) 1.06 (0.81–1.39) 0.91 (0.74–1.12) BMI ≥ 30.0 Small waist circumference** 0.90 (0.67–1.19) 1.28 (0.66–2.46) 1.10 (0.67–1.82) 0.58 (0.30–1.12) 0.80 (0.47–1.34) Large waist circumference†† 1.16 (1.02–1.31) 1.74 (1.30–2.32) 1.11 (0.86–1.42) 0.88 (0.66–1.16) 1.18 (0.95–1.47) Note: CI = confidence interval, NIH = National Institutes of Health, RR = relative risk.
↵* Adjusted for age (5-year groups), sex (female, male), marital status (married or common law, never married, separated, divorced, widowed), education (high school or less than high school, vocational training or some college, college education, postgraduate education), ethnicity (non-Hispanic white, non-Hispanic black, Hispanic, Asian, other ethnic background), alcohol intake (0, 0.1–14.9, 15.0–29.9, 30.0–59.9, ≥ 60 g/d), history of type 2 diabetes mellitus (no, yes) and height (sex-specific quintiles). Analyses involving participants who formerly and currently smoked were additionally adjusted for those of the 30 combinations of smoking status (currently smoking, stopped smoking within the last 12 months, stopped smoking 1–4 years ago, stopped smoking 5–9 years ago, stopped smoking ≥ 10 years ago, never smoked) and smoking intensity (never smoked: 0 cigarettes per day; ever smoked: 1–10, 11–20, 21–30, 31–40, 41–60, ≥ 61 cigarettes/d) applicable to the smoking stratum.
↵† Underweight participants (BMI < 18.5, n = 887) were excluded from the analysis because of a lack of cases in underweight participants with a waist circumference of ≥ 88 cm (women) and ≥ 102 cm (men). For similar reasons, participants with a waist circumference of < 64 cm (women) or < 80 cm (men) were excluded (n = 984).
↵‡ Distant past defined as ≥ 10 years ago.
↵§ Recent past defined as < 10 years ago.
↵¶ The multivariate analysis was additionally adjusted for physical activity (0, < 1, 1–2, 3–4, ≥ 5 times/wk).
↵** A small waist circumference was defined as a waist circumference of < 88 cm (women) and < 102 cm (men).
↵†† A large waist circumference was defined as a waist circumference of ≥ 88 cm (women) and ≥ 102 cm (men).
↵‡‡ A high level of physical activity was defined as engaging in vigorous physical activity ≥ 3 times/wk.
↵§§ A low level of physical activity was defined as engaging in vigorous physical activity < 3 times/wk.
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