Body mass index and mortality in non-Hispanic black adults in the NIH-AARP Diet and Health Study.

Although the prevalence of obesity (body mass index, kg/m(2), BMI ≥30) is higher in non-Hispanic blacks than in non-Hispanic whites, the relation of BMI to total mortality in non-Hispanic blacks is not well defined.We investigated the association between BMI and total mortality in 16,471 non-Hispanic blacks in the NIH-AARP Diet and Health Study, a prospective cohort of adults aged 50-71 years.During an average of 13 years of follow-up, 2,609 deaths were identified using the Social Security Administration Death Master File and the National Death Index. Cox proportional hazard models were used to estimate relative risks and two-sided 95% confidence intervals (CI), adjusting for potential confounders.Among individuals with no history of cancer or heart disease at baseline and had a BMI of 20 or greater, the relative risk for total death was 1.12 (95% CI:1.05, 1.19, for a 5-unit increase in BMI) in men and 1.09 (95% CI:1.03, 1.15) in women. Among never smokers with no history of cancer or heart disease at baseline, relative risks for total death for BMI 25-<30, 30-<35, 35-<40, and 40-50, compared with BMI 20-<25, were 1.27 (95% CI: 0.91, 1.78), 1.56 (95% CI: 1.07, 2.28), 2.48 (95% CI: 1.53, 4.05), and 2.80 (95% CI: 1.46, 5.39), respectively, in men and 0.78 (95% CI: 0.59, 1.04), 1.17 (95% CI: 0.88, 1.57), 1.35 (95% CI: 0.96, 1.90), and 1.93 (95% CI: 1.33, 2.81), respectively, in women.Our findings suggest that overweight is related to an increased risk of death in black men, but not in black women, while obesity is related to an increased risk of death in both black men and women. A large pooled analysis of existing studies is needed to systematically evaluate the association between a wide range of BMIs and total mortality in blacks

Trait Rumination Predicts Elevated Evening Cortisol in Sexual and Gender Minority Young Adults

Stress may contribute to illness through the impaired recovery or sustained activity of stress-responsive biological systems. Rumination, or mental rehearsal of past stressors, may alter the body’s stress-responsive systems by amplifying and prolonging exposure to physiological mediators, such as cortisol. The primary aim of the current investigation was to test the extent to which the tendency to ruminate on stress predicts diminished diurnal cortisol recovery (i.e., elevated evening cortisol) in a sample of sexual and gender minority young adults. Participants included 58 lesbian, gay, bisexual, and transgender young adults (Mage = 25.0, SD = 4.1) who completed an initial online survey that assessed trait rumination and current depressed mood. Participants completed daily evening questionnaires and provided salivary cortisol samples at wake, 45 min post-wake, 12 h post-wake, and at bedtime over seven consecutive days. Trait rumination predicted significantly higher cortisol concentrations at bedtime, but was unrelated to other cortisol indices (e.g., morning cortisol, diurnal slope, total output). The association with trait rumination was not accounted for by daily negative affect, and was largely independent of depressed mood. These results have implications for identifying and treating those who may be at risk for impaired diurnal cortisol recovery and associated negative health outcomes

Relative risks (RR) and 95% confidence intervals for total mortality by categories of body mass index in non-Hispanic blacks.

a.<p>Subjects who did not have any prevalent cancer except non-melanoma skin cancer or heart disease at baseline.</p>b.<p>Per 100,000 person-years, directly standardized to the age distribution of the cohort according to sex.</p>c.<p>Adjusted for age, sex, education (less than high school, high school graduate, some college, and college graduate/postgraduate), marital status (married and not married), smoking status (never, former, current), time since quitting smoking (never, stopped ≥10 years ago, stopped 5–9 years ago, stopped 1–4 years ago, stopped <1 year ago, and currently smoking), number of cigarettes per day (0, 1–10, 11–20, 21–30, 31–40, 41–50, 51–60, and >60 cigarettes/day), physical activity (never/rare, ≤3 times/mo, and 1–2 and ≥3 times/wk), alcohol consumption (0, >0–<15, 15–<30, and ≥30 g/day) and menopausal hormone therapy use in women (never, ever). In analysis of men and women, sex was excluded from the list of covariates.</p>d.<p>Adjusted for same covariates as noted in footnote c, except smoking status, time since quitting, and number of cigarettes per day. In analysis of men and women separately, sex was excluded from the list of covariates.</p

Relative risks (RR) and 95% confidence intervals for cause-specific deaths in non-Hispanic black never smokers ^a.

a.<p>Never smokers who did not have any prevalent cancer except non-melanoma skin cancer or heart disease at baseline.</p>b.<p>Adjusted for age, sex, education (less than high school, high school graduate, some college, and college graduate/postgraduate), marital status (married and not married), physical activity (never/rare, ≤3 times/mo, and 1–2 and ≥3 times/wk), alcohol consumption (0, >0–<15, 15–<30, and ≥30 g/day) and menopausal hormone therapy use in women (never, ever).</p

Relative risk for total mortality in non-Hispanic black men and women^{a, b, c}.

<p>a. Subjects who did not have any prevalent cancer except non-melanoma skin cancer or heart disease at baseline b. Adjusted for age, education, marital status, smoking status, time since quitting smoking, number of cigarettes per day, physical activity, alcohol consumption, and menopausal hormone therapy use in women. Analysis of never smokers with no history of diseases at baseline was adjusted for same covariates except smoking status, time since quitting smoking, number of cigarettes per day. c. Men, 1,347 deaths in subjects with no history of disease and 288 deaths in never smokers with no history of diseases: Women, 1,262 deaths in subjects with no history of disease and 425 deaths in never smokers with no history of diseases.</p

Relative risk for total mortality per 5-unit increase in body mass index in non-Hispanic blacks, according to selected characteristics^{a, b, c}.

<p>a. Subjects who did not have any prevalent cancer except non-melanoma skin cancer or heart disease at baseline. b. Adjusted for following variables, except for the stratification variable in each analysis: age, sex, education, marital status, smoking status, time since quitting smoking, number of cigarettes per day, physical activity, alcohol consumption, and menopausal hormone therapy use in women. c. Markers indicate the relative risks and horizontal lines indicate 95% confidence intervals. d. Number of death; p value for interaction: 0.55 for sex, 0.50 for age at baseline, <0.001 for smoking, 0.75 for physical activity, 0.40 for education, and 0.13 for alcohol.</p