ArticleScientific reports2020
A Body Shape Index (ABSI) achieves better mortality risk stratification than alternative indices of abdominal obesity: results from a large European cohort.
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139 citing papers in PubMed, 1 synthesis or guideline pooled it.
- The predictive value of a body shape index as a novel obesity metric for cancer risk: a systematic review and meta-analysis.Frontiers in nutrition · 2025Pooled it
- Trial
- Triglyceride-related metabolic indices and low relative muscle mass: a cross-sectional analysis of SMILE and NHANES.Endocrine · 2026Article
- Association and Discriminative Performance of a Body Shape Index (ABSI) for Cardiometabolic Disease in a Korean Population.Healthcare (Basel, Switzerland) · 2026Article
- Association Between a Body Shape Index and Epilepsy Among US Adults: Potential Indirect Pathway Through Depressive Symptoms.Brain and behavior · 2026Article
- A Body Shape Index Shows Stronger Associations with Falls than BMI among Older Adults: Evidence from the NHATS Cohort.Gerontology · 2026Article
- The Value of Five Novel Anthropometric Indicators in Evaluating MASLD and Liver Fibrosis in MASLD: A Cross-Sectional Study.JGH open : an open access journal of gastroenterology and hepatology · 2026Article
- Associations of Central Adiposity With Subclinical Coronary Calcification and Disease Progression: Meta-Analysis of 68,629 Participants.JACC. Advances · 2026Article
- Methodological Issues Related to the Reported Association of A Body Shape Index With Abdominal Aortic Calcification in Patients With Hypertension.Clinical cardiology · 2026Article
- Longitudinal study of central obesity and glucose-lipid metabolism in predicting tumor remission among fertility-sparing endometrial cancer patients.European journal of obstetrics & gynecology and reproductive biology: X · 2026Article
- Area-Level Socioeconomic Inequalities in Adiposity among Older Adults: the Moderating Effect of Neighborhood Walkability.Journal of urban health : bulletin of the New York Academy of Medicine · 2026Article
- Six anthropometric indices and all-cause mortality in ageing populations: an observational cohort study in six longitudinal studies.BMC public health · 2026Observational
- Association of Conventional and Electronic Cigarette Use with Obesity and Central Obesity Among Korean Adults: A Cross-Sectional Analysis of the 2016-2018 KNHANES (2016-2018).Medicina (Kaunas, Lithuania) · 2026Article
- Normal-Weight Obesity and an Unfavorable Cardiometabolic Profile: Results from the Study of Workers' Health (ESAT).Healthcare (Basel, Switzerland) · 2026Article
- Article
- Contribution of genetic and environmental factors to obesity indices and their overlap.Diabetes, obesity & metabolism · 2026Article
- Obesity paradox in patients with non-ST-elevation myocardial infarction undergoing percutaneous coronary intervention: A nationwide retrospective observational study.American heart journal plus : cardiology research and practice · 2026Article
- The weight-adjusted waist index predicts sarcopenia in community-dwelling older adults in a nationwide multicenter prospective study.Scientific reports · 2026Article
- Associations between a body shape index and coronary heart disease: a case-control study in southern China.Frontiers in cardiovascular medicine · 2026Article
- Midlife BMI and A Body Shape Index in relation to mortality and coronary heart disease events in a nationwide cohort.Frontiers in nutrition · 2026Article
79 more citing papers are in PubMed but not listed here.
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Authors and funding
47 authors.
Sofia ChristakoudiDepartment of Epidemiology and Biostatistics, Imperial College London, Norfolk Place, St Mary's Campus, London, W2 1PG, UK. s.christakoudi@imperial.ac.uk.
Konstantinos K TsilidisDepartment of Epidemiology and Biostatistics, Imperial College London, Norfolk Place, St Mary's Campus, London, W2 1PG, UK.
David C MullerDepartment of Epidemiology and Biostatistics, Imperial College London, Norfolk Place, St Mary's Campus, London, W2 1PG, UK.
Heinz FreislingInternational Agency for Research on Cancer, World Health Organization, 150 Cours Albert Thomas, 69372, Lyon CEDEX 08, France.
Elisabete WeiderpassInternational Agency for Research on Cancer, World Health Organization, 150 Cours Albert Thomas, 69372, Lyon CEDEX 08, France.
Kim OvervadDepartment of Public Health, Aarhus University, DK-8000, Aarhus, Denmark.
Stefan SöderbergDepartment of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.
Christel HäggströmDepartment of Biobank Research, Umeå University, Umeå, Sweden.
Tobias PischonMax Delbrück Center for Molecular Medicine, 13125, Berlin, Germany.
Christina C DahmDepartment of Public Health, Aarhus University, DK-8000, Aarhus, Denmark.
Jie ZhangDepartment of Public Health, Aarhus University, DK-8000, Aarhus, Denmark.
Anne TjønnelandDanish Cancer Society Research Center, Strandboulevarden 49, DK-2100, Copenhagen Ø, Denmark.
Jytte HalkjærDanish Cancer Society Research Center, Strandboulevarden 49, DK-2100, Copenhagen Ø, Denmark.
Conor MacDonaldCentre de recherche en Epidemiologie et Sante des Populations (CESP), Fac. de médecine - Univ. Paris-Sud, Fac. de médecine - UVSQ, INSERM, Université Paris-Saclay, 94805, Villejuif, France.
Marie-Christine Boutron-RuaultCentre de recherche en Epidemiologie et Sante des Populations (CESP), Fac. de médecine - Univ. Paris-Sud, Fac. de médecine - UVSQ, INSERM, Université Paris-Saclay, 94805, Villejuif, France.
Francesca Romana ManciniCentre de recherche en Epidemiologie et Sante des Populations (CESP), Fac. de médecine - Univ. Paris-Sud, Fac. de médecine - UVSQ, INSERM, Université Paris-Saclay, 94805, Villejuif, France.
Tilman KühnGerman Cancer Research Center (DKFZ), Division of Cancer Epidemiology, Heidelberg, Germany.
Rudolf KaaksGerman Cancer Research Center (DKFZ), Division of Cancer Epidemiology, Heidelberg, Germany.
Matthias B SchulzeDepartment of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany.
Antonia TrichopoulouHellenic Health Foundation, Athens, Greece.
Anna KarakatsaniHellenic Health Foundation, Athens, Greece.
Eleni PeppaHellenic Health Foundation, Athens, Greece.
Giovanna MasalaCancer Risk Factors and Life-Style Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network - ISPRO, Florence, Italy.
Valeria PalaEpidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Via Venezian, 1, 20133, Milan, Italy.
Salvatore PanicoDipartimento di Medicina Clinica e Chirurgia, Federico II University, Naples, Italy.
Rosario TuminoCancer Registry and Histopathology Department, Azienda Sanitaria Provinciale Ragusa (ASP), Ragusa, Italy.
Carlotta SacerdoteUnit of Cancer Epidemiology, Città della Salute e della Scienza University-Hospital and Center for Cancer Prevention (CPO), Turin, Italy.
J Ramón QuirósPublic Health Directorate, Asturias, Spain.
Antonio AgudoUnit of Nutrition and Cancer, Cancer Epidemiology Research Program, Catalan Institute of Oncology-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain.
Maria-Jose SánchezAndalusian School of Public Health (EASP), Granada, Spain.
Lluís CireraCIBER Epidemiology and Public Health (CIBERESP), Madrid, Spain.
Aurelio Barricarte-GurreaCIBER Epidemiology and Public Health (CIBERESP), Madrid, Spain.
Pilar AmianoCIBER Epidemiology and Public Health (CIBERESP), Madrid, Spain.
Ensieh MemarianDept. Clinical Sciences, Skane University Hospital, Lund University, 20502, Malmö, Sweden.
Emily SonestedtNutritional Epidemiology, Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden.
Bas Bueno-de-MesquitaDepartment of Epidemiology and Biostatistics, Imperial College London, Norfolk Place, St Mary's Campus, London, W2 1PG, UK.
Anne M MayJulius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, STR 6.131, P.O. Box 85500, 3508 GA, Utrecht, The Netherlands.
Kay-Tee KhawSchool of Clinical Medicine, Addenbrooke's Hospital, University of Cambridge, Cambridge, CB2 2QQ, UK.
Nicholas J WarehamMRC Epidemiology Unit, Institute of Metabolic Science, School of Clinical Medicine, University of Cambridge, Cambridge, CB2 0QQ, UK.
Tammy Y N TongCancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK.
Inge HuybrechtsInternational Agency for Research on Cancer, World Health Organization, 150 Cours Albert Thomas, 69372, Lyon CEDEX 08, France.
Hwayoung NohInternational Agency for Research on Cancer, World Health Organization, 150 Cours Albert Thomas, 69372, Lyon CEDEX 08, France.
Elom K AglagoInternational Agency for Research on Cancer, World Health Organization, 150 Cours Albert Thomas, 69372, Lyon CEDEX 08, France.
Merete Ellingjord-DaleDepartment of Epidemiology and Biostatistics, Imperial College London, Norfolk Place, St Mary's Campus, London, W2 1PG, UK.
Heather A WardDepartment of Epidemiology and Biostatistics, Imperial College London, Norfolk Place, St Mary's Campus, London, W2 1PG, UK.
Dagfinn AuneDepartment of Epidemiology and Biostatistics, Imperial College London, Norfolk Place, St Mary's Campus, London, W2 1PG, UK.
Elio RiboliDepartment of Epidemiology and Biostatistics, Imperial College London, Norfolk Place, St Mary's Campus, London, W2 1PG, UK.
Funding
Cancer Research UK 14136Cancer Research UK 24390Cancer Research UK 29017Cancer Research UK C570/A16491Cancer Research UK C8221/A19170Medical Research Council G0401527Medical Research Council G1000143Medical Research Council MC_UU_00006/1Medical Research Council MC_UU_12015/1Medical Research Council MR/M012190/1Medical Research Council MR/N003284/1World Health Organization 001
Abstract
Abdominal and general adiposity are independently associated with mortality, but there is no consensus on how best to assess abdominal adiposity. We compared the ability of alternative waist indices to complement body mass index (BMI) when assessing all-cause mortality. We used data from 352,985 participants in the European Prospective Investigation into Cancer and Nutrition (EPIC) and Cox proportional hazards models adjusted for other risk factors. During a mean follow-up of 16.1 years, 38,178 participants died. Combining in one model BMI and a strongly correlated waist index altered the association patterns with mortality, to a predominantly negative association for BMI and a stronger positive association for the waist index, while combining BMI with the uncorrelated A Body Shape Index (ABSI) preserved the association patterns. Sex-specific cohort-wide quartiles of waist indices correlated with BMI could not separate high-risk from low-risk individuals within underweight (BMI < 18.5 kg/m
Indexed as
Body Mass IndexCohort StudiesEuropeFemaleHumansMaleObesity, AbdominalProportional Hazards ModelsRisk FactorsWaist CircumferenceWaist-Hip Ratio
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