Diet Composition, Anthropometrics, and Mortality Risk.

While overeating is considered a cause of the obesity epidemic as quantified by body mass index (BMI), the association of diet with a body shape index (ABSI) and hip index (HI), which are transformations of waist and hip circumference that are independent of BMI and which predict mortality risk, is poorly known. We used data from the Atherosclerosis Risk in Communities (ARIC) study of about 15,000 middle-aged adults to investigate associations between macronutrient intake (energy, carbohydrate, protein, and fat, the latter two divided into plant and animal sources, all based on self-reported food frequency) with anthropometric indices (BMI, ABSI, and HI). We also analyzed the association of diet and anthropometrics with death rate during approximately 30 years of follow-up. High intake of energy and animal fat and protein was generally associated with higher ABSI and lower HI at baseline, as well as greater mortality hazard. BMI was also positively linked with animal fat and protein intake. In contrast, higher intake of carbohydrates and plant fat and protein was associated with lower ABSI and BMI, higher HI, and lower mortality hazard. For example, after adjustment for potential confounders, each standard deviation of additional plant fat intake (as a fraction of total energy) was associated with a 5% decrease in mortality rate, while animal fat intake was associated with a 5% mortality increase per standard deviation. The directions of the associations between diet and anthropometrics are consistent with those found between anthropometrics and mortality without reference to diet.