Contribution of Ethnicity, Sex, and Age to the Relationship between Obesity and Mortality: Analyses from the U.S. National Health and Nutrition Examination Survey (NHANES)

Background: Risk factors of obesity are well documented and there are various clinical tools used to assess the risk of obesity including Obesity scaling using BMI, metabolic syndrome, metabolic phenotyping and EOSS. What is still not known is how population demographics have changed over time and their association with obesity and obesity-related health risk. Methods: Data analysis was performed on a merged dataset of continuous cycles of the National Health and Nutrition Examination Survey (NHANES 19992014). Descriptive statistics, Kaplan-Meier curves and Cox proportional hazard regressions were performed on the participants and their assessments from the various clinical tools to visualize and determine patterns overtime. Results: Over time the proportion of individuals in high-risk groups increased across all clinical tools and these high risk groups demonstrated the greatest mortality over time. Over time we have seen the population of the US getting older and more ethnically diverse increasing the risk for obesity and other metabolic factors. Conclusion: In summary, of all the clinical tools assessed in this study, EOSS was the most robust method for the prediction of mortality risk over time. By contrasting the different preclinical tools, we were able to learn which factors are the most crucial in predicting risk of death, and in the future, may contribute to more targeted interventions.