Associations among Body Mass Index, Waist Circumference, and Health Indicators in American Indian and Alaska Native Adults

Abstract

Purpose. Little is known about obesity-related health issues among American Indian and Alaska Native (AIAN) populations. Approach. A large cohort of AIAN people was assembled to evaluate factors associated with health. Setting. The study was conducted in Alaska and on the Navajo Nation. Participants. A total of 11,293 AIAN people were included. Methods. We present data for body mass index (BMI, kg/m2) and waist circumference (cm) to evaluate obesity-related health factors. Results. Overall, 32.4% of the population were overweight (BMI 25-29.9 kg/m2), 47.1% were obese (BMI ≥ 30 kg/m2), and 21.4% were very obese (BMI, ≥ 35 kg/m2). A waist circumference greater than 102 cm for men and greater than 88 cm for women was observed for 41.7% of men and 78.3% of women. Obese people were more likely to perceive their health as fair/poor than nonobese participants (prevalence ratio [PR], 1.91; 95% CI, 1.71-2.14). Participants younger than 30 years were three times more likely to perceive their health as being fair or poor when their BMI results were 35 or greater compared with those whose BMI results were less than 25 kg/m2. A larger BMI was associated with having multiple medical conditions, fewer hours of vigorous activity, and more hours of television watching. Conclusions. Given the high rates of obesity in AIAN populations and the association of obesity with other health conditions, it is important to reduce obesity among AIAN people.