Visual Abstract

Cardiometabolic risk is linked to BMI but there is a lack of data on whether there are sex differences in the BMI of cardiometabolic risk in Africans. So we compared by sex, cardiometabolic risk and BMI in 192 African-born blacks living in America (men: 64%, age 40±10, (mean±SD)). Cardiometabolic risk was defined by Framingham Risk Score (FRS) which includes sex-specific thresholds for age, systolic BP, cholesterol, HDL, diabetes and smoking. In addition, the influence on FRS of alcohol consumption, fiber intake, education, income and exercise were evaluated. Even though BMI was higher in women (29.4±4.7 vs. 26.5±3.5, P<0.01), FRS was lower (2.28±2.82 vs. 5.28±6.19, P<0.01). Fiber intake was higher in women P<0.01), and smoking was lower (P=0.01). Alcohol intake tended to be lower in women (P=0.08). By multiple regression analyses with FRS as the outcome, adjR2=39%, income and exercise lowered FRS, while years in the US and alcohol intake increased FRS. Importantly, there was a significant interaction between sex and BMI (P<0.01). For every unit increase in BMI, FRS increased in women by 0.13%, but in men increased by 0.57%(Figure). Therefore, at every level of BMI, cardiometabolic risk is lower in women than men and this could be due to a combination of social, behavioral and metabolic factors. Overall, in the absence of sex-specific BMI categories, cardiometabolic risk may be overestimated in obese African women.


T. Hormenu: None. A. E. Sumner: None. A. Wentzel: None. M. Ishimwe: None. E. M. Shoup: None. N. H. Osei-tutu: None. A. Patterson: None. C. Dubose: None. L. Mabundo: None. M. F. Horlyck-romanovsky: None.

Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. More information is available at