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Midlife Body Mass Index and Total Mortality—Reply
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In Reply: We agree with Dr Cheng that the relationship between obesity and total mortality is an important association for investigation. Our study deliberately focused on the outcomes of heart disease and diabetes because previous literature has shown that the relationship between body mass index and all-cause mortality is U-shaped1 (particularly among older adults). It is complicated by a number of factors such as preexisting conditions, length of follow-up, and smoking.2 It therefore requires a different type of analysis than we conducted and cannot be derived directly from the data that we presented. However, we do intend to perform that study and will report the results when they are available.
Financial Disclosures: None reported.
Lijing L. Yan, PhD, MPH
lijing@northwestern.edu
Kiang Liu, PhD;
Martha L. Daviglus, MD, PhD;
Alan R. Dyer, PhD;
Philip Greenland, MD
Department of Preventive Medicine
Feinberg School of Medicine
Northwestern University
Chicago, Ill
1. Flegal KM, Graubard BI, Williamson DF, Gail MH. Excess deaths associated with underweight, overweight, and obesity. JAMA. 2005;293:1861-1867.
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2. Dyer AR, Stamler J, Garside DB, Greenland P. Long-term consequences of body mass index for cardiovascular mortality: the Chicago Heart Association detection project in industry study. Ann Epidemiol. 2004;14:101-108.
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Letters Section Editor: Robert M. Golub, MD, Senior Editor.
JAMA. 2006;295:1772.
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