Causes of Death Are Linked to a Person’s Weight

[Guest guest]

I got this from the NYtimes site. I'm not sure the link will work if

you're not a subscriber, but here it is anyway:

http://snipurl.com/1taov

The astounding thing I noticed in this article was this statement by

Dr. Barrett-Connor, a professor of family and preventive

medicine at the University of California, San Diego: " A body mass

index of 25 to 30, the so-called overweight range, " may be optimal, "

The article:

November 7, 2007

Causes of Death Are Linked to a Person's Weight

By GINA KOLATA

About two years ago, a group of federal researchers reported that

overweight people have a lower death rate than people who are normal

weight, underweight or obese. Now, investigating further, they found

out which diseases are more likely to lead to death in each weight group.

Linking, for the first time, causes of death to specific weights, they

report that overweight people have a lower death rate because they are

much less likely to die from a grab bag of diseases that includes

Alzheimer's and Parkinson's, infections and lung disease. And that

lower risk is not counteracted by increased risks of dying from any

other disease, including cancer, diabetes or heart disease.

As a consequence, the group from the Centers for Disease Control and

Prevention and the National Cancer Institute reports, there were more

than 100,000 fewer deaths among the overweight in 2004, the most

recent year for which data were available, than would have expected if

those people had been of normal weight.

Their paper is published today in the Journal of the American Medical

Association.

The researchers also confirmed that obese people and people whose

weights are below normal have higher death rates than people of normal

weight. But, when they asked why, they found that the reasons were

different for the different weight categories.

Some who studied the relation between weight and health said the

nation might want to reconsider what are ideal weights.

" If we use the criteria of mortality, then the term `overweight' is a

misnomer, " said McGee, professor of statistics at Florida State

University.

" I believe the data, " said Dr. Barrett-Connor, a professor

of family and preventive medicine at the University of California, San

Diego. A body mass index of 25 to 30, the so-called overweight range,

" may be optimal, " she said.

Others said there were plenty of reasons that being overweight was not

desirable.

" Health extends far beyond mortality rates, " said Dr. JoAnn Manson,

chief of preventive medicine at Brigham and Women's Hospital in Boston.

Dr. Manson added that other studies, including ones at Harvard, found

that being obese or overweight increased a person's risk for any of a

number of diseases, including diabetes, heart disease and several

forms of cancer. And, she added, excess weight makes it more difficult

to move about and impairs the quality of life.

" That's the big picture in terms of health outcomes, " Dr. Manson said.

" That's what the public needs to look at. "

Researchers generally divide weight into four categories — normal,

underweight, overweight and obese — based on the body mass index,

which is a measure of body fat based on height and weight. A woman who

is 5 foot 4, for instance, would be considered at normal weight at

130, underweight at 107 pounds, overweight at 150 pounds and obese at 180.

In this study, those with normal weight were considered the baseline

and others were compared to them.

The federal researchers, led by Flegal, of the Centers for

Disease Control and Prevention, said the big picture they found was

surprisingly complex. The higher death rate in obese people, as might

be expected, was almost entirely driven by a higher death rate from

heart disease.

But, contrary to expectations, the obese did not have an increased

risk of dying from cancer. They were slightly more likely than people

of normal weights to die of a handful of cancers that are thought to

be related to excess weight — cancers of the colon, breast, esophagus,

uterus, ovary, kidney and pancreas. Yet they had a lower risk of dying

from other cancers, including lung cancer. In the end, the increases

and decreases in cancer risks balanced out.

As for diabetes, it showed up in the death rates only when the

researchers grouped diabetes and kidney disease as one category.

Diabetes can cause kidney disease, they note. But, the researchers

point out, the number of diabetes deaths may be too low because many

people with diabetes die from heart disease, and often the cause of

death is listed as a heart attack.

The diverse collection of diseases other than cancer, heart disease

and diabetes, which show up in the analyses of the underweight and the

overweight, have gone relatively unscrutinized among epidemiologists,

noted Dr. Gail, a cancer institute scientist and an author of

the paper. But, Dr. Gail added, " these are not a negligible source of

mortality. "

The new study began several years ago when the investigators used

national data to look at death risks according to body weight. They

concluded that, compared with people of normal weight, the overweight

had a decreased death risk and the underweight and obese had increased

risk.

That led them to ask if being fat or thin affects a person's life

span, what diseases, exactly, are those individuals at risk for, or

protected from?

The research involved analyzing data from three large national

surveys, the National Health and Nutrition surveys, which are

administered by the National Center for Health Statistics. Their

participants are a nationally representative group of Americans who

are weighed and measured, assuring that heights and weights are

accurate, and followed until death. The investigators determined the

causes of death by asking what was recorded on death certificates.

The researchers caution that a study like theirs cannot speak to cause

and effect. They do not yet know, precisely, what it is about being

underweight, for instance, that increases the death rate from

everything except heart disease and cancer. Researchers tried to rule

out those who were thin, because they might have been already sick.

They also ruled out smokers, and the results did not change.

Dr. Gail, though, had some advice, which, he said, is his personal

opinion as a physician and researcher: " If you are in the pink and

feeling well and getting a good amount of exercise and if your doctor

is very happy with your lab values and other test results, then I am

not sure there is any urgency to change your weight. "

[Guest guest]

Hi folks:

I have previously posted here what I believe to be the explanation

for these data. They do not, imo, invalidate the substantial

benefits available from CRON.

Here is the abstract:

" Cause-Specific Excess Deaths Associated With Underweight,

Overweight, and Obesity. "

M. Flegal, PhD; Barry I. Graubard, PhD; F.

on, PhD; H. Gail, MD, PhD

JAMA. 2007;298(17):2028-2037.

Context: The association of body mass index (BMI) with cause-

specific mortality has not been reported for the US population.

Objective: To estimate cause-specific excess deaths associated with

underweight (BMI <18.5), overweight (BMI 25-<30), and obesity (BMI

30).

Design, Setting, and Participants: Cause-specific relative risks of

mortality from the National Health and Nutrition Examination Survey

(NHANES) I, 1971-1975; II, 1976-1980; and III, 1988-1994, with

mortality follow-up through 2000 (571 042 person-years of follow-up)

were combined with data on BMI and other covariates from NHANES 1999-

2002 with underlying cause of death information for 2.3 million

adults 25 years and older from 2004 vital statistics data for the

United States.

Main Outcome Measures: Cause-specific excess deaths in 2004 by BMI

levels for categories of cardiovascular disease (CVD), cancer, and

all other causes (noncancer, non-CVD causes).

Results: Based on total follow-up, underweight was associated with

significantly increased mortality from noncancer, non-CVD causes (23

455 excess deaths; 95% confidence interval [CI], 11 848 to 35 061)

but not associated with cancer or CVD mortality. Overweight was

associated with significantly decreased mortality from noncancer, non-

CVD causes (–69 299 excess deaths; 95% CI, –100 702 to –37 897) but

not associated with cancer or CVD mortality. Obesity was associated

with significantly increased CVD mortality (112 159 excess deaths;

95% CI, 87 842 to 136 476) but not associated with cancer mortality

or with noncancer, non-CVD mortality. In further analyses, overweight

and obesity combined were associated with increased mortality from

diabetes and kidney disease (61 248 excess deaths; 95% CI, 49 685 to

72 811) and decreased mortality from other noncancer, non-CVD causes

(–105 572 excess deaths; 95% CI, –161 816 to –49 328). Obesity was

associated with increased mortality from cancers considered obesity-

related (13 839 excess deaths; 95% CI, 1920 to 25 758) but not

associated with mortality from other cancers. Comparisons across

surveys suggested a decrease in the association of obesity with CVD

mortality over time.

Conclusions: The BMI-mortality association varies by cause of death.

These results help to clarify the associations of BMI with all-cause

mortality.

Author Affiliations: National Center for Health Statistics, Centers

for Disease Control and Prevention, Hyattsville (Dr Flegal) and

Division of Cancer Epidemiology and Genetics, National Cancer

Institute, Bethesda (Drs Graubard and Gail), land; and Division

of Diabetes Translation, Centers for Disease Control and Prevention,

Atlanta, Georgia (Dr on).

Rodney.

>

>

> I got this from the NYtimes site. I'm not sure the link will work

if

> you're not a subscriber, but here it is anyway:

>

> http://snipurl.com/1taov

>

> The astounding thing I noticed in this article was this statement

by

> Dr. Barrett-Connor, a professor of family and preventive

> medicine at the University of California, San Diego: " A body mass

> index of 25 to 30, the so-called overweight range, " may be

optimal, "

>

> The article:

>

> November 7, 2007

> Causes of Death Are Linked to a Person's Weight

> By GINA KOLATA

>

> About two years ago, a group of federal researchers reported that

> overweight people have a lower death rate than people who are normal

> weight, underweight or obese. Now, investigating further, they found

> out which diseases are more likely to lead to death in each weight

group.

>

> Linking, for the first time, causes of death to specific weights,

they

> report that overweight people have a lower death rate because they

are

> much less likely to die from a grab bag of diseases that includes

> Alzheimer's and Parkinson's, infections and lung disease. And that

> lower risk is not counteracted by increased risks of dying from any

> other disease, including cancer, diabetes or heart disease.

>

> As a consequence, the group from the Centers for Disease Control and

> Prevention and the National Cancer Institute reports, there were

more

> than 100,000 fewer deaths among the overweight in 2004, the most

> recent year for which data were available, than would have expected

if

> those people had been of normal weight.

>

> Their paper is published today in the Journal of the American

Medical

> Association.

>

> The researchers also confirmed that obese people and people whose

> weights are below normal have higher death rates than people of

normal

> weight. But, when they asked why, they found that the reasons were

> different for the different weight categories.

>

> Some who studied the relation between weight and health said the

> nation might want to reconsider what are ideal weights.

>

> " If we use the criteria of mortality, then the term `overweight' is

a

> misnomer, " said McGee, professor of statistics at Florida

State

> University.

>

> " I believe the data, " said Dr. Barrett-Connor, a professor

> of family and preventive medicine at the University of California,

San

> Diego. A body mass index of 25 to 30, the so-called overweight

range,

> " may be optimal, " she said.

>

> Others said there were plenty of reasons that being overweight was

not

> desirable.

>

> " Health extends far beyond mortality rates, " said Dr. JoAnn Manson,

> chief of preventive medicine at Brigham and Women's Hospital in

Boston.

>

> Dr. Manson added that other studies, including ones at Harvard,

found

> that being obese or overweight increased a person's risk for any of

a

> number of diseases, including diabetes, heart disease and several

> forms of cancer. And, she added, excess weight makes it more

difficult

> to move about and impairs the quality of life.

>

> " That's the big picture in terms of health outcomes, " Dr. Manson

said.

> " That's what the public needs to look at. "

>

> Researchers generally divide weight into four categories — normal,

> underweight, overweight and obese — based on the body mass index,

> which is a measure of body fat based on height and weight. A woman

who

> is 5 foot 4, for instance, would be considered at normal weight at

> 130, underweight at 107 pounds, overweight at 150 pounds and obese

at 180.

>

> In this study, those with normal weight were considered the baseline

> and others were compared to them.

>

> The federal researchers, led by Flegal, of the Centers for

> Disease Control and Prevention, said the big picture they found was

> surprisingly complex. The higher death rate in obese people, as

might

> be expected, was almost entirely driven by a higher death rate from

> heart disease.

>

> But, contrary to expectations, the obese did not have an increased

> risk of dying from cancer. They were slightly more likely than

people

> of normal weights to die of a handful of cancers that are thought to

> be related to excess weight — cancers of the colon, breast,

esophagus,

> uterus, ovary, kidney and pancreas. Yet they had a lower risk of

dying

> from other cancers, including lung cancer. In the end, the increases

> and decreases in cancer risks balanced out.

>

> As for diabetes, it showed up in the death rates only when the

> researchers grouped diabetes and kidney disease as one category.

> Diabetes can cause kidney disease, they note. But, the researchers

> point out, the number of diabetes deaths may be too low because many

> people with diabetes die from heart disease, and often the cause of

> death is listed as a heart attack.

>

> The diverse collection of diseases other than cancer, heart disease

> and diabetes, which show up in the analyses of the underweight and

the

> overweight, have gone relatively unscrutinized among

epidemiologists,

> noted Dr. Gail, a cancer institute scientist and an author

of

> the paper. But, Dr. Gail added, " these are not a negligible source

of

> mortality. "

>

> The new study began several years ago when the investigators used

> national data to look at death risks according to body weight. They

> concluded that, compared with people of normal weight, the

overweight

> had a decreased death risk and the underweight and obese had

increased

> risk.

>

> That led them to ask if being fat or thin affects a person's life

> span, what diseases, exactly, are those individuals at risk for, or

> protected from?

>

> The research involved analyzing data from three large national

> surveys, the National Health and Nutrition surveys, which are

> administered by the National Center for Health Statistics. Their

> participants are a nationally representative group of Americans who

> are weighed and measured, assuring that heights and weights are

> accurate, and followed until death. The investigators determined the

> causes of death by asking what was recorded on death certificates.

>

> The researchers caution that a study like theirs cannot speak to

cause

> and effect. They do not yet know, precisely, what it is about being

> underweight, for instance, that increases the death rate from

> everything except heart disease and cancer. Researchers tried to

rule

> out those who were thin, because they might have been already sick.

> They also ruled out smokers, and the results did not change.

>

> Dr. Gail, though, had some advice, which, he said, is his personal

> opinion as a physician and researcher: " If you are in the pink and

> feeling well and getting a good amount of exercise and if your

doctor

> is very happy with your lab values and other test results, then I am

> not sure there is any urgency to change your weight. "

>