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Body Weight and Longevity-Reply FREE

JoAnn E. Manson, MD; Walter C. Willett, MD; Meir J. Stampfer, MD; Charles H. Hennekens, MD
JAMA. 1987;257(14):1896-1896. doi:10.1001/jama.1987.03390140065012
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In Reply.—  We are grateful to Drs Beasley and Ernsberger for their comments.Dr Beasley suggests that physical activity, social status, and diet should also be examined as confounding variables in the assessment of body weight and longevity. We did note in our report that "improved understanding of the extent to which nutrition and physical activity influence, or mediate, the relationship observed between obesity and mortality is important." We believe, however, that there is a distinction between the nature of these variables and the methodological biases that we emphasized. These variables are not clear and distinct confounders of the weightmortality relationship in the same sense as cigarette smoking. Rather, they have complex interrelationships with body weight, and the causal pathways are unclear. For example, physical inactivity is both a cause and a consequence of obesity, and part of the benefit of exercise may be to control weight. Social status is

REFERENCES

Pooling Project Research Group:  Relationship of blood pressure, serum cholesterol, smoking habit, relative weight and ECG abnormalities to incidence of major coronary events: Final report of the pooling project . J Chronic Dis 1978;;31:201-306.
Waaler HT:  Height, weight and mortality: The Norwegian experience . Acta Med Scand Suppl 1984;;679:1-56.
Rose G, Hamilton PS, Keen H, et al:  Myocardial ischemia, risk factors and death from coronary heart disease . Lancet 1977;;1:105-109.
Marton KI, Sox HC, Krupp JR:  Involuntary weight loss: Diagnostic and prognostic significance . Ann Intern Med 1981;;95:568-574.
Gruchow HW, Sobocinski KA, Barboriak JJ, et al:  Alcohol consumption, nutrient intake and relative body weight among US adults . Am J Clin Nutr 1985;;42:289-295.

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Pooling Project Research Group:  Relationship of blood pressure, serum cholesterol, smoking habit, relative weight and ECG abnormalities to incidence of major coronary events: Final report of the pooling project . J Chronic Dis 1978;;31:201-306.
Waaler HT:  Height, weight and mortality: The Norwegian experience . Acta Med Scand Suppl 1984;;679:1-56.
Rose G, Hamilton PS, Keen H, et al:  Myocardial ischemia, risk factors and death from coronary heart disease . Lancet 1977;;1:105-109.
Marton KI, Sox HC, Krupp JR:  Involuntary weight loss: Diagnostic and prognostic significance . Ann Intern Med 1981;;95:568-574.
Gruchow HW, Sobocinski KA, Barboriak JJ, et al:  Alcohol consumption, nutrient intake and relative body weight among US adults . Am J Clin Nutr 1985;;42:289-295.
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