To the Editor: The need for concern regarding epidemic US obesity trends was highlighted by the study by Dr Flegal and colleagues1 that confirmed the association between obesity and mortality from cardiovascular disease and certain cancers. Furthermore, individuals with severe obesity have particularly high mortality from cardiovascular and noncancer noncardiovascular causes. However, the results should not be interpreted to suggest that overweight does not confer health risk. Considerable data link overweight with coronary heart disease,2 - 3 as well as incident hypertension3 - 5 and diabetes,3 - 5 2 cardiovascular risk factors with established morbidity and mortality consequences. They are likely to mediate much of the effects of overweight body mass index on long-term mortality.
The study by Flegal et al did not consider treatment of cardiovascular risk factors. The management of cardiovascular risk factors can alleviate much of their associated health risk, potentially masking the full impact of overweight on health. However, effective treatment does not obviate risk. For example, development of a new treatment that prevented lung cancer deaths among smokers would not lead to a conclusion that smoking does not increase risk of lung cancer death. Furthermore, medical management is not without cost. Treatment of cardiovascular risk factors contributes to the high US health care costs, and it is likely that residual morbidity and disability persist even with good treatment.
Financial Disclosures: None reported.
Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature
Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal
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