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We calculated time to death from the interview
date through December 31, 2006, as
person-months of follow-up by using the
Objectives. We examined the association of body mass index with all-cause
and cardiovascular disease (CVD)–specific mortality risks among US adults and
calculated the rate advancement period by which death is advanced among the
exposed groups.
Methods. We used data from the Third National Health and Nutrition
Examination Survey (1988–1994) linked to the National Death Index mortality
file with follow-up to 2006 (n = 16 868). We used Cox proportional hazards
regression to estimate the rate of dying and rate advancement period for
all-cause and CVD-specific mortality for overweight and obese adults relative
to their normal-weight counterparts.
Results. Compared with normal-weight adults, obese adults had at least 20%
significantly higher rate of dying of all-cause or CVD. These rates advanced death
by 3.7 years (grades II and III obesity) for all-cause mortality and between 1.6
(grade I obesity) and 5.0 years (grade III obesity) for CVD-specific mortality. The
burden of obesity was greatest among adults aged 45 to 64 years for all-cause
and CVD-specific mortality and among women for all-cause mortality.
Conclusions. These findings highlight the impact of the obesity epidemic on
mortality risk and premature deaths among US adults. (AmJPublicHealth. 2014;104:
512–519. doi:10.2105/AJPH.2013.301597)
RESEARCH AND PRACTICE
512 | Research and Practice | Peer Reviewed | Borrell and Samuel American Journal of Public Health | March 2014, Vol 104, No. 3
NHANES III interview date through the date
of death for participants who died; and from
NHANES III interview date to December 31,
2006, for participants assumed to be alive
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