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We calculated time to death from the interviewdate through December 31, 2006, asperson-months of follow-up by using theObjectives. We examined the association of body mass index with all-causeand cardiovascular disease (CVD)–specific mortality risks among US adults andcalculated the rate advancement period by which death is advanced among theexposed groups.Methods. We used data from the Third National Health and NutritionExamination Survey (1988–1994) linked to the National Death Index mortalityfile with follow-up to 2006 (n = 16 868). We used Cox proportional hazardsregression to estimate the rate of dying and rate advancement period forall-cause and CVD-specific mortality for overweight and obese adults relativeto 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 deathby 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. Theburden of obesity was greatest among adults aged 45 to 64 years for all-causeand CVD-specific mortality and among women for all-cause mortality.Conclusions. These findings highlight the impact of the obesity epidemic onmortality risk and premature deaths among US adults. (AmJPublicHealth. 2014;104:512–519. doi:10.2105/AJPH.2013.301597)RESEARCH AND PRACTICE512 | Research and Practice | Peer Reviewed | Borrell and Samuel American Journal of Public Health | March 2014, Vol 104, No. 3NHANES III interview date through the dateof death for participants who died; and fromNHANES III interview date to December 31,2006, for participants assumed to be alive
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