Letters Section Editor: Stephen J. Lurie,
MD, PhD, Senior Editor.
To the Editor: Dr Mokdad and colleagues1 attributed 400 000 US deaths to obesity, just
below the 435 000 they attributed to tobacco. The estimate for tobacco
was achieved2 by stratifying by cause of
death, sex, and age, then adding up the resulting individual causes. The estimate
for obesity does not account for important variables, particularly age and
unmodifiable genetic factors.3 Because the
risk of dying because of obesity decreases at advanced age,4 the
authors should have taken this variable into account in the estimations. In
addition, the population age distribution is now older than when these studies
were performed, so applying unadjusted risk estimates to the current population
overestimates the number of deaths.
Barnoya J, Glantz SA. Modifiable Behavioral Factors as Causes of Death. JAMA. 2004;291(24):2941. doi:10.1001/jama.291.24.2941-c