Letters Section Editor: Robert M. Golub, MD, Senior Editor.
In Reply: We agree with Dr Cheng that the relationship between obesity and total mortality is an important association for investigation. Our study deliberately focused on the outcomes of heart disease and diabetes because previous literature has shown that the relationship between body mass index and all-cause mortality is U-shaped1 (particularly among older adults). It is complicated by a number of factors such as preexisting conditions, length of follow-up, and smoking.2 It therefore requires a different type of analysis than we conducted and cannot be derived directly from the data that we presented. However, we do intend to perform that study and will report the results when they are available.
Yan LL, Liu K, Daviglus ML, Dyer AR, Greenland P. Midlife Body Mass Index and Total Mortality—Reply. JAMA. 2006;295(15):1772. doi:10.1001/jama.295.15.1772-b