More evidence on obesity and mortality. Where did the obesity paradox go?

January 15th, 2014 by MorganDowney Leave a reply »

The January 16, 2013 issue of the New England Journal of Medicine contains an article by Frank Hu and colleagues looking at mortality among adults with incident type 2 diabetes by Body Mass Index (BMI). Using two large databases, they found a J-shaped association between BMI and mortality among those who had ever smoked and a direct, linear relationship among those who had never smoked. They found no evidence of an “obesity paradox,” the supposed protective effective of overweight. They concluded, “…given the relationship of overweight and obesity to other critical public health end points (e.g. cardiovascular disease and cancer), the maintenance of a healthy body weight should remain the cornerstone of diabetes management, irrespective of smoking cessation.” The article is a contribution to the understanding of obesity’s relationship with premature mortality but will surely not be the last word on this topic.


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