OBESITY: Correlates Closely with Early Death

      Overweight individuals have a higher rate of early death, with the exception of black women, according to a new study conducted by the American Cancer Society published in this week's issue of the New England Journal of Medicine. Tracking the health of more than one million African Americans and whites between 1982 and 1996, researchers have put an end to "any lingering questions about whether weight alone increases the risk of death and disease." Dr. JoAnn Manson, a Harvard University endocrinologist and preventive heart specialist, said, "The evidence is now compelling and irrefutable. Obesity is probably the second-leading preventable cause of death in the United States after cigarette smoking, so it is a very serious problem." Lead author Eugenia Calle said, "The message is we're too fat and it's killing us. We need to come up with ways as a society to eat less and exercise more," (Webster, AP/Washington Times, 10/7). Roughly 55% of American adults fall into the World Health Organization definition of being overweight -- a body mass index (weight-height ratio) of 25 to 29.9 (McCullough, Philadelphia Inquirer, 10/7). Researchers discovered that "the lowest rates of death from all causes were found at BMIs between 23.5 and 24.9 in men and 22.0 and 23.4 in women" (NEJM, 10/7 issue).

Unexplained Exception
      The most puzzling finding was the relatively low rate of mortality among overweight black women. The Philadelphia Inquirer reports that while "[e]xcess weight is a particularly serious problem for black women," there is no clear association between being overweight and death. June Stevens, a University of North Carolina professor of nutrition and epidemiology, said, "I think it's very important that we figure it out. We still know that there's an increased prevalence of hypertension, diabetes and cardiovascular disease in heavier African American women, so the message is not that if you're African American and a woman, you don't need to worry about your weight" (10/7). In an editorial in the New England Journal of Medicine, the CDC's David Williamson speculated that blacks "have less access to a regular source of health care and may have less adequate communication with their physicians than whites. Hence, blacks may underreport their current disease." Williamson added, "There is now an opportunity for clinical medicine and public health agencies to begin a dialogue about the prevention of obesity with hitherto unrecognized partners," including food marketers and manufacturers, as well as private and public purchasers of health care (NEJM, 10/7 issue).