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IJE Advance Access originally published online on January 4, 2006
International Journal of Epidemiology 2006 35(1):187-189; doi:10.1093/ije/dyi298
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Published by Oxford University Press on behalf of the International Epidemiological Association © The Author 2006; all rights reserved.

Commentary

Commentary: Obesity and cardiovascular disease risk among the young and old—is BMI the wrong benchmark?

Alan J. Flint1,2 and Eric B. Rimm1,2,3,*

1 Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA
2 Departments of Nutrition, Harvard School of Public Health, Boston, MA, USA
3 Channing Laboratory, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA

* Corresponding author. Department of Epidemiology, Harvard School of Public Health, 655 Huntington Avenue, Boston, MA 02115, USA. E-mail: erimm@hsph.harvard.edu

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The positive relationship between body mass index (BMI) and cardiovascular disease (CVD) mortality has been reported from analyses of data from many large prospective cohort studies.1–5 There is less agreement, however, as to the shape of the curve1 and to what degree the risk of mortality from CVD increases with greater BMI. This has also led to a debate on the proper epidemiological methods for analysis and on the optimal BMI range for lowest risk. The reference category of lowest risk should ideally be defined in a population free of existing disease since clinical and pre-clinical disease can cause weight loss and bias rates of CVD upwards in lower BMI categories. The lowest risk group should also be defined among non-smokers because smoking-induced weight loss can again artificially inflate the . . . [Full Text of this Article]


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