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  • Letter to the Editor
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Simple examples should not be extrapolated to the US population

International Journal of Obesity volume 32, page 875 (2008)Cite this article

Greenberg et al.1 used data from the Atherosclerosis Risk in Communities (ARIC) study to address some methodological issues in studies of BMI and mortality. We have published2 comments on the issues of regression to the mean and regression dilution raised by Greenberg et al.1 Here, we comment on the approach used by Greenberg et al.1 to extrapolate their findings to the US population.

Greenberg et al.1 excluded most (533/606 or 88%) of the deaths in the ARIC sample. They then attempted to evaluate the possible effects of similar exclusions on estimates of obesity-attributable mortality in the US population by combining analyses of the remaining 73 deaths with some hypothetical examples from our 2005 article.3 However, this is not a valid approach. The simple examples in our article bear no relation to our NHANES analyses and should not be used to extrapolate from the effects of a given change in relative risks in the ARIC sample to changes in estimated deaths attributable to obesity in the US population.

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References

  1. Greenberg JA, Fontaine K, Allison DB . Putative biases in estimating mortality attributable to obesity in the US population. Int J Obes (Lond) 2007; 31: 1449–1455.

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Authors and Affiliations

  1. National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, MD, USA

    K M Flegal

  2. Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA

    B I Graubard & M H Gail

  3. Division of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta, GA, USA

    D F Williamson

Authors
  1. K M Flegal
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  2. B I Graubard
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  3. D F Williamson
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  4. M H Gail
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Correspondence to K M Flegal.

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Flegal, K., Graubard, B., Williamson, D. et al. Simple examples should not be extrapolated to the US population. Int J Obes 32, 875 (2008). https://doi.org/10.1038/sj.ijo.0803788

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