Sources of differences in estimates of obesity-associated deaths from first National Health and Nutrition Examination Survey  

Oleh:

Flegal, Katherine M ; Graubard, Barry I. ; Williamson, David F.

Jenis: Article from Journal - ilmiah internasional
Dalam koleksi: The American Journal of Clinical Nutrition vol. 91 no. 03 (Mar. 2010), page 519-527.
Topik: HEALTH AND NUTRITION; Obesity and eating disorders

Ketersediaan

Perpustakaan FK Nomor Panggil: A07.K.2010.01 Non-tandon: 1 (dapat dipinjam: 0) Tandon: tidak ada

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Isi artikel

Background: Estimates of obesity-associated deaths in the United States for 1991 were published by Allison et al (JAMA 1999;282:1530–8) and subsequently for 2000 by Mokdad et al (JAMA 2004;291:1238–45). Flegal et al (JAMA 2005;293:1861–7) then published lower estimates of obesity-associated deaths for 2000. All 3 studies incorporated data from the first National Health and Nutrition Examination Survey (NHANES I). Objective: The objective was to clarify the effects of methodologic differences between the 3 studies in estimates of obesity-associated deaths in the US population by using NHANES I hazard ratios. Design: The earlier reports used imputed smoking data for much of the NHANES I sample rather than the available reported data and applied a method of calculating attributable fractions that did not adjust for the effects of age, sex, and smoking on mortality in the target US population and did not account for effect modification by age. The effects of these and other methodologic factors were examined. Results: The NHANES I hazard ratios in the earlier reports were too low, probably because of the imputed smoking data. The low hazard ratios obscured the magnitude and direction of the bias arising from the incompletely adjusted attributable fraction method. When corrected hazard ratios were used, the incompletely adjusted attributable fraction method overestimated obesity-associated mortality in the target population by >100,000 deaths.

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