Eugenia E. Calle, PhD, director of analytic epidemiology for the ACS, and her colleagues analyzed data from the ACS's Cancer Prevention Study II (CPS II).

"In a prospective study of more than 1 million adults in the US, 201,622 deaths occurred during 14 years of follow-up," the authors wrote. "We examined the relation between body-mass index and the risk of death from all causes in four subgroups categorized according to smoking status and history of disease. In healthy people who had never smoked, we further examined whether the relation varied according to race, cause of death, or age."

The researchers examined the relationship between body-mass index (BMI), a measure of weight adjusted for height, and risk of death from all causes. Results of the analyses show that the risk of death:
 

• increases for moderately and severely overweight adults in both men and women and in all age groups;
• is greater in whites than in blacks.

"In summary, our findings support the well-established increase in the risk of death associated with severe overweight, as well as a gradient of increasing risk associated with moderate overweight. The consistency of our findings in men and women and in all age groups also argues for the use of a single recommended range of body weight throughout life," the authors concluded.

In an accompanying editorial, David Williamson, PhD, of the Centers for Disease Control and Prevention, reports that large community-based trials have shown that targeting individual behavior regarding weight control has been largely ineffective, and there is considerable motivation for new public health programs outside the operations of what the individual physician may recommend.

"The data reported by Calle et al. better reflect our current mortality among US adults than the earlier study by Stevens et al. Otherwise, the studies appear similar; in both the data were carefully analyzed, and both are among the largest investigations ever of body mass and mortality," he wrote.

He suggested that clinical medicine and public health consider partnerships with food marketers and manufacturers, large employers, transportation agencies, urban planners, and even real estate developers. These potential partners, he wrote, might play key roles in developing and supporting social and environmental policies that can help people improve their diets and also be more physically active.