«These findings
suggest that limiting high - glycemic index carbohydrates like white bread and potatoes could help
obese individuals reduce cravings and control the urge to overeat,» says Ludwig.
A potential explanation for the secular trend may be that while improved treatment for cardiovascular risk factors or complicating diseases has reduced mortality in all weight classes, the effects may have been greater at higher BMI levels than at lower BMI levels.12 Because obesity is a causal risk factor for hypertension, diabetes, cardiovascular disease, and dyslipidemia,15,19 - 22
obese individuals may have had a higher selective decrease in mortality.18 Indirect evidence of this effect is seen in the findings as the deaths occur at similar time periods in the 3 cohorts, but cohorts recruited at later periods have an increase in the BMI associated with the lowest mortality, possibly
suggesting a period effect related to changes in clinical practice, such as improved treatments, or general public health status, such as decreased smoking or increased physical activity.