Emma Cooper

SLCC Math 1030

Commentary #3 Correlation vs. Causation
In a study from the New England Journal of Medicine a conclusion was made that a
higher B.M.I. in adolescents (even in the normal range) can cause an increased risk in heart
disease in adulthood. The group used in the study were 2.3 million Israeli adolescents (starting at
around age 17) whose height and weight were taken as a part of medical evaluations for military
service from 1967 to 2010. After following up after 40 years they assessed the association
between the B.M.I. in late adolescence and death from coronary heart disease, stroke, and sudden
death in adulthood (Twig, 2016). They found that there were 2,918 deaths from cardiovascular
causes, about half of them from coronary heart disease (Bakalar, 2016).
The variables in the study were the age at the time of examination, year of birth, and
height. Data regarding education, socioeconomic status, and country of origin were also
recorded (Twig, 2016). 17- year-olds with B.M.I. in the 5th to 24th percentile (median B.M.I. of
about 18.9) and those in the 25th to 49th percentile had only a small increased risk for coronary
heart disease in adulthood (Bakalar, 2016). The surprising thing found though is that those in
the 50th to 74th percentile had a 49% increased risk and those in the 75th to 84th percentile, which
is still normal by current guidelines, had more than twice the risk for coronary heart disease in
adulthood (Bakalar, 2016).
The relationship between a high B.M.I. in adolescence and death from a cardiovascular
related cause in adulthood is a relatively strong one. The correlation between obesity in
adolescents and an increased risk for a cardiovascular death in adulthood has already been

known for a while, but knowing that even a B.M.I. in the higher end of the normal range can
cause a cardiovascular related death is an important conclusion. There is ample evidence in the
article that lends support to this deduction. The fact that those with a B.M.I. in the 50th to 74th
percentile (a normal range for B.M.I.) jumped to a 49% increased risk for coronary heart disease
is significant.
There is reason to think that there is a cause and effect because the data lends itself to be
that way. One thing I think could be looked into further with this study is the effect of
environmental factors on those participating (i.e. diet). Breaking up the data according to
percentiles for B.M.I. in teens and then following up after 40 years helps contribute to the
validity of the study. The percentiles show somewhat extreme differences in regards to the
outcomes of cardiovascular related deaths. Exact data given, for example 2918 of 32,127 deaths
(9.1%) were from cardiovascular causes supports the legitimacy of argument (Twig, 2016).

Works Cited
Bakalar, N. (2016, April 15). Higher B.M.I in Teenagers Tied to Heart Risks Later. Retrieved
from New York Times: http://well.blogs.nytimes.com/2016/04/15/higher-b-m-i-inteenagers-tied-to-heart-risks-later/?&moduleDetail=section-news4&action=click&contentCollection=Health&region=Footer&module=MoreInSection&ve
rsion=WhatsNext&contentID=WhatsNext&pgtype=Blogs&_r=2
Twig, G. (2016, April 13). Body-Mass Index in 2.3 Million Adolescents and Cardiovascular
Death in Adulthood. Retrieved from The New England Journal of Medicine:
http://www.nejm.org/doi/full/10.1056/NEJMoa1503840