Opposing socioeconomic gradients in overweight and obese adults

Objective: Investigate the relationship between socioeconomic status (SES) and prevalence of overweight and/or obesity, by sex, using total annual household income as the indicator of SES and the World Health Organization (WHO) recommended ranges of self‐reported Body Mass Index (BMI) as the indicator of overweight and/or obesity. Methods : Total annual household income and BMI data were obtained from the Victorian Population Health Survey (VPHS), an annual computer‐assisted telephone survey of the health and well‐being of Victorian adults aged 18 years and older. Statistical analysis was conducted using ordinary least squares linear regression on the logarithms of age‐standardised prevalence estimates of overweight (25.0–29.9 kg/m²), obesity (≥30.0 kg/m²), and overweight and obesity combined (≥25.0 kg/m²), by income category and sex. Results: Typical SES gradients were observed in obese males and females, where the prevalence of obesity decreased with increasing income. No SES gradient was observed in overweight females, however, a reverse SES gradient was observed in overweight males, where the prevalence of overweight increased with increasing income. Combining the overweight and obesity categories into a single group eliminated the typical SES gradients observed in males and females for obesity, and resulted in a statistically significant reverse SES gradient in males. Conclusions: Combining the BMI categories of overweight and obesity into a single category masks important SES differences, while combining the data for males and females masks important sex differences. BMI categories of overweight and obesity should be analysed and reported independently, as should BMI data by sex.     

Energy Metabolism in Relation to Diet and Physical Activity: A South Asian Perspective

The prevalence of overweight and obesity is on the rise around the world, not only in the West, but also in Asian countries. South Asian countries in particular are experiencing a rapid increase in overweight and obesity, that coexists with the rapid increase in non-communicable diseases linked to obesity such as diabetes and cardiovascular disease than any other country in Asia. The phenomena observed in South Asian countries are due to the size of the population, the ageing of the population, the high degree of urbanization and the lifestyle changes in favor of increased energy consumption and reduced physical activity. The imbalance between energy consumption and energy expenditure results in the development of a positive energy balance that, over time, accumulates in higher body fat. South Asians were reported to have a more unfavorable body composition with a higher percentage of body fat than Caucasians with an equivalent BMI. Body composition is a major determinant of resting energy expenditure. It has been reported that South Asians have a lower resting energy expenditure than Caucasians with the same BMI. Resting energy expenditure accounts for the majority of total daily energy expenditure and, therefore, plays a crucial role in achieving the balance between energy intake and expenditure.     

Estimating equations to correct self‐reported height and weight: implications for prevalence of overweight and obesity in Australia

Objective: To derive correction equations based on nationally representative data, for the error associated with self‐reported height and weight and to apply these to recent estimates of overweight and obesity in the Australian adult population. Methods: Linear regression was used to derive correction equations to predict reporting error on height, weight and body mass index (BMI) for 8,435 adults, aged 20 and over, who had their height and weight accurately measured as participants of the 1995 National Nutrition Survey (NNS) and who had also supplied self‐reported information within the 1995 National Health Survey (NHS). Results: Evaluation of different correction algorithms suggests that simple correction equations for height and weight (each with one independent variable) are the most useful in the prediction of corrected prevalence of overweight and obesity. Applying these equations to nationally representative data suggests that the prevalence of overweight and obesity (BMI>=25) in Australia in 2004/05 was 66% compared with the value of 54% determined from self‐reported data. Conclusion: We present a simple and reliable method for correcting true prevalence of overweight and obesity from self‐reported data. Implications: In order to get realistic estimates of overweight and obesity in Australia, either measured height and weight data should be collected directly, or equations to correct for self report error should be used.     

SNAP Participation in Preschool‐Aged Children and Prevalence of Overweight and Obesity

BACKGROUND: An increased prevalence of overweight and obesity for adults on government‐funded nutrition assistance, such as the Supplemental Nutrition Assistance Program (SNAP), has been observed; however, this association among preschool‐aged children is not well understood. Longitudinal research designs tracking changes in body mass index‐for‐age (BMI) in children of low‐income households may provide a clearer picture of the association between SNAP participation and overweight and obesity among this age group. To determine if there is a relationship between SNAP participation and overweight and obesity prevalence in low‐income, preschool children, we conducted a cross‐sectional analysis of children in a Head Start program, and a longitudinal analysis of those children who were enrolled for 2 years. METHODS: Height and weight data and SNAP participation of 386 students (207 male, 179 female, 4.2 ± 0.5 years) enrolled in a Head Start program were analyzed; data for 2 years were available for 167 of the students. Height and weight measures were used to determine BMI percentile per Centers for Disease Control and Prevention guidelines. SNAP participation was obtained through a nutritional questionnaire given to parents at time of Head Start Program enrollment. RESULTS: No significant differences were found between SNAP and non‐SNAP participants for BMI percentile in either the cross‐sectional or longitudinal analysis. BMI percentile increased for both groups over time, but failed to reach significance (p = .13). CONCLUSION: Future studies are warranted with an inclusion of a larger and more geographically diverse sample to further determine the association between SNAP participation and overweight and obesity in preschool‐aged children.     

Is ideal body image related to obesity and lifestyle behaviours in African American adolescents?

Background Childhood obesity epidemic has become a public health issue in the USA, especially among African American youths. Research on the association between ideal body image (IBI) and obesity and related lifestyle factors among African American children and adolescents is limited. Methods Data collected from 402 low‐income African American adolescents aged 10–14 years in four Chicago public schools were used. Questionnaires were used to assess IBI, weight perception, weight control practices, and self‐efficacy towards food and physical activity. Body mass index was calculated using measured weight and height. Associations between IBI and weight perception, overweight/obesity and lifestyle behaviours were assessed using linear and logistic regression models. Results The most frequently chosen ideal body size was the fourth of eight silhouettes (from thinnest to heaviest) for boys (55%) and girls (49%). Overweight and obese girls selected larger ideal body figures than the others (trend test: P < 0.001). Compared with those with middle ideal body figures, girls who selected smaller ones were twice as likely to have an unhealthy diet as indicated by less fruit and milk consumption; the odds ratios (ORs) and 95% confidence intervals (95% CIs) were 2.40 (1.15–5.02) for fruits intake (P < 0.05). Overweight and obese boys and girls appeared to have better food choice intentions and food self‐efficacy than their non‐overweight peers (trend test: both P < 0.01). Conclusions Ideal body image is associated with weight status, food self‐efficacy and lifestyle behaviours among low‐income African American adolescents.     

High prevalence of overweight and obesity in women of Islamshahr, Iran

This study determined the prevalence of overweight, overall and central obesity in female adolescents and women and their possible association with marital status, occupation, literacy, parity, daily meal and snack consumption. The study was a cross-sectional, random survey of households. Rural and urban areas of Islamshahr district in Iran were selected and 1003 female adolescents and women aged 10-65 years were studied. The frequency of overweight and obesity were similar in rural and urban areas. On the basis of body mass index (BMI), more than 19% of adolescents were overweight or at risk of it and 66.8% of adult females were overweight or obese. Frequency of central obesity [waist to hip ratio (WHR) > or = 0.85]was 35.7% in all females. The mean BMI was significantly higher in married women and in women with less than 8 years of formal education. The mean WHR was significantly higher in women with less than 8 years of education or with more than 6 parity female adults. In addition, the mean BMIs and WHRs were significantly higher in women without any daily snack consumption. Overweight and obesity was very common in adult females of Islam shahr thus prevention of overweight and obesity through a healthy diet and increased physical activity should now be an important priority area.     

Factors associated with fruit and vegetable consumption among adults

Background: The higher consumption of fruit and vegetables is considered to be an indicator of healthy eating and the protective effects of fruit and vegetable (FV) consumption for noncommunicable diseases have been investigated extensively. The present study aimed to investigate the association between fruit and vegetable intake (FVI), health behaviours and socio‐demographic factors among adult Canadians. Methods: This analysis was based on the information from the Canadian Community Health Survey, Cycle 3.1. Daily intake of fruit and vegetables from a total number of 15 512 apparently healthy individuals, aged 18–64 years, were assessed using a structured questionnaire, which included 20 questions on the frequency of consumption of different types of fruit and vegetables. Multiple logistic regression models were used to determine the association between FVI and some socio‐economic factors and lifestyle behaviour among adult Canadians. Results: In total 77% of Canadian adults consumed fruit and vegetables less than five times per day. Females were more likely to consume more fruit [odds ratio (OR) 2.05; 95% confidence interval (CI) 1.75–2.4], vegetables (OR 1.95; 95% CI 1.65–2.29) and FV (OR 2.52; 95% CI 2.20–2.90) than males. Single/never married individuals, individuals with higher levels of education, never smokers, former drinkers and older people reported more consumption of fruit and vegetables than others. Conclusions: The results obtained in the present study indicate an association between FVI and some socio‐economic and healthy lifestyle behaviours, and that a substantial gap exists between the recommended level and the actual intake of the FV among the Canadian population. Because a higher intake of FV improves public health, it is imperative to tailor nutrition education at the individual and community levels in Canadian populations.     

Changes of overweight and obesity in the adult Swiss population according to educational level,from 1992 to 2007

Background  

In many high income developed countries, obesity is inversely associated with educational level. In some countries, a widening gap of obesity between educational groups has been reported. The aim of this study was to assess trends in body mass index (BMI) and in prevalence of overweight and obesity and their association with educational level in the adult Swiss population.     

Does Overweight and Obesity Impact on Self‐Rated Health? Evidence Using Instrumental Variables Ordered Probit Models

This paper, for the first time, presents estimates of the causal impact of overweight and obesity on self‐rated health (SRH) using instrumental variables (IV) econometric methods. While a number of previous studies have sought to better understand the determinants of SRH, there is no consensus in relation to the impact of overweight and obesity. Using data from a large nationally representative sample of Irish parents and their children, we estimate a range of ordered probit models to isolate the causal effect of overweight and obesity on SRH. Our data includes independently and objectively recorded weight and height measures for parents and their children and we instrument for parental body mass index (BMI) status using the BMI of a biological child. After controlling for a range of individual, socioeconomic, health and lifestyle related variables, we find that being overweight has a negligible impact on SRH, while being obese has a practically and statistically significant negative impact on SRH, with these effects most pronounced for those who are most obese. We find only minor differences in these effects across gender. Copyright © 2015 John Wiley & Sons, Ltd.     

Prevalence of obesity and associated risk factors in a Turkish population (trabzon city, Turkey)

OBJECTIVE: To estimate the prevalence of overweight and obesity (general and central) in the Trabzon Region and its associations with demographic factors (age, sex, marital status, reproductive history in women, and level of education), socioeconomic factors (household income and occupation), family history of selected medical conditions (diabetes, hypertension, and obesity), lifestyle factors (smoking habits, physical activity, and alcohol consumption), and hypertension in the adult population. RESEARCH METHODS AND PROCEDURES: A sample of households was systematically selected from the central province of Trabzon and its five towns, namely, Sürmene, Vakfikebir, Ma?ka, Hayrat, and Tonya. A total of 5016 subjects (2728 women and 2288 men) were included in the study. Individuals more than 20 years old were selected from their family health cards. Demographic factors, socioeconomic factors, family history of selected medical conditions, and lifestyle factors were obtained for all participants. Systolic blood pressure and diastolic blood pressure levels were measured for all subjects. Study procedures were carried out in the local health centers in each town over an 8-month period. Obesity was defined as BMI > or = 30 kg/m2 and overweight as BMI = 25.0 to 29.9 kg/m2. RESULTS: The prevalence of obesity was 23.5%: 29.4% in women and 16.5% in men. The combined prevalence of both overweight and obesity was 60.3%. The prevalence of abdominal obesity was 29.4%: 38.9% among women and 18.1% among men. The prevalence of obesity increased with age, being highest in the 60- to 69-year-old age group (40.8%) but lower again in the 70+ age group. Obesity was associated positively with marital status, parity, cessation of cigarette smoking, alcohol consumption, and household income and inversely with level of education, cigarette use, and physical activity. Also, obesity was associated positively with hypertension. DISCUSSION: In the Trabzon Region, 60.3% of the adult population presents with some excess weight. Obesity is a major public health problem that requires generalized interventions to prevent it among the adult population.     

Occupational sitting time and overweight and obesity in Australian workers

BACKGROUND: One of the major immediate and long-term health issues in modern society is the problem of overweight and obesity. This paper examines the role of the workplace in the problem by studying the association between occupational sitting time and overweight and obesity (body mass index [BMI] > or =25) in a sample of adult Australians in full-time employment. METHODS: Data on age, gender, occupation, physical activity, occupational sitting time, and BMI were collected in September 2003 from a sample of 1579 adult men and women in full-time employment at the time of the survey. Logistic regression was used to examine the association between occupational sitting time and overweight and obesity. RESULTS: Mean occupational sitting time was >3 hours/day, and significantly higher in men (209 minutes) than in women (189 minutes, p=0.026). Univariate analyses showed significant associations between occupational sitting time and BMI of > or =25 in men but not in women. After adjusting for age, occupation, and physical activity, the odds ratio for BMI > or =25 was 1.92 (confidence interval: 1.17-3.17) in men who reported sitting for >6 hours/day, compared with those who sat for <45 minutes/day. CONCLUSIONS: Occupational sitting time was independently associated with overweight and obesity in men who were in full-time paid work. These results suggest that the workplace may play an important role in the growing problem of overweight and obesity. Further research is needed to clearly understand the association between sitting time at work and overweight and obesity in women.     

Fruit and Vegetable Intake and Body Mass Index in a Large Sample of Middle-Aged Australian Men and Women

Dietary guidelines around the world recommend increased intakes of fruits and non-starchy vegetables for the prevention of chronic diseases and possibly obesity. This study aimed to describe the association between body mass index (BMI) and habitual fruit and vegetable consumption in a large sample of 246,995 Australian adults aged 45 + year who had been recruited for the “45 and Up” cohort study. Fruit and vegetable intake was assessed using validated short questions, while weight and height were self-reported. Multinomial logistic regression was used, by sex, to assess the association between fruit and vegetable intake and BMI. Compared to the referent normal weight category (BMI 18.5 to 24.9), the odds ratio (OR) of being in the highest vegetable intake quartile was 1.09 (95% confidence interval (CI) 1.04–1.14) for overweight women (BMI 25.0–29.9) and 1.18 (95% CI 1.12–1.24) for obese women. The association was in the opposite direction for fruit for overweight (OR 0.85; 95% CI 0.80–0.90) and obese women (OR 0.75; 95% CI 0.69–0.80). Obese and overweight women had higher odds of being in the highest intake quartile for combined fruit and vegetable intake, and were more likely to meet the “2 and 5” target or to have five or more serves of fruit and vegetables per day. In contrast, overweight men were less likely to be in high intake quartiles and less likely to meet recommended target of 5 per day, but there was no consistent relationship between obesity and fruit and vegetable intake. Underweight women and underweight men were less likely to be in the highest intake quartiles or to meet the recommended targets. These data suggest that improving adherence to dietary targets for fruit and vegetables may be a dietary strategy to overcome overweight among men, but that overweight and obese women are already adhering to these targets. The association between fruit and vegetable intake and underweight in adults suggests that improving fruit and vegetables intakes are important for the overall dietary patterns of people in this group.     

Perception of overweight is associated with poor academic performance in US adolescents

BACKGROUND: To improve understanding of the mechanisms affecting the relationship between adolescent obesity and poor academic performance, we examined the association of overweight or perceived weight status with academic achievement. METHODS: We performed a cross‐sectional study of 14–17‐year‐olds (N = 11,012) from the nationally representative 2003 Youth Risk Behavior Survey. The main outcome measure was self‐reported grades (mostly A, B, C, D, or F). The primary independent variables were medically defined overweight (body mass index [BMI] ≥ 85th percentile), obesity (BMI ≥ 95th percentile), and participants' perception of their weight status. RESULTS: Medically defined overweight youth were less likely to report higher grades in unadjusted analysis (OR 0.67, 95% CI: 0.60‐0.76, p < .001) and after adjustment for demographics, depression, television and video game use, and physical activity (OR 0.83, 95% CI: 0.74–0.94, p = .003). Statistically significant results also were seen with medically defined obese participants. Youth who perceived themselves as overweight were less likely to report higher grades (OR 0.82, 95% CI: 0.73–0.92, p = .001) in unadjusted analysis and after adjustment for the same variables (OR 0.79, 95% CI: 0.68–0.91, p = .002). The perception of overweight was a more significant determinant of academic performance (OR 0.81, 95% CI: 0.69–0.95, p = .012) compared to medically defined obesity (OR 0.90, 95% CI: 0.77–1.05, p = .174). CONCLUSIONS: Perceived overweight status is negatively associated with academic performance, regardless of actual weight status. These findings suggest that perception of overweight may be a mechanism for prior results indicating a negative association of obesity and academic achievements, and have implications for the academic health of these adolescents.     

Carbohydrate Intake and Overweight and Obesity among Healthy Adults

Background

Little is known about the dietary habits of people with optimal body weight in communities with high overweight and obesity prevalence.

Objective

To evaluate carbohydrate intake in relation to overweight and obesity in healthy, free-living adults.

Design

We used a cross-sectional analysis.

Subjects/setting

The Canadian Community Health Survey Cycle 2.2 is a cross-sectional survey of Canadians conducted in 2004-2005. There were 4,451 participants aged 18 years and older with anthropometric and dietary data and no comorbid conditions in this analysis.

Main outcome measures

Outcome variables were body mass index (BMI; calculated as kg/m²) and overweight or obesity status (dichotomous) defined as BMI ≥25 compared with BMI <25 based on measured height and weight. Diet was evaluated by 24-hour dietary recall based on the Automated Multi-Pass Method.

Statistical analyses performed

Weighted regression models with bootstrapping and cubic splines were used. Outcome variables were BMI and overweight or obesity, and predictors were daily nutrient intake. Adjustment for total energy intake, age, leisure time energy expenditure, sex, smoking, education, and income adequacy was performed.

Results

Risk of overweight and obesity was decreased in all quartiles of carbohydrate intake compared to the lowest intake category (multivariate odds ratio quartile 2=0.63; 95% confidence interval: 0.49 to 0.90; odds ratio quartile 3=0.58; 95% confidence interval: 0.41 to 0.82; odds ratio quartile 4=0.60; 95% confidence interval: 0.42 to 0.85). Spline analyses revealed lowest risk among those consuming 290 to 310 g/day carbohydrates.

Conclusions

Consuming a low-carbohydrate (approximately <47% energy) diet is associated with greater likelihood of being overweight or obese among healthy, free-living adults. Lowest risk may be obtained by consuming 47% to 64% energy from carbohydrates.     

Cheese consumption and prevalence of overweight and obesity in a Basque adult population: a cross-sectional study

Studies have reported a negative association between dairy product consumption and weight status. However, not as much research has focused on cheese; therefore, the aim of this study was to study the association between cheese intake and overweight and obesity in a representative Basque adult population. A food frequency questionnaire (FFQ) was obtained from a random sample of 1081 adults (530 males and 551 females, 17–96 years old). Cheese consumption data were expressed as g/1000?kcal/day. The prevalence of overweight/obesity was higher in men (55.1%) than in women (35.4%) (p?相似文献   

Does consumption of processed foods explain disparities in the body weight of individuals? The case of Guatemala

Overweight/obesity, caused by the ‘nutrition transition’, is identified as one of the leading risk factors for non‐communicable mortality. The nutrition transition in developing countries is associated with a major shift from the consumption of staple crops and whole grains to highly and partially processed foods. This study examines the contribution of processed foods consumption to the prevalence of overweight/obesity in Guatemala using generalized methods of moments (GMM) regression. The results show that all other things remaining constant, a 10% point increase in the share of partially processed foods from the total household food expenditure increases the BMI of family members (aged 10 years and above) by 3.95%. The impact of highly processed foods is much stronger. A 10% point increase in the share of highly processed food items increases the BMI of individuals by 4.25%, ceteris paribus. The results are robust when body weight is measured by overweight/obesity indicators. These findings suggest that increasing shares of partially and highly processed foods from the total consumption expenditure could be one of the major risk factors for the high prevalence of overweight/obesity in the country. Copyright © 2009 John Wiley & Sons, Ltd.     

The prevalence of obesity and the level of adherence to the Korean Dietary Action Guides in Korean preschool children

The objective of this study was to investigate the associations between the prevalence of overweight and obesity and the degree of adherence to the Korean Dietary Action Guides for Children (KDAGC). In a cross-sectional study based on a child care center-based survey in Seoul, Korea, we collected parental-reported questionnaires (n = 2,038) on children''s weight and height, frequency of fruit and vegetable consumption, and the quality of dietary and activity behaviors based on the 2009 KDAGC Adherence Index (KDAGCAI) which was developed as a composite measure of adherence to the KDAGC. Overweight and obesity were determined according to age- and sex-specific BMI percentile from the 2007 Korean national growth chart. Associations were assessed with generalized linear models and polytomous logistic regression models. Approximately 17.6% of Korean preschool children were classified as overweight or obese. Obese preschoolers had lower adherence to the KDAGCAI compared to those with lean/normal weight. Preschoolers with a high quality of dietary and activity behaviors had a 51% decreased odds ratio (OR) of being obese (highest vs. lowest tertile of KDAGCAI-score, 95% CI 0.31, 0.78; P = 0.001); the associations were more pronounced among those who were older (P = 0.048) and lived in lower income households (P = 0.014). A greater frequency of vegetable consumption, but not fruit, was associated with a borderline significant reduction in the prevalence of obesity. Our findings support the association between obesity prevention and high compliance with the Korean national dietary and activity guideline among preschool children.     

Physical Activity and BMI: Evidence From the Panel Study of Income Dynamics Child Development Supplement

BACKGROUND: This study assessed the association between amount of physical activity and body mass index (BMI) percentile among middle and high school children. Total daily physical activity needs to include both in and out of school physical activity. METHODS: A secondary data analysis was performed on 1306 children drawn from the Panel Study of Income Dynamics Child Development Supplement (CDS III, 2007). The dependent variable in this study was BMI percentile, while the independent variable was physical activity. The multinomial logistic regression model was used to assess the associations between physical activity and BMI percentile controlling for age, gender, race/ethnicity, parental income, and neighborhood safety. RESULTS: Children who engaged in low daily physical activity levels had 1.8 times the odds of being obese versus normal weight than those who engaged in moderate levels [odds ratio (OR) = 1.80, confidence interval (CI) = 1.31, 2.48]. African‐American children had 1.6 times the odds of being obese than normal weight (OR = 1.55, CI = 0.99, 2.43) and Hispanic children had approximately 1.8 times the odds of being obese than normal weight in comparison to non‐Hispanic white children (OR = 1.79, CI = 1.00, 3.21). Females had about 1.5 times the odds of being overweight than normal weight than males (OR = 1.49, CI = 1.04, 2.13). CONCLUSIONS: This study suggests that the accumulation of 30 minutes or more of daily physical activity may be effective in decreasing obesity prevalence among middle and high school‐aged children.     

Using simulated patients to develop doctors' skills in facilitating behaviour change: addressing childhood obesity

Medical Education 2010: 44 : 706–715 Objectives This study aimed to describe the application, feasibility and outcomes of using simulated patients (SPs) to increase the skills of general practitioners (GPs) delivering a behavioural intervention to reduce childhood overweight and mild obesity. Methods Five female actors were trained as SPs. A total of 67 GPs from 46 general practices in Melbourne, Victoria, Australia, conducted two simulated consultation visits regarding healthy lifestyle family behaviour change, during which they practised their skills and received formative feedback. The GPs and SPs rated GP performance immediately after each consultation. Subsequently, 139 parents of overweight or obese 5–9‐year‐old children rated GP performance during real‐life consultations. Other measures included child body mass index (BMI) Z‐scores (at baseline and at a 9‐month follow‐up) and GP‐reported levels of comfort and competence and the perceived value of SP visits. Results Simulated patient ratings, but not GP self‐ratings, of GP performance predicted both parent ratings of real‐life consultations (Spearman’s rho 0.39 for correlation with SP rating at Visit 1) and subsequent reductions in BMI Z‐scores between baseline and follow‐up (Visit 1, rho ? 0.45; Visit 2, rho ? 0.46). GP levels of comfort and competence were maintained during and after the SP visits. A total of 95% of GPs rated simulated consultations as useful, although only 18% said they would pay for them. Conclusions Simulated patient assessment may predict real patient feedback and clinical outcomes, helping to identify doctors who require further training in behaviour change techniques. Randomised controlled trials may establish whether SPs actually raise skills or improve outcomes.     

Obesity and leisure time physical activity among Canadians

BACKGROUND: The association between physical activity and obesity are age and sex related. METHODS: The analysis was based on data from 81,512 Canadians aged 20 to 64 years who participated in the Canadian Community Health Survey conducted in 2000-01. Information collected included body mass index (BMI:<25.0 kg/m(2) (normal weight); 25.0-29.9 kg/m(2) (overweight); and 30.0+ kg/m(2) (obese)) and energy expenditure (EE) calculated based on the frequency and duration of leisure time physical activity (LTPA) and its value of metabolic energy cost. RESULTS: Obese men and both obese and overweight women had lower EE values compared with those with normal weight. Overweight men 30 to 49 years of age were more active than men with normal weight. Average EE values decreased with age. Overall, 53.2% of men and 57.1% of women were inactive (EE<1.5 kcal/kg/day). In obese men and women, the corresponding prevalences were 59.7% and 71.4%, respectively. The prevalence of physical inactivity increased with increasing BMI in women and there was no "dose-effect" relationship in men. CONCLUSIONS: Obese Canadians are less active, but overweight men tend to be more active than those with normal weight. The variation in the associations across age and sex groups suggests that intervention program development should take age and sex into consideration.