Evaluation of waist circumference to predict general obesity and arterial hypertension in women in Greater Metropolitan Belo Horizonte,Brazil

This study examined the capacity of waist circumference (WC) to identify subjects with overweight (BMI >/=25) and obesity (BMI >/=30), in agreement with internationally recommended levels of action. Data were obtained from 791 women, 15-59 years old. After identifying overweight and obesity according to WC values, sensitivity and specificity were calculated to verify whether WC could be a good risk predictor for hypertension. Associations were tested by linear regression and logistic regression, controlling for confounding. WC cut-off points of 80cm and 88cm correctly identified 89.8% and 88.5% of women with overweight and obesity, respectively. Abdominal obesity (WC >/=88cm) was statistically associated with hypertension in the multivariate analysis (OR = 2.88; 95% CI: 1.77-4.67). Hypertension was identified with a sensitivity of 63.8% and 42.8%, and with a specificity of 68.0% and 83.3%, for WC >/=80 and >/=88, respectively. The proposed cut-off points for abdominal obesity can potentially distinguish individuals at risk for future obesity, but has only moderate power to predict individuals with high blood pressure.     

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.     

体重指数、腰围和腰臀比预测高血压、高血糖的实用价值及其建议值探讨

目的：探讨体重指数（BMI）、腰围（WC）、腰臀比（WHR）对于预测高血压、高血糖患病的实用价值及其诊断建议值，为确定我国肥胖和腹部肥胖的诊断指标及其界值提供科学依据。方法：利用1995－1997年全国糖尿病（DM）流行病学调查资料进行分析，方法包括偏相关分析、logistic多因素回归分析、交互作用分析，计算BMI、WC、WHR在不同截点暴露对高血压、高血糖和二者聚集的相对危险度（RR）、暴露组归因危险百分比（ARP）和人群归因危险百分比（PARP）。结果：①BMI、WC与血压和血糖的相关性比WHR好；②logistic调整了年龄、性别、职业性体力活动强度、休闲活动强度、文化强度和DM家族史后，BMI、WC、WHR是患高血压、高血糖以及二者聚集重要的预测因子，三者的相对重要性以BMI＞WC＞WHR；③BMI、WC、WHR三者之间对于高血压和高血糖患病率有相加交互作用，尤其以BMI与WC的交互作用普遍存在，其归因交互作用百分比[A[（AB）]在5．95－29．34％之间；④BMI≥23、≥24、≥25时，RR在2．5左右，从流行病学角度看，RR值处于暴露因子与疾病关联的中高度有害范围，其ARP在0．580－0．626之间，从流行病学角度看，RR值处于暴露因子与疾病关联中的中高度有害范围，其ARP在0．580－0．626之间，PARP在0．259－3．08之间，⑤男性WC≥85cm、女性WC≥80cm和男性WC≥90cm，女性WC≥80cm，RR分别在2．06－3．08之间，此时腹部肥胖对高血压、高血糖和二者聚集的PR值分别处于中、高度有害；RR分别在0．515－0．676之间，PARP分别在0．241－0．431之间。结论：从暴露对疾病危害的程度，人们对超重和肥胖的可接受性，我国开展肥胖防治处于初期阶段及公共卫生人群预防的角度综合考虑，在BMI、WC、WHR中，预测我国高血压和高血糖的实用价值以BMI和WC为好，建议以BMI为肥胖指标，BMI≥24诊断为超重和肥胖；以WC为腹部肥胖指标，男性WC≥80cm、女性WC≥80cm为诊断界值。     

Frailty status is related to general and abdominal obesity in older adults

The association between frailty and obesity may differ according to the heterogeneity of body mass index (BMI) and waist circumference (WC) phenotypes in older adults. We hypothesized that the use of simple indicators of general and abdominal obesity combined, may more accurately represent obesity and allow to further elucidate on how frailty status and its criteria are related to obesity. A sample of 1444 older adults, aged ≥65 years (Nutrition UP 65 study) was included in a cross-sectional analysis. General and abdominal obesity were defined according to World Health Organization BMI and WC cut-offs, and frailty by Fried et al. phenotype. A cluster analysis defined groups according to BMI and WC levels. Overweight (BMI between 25.0 and 29.9 kg/m²; 44.6%), general obesity (BMI ≥30.0 kg/m²; 39.0%), and abdominal obesity (WC >102 cm for men and >88 cm for women) were highly frequent (66.5%). Prefrailty (odds ratio [OR]: 2.33; 95% confidence interval [CI]: 1.52-3.57) and frailty (OR: 2.87; 95% CI: 1.58-5.22) were directly associated with the “general and abdominal obesity” cluster. Regarding frailty criteria, low handgrip strength (OR: 2.29; 95% CI: 1.55-3.38) and weight loss (OR: 0.27; 95% CI: 0.14-0.52) were also associated with this cluster. In this sample of older adults presenting a high frequency of overweight and obesity, prefrailty and frailty are linked to higher levels of adiposity, but only when both general and abdominal obesity are present. Present results emphasize the importance of the evaluation of both BMI and WC in the geriatric clinical practice and suggest that older adults presenting both general and abdominal obesity should be routinely screened for frailty.     

Additive interactions of maternal prepregnancy BMI and breast-feeding on childhood overweight

OBJECTIVE: To examine the interactions of maternal prepregnancy BMI and breast-feeding on the risk of overweight among children 2 to 14 years of age. RESEARCH METHODS AND PROCEDURES: The 1996 National Longitudinal Survey of Youth, Child and Young Adult data in the United States were analyzed (n = 2636). The weighted sample represented 51.3% boys, 78.0% whites, 15.0% blacks, and 7.0% Hispanics. Childhood overweight was defined as BMI >/=95th percentile for age and sex. Maternal prepregnancy obesity was determined as BMI >/=30 kg/m(2). The duration of breast-feeding was measured as the weeks of age from birth when breast-feeding ended. RESULTS: After adjusting for potential confounders, children whose mothers were obese before pregnancy were at a greater risk of becoming overweight [adjusted odds ratio (OR), 4.1; 95% confidence interval (CI), 2.6, 6.4] than children whose mothers had normal BMI (<25 kg/m(2); p < 0.001 for linear trend). Breast-feeding for >/=4 months was associated with a lower risk of childhood overweight (OR, 0.6; 95% CI, 0.4, 1.0; p = 0.06 for linear trend). The additive interaction between maternal prepregnancy obesity and lack of breast-feeding was detected (p < 0.05), such that children whose mothers were obese and who were never breast-fed had the greatest risk of becoming overweight (OR, 6.1; 95% CI, 2.9, 13.1). DISCUSSION: The combination of maternal prepregnancy obesity and lack of breast-feeding may be associated with a greater risk of childhood overweight. Special attention may be needed for children with obese mothers and lack of breast-feeding in developing childhood obesity intervention programs.     

Increasing prevalence of overweight, obesity and physical inactivity: two population-based studies 1986 and 1994

INTRODUCTION: The aim of this study was to investigate the 1986-1994 trend in obesity, overweight and sedentary leisure-time physical activity status, and the educational gradient in overweight and obesity in the city of Malm?, Sweden. MATERIAL/METHODS: The public health surveys in Malm? 1986 and 1994 are cross-sectional studies. A total of 4,800 and 5,600 individuals aged 20-80 years were randomly chosen to be interviewed by a postal questionnaire. The participation rates were 74% and 71%. Obesity was defined as BMI 30.0 or more and overweight as BMI 25.0-29.9. The prevalences of leisure-time physical inactivity, obesity and overweight were computed, and the differences between 1986 and 1994 as well as educational gradients in overweight and obesity were assessed. RESULTS: The prevalence of obesity increased from 4.6% to 11.4% (p<0.001) among men and from 6.1% to 9.8% (p<0.001) among women. The prevalence of overweight (BMI 25.0-29.9) increased from 33.9% to 45.2% (p<0.001) among men, and from 19.6% to 29.1% (p<0.001) among women. The prevalence of leisure time physical inactivity increased among men from 14.7% to 18.1% (p<0.001) among men and from 19.4% to 26.7% (p<0.001) among women. The increasing prevalences of obesity, overweight and physical inactivity were observed in all age, country of origin and educational status groups. The educational differences in BMI 25.0+ observed among both men and women in 1986 disappeared among men in 1994. In contrast, educational differences in obesity (BMI 30.0+), not seen in 1986, appeared in 1994 among men. CONCLUSION: The proportions of the population with obesity and overweight increased significantly between 1986 and 1994 for both men and women. The increasing prevalence of physical inactivity seems to be an important explanation.     

Cut-off point of BMI and obesity-related comorbidities and mortality in middle-aged Koreans

OBJECTIVE: The need for a lower BMI to classify overweight in Asian populations has been controversial. Using both disease and mortality outcomes, we investigated whether lower BMI cut-off points are appropriate for identifying increased health risk in Koreans. RESEARCH METHODS AND PROCEDURES: We conducted a cohort study among 773,915 men and women from 30 to 59 years old with 8- to 10-year follow-up periods. Primary outcomes were change of obesity prevalence, obesity-related disease incidence, and all-cause mortality. RESULTS: Prevalence of overweight (BMI of 25.0-29.9) has steadily increased (1.3% annually), whereas obesity (BMI > or = 30) showed a lower prevalence and only a slight increase (0.1%-0.2% annually). Our study revealed that dose-response relationships exist between obesity and related disease incidences (hypertension, type 2 diabetes, and hypercholesterolemia) beginning at lower BMI levels than previously reported. Compared with those in the healthy weight range, Koreans with a BMI > or = 25 were not at greater risk of hypertension, type 2 diabetes, or hypercholesterolemia than has been reported for whites in similar studies. Obesity-related all-cause mortality also did not seem so different from that of whites. DISCUSSION: Our findings did not support the use of a lower BMI cut-off point for defining overweight in Koreans compared with whites for the purpose of identifying different risks. However, populations with BMI > or = 25 are rapidly increasing and have substantial risks of diseases. To preempt the rapid increases in obesity and related health problems that are occurring in Western countries, Korea should consider using a BMI of 25 as an action point for obesity prevention and control interventions.     

Major increase in prevalence of overweight and obesity between 1987 and 2001 among Danish adults

OBJECTIVE: The aim of the study was to examine the secular trends in the prevalence of obesity (BMI >or= 30.0 kg/m(2)) and overweight (25.0 相似文献   

Associations of body mass index with meniscal tears

BACKGROUND: Meniscal tears are common knee injuries, with limited reported data on associated factors, let alone risk factors. The objective of this study was to determine whether associations exist between increasing obesity and meniscal tears leading to surgery. METHODS: We performed frequency-matched case-control studies using surgical case data for years 1996 to 2000 from administrative databases of two large Utah hospitals; each case was matched with three controls from a large cancer screening trial. Meniscal tear cases (262 male and 282 female) were determined by surgical procedures. Inclusion criteria were age (50 to 79) and body mass index (BMI) (17.00 to 54.99 kg/m(2)). Gender-specific, age-adjusted odds ratios with 95% confidence intervals (CIs) were calculated for BMI categories from <20.00 to >/=40.00. The referent BMI category was 20.00 to 22.49. RESULTS: Age-adjusted odds ratios for likelihood of meniscal surgery among those with a BMI of >/=40.00 were 15.0 (95% CI=3.8-59.0) for men, and 25.1 (95% CI=10.3-60.8) for women. All odds ratios for men and women with BMIs of >/=27.50 and >/=25.00, respectively, were statistically significantly elevated. CONCLUSIONS: Significant associations were demonstrated between increasing BMI and meniscal surgeries in both genders, including obese and overweight adults.     

Comorbidity of overweight and obesity in a nationally representative sample of German adults aged 18-79 years

ABSTRACT: BACKGROUND: Overweight has increased in many countries over the past 20 years and excessive body weight is an established risk factor for adverse health outcomes and chronic diseases. This study aimed to determine comorbidity associated with overweight and obesity in a nationally representative sample of German adults. METHODS: In the German National Health Interview and Examination Survey 1998 standardized measures of body weight, height and waist circumference (WC) were obtained for 7,124 men and women 18 to 79 years of age. Information on pre-existing health conditions, health-related behaviors, and sociodemographic characteristics was collected using physician-administered computer-assisted interviews and self-administered questionnaires. World Health Organization (WHO) cut-off criteria were applied to define overweight (BMI: 25.0-29.9 kg/m2) and obesity (BMI [GREATER-THAN OR EQUAL TO]30.0 kg/m2) and abdominal obesity (men: WC [GREATER-THAN OR EQUAL TO]102 cm; women: WC [GREATER-THAN OR EQUAL TO]88 cm). RESULTS: The crude prevalence of persons with cardio metabolic risk factors, diabetes mellitus, cardiovascular disease (CVD), gall bladder disease, and osteoarthritis showed a significant stepwise increase from the lowest to the highest BMI category in both sexes. In multiple logistic regression models adjusting for age, social status, and smoking, significant associations with overweight and obesity persisted for cardio metabolic risk factors and osteoarthritis. For example, obese persons had a three- to fourfold higher chance of having any cardio metabolic risk factor compared to normal weight persons (odds ratio (OR) = 4.07, 95% CI: 3.16-5.25 for men; OR = 3.40 (2.60-4.46) for women). Only in women, overweight and obesity as well as abdominal obesity, independent of BMI category, were significantly and consistently associated with diabetes (overweight: OR = 1.85 (1.03-3.30); obesity: OR = 2.94 (1.63-5.31); abdominal obesity: OR = 1.44 (1.08-1.92) and gall bladder disease (overweight: OR = 1.65 (1.22-2.25); obesity: OR = 3.06 (2.26-4.14); abdominal obesity: OR = 1.73 (1.25-2.39)). CONCLUSION: Current estimates of disease burden underline the public health importance and clinical relevance related to overweight and obesity and needs to take into account comorbidity aspects.     

Trends in waist circumference among U.S. adults

OBJECTIVE: Waist circumference has been proposed as a measure of obesity or as an adjunct to other anthropometric measures to determine obesity. Our objective was to examine temporal trends in waist circumference among adults in the U.S. RESEARCH METHODS AND PROCEDURES: We used data from 15,454 participants >/=20 years old in National Health and Nutrition Examination Survey (NHANES) III (1988 to 1994) and 4024 participants >/=20 years old from National Health and Nutrition Examination Survey 1999 to 2000. RESULTS: The unadjusted waist circumference increased from 95.3 (age-adjusted, 96.0 cm) to 98.6 (age-adjusted, 98.9 cm) cm among men and from 88.7 (age-adjusted 88.9 cm) to 92.2 (age-adjusted 92.1 cm) cm among women. The percentiles from the two surveys suggest that much of the waist circumference distribution has shifted. Statistically significant increases occurred among all age groups and racial or ethnic groups except men 30 to 59 years old, women 40 to 59 and >/=70 years old, and women who were Mexican American or of "other" race or ethnicity. DISCUSSION: These results demonstrate the rapid increase in obesity, especially abdominal obesity, among U.S. adults. Unless measures are taken to slow the increase in or reverse the course of the obesity epidemic, the burden of obesity-associated morbidity and mortality in the U.S. can be expected to increase substantially in future years.     

Prevalence of overweight and obesity among adults with diagnosed diabetes--United States, 1988-1994 and 1999-2002

Obesity in persons with diabetes is associated with poorer control of blood glucose levels, blood pressure, and cholesterol, placing persons with diabetes at higher risk for both cardiovascular and microvascular disease. Conversely, intentional weight loss is associated with reduced mortality among overweight persons with diabetes. CDC analyzed the prevalence of overweight and obesity among U.S. adults aged >/=20 years with previously diagnosed diabetes by using data from two surveys: the Third National Health and Nutrition Examination Survey (NHANES III), 1988-1994, and NHANES 1999-2002. This report summarizes the results of that analysis, which indicated that most adults with diagnosed diabetes were overweight or obese. During 1999-2002, the prevalence of overweight or obesity was 85.2%, and the prevalence of obesity was 54.8%. Encouraging patients to achieve and maintain a healthy weight should be a priority for all diabetes-care programs.     

Peer Reviewed: Behavioral Risk Factors Associated With Overweight and Obesity Among Older Adults: the 2005 National Health Interview Survey

Introduction

Obesity is associated with coronary heart disease, stroke, certain cancers, hypertension, and type 2 diabetes. Concern about obesity among older adults is growing, and research to examine behaviors associated with risk for increased weight in this population is needed. We examined differences by sex in behaviors associated with overweight and obesity among older adults (aged ≥50 years).

Methods

We analyzed data from the 2005 National Health Interview Survey using logistic regression to predict the likelihood of overweight (body mass index [BMI], 25.0-29.9 kg/m²) and obesity (BMI ≥30.0 kg/m²) relative to healthy weight (BMI, 18.5-24.9 kg/m²) among older adults. We used self-reported weights and heights. Correlates were risk behaviors for chronic disease (smoking status, alcohol intake, consumption of fruits and vegetables, leisure-time physical activity, walking for leisure, walking for transportation, and strength training).

Results

Among older men, the prevalence of overweight was 46.3%, and the prevalence of obesity was 25.1%. Among older women, the prevalence of overweight was 33.4%, and the prevalence of obesity was 28.8%. In adjusted logistic regression models, sex differences were observed in the significance of most risk factors for overweight and obesity. Men who were occasional, light, or moderate drinkers were 28% more likely to be obese than men who were nondrinkers; women who were heavy drinkers were 55% less likely to be obese than women who were nondrinkers. Compared with men and women who were regularly active during leisure time, inactive men were 39% more likely to be obese, and inactive women were 28% more likely to be obese.

Conclusion

Several risk behaviors for chronic disease appear to be associated with overweight and obesity among older adults. Modification of these behaviors has the potential to reduce weight.     

Body mass index, overweight and obesity among Kuwaiti intermediate school adolescents aged 10-14 years

OBJECTIVES: The purpose of this cross-sectional study was to assess the levels of overweight and obesity among Kuwaiti intermediate school adolescents aged 10-14 y. The study comprised a multistage stratified random sample of 14659 adolescents (7205 males and 7454 females), which constitutes approximately 17% of the target population of this school level. METHODS: Weights and heights of the adolescents were measured, from which the body mass index (BMI), which is the weight in kilograms divided by the height in meters squared (kg/m2), was calculated. Overweight and obesity were defined as BMI >85th and >95th centiles, respectively, of the National Center for Health Statistics (NCHS) reference data. RESULTS: The overall prevalence of overweight and obesity among males were 30.0 and 14.7%, respectively (P<0.001). The overall prevalence of overweight and obesity among females were 31.8 and 13.1%, respectively (P<0.001 and P<0.01). There was no consistent rise or decline in overweight and obesity in both genders with respect to age. However, the overall prevalence of overweight was lower in males than in females but obesity was higher in males than in females. CONCLUSION: When compared to the NCHS reference population, the BMI of Kuwaiti adolescents exceeded that of the Americans in each centile category > or = 50th centile. Health education programmes should be instituted to control this syndrome in order to prevent future risk of obesity-related diseases.     

Prevalence of overweight and obesity and its associated factors: findings from National Nutrition and Health Survey in Taiwan, 1993-1996

BACKGROUND: To report the overall and regional prevalence of obesity/overweight in Taiwan and to study its associated risk factors. METHODS: A total of 3046 adults > or = 20 years of age collected in National Nutrition and Health Survey in Taiwan, 1993-1996. RESULTS: Prevalence rates of overweight and obesity were 21.1 and 4.0% under the current WHO definition. The prevalence rates of overweight and obesity, using the Taiwanese definition (BMI = 24-26.99 kg/m(2) and > or = 27 kg/m(2), respectively), were 22.9 and 10.5% for males and 20.3 and 13.2% for females, respectively. The highest prevalence rates of obesity were found in the mountainous areas. In addition to age and residing location, education level in women and metabolic equivalent (MET) score and alcohol consumption in men were correlates of obesity. Effects of nutrition/health-related behaviors might be in part explained by education level and residing location of the subjects. CONCLUSION: The prevalence of obesity defined by WHO criteria among people in Taiwan was moderate, with considerable regional variation. The regional differences in obesity prevalence could not be completely accounted for by the sociodemographic and lifestyle factors studied.     

Relationship between body weight gain and significant knee, hip, and back pain in older Americans

OBJECTIVE: To examine the association between BMI (kilograms per meter squared) and reports of significant knee, hip, and back pain using data from a nationally representative sample of U.S. adults 60 years or older. RESEARCH METHODS AND PROCEDURES: Population-based survey data from the Third National Health and Nutrition Examination Survey, involving 5724 adults 60 years or older, were used. BMI, calculated from measured weight (kilograms) and height (meters squared), was used to categorize participants into six BMI-defined groups: underweight (<18.5), desirable weight (18.5 to 24.9), overweight (25 to 29.9), obese class I (30 to 34.9), obese class II (35 to 39.9), and obese class III (>/=40). The presence of significant knee, hip, and back pain in the groups was studied. RESULTS: The overall prevalences of knee, hip, and back pain were 21%, 14%, and 22%, respectively. Prevalence estimates for knee (underweight 12.1% to obesity class III 55.7%), hip (underweight 10.4% to obesity class III 23.3%), and back (underweight 20.2% to obesity class III 26.1%) pain increased with increased BMI. Sex-, race-, and age-specific pain prevalence estimates also generally increased at increased levels of BMI. DISCUSSION: Among U.S. adults 60 years or older, the prevalence of significant knee, hip, and back pain increases with increased levels of BMI.     

Development of a WHO growth reference for school-aged children and adolescents

OBJECTIVE: To construct growth curves for school-aged children and adolescents that accord with the WHO Child Growth Standards for preschool children and the body mass index (BMI) cut-offs for adults. METHODS: Data from the 1977 National Center for Health Statistics (NCHS)/WHO growth reference (1-24 years) were merged with data from the under-fives growth standards' cross-sectional sample (18-71 months) to smooth the transition between the two samples. State-of-the-art statistical methods used to construct the WHO Child Growth Standards (0-5 years), i.e. the Box-Cox power exponential (BCPE) method with appropriate diagnostic tools for the selection of best models, were applied to this combined sample. FINDINGS: The merged data sets resulted in a smooth transition at 5 years for height-for-age, weight-for-age and BMI-for-age. For BMI-for-age across all centiles the magnitude of the difference between the two curves at age 5 years is mostly 0.0 kg/m(2) to 0.1 kg/m(2). At 19 years, the new BMI values at +1 standard deviation (SD) are 25.4 kg/m(2) for boys and 25.0 kg/m(2) for girls. These values are equivalent to the overweight cut-off for adults (> or = 25.0 kg/m(2)). Similarly, the +2 SD value (29.7 kg/m(2) for both sexes) compares closely with the cut-off for obesity (> or = 30.0 kg/m(2)). CONCLUSION: The new curves are closely aligned with the WHO Child Growth Standards at 5 years, and the recommended adult cut-offs for overweight and obesity at 19 years. They fill the gap in growth curves and provide an appropriate reference for the 5 to 19 years age group.     

我国中年人群超重率和肥胖率的现状及发展趋势

目的：了解我国中年人群超重率和肥胖率现状，定量估价近十余年来超重率和肥胖率发展趋势。方法：选择城乡不同地区、不同职业的15个人群（每个人群1000人左右，男女各半，年龄35－59岁）共计15389人为调查对象，以BMI≥25为超重，BMI≥30为肥胖，分别计算超重率和肥胖率，并与20世纪80年代初和90年代初可比资料比较。结果：①各地人群超重率和肥胖率存在极大差异。在超重严重的地区，中年人群超重率已超过50％；②一般来说这种人群差别表现为：北方高于南方，中城市高于内地农村，女性高于男性；③中年人群的超重目前尚主要表现为“肥胖前期”，肥胖率在绝大多数人群中低于10％；④与80年代初相比，90年代初各人群超重率和肥胖率均上升；与90年代初相比，90年代末多数人群超重率肥胖率均再次 大幅度上升。结论：对我国人群超重和肥胖的干预迫在眉睫。     

Medical costs attributable to overweight and obesity in Japanese individuals

ObjectiveWe aimed to reveal the association between body mass index (BMI) and medical costs in the current Japanese population, and to estimate the population attributable fraction (PAF) of medical costs due to overweight and obesity.MethodsA generalized linear mixed model with log link function and gamma distribution was used to evaluate the association between BMI and medical costs in 34,537 beneficiaries of the National Health Insurance aged 40–69 years in Chiba City. Medical cost data were obtained from insurance claims submitted between April 2012 and March 2016. PAFs due to overweight (BMI ≥25.0 and <30.0 kg/m²) and obesity (BMI ≥30.0 kg/m²) were calculated.ResultsOverweight and obesity were significant predictors of excessive medical costs in all age and sex groups. PAF due to overweight and obesity was estimated to be 9.62% (95% confidence interval, 8.52–10.73%). Additionally, PAFs in 40–59-year-old individuals (12.76% in men and 11.63% in women) were greater than those in 60–69-year-old subjects (6.55% in men and 7.80% in women) for both sexes.ConclusionsIn the Japanese population, overweight and obesity are an excessive financial burden with an estimated PAF of 9.62% of total medical costs.