Frequency of attendance at religious services and cigarette smoking in American women and men: the Third National Health and Nutrition Examination Survey

BACKGROUND: Data are lacking from representative samples of total populations and Hispanic Americans on the association of cigarette smoking and religiousness/spirituality, a protective factor for mortality, and on the validity of self-reported smoking data for religious research. METHODS: The Third National Health and Nutrition Examination Survey (NHANES III) included 18,774 persons aged 20 years and over with complete data on self-reported frequency of attendance at religious services, and cigarette smoking. RESULTS: After stratifying by age, gender, and ethnic group, and adjusting for age, education, region, and health status, infrequent attenders (<24 times/year) were much more likely to be smokers than frequent attenders; odds ratios (95% confidence limits) ranged from 1.74 (1.45-2.10) to 3.06 (1.86-5.03). Among current smokers, frequent attenders smoked an average of 1-5 fewer cigarettes per day. Using serum cotinine > or =14 ng/mL as the gold standard for current smoking, under-reporting of smoking did not vary appreciably with frequency of attendance: false negative percentage for never smokers 3.1% in frequent attenders, 4.2% in others. CONCLUSIONS: Greater frequency of attendance at religious services was associated with lower smoking prevalence by self-report or serum cotinine in a national, multi-ethnic sample.     

Frequency of attendance at religious services and mortality in a U.S. national cohort

OBJECTIVE: Few nationally representative cohort studies have appeared on frequency of attendance at religious services and mortality. We test the hypothesis that > weekly attendance compared with nonattendance at religious services is associated with lower probability of future mortality in such a study. METHODS: Data were analyzed from a longitudinal follow-up study of 8450 American men and women age 40 years and older who were examined from 1988 to 1994 and followed an average of 8.5 years. Measurements at baseline included self-reported frequency of attendance at religious services, sociodemographics, and health, physical and biochemical measurements. RESULTS: Death during follow-up occurred in 2058. After adjusting for confounding by baseline sociodemographics and health status, the hazards ratios (95% confidence limits) were never 1.00 (reference); < weekly 0.89 (0.75-1.04), p = 0.15; weekly 0.82 (0.71-0.94) p = 0.005; and > weekly attenders 0.70 (0.59-0.83), p < 0.001. Mediators, including health behaviors and inflammation, explained part of the association. CONCLUSIONS: In a nationwide cohort of Americans, predominantly Christians, analyses demonstrated a lower risk of death independent of confounders among those reporting religious attendance at least weekly compared to never. The association was substantially mediated by health behaviors and other risk factors.     

The Effects of Religious Attendance and Obesity on Health by Race/Ethnicity

ObjectivesThe objectives of this paper are to examine the effects of religion and obesity on health and determine how the relationship varies by racial/ethnic groups with data from the Panel Study of American Race and Ethnicity (PS-ARE).MethodsUsing ordinal logistic regression, the effects of religion and obesity on self-rated health and how the relationship varies by racial/ethnic groups are investigated. Additionally, to determine whether certain ethnic groups are more impacted by the frequency of religious attendance and obesity, whites, blacks, and Hispanics are analyzed separately with ordinal logistic regression.ResultsWhen obesity was added in focal relationship between religious services attendance and self-rated health strengthened this focal relationship which is a suppression effect between religious services attending and self-rated health adding obesity. For BMI is also significantly associated with decreased odds of reporting better health–normal weight (OR = 2.99; 95% CI = 2.43–3.67) and overweight (OR = 2.19; 95% CI = 1.79–2.68) compared to obese. Subjects who attend religious services 1–2 time a year (OR = 1.30; 95% CI = 1.04–1.62) and 1–3 times a month (OR = 1.28; 95% CI = 1.05–1.57) are associated with increased odds of reporting better health. In whites, attending religious services 1–2 times a year are associated with increased odds of reporting better health (OR = 1.48; 95% CI = 1.09–2.00) and 1–3 times a month are also associated with increased odds of reporting health (OR = 1.34; 95% CI = 1.02–1.78) compared to never attending religious attendance. The frequency of religious services attendance of blacks and Hispanics are not associated with self-rated health. For BMI, being white is more positively associated with increased odds of reporting better health than black and Hispanic subjects. Although white subjects are less likely to attend religious services more frequently than black and Hispanic subjects, the influence on self-rated health in white subjects is more evidenced than other racial/ethnic groups.ConclusionsAlthough it was not proven that the association between participation in religious services and self-rated health is mediated by obesity, the research shows the suppression effect of obesity between participation in religious services and self-rated health.     

Frequent attendance at religious services and mortality over 28 years.

OBJECTIVES: This study analyzed the long-term association between religious attendance and mortality to determine whether the association is explained by improvements in health practices and social connections for frequent attenders. METHODS: The association between frequent attendance and mortality over 28 years for 5286 Alameda Country Study respondents was examined. Logistic regression models analyzed associations between attendance and subsequent improvements in health practices and social connections. RESULTS: Frequent attenders had lower mortality rates than infrequent attenders (relative hazard [RH] = 0.64;95% confidence interval [CI] = 0.53,0.77). Results were stronger for females. Health adjustments had little impact, but adjustments for social connections and health practices reduced the relationship (RH = 0.77; 95% CI = 0.64, 0.93). During follow-up, frequent attenders were more likely to stop smoking, increase exercising, increase social contacts, and stay married. CONCLUSIONS: Lower mortality rates for frequent religious attenders are partly explained by improved health practices, increased social contacts, and more stable marriages occurring in conjunction with attendance. The mechanisms by which these changes occur have broad intervention implications.     

Correlates of overweight and obesity among lesbian and bisexual women

BACKGROUND: Recent studies find lesbians at greater risk for overweight and obesity than heterosexual women. While this may reflect differences in attitudes concerning weight and body shape, little is actually known about risk factors within this group. This study examines correlates of obesity and exercise frequency among lesbians and bisexual women. METHODS: Data from a snowball sample (n = 1209) of lesbians/bisexual women living in Los Angeles Country were utilized. Overweight was defined as BMI >/= 25 kg/m(2); obesity as BMI >/= 30. Associations between sociodemographic characteristics, exercise frequency, health indicators, and weight-related measures were evaluated to identify independent predictors of BMI and exercise frequency. RESULTS: Prevalence of overweight and obesity among lesbians varied by racial/ethnic background. Higher BMI was associated with older age, poorer health status, lower educational attainment, relationship cohabitation, and lower exercise frequency. Higher BMI, perceptions of being overweight, and reporting a limiting health condition were identified as independent predictors of infrequent exercise. Women were generally quite accurate in self-perceptions of weight status. CONCLUSIONS: Correlates of overweight and obesity among lesbians and bisexual women are generally comparable to those observed in studies of heterosexual women. Evidence that lesbians' higher BMI is associated with higher levels of fitness is not supported.     

Disability, arthritis, and body weight among adults 45 years and older

OBJECTIVE: To examine the association between body weight and disability among persons with and without self-reported arthritis. RESEARCH METHODS AND PROCEDURES: Data were analyzed for noninstitutionalized adults, 45 years or older, in states that participated in the Behavioral Risk Factor Surveillance System. Self-reported BMI (kilograms per meter squared) was used to categorize participants into six BMI-defined groups: underweight (<18.5), normal weight (18.5 to < 25), overweight (25 to < 30), obese, class 1 (30 to < 35), obese, class 2 (35 to < 40), and obese, class 3 (> or = 40). RESULTS: Class 3 obesity (BMI > or = 40) was significantly associated with disability among participants both with and without self-reported arthritis. The adjusted odds ratio (AOR) for disability in participants with class 3 obesity was 2.75 [95% confidence interval (CI) = 2.22 to 3.40] among those with self-reported arthritis and 1.77 (95% CI = 1.20 to 2.62) among those without self-reported arthritis compared with those of normal weight (BMI 18.5 to < 25). Persons with self-reported arthritis who were obese, class 2 (BMI 35 to < 40) and obese, class 1 (BMI 30 to <35) and women with self-reported arthritis who were overweight (BMI 25 to < 30) also had higher odds of disability compared with those of normal weight [AOR = 1.72 (95% CI = 1.47 to 2.00), AOR = 1.30 (95% CI = 1.17 to 1.44), and AOR = 1.18 (95% CI = 1.06 to 1.32), respectively]. DISCUSSION: Our findings reveal that obesity is associated with disability. Preventing and controlling obesity may improve the quality of life for persons with and without self-reported arthritis.     

Risk groups for overweight and obesity among Turkish and Moroccan migrants in The Netherlands

OBJECTIVES: The association between sociodemographic factors and acculturation with overweight/obesity in Turks and Moroccans was studied to identify target groups for prevention. STUDY DESIGN: A cross-sectional study was undertaken among a sample of 1384 Turks and Moroccans aged 35-74 years in Amsterdam, The Netherlands. METHODS: Data were collected by structured face-to-face interviews. Body mass index (BMI) was calculated from self-reported height and weight data. Sociodemographic variables collected were sex, age, educational level, marital status, parity and income level. Acculturation was measured by cultural orientation and length of residence in The Netherlands. Data of 1095 Turks and Moroccans were analysed using logistic regression, with overweight/obesity (BMI 25.0) as the dependent variable. RESULTS: The prevalence of overweight/obesity was high (57-89%). Age, marital status, parity, income level, cultural orientation and length of residence were not associated or only weakly associated with overweight/obesity. Educational level and overweight/obesity were strongly associated in Turkish women (odds ratio 4.56; 95% confidence intervals 1.54-13.51). CONCLUSIONS: The high prevalence of overweight/obesity in Turkish and Moroccan migrants varies little across sociodemographic groups and is not associated with acculturation. Poorly educated Turkish women are at particularly high risk.     

Does Religiosity Affect Health Risk Behaviors in Pregnant and Postpartum Women?

Objectives We examined the association between religious involvement and health risk behaviors such as smoking, drinking, marijuana use, and having multiple sex partners among a multiethnic sample of pregnant and postpartum women. Methods Using data from the National Survey of Family Growth, we estimated multivariate logistic regression models to determine the association between various aspects of religious involvement (e.g., attendance, salience, and denomination) and certain behaviors known to be risky for pregnant women and their offspring. Results Frequent (more than once a week) and regular (once a week) attenders at religious services had 80% and 60% (respectively) lower odds of drinking alcohol compared to women who attended less than once a week. Similar patterns surfaced with regard to smoking tobacco with the odds of smoking roughly 85% lower (OR = 0.146, P < 0.001) among frequent attenders, and nearly 65% lower among regular attenders (OR = 0.369, P < 0.001). For smoking marijuana, religious attendance again emerges as a strong predictor. The odds of marijuana smoking are nearly 75% lower for women who attend services frequently (OR = 0.260, P < 0.05) and more than 65% lower for those who attend regularly (OR = 0.343, P < 0.01), as compared with their counterparts who attend services less often. Conclusions Religious attendance emerged as an important correlate of less-risky health behaviors among this nationwide sample of pregnant and postpartum women. Future research should include an examination of the links between religious involvement and other important lifestyle factors that may influence maternal and child health.     

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.     

Social class, family, and life-style factors associated with overweight and obesity among adults in Peruvian cities

BACKGROUND: Overweight and obesity have reached epidemic proportions in Latin America. OBJECTIVE: The purpose of this study was to explore social and behavioral factors associated with obesity in Peruvian cities. DESIGN: Between 1998 and 2000 health examination surveys were conducted among adults in 1176 families identified in six cities. Stratified by social class, multistaged random sampling was used. Using body mass index (weight (kg)/height (m)(2)), men and women were classified into normal weight (BMI <25), overweight (BMI 25-29), or obese (BMI > or =30); abdominal circumference (> or =94 cm in men and > or =84 cm in women) further identified morbidity risk. Several demographic, social, and behavioral variables were collected following standardized procedures. RESULTS: Adjusting for age, 37% of women were categorized as normal weight, 40% overweight, and 23% obese; corresponding figures for men were 40, 44, and 16%. More developed cities, e.g., Lima, Arequipa, and Ica, had the largest prevalence of overweight and obesity for both men and women. Adjusted logistic models showed that BMI > or =25 was positively correlated with age; whereas, education was negatively associated, only among women. Other significant associated factors of overweight included city of residence, television viewing > or =4 h daily in women, and underestimation of body weight status. CONCLUSIONS: The study showed elevated rates of overweight across the income level spectrum. Factors such as urban development stage, income, education, and gender posed differential relationships with the risk of overweight and must be considered in designing future public health interventions. Underestimation of body weight status and sedentary behavior may also constitute specific areas of intervention.     

Pediatricians' own weight: self-perception, misclassification, and ease of counseling

OBJECTIVES: Pediatricians underdiagnose overweight and feel ineffective at counseling. Given the relationship between physicians' health and health habits and counseling behaviors, we sought to determine the 1) percentage of pediatricians who are overweight; 2) accuracy of pediatricians' own weight status classification; and 3) relationship between weight self-perception and perceived ease of obesity counseling. RESEARCH METHODS AND PROCEDURES: This study was a cross-sectional, mail survey of North Carolina pediatricians that queried about their weight status and ease of counseling. Accuracy of pediatricians' self-classification of weight status was compared with BMIs derived from self-reported height and weight. Using logistic regression, controlling for potential confounding variables, we examined the association between weight perception and ease of counseling. RESULTS: The unadjusted response rate was 62%, and the adjusted response rate was 71% (n = 355). Nearly one-half (49%) of overweight pediatricians did not identify themselves as such. Men had greater adjusted odds of misclassifying overweight than women [odds ratio (OR), 3.61; 95% confidence interval (CI) = 1.81, 7.21]. Self-classified "thin" pediatricians had nearly six times the odds of reporting more counseling difficulty as a result of their weight than "average" weight pediatricians (OR = 5.69; 95% CI = 2.30, 14.1), and self-identified "overweight" pediatricians reported nearly four times as great counseling difficulty as "average" weight physicians (OR = 3.84; 95% CI = 1.11, 13.3), after adjustment for self-reported BMI weight status and other potential confounders. DISCUSSION: The roles that physician weight misclassification and self-perception potentially play in influencing rates of obesity counseling warrant further research.     

Life events, social support and sense of coherence among frequent attenders in primary health care

OBJECTIVES: The aim of this survey was to compare stressful life events, social support and sense of coherence (SOC) between frequent attenders (FAs) and normal attenders (controls) in primary health care. STUDY DESIGN: A cross-sectional study was conducted in a primary healthcare centre in the south-west of Sweden. METHODS: A postal questionnaire was sent to 263 frequent attenders and 703 normal attenders. The questionnaire comprised sociodemographic variables and scales of stressful life events, social support and SOC. The results from the questionnaire were compared between the groups, and the significance of the variables in terms of attendance was tested in a multiple regression analysis. RESULTS: More of the FAs were secondarily single, they had more chronic diseases and were more often living on a sickness/disablement pension than the controls. FAs did not report more stressful life events than the controls nor was their experience of events more negative. Social support was as strong among FAs as among controls, and it had no significant effect on their frequent attendance. FAs had a significantly weaker SOC compared with controls. The variables that significantly influenced frequent attendance were high age [odds ratio (OR) = 1.02], chronic disease (OR = 3.08), sickness/disablement pension (OR = 2.46) and SOC (OR = 0.97). CONCLUSIONS: SOC had a significant influence on frequent attendance in primary health care, but stressful life events and social support did not. FAs did not report more stressful life events. However, due to an inadequate coping strategy, indicated by a weak SOC, the life events probably caused them more symptoms and diseases, and thereby a higher consulting frequency.     

Religion and mortality among the community-dwelling elderly.

OBJECTIVES: This study analyzed the prospective association between attending religious services and all-cause mortality to determine whether the association is explainable by 6 confounding factors: demographics, health status, physical functioning, health habits, social functioning and support, and psychological state. METHODS: The association between self-reported religious attendance and subsequent mortality over 5 years for 1931 older residents of Marin County, California, was examined by proportional hazards regression. Interaction terms of religion with social support were used to explore whether other forms of social support could substitute for religion and diminish its protective effect. RESULTS: Persons who attended religious services had lower mortality than those who did not (age- and sex-adjusted relative hazard [RH] = 0.64; 95% confidence interval [CI] = 0.52, 0.78). Multivariate adjustment reduced this relationship only slightly (RH = 0.76; 95% CI = 0.62, 0.94), primarily by including physical functioning and social support. Contrary to hypothesis, religious attendance tended to be slightly more protective for those with high social support. CONCLUSIONS: Lower mortality rates for those who attend religious services are only partly explained by the 6 possible confounders listed above. Psychodynamic and other explanations need further investigation.     

Body mass index in individuals with HIV infection and factors associated with thinness and overweight/obesity

A cross-sectional study was conducted using body mass index (BMI) to estimate the prevalence of thinness and overweight/obesity and associated factors in 2,018 individuals with HIV/AIDS attending health services referral centers. The dependent variable was classified as thinness, overweight/obesity and eutrophy. Multinomial logistic regression analyses were performed considering eutrophy as the reference level. The prevalence of thinness was 8.8% and of overweight/obesity, 32.1%. The variables associated with thinness were anemia and CD4 cell count < 200mm3. The variables associated with risk of overweight/obesity were age > 40 years and diabetes, and the variables identified as decreasing likelihood of overweight/obesity were having no long-term partner, smoking, presence of an opportunistic disease, anemia, and albumin levels < 3.5mg/dL. The main nutritional problem observed in this population was overweight and obesity, which were much more prevalent than thinness. Older individuals with diabetes should be targeted for nutritional interventions and lifestyle changes.     

Overweight, obesity, and binge eating in a non-clinical sample of five Brazilian cities

OBJECTIVE: To investigate the relationship between obesity/overweight and binge eating episodes (BEEs) in a large nonclinical population. RESEARCH METHODS AND PROCEDURES: Consumers at shopping centers in five Brazilian cities (N = 2858) who participated in an overweight prevention program were interviewed and had weight and height measured to calculate BMI. RESULTS: Prevalence of overweight (BMI = 25 to 29.9 kg/m2) was 46.6% for men and 36.6% for women. Obesity (BMI > or = 30 kg/m2) was about two-thirds of the prevalence of overweight. BEEs (subjects who binged one or more times per week over the last 3 months) in normal-weight individuals was 1.4% for men and 3.9% for women, whereas in overweight/obese, these prevalences were 6.5% and 5.5%, respectively (p < 0.01). After adjustment for age, socioeconomic variables, and childhood obesity, those who reported BEEs had an odds ratio of being overweight/obese of 3.31 (95% confidence interval: 1.11 to 9.85) for men and 1.73 (95% confidence interval: 1.05 to 2.84) for women. DISCUSSION: These findings indicate a strong association between episodes of binge eating and overweight/obesity, mainly among men.     

Interactions between smoking and weight in pregnancies complicated by preeclampsia and small-for-gestational-age birth

Cigarette smoking protects against preeclampsia but increases the risk of small-for-gestational-age birth (SGA). Regarding body weight, the converse is true: obesity elevates rates of preeclampsia but reduces rates of SGA. The authors assessed the combined effects of smoking and weight among US women developing preeclampsia or SGA, studying 7,757 healthy, primigravid women with singleton pregnancies in 1959-1965. Smoking (never, light, heavy), stratified by prepregnancy body mass index (BMI (weight (kg)/height (m)(2)); underweight, overweight, obese), was examined in relation to preeclampsia and SGA. Among underweight (BMI <18.5) and normal-weight (BMI 18.5-24.9) women, smoking decreased the risk of preeclampsia (for heavy smoking, light smoking, nonsmoking, test for trend p = 0.002 for underweight and p = 0.009 for normal weight) after adjustment for age, race, and socioeconomic status. However, among overweight/obese women (BMI >or=25), this trend was not apparent (p = 0.4). Among both underweight and overweight women, smoking significantly increased SGA risk (trend p < 0.001 for underweight and p = 0.02 for overweight/obese). Obesity eliminated the inverse association between smoking and preeclampsia but did not substantially alter the positive association between smoking and SGA. A possible unifying biologic explanation is discussed in this paper.     

Epidemiology of overweight and obesity and its determinants in Belo Horizonte (MG), Brazil: a cross-sectional population-based study]

OBJECTIVE: To determine the prevalence of overweight and obesity and to study potential risk factors for these conditions in persons over 18 years of age in the metropolitan area of Belo Horizonte, Brazil. METHODS: Data were obtained from a population-based study conducted in 1996 and 1997 by the Brazilian Institute of Geography and Statistics (Instituto Brasileiro de Geografia e Estatística, IBGE) with a random sample of 1 105 individuals. Height and weight were measured by trained personnel. Overweight (body mass index [BMI] > or = 25.0 kg/m2) and obesity (BMI > or = 30.0 kg/m2) were the dependent variables. Bivariate analysis and multivariate logistic regression were used to identify potential risk factors for overweight and obesity. RESULTS: The prevalence of overweight and obesity was 31.1% (95% confidence interval 195% CI]: 27.3 to 35.2) and 5.7% (95% CI: 4.0 to 8.1), respectively, in men, and 25.9% (95% CI: 22.4 to 29.8) and 14.7% (95% CI: 11.9 to 17.9), respectively, in women. Multivariate analysis revealed that age and marital status were independent risk factors for overweight, whereas age, sex, and education were independent risk factors for obesity. Being female and well-educated showed a protective effect against overweight (odds ratio [OR] = 0.52; 95% CI: 0.33 to 0.83), but not against obesity (OR = 3.01; IC 95%: 1.14 to 7.94). Women with low education had a significantly greater risk (OR = 5.95; 95%CI: 2.51 to 14.12) of developing obesity than men having a high educational level. CONCLUSIONS: These results suggest that overweight and obesity may be serious public health problems in the metropolitan area of Belo Horizonte, Brazil. It is important to carry out further studies in order to explore the potential relationship between overweight and obesity on the one hand, and behavioral variables, such as smoking and alcohol consumption, on the other.     

The association between amount of cigarettes smoked and overweight, central obesity among Chinese adults in Nanjing, China

OBJECTIVES: To examine the association between overweight, central obesity and cigarette smoking (total amount of cigarettes smoked [TACS] and status). DESIGN: Population-based cross-sectional study. Setting: Administrative villages and neighborhoods (n=45) randomly selected from three urban districts and two rural counties in Nanjing City, China. SUBJECTS AND METHODS: A representative sample (n=13,463) of permanent local male residents aged 35 years or older; 66.5% were urban residents. The response rate was 90.1%. Overweight (BMI>=24) and central obesity (waist circumference>=85 in men) were defined according to the new Chinese standard. The association between smoking (amount and status) and obesity was examined using logistic and linear regression analysis. RESULTS: The overall prevalence of overweight was 36.1% (29.7% with 24<=BMI<28 and 6.4% with BMI>=28). After adjusted for age, residence, education, occupation, family income, alcohol drinking, dietary intake, occupational and leisure-time physical activity, the prevalence was significantly lower among current smokers (33.0%) than in non-smokers (39.9%) and ex-smokers (39.2%), respectively (p<0.05). The amount of cigarette smoked was reversely associated with BMI (compared to non-smokers, ORs and 95%CIs for smokers with low-, medium- and high-TACS were 0.88 [0.79, 0.98], 0.77 [0.69, 0.86], and 0.77 [0.69, 0.86], respectively). The prevalence of central obesity was 35.9%. Compared to nonsmokers, only male ex-smokers were at increased risk of central obesity (OR=1.38, 95%CI=1.10, 1.74), while there was no significant association with current- smokers (OR=1.02 [0.92, 1.12]). The amount of cigarette smoked was not significantly associated with central obesity. CONCLUSIONS: Cigarette smoking was negatively associated with body weight indicated by BMI but not with central obesity indexed by waist circumference in Chinese men. Cessation of smoking may increase the risk of gaining overall body weight and developing central obesity. Cigarette smoking prevention and cessation should be a public health priority in China.     

Prevalence of obesity and overweight and associated nutritional factors in a population-based Swiss sample: an opportunity to analyze the impact of three different European cultural roots

Purpose

Obesity represents a growing public health concern worldwide. The latest data in Switzerland rely on self-reported body mass index (BMI), leading to underestimation of prevalence. We reassessed the prevalence of obesity and overweight in a sample of the Swiss population using measured BMI and waist circumference (WC) and explored the association with nutritional factors and living in different linguistic-cultural regions.

Methods

Data of 1,505 participants of a cross-sectional population-based survey in the three linguistic regions of Switzerland were analyzed. BMI and WC were measured, and a 24-h urine collection was performed to evaluate dietary sodium, potassium and protein intake.

Results

The prevalence of overweight, obesity and abdominal obesity was 32.2, 14.2 and 33.6 %, respectively. Significant differences were observed in the regional distribution, with a lower prevalence in the Italian-speaking population. Low educational level, current smoking, scarce physical activity and being migrant were associated with an higher prevalence of obesity. Sodium, potassium and protein intake increased significantly across BMI categories.

Conclusions

Obesity and overweight affect almost half of the Swiss adolescents and adults, and the prevalence appears to increase. Using BMI and WC to define obesity led to different prevalences. Differences were furthermore observed across Swiss linguistic-cultural regions, despite a common socio-economic and governmental framework. We found a positive association between obesity and salt intake, with a potential deleterious synergistic effect on cardiovascular risk.