Changes in the prevalence of overweight and obesity and their risk factors in Spain, 1987-1997.

BACKGROUND: The aim of this study was to examine the relationship of the changes in the prevalence of overweight and obesity with the changes in some of their risk factors in Spain from 1987 to 1997. METHODS: Data were obtained from three interview-based health surveys, covering representative samples of the noninstitutionalized Spanish population aged 16 years and over and undertaken in 1987 (n = 17,434), 1995 (n = 4,736), and 1997 (n = 4,678). To compensate for the different sample sizes, the 1995 and 1997 surveys were combined. Risk factors for obesity and overweight considered in this study were age, educational level, physical activity at work, physical activity during leisure time, tobacco use, alcohol consumption, and civil status. Data analysis was performed with logistic regression. RESULTS: The prevalence of overweight and obesity (body mass index >or= 25 kg/m(2)) rose from 35.6% in 1987 to 40.9% in 1995/1997 among women and from 47.1 to 56.2% among men. In the period 1987-1995/1997, the proportion of persons with secondary or university education increased by 11.3% in women and 10.8% in men. Similarly, the prevalence of intense or regular leisure-time physical activity increased by 5.7 and 6.2% in women and men, respectively. The remaining risk factors for overweight and obesity registered no substantial change in prevalence over the study period. The prevalence of overweight and obesity expected in 1995/1997, had educational level and leisure-time physical activity been the same as in 1987, is higher than the observed figures; for educational level, expected figures are 7.3 and 1.4% higher than those observed among women and men, respectively, while for leisure-time physical activity corresponding values are 2.8 and 1.6%. CONCLUSIONS: The rise in the prevalence of overweight and obesity in Spain from 1987 to 1997 may have been attenuated by an increase in leisure-time physical activity and by an improvement in educational level, particularly among women. The contribution to overweight and obesity trends attributable to physical activity at work or to tobacco and alcohol consumption appears to be small or null.     

生命早期营养不良对成年后超重和肥胖患病危险影响的研究

目的 研究生命早期食物短缺及营养不良对成年后超重和肥胖患病危险的影响，对成年人慢性病的原因溯源，为国家制订妇女儿童营养改善政策提供科学依据。方法 应用2002年中国居民营养与健康状况调查资料，将三年自然灾害（1959—1961年）出生的研究对象作为受灾害影响人群，将灾害之后（1964年）出生的人群作为未受灾害影响人群（对照组），比较两组人群平均体重指数（BMI）及超重和肥胖患病率，并计算受灾害影响组人群患超重和肥胖的相对危险度（OR）。结果1959—1961年出生女性的BMI均值显著高于未受灾害影响的1964年出生的女性（P〈0．01），调整地区等因素后，1959—1961年出生女性的超重患病率均显著高于1964年出生的对照组女性（P〈0．05）；1959、1960年出生女性的肥胖患病率显著高于1964年出生的对照组女性（P〈0．05）。与1964年出生女性比较，生命早期受灾害影响的1959—1961年出生女性患超重的危险性分别增加28．9％（OR值95％CI为1．063～1．565）、37．2％（OR值95％CI为1．136～1．658）、35．2％（OR值95％CI为1．103～1．657），1959、1960年出生女性患肥胖的危险性分别增加46．5％（OR值95％CI为1．088～1．972）、39．6％（OR值95％CI为1．039～1．876）。而男性四组之间的平均BMI水平、超重和肥胖患病率的差异均无统计学意义（P〉0．05）。结论 生命早期遭受食物供应不足及营养不良可能会使成年后患超重和肥胖的危险性增加，制订适合国情的妇女、儿童营养改善政策，特别是控制新生儿低体重的有效措施对预防成年后慢性病的发生具有重要意义。     

Supermarkets, other food stores, and obesity: the atherosclerosis risk in communities study

BACKGROUND: Obesity is a leading public health concern, and although environmental factors have been hypothesized to play a role in the prevention of obesity, little empirical data exist to document their effects. The purpose of this study was to examine whether characteristics of the local food environment are associated with the prevalence of cardiovascular disease risk factors. METHODS: A cross-sectional study of men and women participating in the third visit (1993-1995) of the Atherosclerosis Risk in Communities (ARIC) Study was conducted in 2004. The analyses included 10,763 ARIC participants residing in one of the 207 eligible census tracts located in the four ARIC-defined geographic areas. Names and addresses of food stores located in Mississippi, North Carolina, Maryland, and Minnesota were obtained from departments of agriculture. Multilevel modeling was used to calculate prevalence ratios of the associations between the presence of specific types of food stores and cardiovascular disease risk factors. RESULTS: The presence of supermarkets was associated with a lower prevalence of obesity and overweight (obesity prevalence ratio [PR] = 0.83, 95% confidence interval [CI] = 0.75-0.92; overweight PR = 0.94, 95% CI = 0.90-0.98), and the presence of convenience stores was associated with a higher prevalence of obesity and overweight (obesity PR = 1.16, 95% CI = 1.05-1.27; overweight PR = 1.06, 95% CI = 1.02-1.10). Associations for diabetes, high serum cholesterol, and hypertension were not consistently observed. CONCLUSIONS: Results from this study suggest that characteristics of local food environments may play a role in the prevention of overweight and obesity.     

Prevalence and trends in overweight and obesity among children and adolescents in Denmark

AIM: To study the current prevalence and trends in overweight and obesity among children and adolescents in Denmark from 1995 to 2000-2002. METHODS: Cross-sectional national dietary surveys were conducted in 1995 and 2000-2002. The analysis was based on two random population samples from the Danish civil registration system. Body mass index (BMI) was calculated from self-reported height and weight for 1,026 and 1,152 children and adolescents (4-18 years), who participated in 1995 and 2000-2002, respectively. The prevalence of overweight and obesity was defined according to the international age and gender-specific child BMI cut-off points. In the statistical analysis, overweight and obesity were included in the prevalence of overweight. RESULTS: Mean BMI increased significantly between 1995 and 2000-2002 for all combinations of age groups (4-6, 7-10, 11-14 and 15-18 years) and genders. Prevalence of overweight increased between survey years for boys and girls for all age groups (4-6, 7-10, 11-14 and 15-18 years), although formal statistical significance was not reached (p>0.05). When all children and adolescents (4-18 years) were analysed, the prevalence of overweight rose significantly from 10.9% (95% confidence interval (CI) 9.0-12.8) to 14.4% (95% CI 12.5-16.3) between 1995 and 2000- 2002 (p=0.01), whereas the increase in the prevalence of obesity did not reach significance (1995, 2.3% (95% CI 1.3-3.3) vs. 2000-2002, 2.4% (95% CI 1.6-3.3); p=0.74). CONCLUSIONS: The present study revealed a significant increase from 1995 to 2000-2002 in mean BMI for boys and girls for all age groups and a significant increase in the prevalence of overweight when all Danish children and adolescents (4-18 years) were analysed.     

玉环县农村社区≥35岁居民超重和肥胖及其与高血压的关系

  目的  了解浙江省玉环县农村社区≥35岁居民超重和肥胖流行现状,探索超重、肥胖与高血压患病的关系。  方法  2009-2010年,采用整群抽样方法在玉环县所有农村社区中抽取124 693名≥35岁常住居民进行横断面调查,分析超重和肥胖与高血压患病之间的关系。  结果  玉环县农村社区≥35岁居民超重和肥胖率分别为34.53%和10.18%。其中男性超重率（35.56%）高于女性（33.66%）,女性肥胖率（11.26%）高于男性（8.90%）,差异均有统计学意义（均有P<0.05）。多因素分析显示:年龄、是否务农、教育程度、规律体育锻炼、吸烟、饮酒和高盐饮食等均为超重/肥胖的可能影响因素（均有P<0.05）。在调整可能的混杂因素后,非条件Logistic回归分析结果显示:男性超重和肥胖者患高血压的风险分别是体重正常人群的2.02（95%CI:1.93~2.11）和3.83（95%CI:3.57~4.10）倍;女性分别为1.94（95%CI:1.86~2.02）和3.56（95%CI:3.35~3.77）倍。  结论  玉环县农村社区≥35岁居民超重和肥胖患病率较高,且超重和肥胖可能增加高血压的患病风险。     

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   

The prevalence of obesity and its related risk factor in the north of iran in 2006

Background: The main objective of this study was to evaluate the prevalence of the obesity and the related risk factors in the north of Iran. Methods: This was a population-based cross-sectional study that enrolled 2495 subjects (1247 males and 1248 females) using stratified cluster sampling. Interviewers recorded the data using a multidimensional questionnaire including anthropometric indexes. Body mass index equal to or greater than 25 was considered as overweight and that of 30 and 40 as obese and pathologic obese respectively. SPSS 16.0 software was used for statistical data analysis. Results: Mean age of the subjects was 39.2 [95% CI: 38.6, 39.8] yr. Mean body mass index was 25.3 [95% CI: 25.0, 25.6] kg/m(2) for men and 27.5 [95% CI: 27.2, 27.9] kg/m2 for women. The prevalence rates of overweight, obesity and pathologic obesity were 29.9% (745/2495), 22.5% (561/2495) and 1.8% (44/2495) respectively. The prevalence of obesity was higher in urban residents than rural ones, 27.3% versus 18.9% respectively (P<0.001). The prevalence rates of obesity and pathologic obesity were much higher in women than men were, 30.3% versus 15.4% and 3.0% versus 0.6% respectively (P=0.001). The odds ratio estimate was 1.68 [95% CI: 1.40, 2.02] for urban area compared to rural area; 2.60 [95% CI: 2.14, 3.15] for females compared to males; 5.95 [95% CI: 3.54, 9.99] for married people compared to single people; 1.89 [95% CI: 1.44, 2.84] for age group of 55-65 years compared to age group of 15-24 years; 1.76 [95% CI: 1.17, 2.64] for illiterate people compared to those who had academic education; 1.98 [95% CI: 1.13, 2.49] for poor people compared to people with high economic level. Conclusion: The prevalence of obesity and overweight is very high in the north of Iran, hence is a signal of serious health problem, and should be the focus of special attention.     

The size of obesity differences associated with educational level in Spain, 1987 and 1995/97

OBJECTIVE: To determine the size of obesity differences associated with educational level in the adult population in Spain. DESIGN: Three cross sectional studies representative of the adult population in Spain were carried out in 1987, 1995, and 1997. SETTING: The general population in Spain. PARTICIPANTS: 11 461 men and 10 219 women aged 25 to 64 years. MAIN RESULTS: For both men and women the obesity prevalence was highest in those with elementary education. In 1987 the obesity prevalence proportion associated with less than third level education (PA) was 24.5% (95% CI 6.0 to 42.8) and 47.9% (15.7 to 71.8) in men and women, respectively. The PAs in 1995/97 were 19.8% (0.2 to 40.2) and 55.1% (21.3 to 72.8). CONCLUSIONS: In 1995/97 the burden of obesity associated with less than third level education was 20% in men and 55% in women aged 25 to 64 years. Between 1987 and 1997 the obesity prevalence proportion associated with less than third level education increased in women and decreased in men.     

Waist circumference as a measurement of obesity in the Netherlands Antilles; associations with hypertension and diabetes mellitus

OBJECTIVES: To evaluate waist circumference (WC) as a screening tool for obesity in a Caribbean population. To identify risk groups with a high prevalence of (central) obesity in a Caribbean population, and to evaluate associations between (central) obesity and self-reported hypertension and diabetes mellitus. DESIGN: Cross-sectional. SETTING: Population-based study. SUBJECTS: A random sample of adults (18 y or older) was selected from the Population Registries of three islands of the Netherlands Antilles. Response was over 80%. Complete data were available for 2025 subjects. INTERVENTION: A questionnaire and measurements of weight, height, waist and hip. MAIN OUTCOME MEASUREMENT: Central obesity indicator (WC > or =102 cm men, > or =88 cm women). RESULTS: WC was positively associated with age (65-74 y vs 18-24 y) in men (OR=7.7, 95% CI 3.4-17.4) and women (OR=6.4, 95% CI 3.2-12.7). Women with a low education had a higher prevalence of central obesity than women with a high education (OR=0.5, 95% CI 0.3-0.7). However, men with a high income had a higher prevalence of a central obesity than men with a low income (OR=1.7, 95% CI=1.1-2.6). WC was the strongest independent obesity indicator associated with self-reported hypertension (OR=1.7, 95% CI 1.4-2.0) and diabetes mellitus (OR=1.6, 95% CI 1.3-1.9). CONCLUSIONS: The identified risk groups were women aged 55-74 y, women with a low educational level and men with a high income. WC appears to be the major obesity indicator associated with hypertension and diabetes mellitus. SPONSORSHIP: Island Governments of Saba, St Eustatius and Bonaire, the Federal Government of the Netherlands Antilles, Dutch Directorate for Kingdom relationships.     

Body Mass Index (BMI) of Adults: Findings of the Malaysian Adult Nutrition Survey (MANS)

The Malaysian Adults Nutrition Survey (MANS) was carried out between October 2002 and July 2003, involving 6,775 men and 3,441 women aged 18 - 59 years. Anthropometric assessment showed that the overall mean body weight and BMI were 62.65 kg (CI: 62.20, 63.09) and 24.37 kg/m2 (CI: 24.21, 24.53) respectively. Based on the WHO (1998) classification of BMI, 12.15% (CI: 11.26, 13.10) were obese (BMI > 30 kg/m2), and 26.71% (CI: 25.50, 27.96) overweight (BMI > 25 - 29.9 kg/m2). Significantly, more women were obese [14.66% (CI: 13.37, 16.04)] while significantly more men were overweight [28.55% (CI: 26.77, 30.40)]. Ethnicitywise, prevalence of obesity was highest among the Malays [15.28% (CI: 13.91, 16.77)] while overweight was highest for the Indians [31.01% (CI: 26.64, 35.76)]. Both obesity and overweight were highest among those aged 40 - 49 years. Obesity was highest for those whose household income was between RM1,500 - 3,500 while overweight was more prevalent for those whose household income exceeded RM3,500. The prevalence of overweight was highest for those with primary education [31.90% (CI: 29.21, 34.72)]. There was no significant urban rural differential in both obesity and overweight. The study found 9.02% (CI:8.82, 10.61) with chronic energy deficiency (CED) (BMI < 18.5 kg/m2). The prevalence of CED was relatively higher in the indigenous population (Orang Asli) [14.53% (CI: 5.14, 34.77)], subjects aged 18-19 years [26.24% (CI: 21.12, 32.09)], and with monthly household income of < RM1,500 [10.85% (CI: 9.63, 12.20)]. The prevalence of CED was not significantly different among the geographical zones and educational levels, and between urban/rural areas and sexes. The results call for priority action to address the serious problem of overweight and obesity among Malaysian adults as it poses a grave burden to the country's resources and development.     

Obesity and adult asthma: potential effect modification by gender, but not by hay fever

PURPOSE: First, we sought to estimate the magnitude of the cross-sectional associations between overweight/obesity and asthma stratified by gender and by self-reported hay fever and second we sought to assess both directions of causality in longitudinal analyses. METHODS: We used cross-sectional and longitudinal data from a population-based cohort study (n=5114, ages 40-65 at baseline). After 8.5 years, 4010 adults were followed-up by questionnaires. Self-reported height and weight were used to calculate body mass index categories. Multivariate adjusted prevalence ratios (PRs), relative risks (RRs), and 95% confidence intervals (95% CI) were calculated using Poisson regression. RESULTS: In cross-sectional analyses, adjusted PRs were comparable for overweight women and men but differed between obese women and men (PR 1.93, 95% CI 1.19-3.14 and PR 0.98, 95% CI 0.56-1.72). PRs were similar when stratified by hay fever. Longitudinal analyses suggested that overweight/obesity did not increase asthma risk substantially (RR 1.02, 95% CI 0.50-2.06), but a relation between asthma and subsequent weight gain could not be excluded (RR 1.34, 95% CI 1.01-1.77). CONCLUSIONS: The prevalence of asthma is almost twice as high in obese versus normal weight women, but not in obese men. The association between overweight/obesity and asthma does not vary by hay fever. A causal relationship between asthma and incident weight gain cannot be excluded.     

Trends in body mass index and prevalence of obesity in Swedish women 1980-89.

STUDY OBJECTIVE--To assess changes in the body mass index (BMI, weight (kg)/height2 (m2)) and in the prevalence of obesity in Swedish women during the 1980s. DESIGN--Data from two successive cross sectional surveys were used. SETTING--The whole of Sweden. SUBJECTS--A total of 7419 women from a 1980-81 survey (response rate 84.6%) and 6306 women from a 1988-89 survey (response rate 80.3%), aged 16-84 years, and forming a representative sample of Swedish women. MEASUREMENTS AND MAIN RESULTS--The results were based on self reported weight and height during interview. The mean BMI of the whole population, adjusted for age, education level, socioeconomic group, region, and nationality, increased by 0.17 kg/m2 (p = 0.0056) over the eight year period. The increase was particularly pronounced in the group aged 25-34 years (0.74 kg/m2; p < 0.0001, which corresponds to more than 2 kg for a woman 168 cm tall). The higher mean BMI was also reflected in the relative increase in the prevalence of obesity (BMI > 28.6 kg/m2) by 19% (odds ratio (OR) = 1.19; 95% confidence interval (CI): 1.04, 1.37) and of the combination of overweight and obesity (BMI > 23.8 kg/m2) by 12% (OR = 1.12; 95% CI 1.03, 1.23) in the whole female population. CONCLUSIONS--During the 1980s the mean BMI and the prevalence of overweight and obesity in adult Swedish women increased. An influence of the sociocultural environment on the body weight in women was stronger than that in men.     

Nocturia and obesity: a population-based study in Finland

The authors' aim in this study was to analyze the association of nocturia with overweight and obesity. In 2003-2004, a questionnaire was mailed to 6,000 randomly selected Finns aged 18-79 years who were identified from the Finnish Population Register Centre. Information on nocturia was collected through questionnaires using the Danish Prostatic Symptom Score and the American Urological Association Symptom Index. Self-reported body weight and height were used to calculate body mass index (BMI; weight (kg)/height (m)2). Subjects were classified on the basis of BMI as nonoverweight (BMI<25), overweight (BMI 25-29.9 kgm2), or obese (BMI>or=30). Of the 6,000 subjects, 62.4% participated. Among men, the age-standardized prevalence of nocturia, defined as at least one void per night, was 33.4% (95% confidence interval (CI): 28.5, 38.3) in the nonoverweight, 35.8% (95% CI: 31.4, 40.1) in the overweight, and 48.2% (95% CI: 38.8, 57.6) in the obese. Among women, the corresponding figures were 37.2% (95% CI: 33.0, 41.5) in the nonoverweight, 48.3% (95% CI: 42.5, 54.2) in the overweight, and 53.6% (95% CI: 43.9, 63.2) in the obese. The associations remained similar when nocturia was defined as two or more voids per night. The age-standardized attributable fraction (population) of increased BMI for nocturia was 17.7% for men and 18.5% for women, corresponding to an 8.5% increase in the crude prevalence of nocturia in men and a 13.9% increase in women. The authors conclude that obesity is associated with increased nocturia, more strongly among women than among men.     

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.     

Prevalence of overweight, obesity and thinness in 9-10 year old children in Mauritius

ABSTRACT: OBJECTIVE: To document the prevalence of overweight, obesity and thinness in 9-10 year old children in Mauritius. METHODS: 412 boys and 429 girls aged 9-10 years from 23 primary schools were selected using stratified cluster random sampling. All data was cross-sectional and collected via anthropometry and self-administered questionnaire. Outcome measures were BMI (kg/m2), prevalence of overweight, obesity (International Obesity Task Force definitions) and thinness (low BMI for age). Linear and logistic regression analyses, accounting for clustering at the school level, were used to assess associations between gender, ethnicity, school location, and school's academic performance (average) to each outcome measure. RESULTS: The distribution of BMI was marginally skewed with a more pronounced positive tail in the girls. Median BMI was 15.6 kg/m2 in boys and 15.4 kg/m2 in girls, respectively. In boys, prevalence of overweight was 15.8% (95% CI: 12.6, 19.6), prevalence of obesity 4.9% (95% CI: 3.2, 7.4) and prevalence of thinness 12.4% (95% CI: 9.5, 15.9). Among girls, 18.9% (95% CI: 15.5, 22.9) were overweight, 5.1% (95% CI: 3.4, 7.7) were obese and 13.1% (95% CI: 10.2, 16.6) were thin. Urban children had a slightly higher mean BMI than rural children (0.5 kg/m2, 95% CI: 0.01, 1.00) and were nearly twice as likely to be obese (6.7% vs. 4.0%; adjusted odds ratio 1.6; 95% CI: 0.9, 3.5). Creole children were less likely to be classified as thin compared to Indian children (adjusted odds ratio 0.3, 95% CI: 0.2, 0.6). CONCLUSION: Mauritius is currently in the midst of nutritional transition with both a high prevalence of overweight and thinness in children aged 9-10 years. The coexistence of children representing opposite sides of the energy balance equation presents a unique challenge for policy and interventions. Further exploration is needed to understand the specific causes of the double burden of malnutrition and to make appropriate policy recommendations.     

Influence of sociodemographic factors in the prevalence of obesity in Spain. The SEEDO'97 Study.

OBJECTIVE: To analyse the influence of social and cultural factors in the prevalence of obesity in the Spanish adult population aged 25--60 y based on available population data. DESIGN: Pooled analysis of four cross-sectional nutrition surveys. SUBJECTS: A total of 5388 free-living subjects aged 25--60 y, respondents of the Nutritional Surveys carried out in four Spanish regions (Catalunya, Basque Country, Madrid and Valencia) from 1990 to 1994. The samples were pooled together and weighted to build a national random sample. MEASUREMENTS: Weight and height were measured on each individual by trained observers. Age, gender, educational level, occupation, habitat (rural/urban) and region were considered. Obesity was defined as body mass index > or = 30 kg/m(2). The protocol used in each survey was in accordance with the recommendations of the Spanish Society for the Study of Obesity (SEEDO). Logistic regression models were designed to analyse the influence of sociodemographic factors in the prevalence of obesity in men and women. RESULTS: The prevalence of obesity was higher in older age groups in men and women, odds ratio (OR) for every 10 y OR=1.40 (95% CI 1.39--1.41) for men and OR=1.86 (95% CI 1.85--1.87) for women. Logistic regression analysis adjusted for age showed higher obesity rates among low educated people, OR=1.80 (95% CI 1.78--1.81) in men and OR=2.36 (95% CI 2.29--2.42) in women (P<0.001). Among men the odds ratio for the prevalence of obesity in rural areas was OR=1.87 (95% CI 1.86--1.89), compared to cities. The geographical distribution showed higher obesity rates in the southeast. CONCLUSION: This study supports that obesity is a multifactorial problem. Older women with low educational level and low income seem to be the most susceptible group to weight gain. Therefore, Public Health Programs should consider this type of environmental factor when planning strategies aimed at preventing or reducing the problem of obesity in western societies.     

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.     

Rural and urban differences in diabetes prevalence in Tanzania: the role of obesity, physical inactivity and urban living

A population-based survey in 1996 and 1997 of 770 adults (aged > or = 15 years) from an urban district of Dares Salaam and 928 from a village in rural Kilimanjaro district (Tanzania) revealed that the prevalence of diabetes, impaired fasting glucose (IFG), overweight, obesity, and physical inactivity was higher in the urban area for men and women. The difference between urban and rural prevalence of diabetes was 3.8 [1x1-6.5]% for men and 2x9 [0x8-4.9]% for women. For IFG, the difference was 2x8 [0x3-5x3]% for men and 3x9 [1x4-6x4]% for women; for overweight and obesity, the difference was 21.5 [15.8-27.1]% and 6.2 [3x5-8.9]% for men and 17x4 [11.5-23.3]% and 12.7 [8x5-16x8]% for women, respectively. The difference in prevalence of physical inactivity was 12x5 [7.0-18.3]% for men and 37.6 [31x9-43.3]% for women. For men with diabetes, the odds for being overweight, obese and having a large waist:hip ratio were 14.1, 5.3 and 12.5, respectively; for women the corresponding values were 9x0, 10x5 and 2x4 (the last not significant) with an attributable fraction for overweight between 64% and 69%. We conclude that diabetes prevalence is higher in the urban Tanzanian community and that this can be explained by differences in the prevalence of overweight. The avoidance of obesity in the adult population is likely to prevent increases in diabetes incidence in this population.     

Means of transportation to work and overweight and obesity: a population-based study in southern Sweden

OBJECTIVES: To investigate the association between means of transportation to work and overweight+obesity and obesity. METHODS: The 2004 public health survey in Sk?ne is a cross-sectional postal questionnaire study of the population aged 18-80 with a 59% response rate including 16,705 employed participants. RESULTS: Forty-six percent of men and 26.6% of women were overweight (BMI 25.0-29.9); 11.6% of men and 10.3% of women were obese (BMI 30.0-); 18.2% of men and 25.9% of women bicycled and/or walked to work and 10.4% and 16.2% used public transportation, respectively. In contrast, 68.3% of men and 55.8% of women went to work by car. The odds ratios of overweight+obesity among persons who walked or bicycled were significantly lower and remained 0.62 (95% CI 0.51-0.76) among men and 0.79 (95% CI 0.67-0.94) among women in the models including all confounders compared to the car driving reference category. The odds ratios of obesity were initially significantly lower among both men and women who walked or bicycled, but in the final models only among women. The odds ratios of overweight+obesity as well as obesity were also lower among men using public transportation. CONCLUSIONS: Walking and bicycling to work are significantly negatively associated with overweight+obesity and, to some extent, obesity. Public transportation is significantly negatively associated with overweight+obesity and obesity among men.     

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.