1
|
Busutil R, Espallardo O, Torres A, Martínez-Galdeano L, Zozaya N, Hidalgo-Vega Á. The impact of obesity on health-related quality of life in Spain. Health Qual Life Outcomes 2017; 15:197. [PMID: 29017494 PMCID: PMC5634835 DOI: 10.1186/s12955-017-0773-y] [Citation(s) in RCA: 85] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2017] [Accepted: 09/28/2017] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND It is well documented that obesity is strongly associated with mortality and morbidity, but less is known about its impact on functional status and health-related quality of life (HRQOL). The purpose of this study was to calculate the impact of the Body Mass Index (BMI) on the HRQOL of the Spanish adult population, with special emphasis on BMI ≥ 35. METHODS We used the Spanish National Health Survey (SNHS) 2011-2012 to assess the statistical association between HRQOL, measured through the EuroQol-5D-5L questionnaire, and the BMI. We conducted linear regression analysis for the EuroQol-5D-5L Visual Analogue Scale (VAS) and probit regressions for each of the five dimensions of the EuroQol-5D-5L. RESULTS Self-perceived problems in the five dimensions of the EuroQol-5D-5L increased along the BMI, especially in the mobility and pain/discomfort dimensions. Having a BMI ≥ 35 reduced HRQOL even in the absence of chronic diseases. After controlling for comorbidities, severe obesity decreased the VAS score by an average of 1.9 points and increased the probability of reporting any HRQOL problem in mobility (11.8%), self-care (2.2%), usual activities (4.3%) and pain/discomfort (7.4%). No association was found between obesity and mental problems. All the parameters analysed suggest that HRQOL in women and people aged 65 years and over was significantly worse than average. CONCLUSIONS BMI is an explanatory factor of self-perceived quality of life. Obesity is associated with a worse HRQOL, especially in women and people aged over 64 years. These results may be useful for designing prevention or treatment health policies to target obesity among the Spanish population.
Collapse
Affiliation(s)
- Rafael Busutil
- Seminario de Investigación en Economía y Salud, University of Castilla-La Mancha, Toledo, Spain
| | - Olga Espallardo
- Seminario de Investigación en Economía y Salud, University of Castilla-La Mancha, Toledo, Spain
| | | | | | - Néboa Zozaya
- Instituto Max Weber, c/ Norias 123, 28221 Majadahonda, Madrid Spain
| | | |
Collapse
|
2
|
Relationship between physical activity and weight status in adults: a multinomial hierarchical analysis. Public Health 2016; 141:229-231. [PMID: 27932006 DOI: 10.1016/j.puhe.2016.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2015] [Revised: 01/23/2016] [Accepted: 10/02/2016] [Indexed: 11/20/2022]
|
3
|
Romo-Perez V, Souto D, Mota J. Walking, body mass index, and self-rated health in a representative sample of Spanish adults. CAD SAUDE PUBLICA 2016; 32:S0102-311X2016000100706. [PMID: 26886367 DOI: 10.1590/0102-311x00166414] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2014] [Accepted: 08/27/2015] [Indexed: 11/22/2022] Open
Abstract
Obesity and physical inactivity (PI) are risk factors for chronic diseases and are associated with lifestyle and environmental factors. The study tested the association between PI, body mass index (BMI), and self-rated health in a representative sample of the Spanish adult population (N = 21,486). The sample included 41.5% men, with mean age 52.3 years (± 18.03), and age range 20-82 years. Prevalence of overweight/obesity was 34.2%/12.7% in women and 52.1%/12.7% in men (p < 0.001 for obesity in both sexes). 53% of women and 57.5% of men met recommended levels of physical activity by walking (≥ 150 minutes/week). According to logistic regression analysis, individuals that walked less had higher risk of overweight or obesity. Data from the population-based surveillance study support suggestions that regular walking by adults is associated with positive self-rated health and better BMI profile. Obesity and low/very low self-rated health have low prevalence rates to meet the recommendations.
Collapse
Affiliation(s)
| | - Dilia Souto
- Universidad Autónoma de Baja California, Mexicali, México
| | | |
Collapse
|
4
|
Cohen AK, Rai M, Rehkopf DH, Abrams B. Educational attainment and obesity: a systematic review. Obes Rev 2013; 14:989-1005. [PMID: 23889851 PMCID: PMC3902051 DOI: 10.1111/obr.12062] [Citation(s) in RCA: 257] [Impact Index Per Article: 23.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2013] [Revised: 05/14/2013] [Accepted: 05/28/2013] [Indexed: 01/17/2023]
Abstract
Although previous systematic reviews considered the relationship between socioeconomic status and obesity, almost 200 peer-reviewed articles have been published since the last review on that topic, and this paper focuses specifically on education, which has different implications. The authors systematically review the peer-reviewed literature from around the world considering the association between educational attainment and obesity. Databases from public health and medicine, education, psychology, economics, and other social sciences were searched, and articles published in English, French, Portuguese and Spanish were included. This paper includes 289 articles that report on 410 populations in 91 countries. The relationship between educational attainment and obesity was modified by both gender and the country's economic development level: an inverse association was more common in studies of higher-income countries and a positive association was more common in lower-income countries, with stronger social patterning among women. Relatively few studies reported on lower-income countries, controlled for a comprehensive set of potential confounding variables and/or attempted to assess causality through the use of quasi-experimental designs. Future research should address these gaps to understand if the relationship between educational attainment and obesity may be causal, thus supporting education policy as a tool for obesity prevention.
Collapse
Affiliation(s)
- A K Cohen
- Division of Epidemiology, University of California Berkeley School of Public Health, Berkeley, California, USA
| | | | | | | |
Collapse
|
5
|
Lorenzo C, Serrano-Ríos M, Martínez-Larrad MT, Gabriel R, Williams K, Gómez-Gerique JA, Stern MP, Haffner SM. Central Adiposity Determines Prevalence Differences of the Metabolic Syndrome. ACTA ACUST UNITED AC 2012; 11:1480-7. [PMID: 14694212 DOI: 10.1038/oby.2003.198] [Citation(s) in RCA: 63] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
OBJECTIVE To compare the expression of the metabolic syndrome in Spain and San Antonio, TX, two populations with major differences regarding their cardiovascular risk profile. RESEARCH METHODS AND PROCEDURES Cross-sectional analysis of population-based, epidemiological surveys using the metabolic syndrome definition of the National Cholesterol Education Program. In San Antonio, we limited our analysis to non-Hispanic whites because non-Hispanic whites are largely of European ancestry (n = 1339 in San Antonio and 2947 in Spain) RESULTS In men, increased central adiposity was more prevalent in San Antonio than in Spain (29.7 vs. 23.0%, p < 0.0001); in women, it was less prevalent in San Antonio than in Spain (40.2 vs. 66.4%, p < 0.0001). The metabolic syndrome followed that same pattern: more prevalent in men (28.9 vs. 20.8%, p = 0.019) and less in women from San Antonio (27.1 vs. 30.9%, p < 0.0001). In subjects with the metabolic syndrome, most women had increased central adiposity (92.6% in San Antonio and 97.5% in Spain), and most men had either increased central adiposity or blood pressure (99.2% in San Antonio and 95.0% in Spain). DISCUSSION Contrary to men, the metabolic syndrome is more prevalent in Spanish women than in women from San Antonio with differences that mirror differences in central adiposity. Central adiposity and blood pressure may be used to exclude the metabolic syndrome. Considering recent secular trends in obesity, we predict there will be an increase in the prevalence of the metabolic syndrome in both populations in the coming years.
Collapse
Affiliation(s)
- Carlos Lorenzo
- Department of Medicine, University of Texas Health Science Center, San Antonio, Texas 78284-7873, USA.
| | | | | | | | | | | | | | | |
Collapse
|
6
|
Palacios-Ceña D, Alonso-Blanco C, Jiménez-Garcia R, Hernández-Barrera V, Carrasco-Garrido P, Pileño-Martinez E, Fernández-de-las-Peñas C. Time trends in leisure time physical activity and physical fitness in elderly people: 20 year follow-up of the Spanish population national health survey (1987-2006). BMC Public Health 2011; 11:799. [PMID: 21995560 PMCID: PMC3206481 DOI: 10.1186/1471-2458-11-799] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2011] [Accepted: 10/13/2011] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To estimate trends in leisure time physical activity and physical fitness between 1987-2006 in older Spanish people. METHODS We analyzed data collected from the Spanish National Health Surveys conducted in 1987 (n = 29,647), 1993 (n = 20,707), 1995-1997 (n = 12,800), 2001 (n = 21,058), 2003 (n = 21,650), and 2006 (n = 29,478). The number of subjects aged ≥ 65 years included in the current study was 29,263 (1987: n = 4,958-16.7%; 1993: n = 3,751-17.8%; 1995-97: n = 2,229-17.4%; 2001: n = 4,356-20.7%; 2003: 6,134-28.3%; 2006: 7,835-26.5%). Main variables included leisure-time physical activity and physical fitness. We analyzed socio-demographic characteristics, self-rated health status, lifestyle habit and co-morbid conditions using multivariate logistic regression models. RESULTS Women exhibited lower prevalence of leisure time physical activity and physical fitness compared to men (P < 0.05). The multivariate analysis for time trends found that practising leisure time physical activity increased from 1987 to 2006 (P < 0.001). Variables associated with a lower likelihood of practicing leisure time physical activity were: age ≥ 80 years old, ≥ 2 co-morbid chronic conditions, and obesity. Variables associated with lower physical fitness included: age ≥ 80 years, worse self rated health; ≥ 2 medications (only for walking), and obesity. CONCLUSIONS We found an increase in leisure time physical activity in the older Spanish population. Older age, married status, co-morbid conditions, obesity, and worse self-perceived health status were associated with lower activity. Identification of these factors can help to identify individuals at risk for physical inactivity.
Collapse
Affiliation(s)
- Domingo Palacios-Ceña
- Department of Health Science II, Universidad Rey Juan Carlos, Madrid, Spain
- School of Public Health. Madrid. Spain
| | | | - Rodrigo Jiménez-Garcia
- Preventive Medicine and Public Health Teaching and Research Unit, Department of Health Sciences, Universidad Rey Juan Carlos, Madrid, Spain
| | - Valentin Hernández-Barrera
- Preventive Medicine and Public Health Teaching and Research Unit, Department of Health Sciences, Universidad Rey Juan Carlos, Madrid, Spain
| | - Pilar Carrasco-Garrido
- Preventive Medicine and Public Health Teaching and Research Unit, Department of Health Sciences, Universidad Rey Juan Carlos, Madrid, Spain
| | | | - Cesar Fernández-de-las-Peñas
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain
| |
Collapse
|
7
|
PICAVET HSUSANJ, WENDEL-VOS GCWANDA, VREEKEN HILDAL, SCHUIT AJANTINE, VERSCHUREN WMONIQUEM. How Stable Are Physical Activity Habits among Adults? The Doetinchem Cohort Study. Med Sci Sports Exerc 2011; 43:74-9. [DOI: 10.1249/mss.0b013e3181e57a6a] [Citation(s) in RCA: 55] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
|
8
|
Tzotzas T, Vlahavas G, Papadopoulou SK, Kapantais E, Kaklamanou D, Hassapidou M. Marital status and educational level associated to obesity in Greek adults: data from the National Epidemiological Survey. BMC Public Health 2010; 10:732. [PMID: 21110843 PMCID: PMC3004837 DOI: 10.1186/1471-2458-10-732] [Citation(s) in RCA: 68] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2010] [Accepted: 11/26/2010] [Indexed: 11/10/2022] Open
Abstract
Background Obesity is an important public health issue and its prevalence is reaching epidemic proportions in both developed and developing countries. The aim of the present study was to determine associations of overweight (OW), obesity (OB) and abdominal obesity (AO) with marital status and educational level in Greek adults of both genders based on data from the National Epidemiological Survey on the prevalence of obesity. Methods The selection was conducted by stratified sampling through household family members of Greek children attending school during 2003. A total of 17,341 Greek men and women aged from 20 to 70 years participated in the survey and had anthropometric measurements (height, weight, and waist circumference) for the calculation of prevalence of OW, OB and AO. WHO cut-offs were used to define overweight and obesity categories. Waist circumference of more than 102 cm in men and 88 cm in women defined AO. Marital status and educational level were recorded using a specially designed questionnaire and were classified into 4 categories. Results The overall prevalence of OB was 22.3% (25.8% in men, 18.4% in women), that of OW 35.2% (41.0% in men, 29.8% in women) and that of AO 26.4% in men and 35.9% in women. Ahigher risk of OB was found in married men (OR: 2.28; 95% CI: 1.85-2.81) and married women (OR: 2.31; 95% CI: 1.73-3.10) than in the respective unmarried ones. Also, a higher risk of AO was found in married men (OR: 3.40; 95% CI: 2.86-4.03) and in married women (OR: 2.40; 95% CI 2.00-2.88) compared to unmarried ones. The risk for being obese was lower among educated women (primary school, OR: 0.76; 95% CI: 0.60-0.96, high school, OR: 0.58; 95% CI: 0.46-0.74 and University, OR: 0.64; 95% CI: 0.49-0.81) than among illiterates. No significant differences were found among men. Conclusions In Greek adults, marital status was significantly associated with obesity and abdominal obesity status in both genders while educational level was inversely associated with obesity status only in women.
Collapse
|
9
|
Gomes A, Damasceno A, Azevedo A, Prista A, Silva-Matos C, Saranga S, Lunet N. Body mass index and waist circumference in Mozambique: urban/rural gap during epidemiological transition. Obes Rev 2010; 11:627-34. [PMID: 20406415 DOI: 10.1111/j.1467-789x.2010.00739.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
In 2005 we evaluated a nationally representative sample of the Mozambican adult population (n=2913; 25-64 years old) following the STEPwise approach to chronic disease risk factor surveillance to estimate urban-rural differences in overweight and obesity and waist circumferences. The prevalences of obesity and overweight were, respectively, 6.8% (95% CI: 5.1-8.6) and 11.8% (95% CI: 8.4-15.4) among women, and 2.3% (95% CI: 1.1-3.6) and 9.4% (95% CI: 5.7-13.1) among men. Overweight/obesity was more frequent in urban settings (age-, income- and education-adjusted prevalence ratios; women, 2.76, 95% CI: 1.82-4.18; men, 1.76, 95% CI: 0.80-3.85). The average waist circumference in Mozambique was 75.2cm (95% CI: 74.3-76.0) in women, significantly higher in urban than rural areas (age-, income- and education-adjusted β=3.6cm, 95% CI: 1.6-5.5) and 76.1cm (95% CI: 75.0-77.3) in men, with no urban-rural differences (adjusted β=1.3cm, 95% CI: -0.9 to 3.5). Our results show urban-rural differences, as expected in a country under epidemiological transition, with urban areas presenting a higher prevalence of overweight/obesity, but age- and education-specific estimates suggesting a trend towards smaller divergences. The development and implementation of strategies to manage the foreseeable obesity-related healthcare demands are needed.
Collapse
Affiliation(s)
- A Gomes
- Department of Hygiene and Epidemiology, University of Porto Medical School, Porto, Portugal
| | | | | | | | | | | | | |
Collapse
|
10
|
Vioque J, Manuel Ramos J, Navarrete-Muñoz EM, García De La Hera M. [Spanish scientific production in obesity research published in PubMed (1988-2007)]. GACETA SANITARIA 2010; 24:225-32. [PMID: 20381211 DOI: 10.1016/j.gaceta.2010.01.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/04/2009] [Revised: 01/25/2010] [Accepted: 01/26/2010] [Indexed: 10/19/2022]
Abstract
OBJECTIVE To analyse Spanish scientific research output related to obesity during a 20-year period from 1988 to 2007 into context with the European Union productivity METHODS The bibliometric study was based on research of the MEDLINE database in PubMed. Search terms were "obesity" appearing in MeSH. Linear regression was used to estimate trends in number of publications. RESULTS We retrieved 50,120 documents on obesity in the study period, and 1,407 were by Spanish authors (2.7% of the world production). Spain, accounting for 8.1% of scientific output in this area, was the fifth most productive country in the European Union; 932 (69.1%) of papers were published in English. The average yearly increase in publications was 15%, from 91 documents in the first five-year period to 702 in the last five-period. The most frequent specialty of first author was endocrinology (279 documents, or 22.8%), followed by physiology-nutrition-bromatology (203, or 16.6%), and biochemistry (161, or 13.2%). Journals publishing the largest numbers of papers on obesity were Medicina Clínica (83 or 6.1%), Obesity Surgery (79 or 5.8%), International Journal of Obesity (73) and Nutricion Hospitalaria (59). The most productive regions in Spain were Cataluña (338 or 24.9%), Madrid (286 or 20,6%), and Navarra (159 or 11,7%). The most productive institutions were hospitals, with 708 titles (52.1%), followed by universities, with 521 (38.5%). CONCLUSIONS Obesity research in Spain has increased over the last 20 years and accounted for a substantial proportion of European Union research in this field. Half of the papers by Spanish authors were published in international non-Spanish journals. Most of papers were carried out from hospital settings and universities.
Collapse
Affiliation(s)
- Jesús Vioque
- Departamento de Salud Pública, Facultad de Medicina, Campus de San Juan, Universidad Miguel Hernández, San Juan de Alicante, Alicante, España.
| | | | | | | |
Collapse
|
11
|
Meseguer CM, Galán I, Herruzo R, Zorrilla B, Rodríguez-Artalejo F. Leisure-time physical activity in a southern European mediterranean country: adherence to recommendations and determining factors. Rev Esp Cardiol 2010; 62:1125-33. [PMID: 19793518 DOI: 10.1016/s1885-5857(09)73327-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
INTRODUCTION AND OBJECTIVES To determine whether adults in Madrid, Spain adhere to leisure-time physical activity (LTPA) recommendations and to identify factors associated with adherence. METHODS A telephone survey of 12,037 individuals, representative of the Madrid population aged 18-64 years, was conducted. The LTPA level was quantified in metabolic equivalent (MET) hours per week from answers to a questionnaire on the frequency and duration of LTPA. This level was compared with the recommendation to engage in at least moderate activity >or=150 min/week or vigorous activity >or=60 min/week. Factors associated with adherence to the recommendation were identified using logistic regression analysis. RESULTS The mean LTPA level was 17.3 MET-hours/ week (95% confidence interval [CI], 16.9-17.7 MET-hours/week) and 28.8% (95% CI, 28%-29.7%) adhered to the recommendation. The recommended level was achieved more frequently in men than women (odds ratio [OR]=2.41; 95% CI, 2.20-2.64). In comparison with younger individuals, adherence decreased gradually with age until 60-64 years, when the OR was 0.20 (95% CI, 0.15-0.25). Compared with less well-educated individuals, the university-educated were more likely to meet the recommendation (OR=2.28; 95% CI, 1.82-2.87). Obese individuals achieved it less frequently (OR=0.49; 95% CI, 0.40-0.61) than normal-weight individuals. Those whose job involved low-intensity physical activity achieved it more frequently than those with sedentary occupations (OR=1.21; 95% CI, 1.10-1.34). CONCLUSIONS The majority of adults in Madrid did not achieve the recommended LTPA level. Adherence was lower in women, older individuals, the less well-educated and the obese, while it was greater in those with a job involving low-intensity physical activity.
Collapse
|
12
|
Camões M, Lopes C, Oliveira A, Santos AC, Barros H. Overall and central obesity incidence in an urban Portuguese population. Prev Med 2010; 50:50-5. [PMID: 19945478 DOI: 10.1016/j.ypmed.2009.11.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2009] [Revised: 11/05/2009] [Accepted: 11/13/2009] [Indexed: 12/20/2022]
Abstract
OBJECTIVE To provide overall and central obesity incidence estimates by gender, age and educational level in an urban Portuguese population. METHODS As part of the EPIPorto study, 1,621 Porto, Portugal adult residents were evaluated in 1999-2003 and 2005-2008. Overall obesity was defined by a BMI > or = 30.0 kg/m(2) and central obesity by a WC >88.0 cm in women and >102.0 cm in men. Relative risks (RR) and 95% confidence intervals (95% CI) were computed using Poisson regression. Survival analysis was also performed. RESULTS The age-adjusted incidence rates/100 person-years of overall and central obesity were, respectively, 1.70, 95% CI: 1.34-2.19 and 5.97, 95% CI: 5.09-7.03 in women; 1.08, 95% CI: 0.73-1.64 and 2.38, 95% CI: 1.81-3.20 in men. In multivariate analysis, older women presented a higher risk of overall obesity. Moreover, a significant inverse association was found between obesity and education in women (>11 vs. <5 years: RR=0.43, 95% CI: 0.22-0.84, for overall obesity; RR=0.45 95% CI: 0.29-0.69, for central obesity). For overall obesity, 10.1% of women and 5.1% of men became obese during the 5-year study period. Higher proportions were observed regarding central obesity, 29.1% and 11.4% for women and men, respectively. CONCLUSIONS Over time, individuals developed central obesity faster than overall obesity. Our results support that increasing levels of education limit this ongoing development of obesity, particularly among women.
Collapse
Affiliation(s)
- Miguel Camões
- Department of Hygiene and Epidemiology, University of Porto Medical School, Alameda Prof. Hernani Monteiro, 4200-319 Porto, Portugal
| | | | | | | | | |
Collapse
|
13
|
García-Porrero E, Andrés-Esteban E, de Pablo-Zarzosa C, León-Latre M. Cardiología preventiva y rehabilitación. Rev Esp Cardiol 2010; 63 Suppl 1:40-8. [DOI: 10.1016/s0300-8932(10)70139-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
|
14
|
Craig CL, Cameron C, Griffiths J, Bauman A, Tudor-Locke C, Andersen RE. Non-response bias in physical activity trend estimates. BMC Public Health 2009; 9:425. [PMID: 19930603 PMCID: PMC2785794 DOI: 10.1186/1471-2458-9-425] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2009] [Accepted: 11/22/2009] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Increases in reported leisure time physical activity (PA) and obesity have been observed in several countries. One hypothesis for these apparently contradictory trends is differential bias in estimates over time. The purpose of this short report is to examine the potential impact of changes in response rates over time on the prevalence of adequate PA in Canadian adults. METHODS Participants were recruited in representative national telephone surveys of PA from 1995-2007. Differences in PA prevalence estimates between participants and those hard to reach were assessed using Student's t tests adjusted for multiple comparisons. RESULTS The number of telephone calls required to reach and speak with someone in the household increased over time, as did the percentage of selected participants who initially refused during the first interview attempt. A higher prevalence of adequate PA was observed with 5-9 attempts to reach anyone in the household in 1999-2002, but this was not significant after adjustment for multiple comparisons. CONCLUSION No significant impact on PA trend estimates was observed due to differential non response rates. It is important for health policy makers to understand potential biases and how these may affect secular trends in all aspects of the energy balance equation.
Collapse
Affiliation(s)
- Cora L Craig
- Canadian Fitness and Lifestyle Research Institute, Ottawa, Canada
- School of Public Health, University of Sydney, Australia
| | | | - Joe Griffiths
- Canadian Fitness and Lifestyle Research Institute, Ottawa, Canada
| | - Adrian Bauman
- Canadian Fitness and Lifestyle Research Institute, Ottawa, Canada
- School of Public Health, University of Sydney, Australia
| | | | - Ross E Andersen
- Department of Kinesiology and Physical Education, McGill University, Montreal, Canada
| |
Collapse
|
15
|
Heeb JL. Changes in the prevalence of overweight and obesity: some evidence from the Swiss Health Surveys 1992/93 and 2002. Eur J Public Health 2009; 21:407-13. [PMID: 19887519 DOI: 10.1093/eurpub/ckp138] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND This study examines changes in the prevalence of overweight and obesity in the Swiss general population from 1992/93 to 2002 and their relationship with changes in the distribution and effect of socioeconomic and health behavioural risk factors. METHODS Cross-sectional data from telephone interviews of the non-institutionalized Swiss population aged 19 years and more were obtained from the Swiss Health Study 1992/93 (n = 13798) and 2002 (n = 17677). Binary logistic regression was used to address changes in overweight and obesity, defined as body mass index 25.0 kg/m(2) or more. The expected prevalence of overweight and obesity under adjusted models was computed to demonstrate the influence of changes in risk factors. RESULTS The prevalence of overweight and obesity rose from 22.8% in 1992/93 to 30.9% in 2002 among women and from 41.1% to 48.1% among men. In international comparison, the increase in the overall prevalence of overweight and obesity in Switzerland was lower. Contrary to similar studies from other countries, the increase in prevalence was lower among men than that among women, possibly because of an increased protective effect of the observed health behavioural factors among men and unobserved behavioural factors among middle-aged men. CONCLUSION Public health action should consider the potential of changing health behavioural factors in subgroups with a higher prevalence of overweight and obesity. Measures that stimulate, for instance, light physical activity or healthy diet, to be supported by changes in the obesogenic environment, should be encouraged. More evidence is needed for gender-specific approaches.
Collapse
|
16
|
Incidence and mortality by colorectal cancer in Spain during 1951–2006 and its relationship with behavioural factors. Eur J Cancer Prev 2009; 18:436-44. [DOI: 10.1097/cej.0b013e328330eb2f] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
|
17
|
Meseguer CM, Galán I, Herruzo R, Zorrilla B, Rodríguez-Artalejo F. Actividad física de tiempo libre en un país mediterráneo del sur de Europa: adherencia a las recomendaciones y factores asociados. Rev Esp Cardiol 2009. [DOI: 10.1016/s0300-8932(09)72381-4] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
18
|
Association of socioeconomic status with overall overweight and central obesity in men and women: the French Nutrition and Health Survey 2006. BMC Public Health 2009; 9:215. [PMID: 19573222 PMCID: PMC2714511 DOI: 10.1186/1471-2458-9-215] [Citation(s) in RCA: 65] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2008] [Accepted: 07/02/2009] [Indexed: 11/22/2022] Open
Abstract
Background Identification of subpopulations at high risk of overweight and obesity is crucial for prevention and management of obesity in different socioeconomic status (SES) categories. The objective of the study was to describe disparities in the prevalence of overweight and obesity across socioeconomic status (SES) groups in 18–74 year-old French adults. Methods Analyses were based on a multistage stratified random sample of non-institutionalized adults aged 18–74-years-old from the French Nutrition and Health Survey (ENNS), a cross-sectional national survey carried out in 2006/2007. Collected data included measured anthropometry (weight, height and waist circumference (WC)), demographic and SES data (occupation, education and frequency of holiday trips as a marker of family income). SES factors associated with overweight (BMI ≥ 25) and central obesity (WC above gender-specific references) were identified using multiple logistic regression. Results Almost half (49.3%) of French adults were overweight or obese and 16.9% were obese. In men, the risk of overall overweight or obesity was associated with occupation (p < 0.05), whereas the risk of central obesity was independently associated with occupation (p < 0.05) and frequency of holiday trips (p < 0.01). In women, both overall and central overweight and obesity were independently associated with educational level (respectively p < 10-3 and p < 10-3) and frequency of holiday trips (respectively p < 0.05 and p < 10-3). Conclusion The prevalence of overweight and obesity was found to be similar to that of several neighbouring western European countries, and lower than the UK and eastern Europe. Risk of being overweight or obese varied across SES groups both in men and women, but associations were different between men and women, indicating differing determinants.
Collapse
|
19
|
van der Mark M, Jonasson J, Svensson M, Linnéb Y, Rössner S, Lagerros YT. Older members perform better in an internet-based behavioral weight loss program compared to younger members. Obes Facts 2009; 2:74-9. [PMID: 20054209 PMCID: PMC6444773 DOI: 10.1159/000209383] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND New technology offers increased opportunities for weight control. However, it is not clear whether older people with less computer training can make use of this tool. Our objective was to examine how members above the age of 65 years performed in an internet-based behavioral weight loss program, compared to younger members. METHODS Data from members (n = 23,233) of an internet-based behavioral weight loss program were analyzed. We restricted our study to active participants accessing the weight club, during a 6-month period (n = 4,440). The number of logins, food intake, and weight records were examined. Participants were divided into age tertiles separately for men and women. The oldest tertile was further subdivided into two groups: above and below the age of 65 years. RESULTS Participants aged 65 or older were more likely to remain active in the weight club for at least 6 months compared to younger age groups. They had the highest frequency of recordings of food intake and current weight. Among women, those older than 65 years had on average the highest percentage of weight loss (5.6 kg, 6.8%). Men above 65 years of age had the highest number of logins, on average 161 times during the 6-month period. CONCLUSION Older participants are performing equally well or even better in an internet-based behavioral weight loss program than younger participants. Internet-based programs could be a promising and attractive option for older adults requiring assistance in losing weight.
Collapse
Affiliation(s)
| | | | - Madeleine Svensson
- Unit of Clinical Epidemiology, Karolinska Institutet, M9:01, Stockholm
- Obesity Unit, Karolinska Hospital, Huddinge, Stockholm, Sweden
| | - Yvonne Linnéb
- Obesity Unit, Karolinska Hospital, Huddinge, Stockholm, Sweden
| | - Stephan Rössner
- Obesity Unit, Karolinska Hospital, Huddinge, Stockholm, Sweden
| | - Ylva Trolle Lagerros
- Unit of Clinical Epidemiology, Karolinska Institutet, M9:01, Stockholm
- Obesity Unit, Karolinska Hospital, Huddinge, Stockholm, Sweden
- *Dr. Ylva Trolle Lagerros, Unit of Clinical Epidemiology, Karolinska Institutet, T2, 171 76 Stockholm, Sweden, Tel. +46 8-517 79183, Fax -517 79304,
| |
Collapse
|
20
|
Prevalence of overweight and obesity among 2.6 million rural Chinese adults. Prev Med 2009; 48:59-63. [PMID: 19026678 DOI: 10.1016/j.ypmed.2008.10.020] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2008] [Revised: 10/15/2008] [Accepted: 10/19/2008] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To investigate the prevalence of overweight and obesity among Chinese rural adults based on the World Health Organization and Chinese standards. METHODS A cross-sectional whole-population health survey of 1,250,062 men and 1,372,026 women aged 15 years and over was undertaken in Tianjin true rural areas in 2004 (response rate, 85.6%). Height and weight were measured using a standardized protocol. RESULTS Using the World Health Organization standard, the age-standardized prevalence of overweight (body mass index [BMI] 25-29.9 kg/m(2)) and obesity (BMI> or =30 kg/m(2)) was 21.8% and 3.1% in men, 23.1% and 4.7% in women, and 22.5% and 3.9% in men and women combined, respectively. Using the Chinese standard, the age-standardized prevalence of overweight (BMI 24-27.9 kg/m(2)) and obesity (BMI> or =28 kg/m(2)) was 31.3% and 7.0% in men, 28.7% and 9.7% in women, and 30.0% and 8.4% in men and women combined, respectively. The prevalence of overweight and obesity was higher among Tianjin rural adults than in the whole Chinese rural population based on the 2002 Fourth National Nutritional Survey. CONCLUSIONS The prevalence of overweight or overweight/obesity is relatively high in this Chinese rural population and might be an important lifestyle-related public health problem in China.
Collapse
|
21
|
Martín AR, Nieto JMM, Ruiz JPN, Jiménez LE. Overweight and obesity: The role of education, employment and income in Spanish adults. Appetite 2008; 51:266-72. [DOI: 10.1016/j.appet.2008.02.021] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2007] [Revised: 02/21/2008] [Accepted: 02/22/2008] [Indexed: 12/22/2022]
|
22
|
The epidemiology of obesity and gastrointestinal and other diseases: an overview. Dig Dis Sci 2008; 53:2293-9. [PMID: 18636328 DOI: 10.1007/s10620-008-0410-z] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2008] [Accepted: 06/18/2008] [Indexed: 01/25/2023]
Abstract
The worldwide prevalence of obesity continues to increase, with devastating implications for overall health. Epidemiological trends indicate the primary contributors are environmental (e.g., increased caloric intake, lack of exercise), although the evidence is surprisingly equivocal. Increased body mass index (BMI) is associated with an increase in all-cause mortality and in diseases related to this increasing mortality rate, such as diabetes mellitus, cardiovascular disease, and cancer, including those of the gastrointestinal system. Some of these associations are even more pronounced when obesity is measured by waist-to-hip ratio, a marker of visceral adipose tissue, versus BMI. Higher BMI is related to increased risk of developing gall stones, and obese patients experience GI symptoms, such as vomiting and diarrhea, more often compared with those of normal body mass. Although the exact cause remains uncertain, these symptoms may be connected to eating habits or to changes in gastrointestinal motility.
Collapse
|
23
|
Cea-Calvo L, Moreno B, Monereo S, Gil-Guillén V, Lozano JV, Martí-Canales JC, Llisterri JL, Aznar J, González-Esteban J, Redón J. Prevalencia de sobrepeso y obesidad en población española de 60 años o más y factores relacionados. Estudio PREV-ICTUS. Med Clin (Barc) 2008; 131:205-10. [DOI: 10.1157/13124609] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
|
24
|
Peixoto MDRG, Benício MHD, Jardim PCBV. The relationship between body mass index and lifestyle in a Brazilian adult population: a cross-sectional survey. CAD SAUDE PUBLICA 2007; 23:2694-740. [DOI: 10.1590/s0102-311x2007001100017] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
This study focused on adult obesity prevalence in Goiânia, Goiás State, Brazil, and the association between socio-demographic variables, lifestyle, physical activity, eating habits, and food consumption frequency and body mass index (BMI). A cross-sectional study was conducted in 2001 with a sample of 1,252 individuals from 20 to 64 years of age. The association between socio-demographic variables, lifestyle, food consumption, and physical activity and BMI was evaluated by hierarchical multiple linear regression analysis. Obesity prevalence was 10.7% in men and 13.9% in women. In males, age, income, and meat consumption showed a positive association with BMI, while physical activity during leisure time and commuting and the habit of eating > 4 meals per day were inversely associated with BMI. In women, positively associated factors were age, no smoking, and no meat consumption; in contrast, consumption of grains was inversely associated with BMI. High obesity prevalence was observed; active lifestyle coupled with ingestion of more grains and less meat appeared to protect against increased BMI.
Collapse
|
25
|
Aytur SA, Rodriguez DA, Evenson KR, Catellier DJ, Rosamond WD. The sociodemographics of land use planning: relationships to physical activity, accessibility, and equity. Health Place 2007; 14:367-85. [PMID: 17890137 DOI: 10.1016/j.healthplace.2007.08.004] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2007] [Revised: 07/12/2007] [Accepted: 08/06/2007] [Indexed: 11/16/2022]
Abstract
Little is known about relationships between attributes of land use plans and sociodemographic variations in physical activity (PA). This study evaluates associations between policy-relevant plan attributes, sociodemographic factors, and PA in North Carolina. Results suggest that land use plans that included non-automobile transportation improvements and more comprehensive policies to guide development were positively associated with both leisure and transportation-related PA. However, residents of counties with lower-income levels and higher proportions of non-white residents were less likely to have attributes supportive of PA included in their plans. Implications for transdisciplinary collaboration with respect to reducing health disparities are discussed.
Collapse
Affiliation(s)
- Semra A Aytur
- Department of Epidemiology, School of Public Health, Bank of America Center, University of North Carolina at Chapel Hill, 137 East Franklin Street Suite 306, Chapel Hill, NC 27514, USA.
| | | | | | | | | |
Collapse
|
26
|
Sulander TT, Uutela AK. Obesity and education: recent trends and disparities among 65- to 84-year-old men and women in Finland. Prev Med 2007; 45:153-6. [PMID: 17379293 DOI: 10.1016/j.ypmed.2007.02.008] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2006] [Revised: 02/02/2007] [Accepted: 02/08/2007] [Indexed: 11/24/2022]
Abstract
OBJECTIVES The purpose of this study was to analyze trends and disparities in obesity by education among Finnish men and women aged 65-84 years from 1993 to 2003. METHOD.: Data were derived from nationally representative monitoring surveys conducted biennially from 1993 to 2003 by the National Public Health Institute (KTL). In total, 5740 men and 5746 women were included in the study (response rate 80%). Obesity was set as body mass index (BMI) >or=30, based on self-reported measurements. Age adjusted trends were examined by education and gender. A logistic regression model was used to study educational disparities in obesity. RESULTS Obesity trends were similar among men and women. The prevalence of obesity increased in both educational groups over the ten-year period. Throughout the period, those with lower education had higher risk of obesity, and educational disparities persisted at about the same level. CONCLUSIONS Obesity is increasing among older people. Information on continuing socioeconomic disparities in obesity is important for those targeting health promotion activities.
Collapse
Affiliation(s)
- Tommi T Sulander
- Department of Health Promotion and Chronic Diseases Prevention, National Public Health Institute (KTL), Mannerheimintie 166, FIN-00300 Helsinki, Finland.
| | | |
Collapse
|
27
|
Warwick PM, Reid J. Trends in energy and macronutrient intakes, body weight and physical activity in female university students (1988–2003), and effects of excluding under-reporters. Br J Nutr 2007; 92:679-88. [PMID: 15522138 DOI: 10.1079/bjn20041247] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The present study investigated trends in reported energy intake, macronutrient intake, physical activity level (PAL) and body weight and effects of excluding under-reporters (UR). Dietary intake and time spent in sixteen activity categories were recorded by 887 female university students (median age 29 years) from 1988 to 2003. Energy expenditure (EE) and PAL were measured using a factorial method. All data collected were self-reported. Individuals with reported EI:EE<0·76 were classified as UR. The remainder were classified as non-under-reporters (NUR). Trends were determined from simple linear regression of median data for each year for the entire cohort (ALL) and for NUR and UR separately, and from multiple regression analysis with the subgroups (NUR and UR) as an additional predictor (BOTH). Prevalence of under-reporting and overweight increased between 1988 and 2003. In ALL and BOTH there were trends to increased body mass, protein intake (g/d and % energy) and carbohydrate intake (% energy only) and decreased fat and alcohol intakes (g/d and % energy). In BOTH there were also increases in reported EI and carbohydrate intake (g/d). None of the trends in NUR was significantly different from those in UR, but some trends in ALL and/or BOTH were not significant when UR were excluded. Trends remaining significant in NUR were increased reported energy intake, protein (g/d) and carbohydrate (g/d) intakes, and decreased fat (% energy only) intake. There were no significant trends in PAL. We conclude that some, but not all, dietary trends were affected by exclusion of UR.
Collapse
Affiliation(s)
- Penelope M Warwick
- School of Biological, Biomedical and Molecular Sciences, University of New England, Armidale, Australia.
| | | |
Collapse
|
28
|
Mayo Montero E, Hernández-Barrera V, Carrasco-Garrido P, Gil de Miguel A, Jiménez-García R. Influenza vaccination among persons with chronic respiratory diseases: coverage, related factors and time-trend, 1993-2001. Public Health 2007; 121:113-21. [PMID: 17217975 DOI: 10.1016/j.puhe.2006.09.009] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2005] [Revised: 07/06/2006] [Accepted: 09/18/2006] [Indexed: 10/23/2022]
Abstract
BACKGROUND Influenza vaccination has shown itself to be effective in reducing morbidity and mortality in patients with underlying chronic respiratory diseases. This study sought to: (1) estimate influenza vaccination coverage among asthma and chronic bronchitis sufferers; (2) ascertain which variables were associated with vaccination; and (3) analyse the time-trend in coverage between 1993 and 2001. METHODS This was a descriptive study covering the 2611 subjects included in the 1993, 1995, 1997 and 2001 Spanish National Health Surveys who reported suffering from asthma or chronic bronchitis. Vaccination coverage was calculated for each year and the influence of socio-demographic and health-related variables analysed. Using logistic regression, we assessed which of the variables had an independent effect on vaccination, and analysed the time-trend. RESULTS The proportions of vaccinated subjects in 1993, 1995-1997 and 2001 were 44.7%, 45.6% and 44.4%, respectively. Variables that increased the likelihood of having been vaccinated were: higher age, presence of another concomitant chronic disease, poor perception of health, non-smoker status, and being married. There was no significant variation in coverage over the study period. CONCLUSION Influenza vaccination coverage among Spanish asthma and/or chronic bronchitis sufferers is below desirable levels and showed no improvement over the period 1993-2001. Implementation of strategies to improve coverage is necessary.
Collapse
Affiliation(s)
- Elga Mayo Montero
- Preventive Medicine and Public Health Teaching and Research Unit, Health Sciences Faculty, Rey Juan Carlos University, Avda. de Atenas s/n, 28922 Alcorcón, Spain
| | | | | | | | | |
Collapse
|
29
|
Santos R, Aires L, Santos P, Ribeiro JC, Mota J. Prevalence of overweight and obesity in a Portuguese sample of adults: Results from the Azorean Physical Activity and Health Study. Am J Hum Biol 2007; 20:78-85. [DOI: 10.1002/ajhb.20680] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
|
30
|
Hajian-Tilaki KO, Heidari B. Prevalence of obesity, central obesity and the associated factors in urban population aged 20-70 years, in the north of Iran: a population-based study and regression approach. Obes Rev 2007; 8:3-10. [PMID: 17212790 DOI: 10.1111/j.1467-789x.2006.00235.x] [Citation(s) in RCA: 156] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Obesity is an undesirable outcome of changing of lifestyle and behaviours. It is also reversible predisposing factor for the development of several debilitating diseases. This study was aimed to determine the prevalence rate of obesity, overweight, central obesity and their associated factors in the north of Iran. We conducted a population-based cross-sectional study with a sample of 1800 women and 1800 men with respective mean ages of 37.5 +/- 13.0 and 38.5 +/- 14.2 years of urban population aged 20-70 years living in the north of Iran. The demographic and lifestyle data, in particular, age, gender, marital status, marriage age, family history of obesity, educational level, occupation, occupational and leisure time physical activity, duration of exercise per week, parity and the number of children were collected with a designed questionnaire. Diagnosis of obesity and central obesity were confirmed by the WHO standard recommended method by determining of body mass index (BMI) and waist circumference (WC). Logistic regression model was used to estimate the adjusted odds ratio (OR) and its 95% confidence interval. Over half of the study subjects were at educational levels of high school or higher; 79.4% of population was married and 35.3% had a family history of parental obesity. The majority of subjects in particular women had none or low levels of physical activity. The overall prevalence rates of obesity and overweight were 18.8% and 34.8% respectively. The overall prevalence rate of central obesity was 28.3%. The rate of obesity in women was higher than men (P < 0.0001). In both genders, particularly in the women, the rate of obesity was raised by increasing age. There was an inverse relation between the risk of obesity and marriage age, the high level of education (OR = 0.19, P < 0.0001), severe occupational activity (OR = 0.44, P < 0.0001), the level of exercise (in subjects with 3-4 h exercise per week, OR = 0.58, P < 0.001) and leisure time activity. Marriage, history of parental obesity and parity > or =5 were associated with increased risk of obesity (OR = 2.2, P < 0.001 and OR = 2.43, P < 0.0001 and OR = 3.73, P < 0.0001 respectively). The results of this study indicate an increased rate of obesity and overweigh in the north population of Iran. With respect to these findings, low level of activity and education, parity, family history of obesity, marriage at earlier age and ageing are responsible for both obesity and central obesity in the north of Iran. Therefore, a community-based multiple strategies are required to combat with increasing rate of obesity and its subsequent complications such as diabetes, coronary artery disease, hypertension and osteoarthritis.
Collapse
Affiliation(s)
- K O Hajian-Tilaki
- Department of Social Medicine and Health, Babol Faculty of Medicine, Babol University of Medical Sciences, Babol, Iran
| | | |
Collapse
|
31
|
Mendez MA, Popkin BM, Jakszyn P, Berenguer A, Tormo MJ, Sanchéz MJ, Quirós JR, Pera G, Navarro C, Martinez C, Larrañaga N, Dorronsoro M, Chirlaque MD, Barricarte A, Ardanaz E, Amiano P, Agudo A, González CA. Adherence to a Mediterranean diet is associated with reduced 3-year incidence of obesity. J Nutr 2006; 136:2934-8. [PMID: 17056825 DOI: 10.1093/jn/136.11.2934] [Citation(s) in RCA: 163] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Few studies have prospectively examined dietary patterns and adult weight change, and results to date are inconsistent. This study examines whether a Mediterranean diet (MD) pattern is associated with reduced 3-y incidence of obesity using data from the Spanish cohort of the European Prospective Investigation into Cancer and Nutrition (EPIC-Spain). The sample included 17,238 women and 10,589 men not obese and aged 29-65 y at baseline (1992-96). Height and weight were measured at baseline; weight was self-reported in a follow-up survey a mean of 3.3 y later. Detailed dietary history data, collected using a validated method, were used to construct a MD score. Logistic regression models were used to estimate odds of becoming overweight or obese. Among initially overweight subjects, 7.9% of women and 6.9% of men became obese, whereas 13.8% of normal weight men and 23.0% women became overweight. High MD adherence was associated with significantly lower likelihood of becoming obese among overweight subjects, with stronger associations after adjusting for underreporting of dietary data. Associations (odds ratios with 95% CI) were similar in women (0.69, 0.54-0.89) and men (0.68, 0.53-0.89). Adjusting for the plausibility of reported dietary intakes increased the magnitude of these associations, which were approximately 0.8 without this adjustment. MD adherence was not associated with incidence of overweight in initially normal-weight subjects. Nonetheless, results suggest that promoting eating habits consistent with MD patterns may be a useful part of efforts to combat obesity.
Collapse
Affiliation(s)
- Michelle A Mendez
- IDIBELL, Institut Català d'Oncologia, L'Hospitalet de Llobregat, Barcelona, Spain.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
32
|
Gallus S, Colombo P, Scarpino V, Zuccaro P, Negri E, Apolone G, La Vecchia C. Overweight and obesity in Italian adults 2004, and an overview of trends since 1983. Eur J Clin Nutr 2006; 60:1174-9. [PMID: 16639416 DOI: 10.1038/sj.ejcn.1602433] [Citation(s) in RCA: 58] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVE Overweight has been increasing in several developed countries over the last few decades. No update information on the issue is available for Italy. DESIGN AND SETTING We conducted a computer assisted personal in-house interview survey in March-April 2004, on a sample of 2932 Italian individuals (1407 men and 1525 women) aged 18 years or over, representative of the general adult Italian population. Information on weight and height was self-reported. RESULTS Overall, 3.4% of the Italian adult population were underweight (< 18.5 kg/m2, 0.9% of men and 5.8% of women), 31.3% were overweight (25.0-29.9 kg/m2, 38.4% of men, 24.7% of women), and 8.2% were obese (> or = 30.0 kg/m2, 7.4% of men and 8.9% of women). Overweight or obesity was reported by 14.2% of subjects aged 18-24 years (20.6% of men and 7.6% of women). The highest proportions of overweight and obese subjects were in the 45-64 year age group for men (51.4% overweight, 10.0% obese) and in the > or = 65 year age group for women (38.8% overweight, 13.8% obese). Age- and sex-standardised prevalence of overweight or obesity was 36.0% for more educated subjects, and 54.0% for less educated ones. It was 32.3% in northern, 44.3% in central and 47.0% in southern Italy. Overweight increased from 1983 to the early 1990s, and levelled off thereafter. Prevalence of obesity remained around 8-9% across the last 20 years. CONCLUSIONS Trends of overweight and obesity in Italy are more favourable than in several developed countries. Still, approximately 15 million of Italian adults are overweight and 4 million obese.
Collapse
Affiliation(s)
- S Gallus
- Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy.
| | | | | | | | | | | | | |
Collapse
|
33
|
Marques-Vidal P, Dias CM. Trends in overweight and obesity in Portugal: the National Health Surveys 1995-6 and 1998-9. ACTA ACUST UNITED AC 2006; 13:1141-5. [PMID: 16076982 DOI: 10.1038/oby.2005.135] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To assess overweight and obesity trends in the Portuguese population. RESEARCH METHODS AND PROCEDURES National Health Surveys, conducted in 1995-6 (17,989 men; 20,249 women) and 1998-9 (17,923 men; 20,302 women), were used. RESULTS In men, the prevalence of overweight and obesity increased from 39.9% (95% CI: 39.2 to 40.6) and 10.3% (95% CI: 9.9 to 10.7), respectively, in 1995-6, to 42.5% (95% CI: 41.8 to 43.2) and 11.5% (95% CI: 11.0 to 12.0), respectively, in 1998-9. In women, prevalence of obesity increased from 12.7% (95% CI: 12.2 to 13.2) in 1995-6 to 14.2% (95% CI: 13.7 to 14.6) in 1998-9, whereas the prevalence of overweight remained stable: 32.2% (95% CI: 31.6 to 32.9) in 1995-6 and 32.3% (95% CI: 31.6 to 32.9) in 1998-9. In men, prevalence of overweight and obesity were higher among former smokers and educational group of 6 to 12 years, and prevalence of obesity was higher in the Lisbon region. In women, prevalence of overweight and obesity were higher among never smokers, and prevalence of obesity was higher among educational group of -6 years. Prevalence of obesity was higher in the Alentejo region, and overweight was higher in the Center region. Finally, prevalence of obesity increased in both sexes for all strata studied (age, smoking status, educational level, and geographic region), whereas prevalence of overweight increased only in men. DISCUSSION In Portugal, overweight and obesity levels are related to sociodemographic factors; the increase in obesity levels stresses the need for preventive measures.
Collapse
Affiliation(s)
- Pedro Marques-Vidal
- Centro de Nutrição e Metabolismo, Instituto de Medicina Molecular, Faculdade de Medicina da Universidade de Lisboa, Lisboa, Portugal.
| | | |
Collapse
|
34
|
|
35
|
Aranceta-Bartrina J, Serra-Majem L, Foz-Sala M, Moreno-Esteban B. Prevalencia de obesidad en España. Med Clin (Barc) 2005; 125:460-6. [PMID: 16216203 DOI: 10.1157/13079612] [Citation(s) in RCA: 161] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
|
36
|
Alegría E, Cordero A, Laclaustra M, Grima A, León M, Casasnovas JA, Luengo E, del Río A, Ferreira I. Prevalencia del síndrome metabólico en población laboral española: registro MESYAS. Rev Esp Cardiol 2005. [DOI: 10.1157/13077231] [Citation(s) in RCA: 114] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
|
37
|
Kouvonen A, Kivimäki M, Cox SJ, Cox T, Vahtera J. Relationship between work stress and body mass index among 45,810 female and male employees. Psychosom Med 2005; 67:577-83. [PMID: 16046370 DOI: 10.1097/01.psy.0000170330.08704.62] [Citation(s) in RCA: 122] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The proportion of overweight and obese people has grown rapidly, and obesity has now been widely recognized as an important public health problem. At the same time, stress has increased in working life. The 2 problems could be connected if work stress promotes unhealthy eating habits and sedentary behavior and thereby contributes to weight gain. This study explored the association between work stress and body mass index (BMI; kg/m2). METHODS We used cross-sectional questionnaire data obtained from 45,810 female and male employees participating in the ongoing Finnish Public Sector Cohort Study. We constructed individual-level scores, as well as occupational- and organizational-level aggregated scores for work stress, as indicated by the demand/control model and the effort-reward imbalance model. Linear regression analyses were stratified by sex and socioeconomic status (SES) and adjusted for age, marital status, job contract, smoking, alcohol consumption, physical activity, and negative affectivity. RESULTS The results with the aggregated scores showed that lower job control, higher job strain, and higher effort-reward imbalance were associated with a higher BMI. In men, lower job demands were also associated with a higher BMI. These associations were not accounted for by SES, although an additional adjustment for SES attenuated the associations. The results obtained with the individual-level scores were in the same direction, but the relationships were weaker than those obtained with the aggregated scores. CONCLUSIONS This study shows a weak association between work stress and BMI.
Collapse
Affiliation(s)
- Anne Kouvonen
- Department of Psychology, University of Helsinki, Finland.
| | | | | | | | | |
Collapse
|
38
|
Galán I, Rodríguez-Artalejo F, Tobías A, Gandarillas A, Zorrilla B. Vigilancia de los factores de riesgo de las enfermedades no transmisibles mediante encuesta telefónica: resultados de la Comunidad de Madrid en el período 1995-2003. GACETA SANITARIA 2005; 19:193-205. [PMID: 15960952 DOI: 10.1157/13075952] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To illustrate -for the first time with Spanish data- the usefulness of telephone-interview-based surveillance of non-communicable diseases risk factors for the purpose of drawing up public health policies. METHODS We analysed information from the Non-Communicable Disease Risk Factor Surveillance System (Sistema de Vigilancia de Factores de Riesgo asociados a Enfermedades No Transmisibles- SIVFRENT) for the period 1995-2003. This system is based on monthly telephone interviews covering a representative population sample, aged 18-64 years. 18,049 interviews were conducted for the whole period. Indicators of overweight and obesity, sedentary lifestyle, diet, tobacco and alcohol consumption, preventive practices, accidents and injuries, and road safety were calculated. The time trend was estimated using average annual prevalence ratios, obtained from generalised linear models with binomial family and logarithmic link. RESULTS Among men, the changes of greatest magnitude corresponded to an increase in overweight and obesity, which registered a relative annual rise of 3.7%, and a decrease in dieting (-3%), high alcohol consumption (-6.1%) and non-use of safety belts (-4%). Among women, there was a marked increase in overweight and obesity (3.3%), cessation of smoking (3.1%) and recourse to mammograms (6.4%), and a decrease in dieting (-4.1%) and non-use of safety belts (-4.5%). CONCLUSIONS Although important progress was observed in a number of indicators, such as tobacco and alcohol consumption, road safety and the undertaking of preventive practices, the situation worsened in others, i.e., fundamentally the increase in overweight and obesity.
Collapse
Affiliation(s)
- Iñaki Galán
- Servicio de Epidemiología, Instituto de Salud Pública, Consejería de Sanidad y Consumo de la Comunidad de Madrid, 28037 Madrid, España.
| | | | | | | | | |
Collapse
|
39
|
Guallar-Castillón P, Santa-Olalla Peralta P, Banegas JR, López E, Rodríguez-Artalejo F. [Physical activity and quality of life in older adults in Spain]. Med Clin (Barc) 2005; 123:606-10. [PMID: 15546517 DOI: 10.1016/s0025-7753(04)74616-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
BACKGROUND AND OBJECTIVE This study examined the relationship between leisure-time physical activity (LTPA) and health-related quality of life (HRQL) in the older adult population of Spain. SUBJECTS AND METHOD Household cross-sectional survey on 3,066 subjects representatives of the non-institutionalized Spanish population aged 60 years and over. Data on LTPA was obtained with a structured questionnaire and HRQL was measured with the SF-36 instrument. Analyses were done through linear regression, where the dependent variable was each of the eight scales of the SF-36 and the main independent variable was LTPA. Analyses were adjusted for sociodemographic and social network variables, health habits, health services use, and chronic diseases. RESULTS A total of 42.7% subjects had a sedentary activity, 54.2% light LTPA and 3% moderate/intense LTPA. As compared with sedentary activity, light LTPA was associated with a higher score in all SF-36 scales, except for the physical role and emotional role, among men and women. For subjects with light LTPA the increase in score was over 3 points in most SF-scales, which is usually considered as a clinically relevant change in HRQL. Results did not vary materially by age, level of education, obesity or chronic disease. The higher LTPA, the better HRQL (p for linear trend < 0.05 in most scales of the SF-36 questionnaire). CONCLUSIONS Light LTPA is associated with better HRQL than sedentary activity. Because this association did not change with age, level of education, obesity or chronic disease, it is suggested that most older adults could improve their HRQL with, at least, a light LTPA.
Collapse
Affiliation(s)
- Pilar Guallar-Castillón
- Departamento de Medicina Preventiva y Salud Pública, Facultad de Medicina, Universidad Autónoma de Madrid, Madrid, Spain
| | | | | | | | | |
Collapse
|
40
|
Gutiérrez-Fisac JL, Regidor E, López García E, Banegas Banegas JR, Rodríguez Artalejo F. [The obesity epidemic and related factors: the case of Spain]. CAD SAUDE PUBLICA 2004; 19 Suppl 1:S101-10. [PMID: 12886440 DOI: 10.1590/s0102-311x2003000700011] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The obesity epidemic is a global phenomenon that does not respect geographic or socio-demographic boundaries. Thus, research on factors related to the obesity epidemic has focused on social and economic characteristics of modern societies. This article discusses obesity in Spain and trends in several associated factors. Together with the increase in the prevalence of obesity, important changes in the population's dietary pattern have been observed, although total energy and fat intake appear to be stable. According to several indirect indicators, sedentary behavior predominates, although the percentage of the population reporting some leisure exercise is increasing. An increase in the amount of leisure time in modern societies is suggested as an explanation for this paradox. Factors related to energy expenditure could be as important as dietary factors in the genesis of the obesity epidemic.
Collapse
Affiliation(s)
- Juan Luis Gutiérrez-Fisac
- Departamento de Medicina Preventiva y Salud Pública, Facultad de Medicina, Universidad Autónoma de Madrid, Madrid, España.
| | | | | | | | | |
Collapse
|
41
|
Abstract
Obesity rates have increased markedly in Latin America, especially during the last 10-15 years, becoming a public health problem in most countries. Prevalence of obesity among preschool children remains low, while among schoolchildren it has increased considerably. Prevalence is high in the adult population, especially among women with less schooling. In developed populations, obesity occurs more frequently among the poor; the opposite occurs in less developed societies, where in households undergoing nutritional transition, underweight can coexist with obesity. The most important determinant factors involved in the increasing obesity prevalence are fetal and infant nutritional conditions (stunting), education and socioeconomic conditions, dietary changes (especially increased total energy intake), and physical inactivity. Because chronic diseases are the main causes of death in the Region and obesity is one of the main risk factors for these diseases, policies to improve economic and educational levels with the implementation of health promotion and prevention should be a priority in every country.
Collapse
Affiliation(s)
- Juliana Kain
- Instituto de Nutrición y Tecnología de los Alimentos, Universidad de Chile, Santiago, Chile.
| | | | | |
Collapse
|
42
|
Abstract
Obesity prevalence has increased markedly over the past few decades. The obesity pandemic has huge implications for public health and our society. Although multiple studies show that the genetic contribution to obesity is significant, our genes have not changed appreciably over this time period. It was hypothesized that natural selection favors genotypes that result in a thrifty metabolism because individuals who carry these genotypes would be more likely to survive times of nutrient scarcity and to pass these genotypes to successive generations. Now that most of the world has adopted an increasingly "obesigenic" lifestyle of excess caloric intake and decreased physical activity, these same genes contribute to obesity and poor health. With the exception of the rare mutations that cause severe morbid obesity, it seems that numerous genes, each with modest effect, contribute to an individual's predisposition toward the more common forms of obesity. Variants in several candidate genes have been identified: association analyses and functional studies show that they contribute to modest obesity and related phenotypes. More recently, insights regarding gene-gene interactions have begun to emerge. Genome-wide scans for obesity phenotypes have led to the identification of several chromosome regions that are likely to harbor obesity susceptibility genes. Because of the increasing number of genome scans, several regions of replication have emerged. Positional cloning of these genes will undoubtedly unveil new insights into the molecular and pathophysiologic mechanisms of energy homeostasis and obesity.
Collapse
Affiliation(s)
- Coleen M Damcott
- Division of Endocrinolog, Diabetes, and Nutrition, University of Maryland School of Medicine, 660 West Redwood Street, Baltimore, MD 21201, USA
| | | | | |
Collapse
|
43
|
Schröder H, Marrugat J, Elosua R, Covas MI. Relationship between body mass index, serum cholesterol, leisure-time physical activity, and diet in a Mediterranean Southern-Europe population. Br J Nutr 2003; 90:431-9. [PMID: 12908905 DOI: 10.1079/bjn2003899] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
The aim of the present study was to determine the relationship of BMI with other cardiovascular risk factors, leisure-time physical activity and diet. Participants were recruited in a cross-sectional population-based survey in a southern-Europe Mediterranean population (Spain); cardiovascular risk factors were measured, and leisure-time physical activity and diet intake were evaluated. Linear regression analysis adjusted for several confounders showed a significant, direct association of BMI and total cholesterol (P<0.005) and LDL-cholesterol (P<0.006), in men. HDL-cholesterol was inversely related to BMI in both sexes (P<0.0001). Higher BMI was more frequent in less-active men (P<0.04) but not in women. BMI increased significantly (P<0.0001) by 1.92 kg/m(2) with each 4.18 MJ consumed in men but not in women. Dietary intakes of carbohydrate (P<0.03), total fat (P<0.03) and saturated fatty acids (P<0.02) were directly associated with BMI in men but not in women, in whom protein intake was correlated (P<0.001) with BMI. Linear regression models including dietary components explained up to 10.6 and 21.1 % of BMI variability in men and women, respectively. Sex differences in the association of BMI with total cholesterol, and LDL-cholesterol, may account for the lower risk for CHD in women compared with men of similar BMI reported in the literature for the southern-Europe Mediterranean region. An increases of BMI may be more deleterious in populations in which it is accompanied by other risk factors such as a higher intake of total fat and, particularly, of saturated fatty acids, or lower leisure-time physical activity.
Collapse
Affiliation(s)
- Helmut Schröder
- Lipids and Cardiovascular Epidemiology Unit, Institut Municipal d'Investigació Mèdica, IMIM and Department of Nutrition, Sports Medicine Barcelona, Barcelona, Spain
| | | | | | | |
Collapse
|
44
|
Marti A, Corbalán MS, Martínez-Gonzalez MA, Martinez JA. TRP64ARG polymorphism of the beta 3-adrenergic receptor gene and obesity risk: effect modification by a sedentary lifestyle. Diabetes Obes Metab 2002; 4:428-30. [PMID: 12406043 DOI: 10.1046/j.1463-1326.2002.00227.x] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
AIM We performed a case-control study to assess the association between obesity risk and the Trp64Arg polymorphism of the beta 3-adrenergic receptor gene. METHODS Obese subjects [n = 159; body mass index (BMI) > 30 kg/m2] and controls (n = 154; BMI < 25 kg/m2) were compared using multivariable logistic regression to control for potential confounders. RESULTS A higher obesity risk (adjusted OR: 2.98; 95% CI: 1.00-8.56; p = 0.05) was associated with the Trp64Arg polymorphism among sedentary, but not among more active people. CONCLUSIONS Our results suggest that the TRP64ARG polymorphism of the ADRB3 seems to be a risk factor for obesity that is dependent on a sedentary lifestyle.
Collapse
Affiliation(s)
- A Marti
- Department of Physiology and Nutrition, University of Navarra, Pamplona, Spain.
| | | | | | | |
Collapse
|
45
|
Vizcaíno FM, Aguilar FS, Artalejo FR, Vizcaíno VM, Luz Domínguez Contreras M, Regidor RT. Prevalencia de la obesidad y mantenimiento del estado ponderal tras un seguimiento de 6 años en niños y adolescentes: estudio de Cuenca. Med Clin (Barc) 2002. [DOI: 10.1016/s0025-7753(02)73406-4] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
|