Aranceta J, Perez-Rodrigo C, Serra-Majem L, Ribas L, Quiles-Izquierdo J, Vioque J, Foz M
Community Nutrition Unit, Department of Public Health, Municipality of Bilbao, Bilbao, Spain.
Eur J Clin Nutr. 2001 Jun;55(6):430-5. doi: 10.1038/sj.ejcn.1601189.
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.
Pooled analysis of four cross-sectional nutrition surveys.
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.
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.
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.
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.
基于现有总体数据,分析社会和文化因素对25至60岁西班牙成年人群肥胖患病率的影响。
四项横断面营养调查的汇总分析。
共有5388名年龄在25至60岁的自由生活受试者,他们是1990年至1994年在西班牙四个地区(加泰罗尼亚、巴斯克地区、马德里和巴伦西亚)进行的营养调查的受访者。将样本汇总并加权以构建全国随机样本。
由经过培训的观察员测量每位受试者的体重和身高。考虑了年龄、性别、教育水平、职业、居住环境(农村/城市)和地区。肥胖定义为体重指数≥30 kg/m²。每次调查所使用的方案均符合西班牙肥胖研究协会(SEEDO)的建议。设计逻辑回归模型以分析社会人口学因素对男性和女性肥胖患病率的影响。
男性和女性中,年龄较大的年龄组肥胖患病率较高,男性每10岁的优势比(OR)为OR = 1.40(95%可信区间1.39 - 1.41),女性为OR = 1.86(95%可信区间1.85 - 1.87)。经年龄调整的逻辑回归分析显示,低教育水平人群的肥胖率较高,男性为OR = 1.80(95%可信区间1.78 - 1.81),女性为OR = 2.36(95%可信区间2.29 - 2.42)(P < 0.001)。与城市相比,农村地区男性肥胖患病率的优势比为OR = 1.87(95%可信区间1.86 - 1.89)。地理分布显示东南部的肥胖率较高。
本研究支持肥胖是一个多因素问题。教育水平低且收入低的老年女性似乎是最易体重增加的群体。因此,公共卫生项目在制定旨在预防或减少西方社会肥胖问题的策略时应考虑这类环境因素。