Eiben G, Dey D K, Rothenberg E, Steen B, Björkelund C, Bengtsson C, Lissner L
Department of Primary Health Care, Göteborg University, Sweden.
Int J Obes (Lond). 2005 Jul;29(7):810-7. doi: 10.1038/sj.ijo.0802940.
Secular increases in obesity have been widely reported in middle-aged adults, but less is known about such trends among the elderly. The primary purpose of this paper is to document the most recent wave of the obesity epidemic in population-based samples of 70-y-old men and women from Göteborg. Additionally, we will investigate the influences of physical activity, smoking and education on these secular trends.
Five population-based samples of 3702 70-y-olds (1669 men and 2033 women) in Göteborg, Sweden, born between 1901 and 1930, were examined in the Gerontological and Geriatric Population Studies (H70) between 1971 and 2000. Cohort differences in anthropometric measures were the main outcomes studied. Physical activity, smoking habits and education were assessed by comparable methods in all cohorts. Subsamples of the women in the latest two cohorts (birth years 1922 and 1930) were also part of the Prospective Population Study of Women in Göteborg. In these women, it was possible to examine body mass index (BMI) and waist-to-hip circumference ratio (WHR) longitudinally since 1968.
Significant upward trends were found for height, weight, BMI, waist circumference (WC), WHR, prevalence of overweight (BMI> or =25 kg/m(2)) and obesity (BMI> or =30 kg/m(2)) across cohorts in both sexes. In 2000, 20% of the 70-y-old men born in 1930 were obese, and the largest increment (almost doubling) had occurred between the early 1980s and the early 1990s. In 70-y-old women the prevalence of obesity was 24% in 2000, a 50% increase compared to the cohort born 8 y earlier. BMI increased over time in all physical activity, smoking and education groups, with the exception of never-smoking men. Although 70-y-old women in 2000 were heavier than cohorts examined 8 y previously, data from the women studied longitudinally revealed that these differences were already present in earlier adulthood. In conclusion, the elderly population is very much part of the obesity epidemic, although secular trends in BMI were detected slightly earlier in men than in women. The health implications of these secular trends should be focused on in future gerontological research.
中年成年人肥胖率的长期上升已被广泛报道，但老年人中的此类趋势却鲜为人知。本文的主要目的是记录来自哥德堡的70岁男性和女性基于人群样本中肥胖流行的最新情况。此外，我们将研究体育活动、吸烟和教育对这些长期趋势的影响。
瑞典哥德堡有五组基于人群的样本，共3702名70岁老人（1669名男性和2033名女性），他们出生于1901年至1930年之间，在1971年至2000年的老年学和老年人口研究（H70）中接受了检查。人体测量指标的队列差异是主要研究结果。所有队列均采用可比方法评估体育活动、吸烟习惯和教育程度。最新两组队列（出生年份为1922年和1930年）中的女性子样本也是哥德堡女性前瞻性人群研究的一部分。在这些女性中，自1968年以来可以纵向检查体重指数（BMI）和腰臀围比（WHR）。
在两个性别的各队列中，身高、体重、BMI、腰围（WC）、WHR、超重（BMI≥25 kg/m²）和肥胖（BMI≥30 kg/m²）患病率均呈现显著上升趋势。2000年，1930年出生的70岁男性中有20%肥胖，最大增幅（几乎翻倍）出现在20世纪80年代初至90年代初之间。2000年，70岁女性的肥胖患病率为24%，与早8年出生的队列相比增加了50%。除从不吸烟的男性外，所有体育活动、吸烟和教育程度组的BMI均随时间增加。尽管2000年的70岁女性比8年前检查的队列更重，但纵向研究的女性数据显示，这些差异在成年早期就已存在。总之，老年人群是肥胖流行的重要组成部分，尽管BMI的长期趋势在男性中比在女性中发现得略早。这些长期趋势对健康的影响应在未来的老年学研究中予以关注。
