Fernald Lia C H
School of Public Health, University of California, 140 Warren Hall, MC 7360, Berkeley, CA 94720-7360, USA.
Soc Sci Med. 2007 May;64(10):2030-42. doi: 10.1016/j.socscimed.2007.02.002. Epub 2007 Mar 21.
The study reported here explored the associations of body mass index (BMI), socio-economic status (SES), and beverage consumption in a very low-income population. A house-to-house survey was conducted in 2003 of 12,873 Mexican adults. The sample was designed to be representative of the poorest communities in seven of Mexico's 31 states. Greater educational attainment was significantly associated with higher BMI and a greater prevalence of overweight (25 < or = BMI<30) and obesity (30 < or = BMI) in men and women. The combined prevalence of overweight and obesity was over 70% in women greater than the median age of 35.4 years with at least some primary education compared with a prevalence of 45% in women below the median age with no education. In both sexes, BMI was positively correlated with education, occupation, quality of housing conditions, household assets, and subjective social status. BMI and household income were significantly correlated in women but not in men. In the models including all SES variables, education, occupation, housing conditions and household assets all contributed independently and significantly to BMI, and household income and subjective social status did not. Increased consumption of alcoholic and carbonated sugar beverages was associated with higher SES and higher BMI. Thus, in spite of the narrow range of socio-economic variability in this population, the increased consumption of high calorie beverages may explain the positive relationship between SES and BMI. The positive associations between SES and BMI in this low-income, rural population are likely to be related to the changing patterns of food availability, food composition, consumption patterns and cultural factors. Contextually sensitive population-level interventions are critically needed to address obesity and overweight in poor populations, particularly in older women.
本文所报告的研究探讨了在极低收入人群中体重指数(BMI)、社会经济地位(SES)与饮料消费之间的关联。2003年对12873名墨西哥成年人进行了挨家挨户的调查。该样本旨在代表墨西哥31个州中7个州最贫困的社区。在男性和女性中,受教育程度越高,BMI越高,超重(25≤BMI<30)和肥胖(30≤BMI)的患病率也越高。年龄中位数为35.4岁及以上且至少接受过一些小学教育的女性中,超重和肥胖的合并患病率超过70%,而年龄中位数以下且未受过教育的女性患病率为45%。在男性和女性中,BMI与教育、职业、住房条件质量、家庭资产和主观社会地位呈正相关。BMI与家庭收入在女性中显著相关,但在男性中不相关。在包含所有SES变量的模型中,教育、职业、住房条件和家庭资产均对BMI有独立且显著的贡献,而家庭收入和主观社会地位则没有。酒精饮料和含糖碳酸饮料消费的增加与较高的SES和较高的BMI相关。因此,尽管该人群的社会经济差异范围较窄,但高热量饮料消费的增加可能解释了SES与BMI之间的正相关关系。在这个低收入农村人群中,SES与BMI之间的正相关关系可能与食物供应模式、食物成分、消费模式和文化因素的变化有关。迫切需要针对具体情况的人群层面干预措施来解决贫困人口,尤其是老年女性中的肥胖和超重问题。