Ward Heather, Tarasuk Valerie, Mendelson Rena
Department of Nutritional Sciences, University of Toronto, 150 College Street, Toronto, ON M5S 3E2, Canada.
Appl Physiol Nutr Metab. 2007 Apr;32(2):206-16. doi: 10.1139/h06-104.
Among Canadians, previous research has associated obesity with indicators of socioeconomic position. Several health behaviours have demonstrated similar variation, suggesting that social patterning of obesity may be partially explained by behavioural differences. The objective of this study was to examine obesity in relation to income and education among Canadians, and to characterize the indirect associations potentially occurring through fruit and vegetable intake, leisure-time physical activity (LTPA), and smoking. The present secondary analysis of the 2004 Canadian Community Health Survey was restricted to adults (25-64 y) with measured height and weight data (men, n = 3767; women, n = 3823). Interrelationships among socioeconomic indicators, behaviours, and BMI groups were examined by age-adjusted path analysis. For men, obesity was positively associated with income directly and through current smoking. Obesity was also negatively associated with education, directly and through fruit and vegetable intake, and was negatively associated with income through LTPA (r2 = 0.17). For women, obesity was negatively associated with education both directly and indirectly through LTPA and with fruit and vegetable intake. No direct association was observed between income and obesity for women, but an indirect negative association existed via LTPA and fruit and vegetable intake (r2 = 0.15). The direct and indirect associations between obesity and socioeconomic indicators were consistently inverse among women, but this relationship was not the case in men, suggesting that clearer social patterns of adiposity exist for Canadian women. The limited amount of variance explained by these models likely reflects the complexity of obesity development.
在加拿大人中，先前的研究已将肥胖与社会经济地位指标联系起来。一些健康行为也表现出类似的差异，这表明肥胖的社会模式可能部分可由行为差异来解释。本研究的目的是考察加拿大人中肥胖与收入和教育的关系，并描述可能通过水果和蔬菜摄入量、休闲时间体力活动（LTPA）及吸烟产生的间接关联。对2004年加拿大社区健康调查的本次二次分析仅限于有身高和体重测量数据的成年人（25 - 64岁）（男性，n = 3767；女性，n = 3823）。通过年龄校正的路径分析来研究社会经济指标、行为和体重指数（BMI）组之间的相互关系。对于男性，肥胖与收入直接相关，且通过当前吸烟也相关。肥胖与教育也呈负相关，直接相关且通过水果和蔬菜摄入量相关，还通过LTPA与收入呈负相关（r² = 0.17）。对于女性，肥胖与教育直接及间接通过LTPA和水果及蔬菜摄入量均呈负相关。未观察到女性收入与肥胖之间的直接关联，但通过LTPA和水果及蔬菜摄入量存在间接负相关（r² = 0.15）。肥胖与社会经济指标之间的直接和间接关联在女性中始终呈反向，但在男性中并非如此，这表明加拿大女性的肥胖社会模式更清晰。这些模型所解释的方差量有限，可能反映了肥胖发展的复杂性。
