Monteiro Carlos A, Conde Wolney L, Popkin Barry M
Department of Nutrition, School of Public Health, University of Sao Paulo, Brazil.
Am J Public Health. 2007 Oct;97(10):1808-12. doi: 10.2105/AJPH.2006.099630. Epub 2007 Aug 29.
We sought to update income-specific secular trends in obesity in Brazil to assess the hypothesis that the disease burden is shifting toward the poor.
We compared overall and income-specific obesity prevalence rates estimated for Brazilian men and women from national surveys conducted in 1975, 1989, and 2003. We calculated age-adjusted prevalence ratios to assess time trends.
In the first 14-year period examined (1975-1989), obesity rates among men and women increased by 92% and 63%, respectively, and increases were relatively higher among individuals in lower income groups. In the second 14-year period (1989-2003), there were further increases in obesity among men, and again increases were larger among the poor. In this second period, the obesity rate remained virtually stable in the overall female population, but it increased by 26% among women in the 2 lower income quintiles and decreased by 10% among women in the 3 higher income quintiles.
The burden of obesity is shifting toward the poor and can no longer be considered a disease of the socioeconomic elite. Policymakers need to design policy and programs that reach all members of society, but especially the poor.
我们试图更新巴西肥胖症的特定收入长期趋势,以评估疾病负担正向贫困人口转移这一假设。
我们比较了1975年、1989年和2003年全国性调查中估算的巴西男性和女性的总体肥胖患病率以及特定收入群体的肥胖患病率。我们计算了年龄调整患病率比值以评估时间趋势。
在首个研究的14年期间(1975 - 1989年),男性和女性的肥胖率分别上升了92%和63%,且低收入群体个体的肥胖率增幅相对更大。在第二个14年期间(1989 - 2003年),男性肥胖率进一步上升,贫困人口的增幅依然更大。在这第二个时期,总体女性人群的肥胖率基本保持稳定,但最低的两个收入五分位数组的女性肥胖率上升了26%,而最高的三个收入五分位数组的女性肥胖率下降了10%。
肥胖症负担正在向贫困人口转移,不能再将其视为社会经济精英阶层的疾病。政策制定者需要设计面向社会所有成员、尤其是贫困人口的政策和项目。