Department of Epidemiology, State University of Rio de Janeiro, Brazil.
Br J Nutr. 2010 May;103(10):1534-8. doi: 10.1017/S0007114509993448. Epub 2010 Jan 14.
To ascertain the association of BMI and obesity with short stature, a cross-sectional telephone survey was conducted in 2006, using a multilevel approach, adjusting for individual- and city-level measures of socio-economic status. The study probabilistic sample consisted of 54 369 adults (>18 years) living in households with access to telephone lines in each urban area of the twenty-six Brazilian state capitals and federal district. Odds of being currently obese and obese at age 20 years were compared between short stature individuals (5th percentile) and those with normal stature. After controlling for individual- and city-level sociodemographic characteristics and behaviours, high BMI was strongly associated with short stature individuals (P = 0.001). Among short stature women the adjusted OR of being obese was 3.0 (95 % CI 2.2, 4.2) compared with those with stature greater than the 5th percentile. Among men this adjusted OR was 2.0 (95 % CI 1.5, 2.6). When comparisons were made for BMI at age 20 years the OR were even larger (6 for men and 8 for women). Despite the growing body of evidence that environmental factors such as poor food choices and physical inactivity are the main determinants of the worldwide obesity epidemic, the greater difference in BMI and prevalence of obesity in the Brazilian capitals was explained mainly by individual factors. We found a strong association between obesity and short stature after adjustment for diet, physical activity, and many environmental factors. Intra- and inter-generational consequences of undernutrition are an alternative explanation for the regional disparities in obesity in Brazil.
为了确定 BMI 和肥胖与身材矮小之间的关系，我们于 2006 年采用多水平方法进行了一项横断面电话调查，调整了个体和城市层面的社会经济地位指标。该研究的概率样本由 26 个巴西州首府和联邦区中每个城市中拥有电话线的家庭中的 54369 名成年人（>18 岁）组成。比较了身材矮小个体（第 5 百分位数）和正常身材个体目前肥胖和 20 岁时肥胖的几率。在控制了个体和城市层面的社会人口特征和行为因素后，高 BMI 与身材矮小个体强烈相关（P=0.001）。在身材矮小的女性中，肥胖的调整比值比（OR）为 3.0（95%CI 2.2, 4.2），与身高大于第 5 百分位数的女性相比。在男性中，这一调整后的 OR 为 2.0（95%CI 1.5, 2.6）。当比较 20 岁时的 BMI 时，OR 甚至更大（男性为 6，女性为 8）。尽管越来越多的证据表明，环境因素（如不良的食物选择和缺乏身体活动）是全球肥胖流行的主要决定因素，但巴西首府之间 BMI 和肥胖患病率的更大差异主要是由个体因素解释的。在调整了饮食、身体活动和许多环境因素后，我们发现肥胖与身材矮小之间存在强烈关联。营养不足的代际和内际后果是巴西肥胖地区差异的另一种解释。
