Institute of Social and Preventive Medicine, CHUV and Faculty of biology and medicine, Lausanne, Switzerland.
BMC Public Health. 2012 Aug 1;12:588. doi: 10.1186/1471-2458-12-588.
The escalating prevalence of obesity might prompt obese subjects to consider themselves as normal, as this condition is gradually becoming as frequent as normal weight. In this study, we aimed to assess the trends in the associations between obesity and self-rated health in two countries.
Data from the Portuguese (years 1995-6, 1998-6 and 2005-6) and Swiss (1992-3, 1997, 2002 and 2007) National Health Surveys were used, corresponding to more than 130,000 adults (64,793 for Portugal and 65,829 for Switzerland). Body mass index and self-rated health were derived from self-reported data.
Obesity levels were higher in Portugal (17.5% in 2005-6 vs. 8.9% in 2007 in Switzerland, p < 0.001) and increased in both countries. The prevalence of participants rating their health as "bad" or "very bad" was higher in Portugal than in Switzerland (21.8% in 2005-6 vs 3.9% in 2007, p < 0.001). In both countries, obese participants rated more frequently their health as "bad" or "very bad" than participants with regular weight. In Switzerland, the prevalence of "bad" or "very bad" rates among obese participants, increased from 6.5% in 1992-3 to 9.8% in 2007, while in Portugal it decreased from 41.3% to 32.3%. After multivariate adjustment, the odds ratio (OR) of stating one self's health as "bad" or "very bad" among obese relative to normal weight participants, almost doubled in Switzerland: from 1.38 (95% confidence interval, CI: 1.01-1.87) in 1992-3 to 2.64 (95% CI: 2.14-3.26) in 2007, and similar findings were obtained after sample weighting. Conversely, no such trend was found in Portugal: 1.35 (95% CI: 1.23-1.48) in 1995-6 and 1.52 (95% CI: 1.37-1.70) in 2005-6.
Obesity is increasing in Switzerland and Portugal. Obesity is increasingly associated with poorer self-health ratings in Switzerland but not in Portugal.
肥胖症的流行率不断上升，可能促使肥胖人群将自己视为正常人群，因为这种情况正逐渐变得和正常体重一样普遍。本研究旨在评估两个国家肥胖症与自我健康评估之间关联的变化趋势。
本研究使用了葡萄牙（1995-6 年、1998-6 年和 2005-6 年）和瑞士（1992-3 年、1997 年、2002 年和 2007 年）国家健康调查的数据，这些数据涵盖了超过 13 万名成年人（葡萄牙为 64793 人，瑞士为 65829 人）。体重指数和自我健康评估数据来自自我报告的数据。
葡萄牙的肥胖水平高于瑞士（2005-6 年为 17.5%，而 2007 年为 8.9%，p < 0.001），且在这两个国家都有所增加。葡萄牙报告健康状况“差”或“非常差”的参与者比例高于瑞士（2005-6 年为 21.8%，而 2007 年为 3.9%，p < 0.001）。在这两个国家，肥胖参与者自评健康状况“差”或“非常差”的频率均高于体重正常的参与者。在瑞士，1992-3 年肥胖参与者报告“差”或“非常差”的比例为 6.5%，而到 2007 年则增加到 9.8%，而在葡萄牙，这一比例则从 41.3%下降到 32.3%。经过多变量调整后，瑞士肥胖参与者自评健康状况“差”或“非常差”的比值比（OR）几乎翻了一番，从 1992-3 年的 1.38（95%置信区间，CI：1.01-1.87）增加到 2007 年的 2.64（95%CI：2.14-3.26），并且在样本加权后也得到了类似的结果。相反，在葡萄牙没有发现这种趋势：1995-6 年为 1.35（95%CI：1.23-1.48），2005-6 年为 1.52（95%CI：1.37-1.70）。
肥胖症在瑞士和葡萄牙都呈上升趋势。肥胖症与瑞士自我健康评估较差的关联性日益增强，但在葡萄牙并非如此。
