Robinson Whitney R, Kershaw Kiarri N, Mezuk Briana, Rafferty Jane, Lee Hedwig, Johnson-Lawrence Vicki, Seamans Marissa J, Jackson James S
Department of Epidemiology, University of North Carolina, Chapel Hill, North Carolina, USA; Carolina Population Center, University of North Carolina, Chapel Hill, North Carolina, USA.
Obesity (Silver Spring). 2015 Jan;23(1):213-9. doi: 10.1002/oby.20913. Epub 2014 Oct 8.
Since the 1980s, older, low-educated White women experienced an unprecedented decrease in life expectancy. We investigated whether a similar phenomenon was evident among younger women for obesity.
Using the National Health and Nutrition Examination Survey, age-adjusted changes were estimated in the prevalence of overall and abdominal obesity (BMI ≥ 30 kg/m(2) , waist circumference > 88 cm) between 1988-1994 and 2003-2010 among non-Hispanic White women aged 25-44 years, stratified by educational attainment (<high school (HS), HS, some college, college degree). To address bias from secular increases in educational attainment, White women's changes in obesity prevalence were compared to changes among similarly educated Black women.
Relative increases in overall obesity were disproportionately larger for low-educated (<HS) compared to college-educated White women: 12.3 (95% CI: 3.1, 21.5) percentage points (ppts). For overall and abdominal obesity, general trends indicated dissimilar racial differences by educational attainment. For instance, overall obesity increased more in Blacks than Whites among college-educated (9.9 ppts) but not low-educated (-2.5 ppts) women.
Contemporary young, low-educated White women showed indications of disproportionate worsening of overall obesity prevalence compared to more educated White and similarly educated Black women. Low education levels are more powerful indicators of obesity risk among contemporary White women than 30 years ago.
自20世纪80年代以来，年长的、低学历白人女性的预期寿命经历了前所未有的下降。我们调查了年轻女性中是否也存在类似的肥胖现象。
利用美国国家健康与营养检查调查，对1988 - 1994年和2003 - 2010年间25 - 44岁非西班牙裔白人女性按教育程度（<高中、高中、大专、大学学位）分层的总体肥胖和腹部肥胖（体重指数≥30 kg/m²，腰围>88 cm）患病率的年龄调整变化进行了估计。为了解决教育程度长期上升带来的偏差，将白人女性肥胖患病率的变化与受教育程度相似的黑人女性的变化进行了比较。
与受过大学教育的白人女性相比，低学历（<高中）白人女性总体肥胖的相对增加幅度更大：12.3（95%置信区间：3.1，21.5）个百分点。对于总体肥胖和腹部肥胖，总体趋势表明按教育程度存在不同的种族差异。例如，在受过大学教育的女性中，黑人的总体肥胖增加幅度比白人更大（9.9个百分点），但在低学历女性中并非如此（-2.5个百分点）。
与受教育程度较高的白人女性和受教育程度相似的黑人女性相比，当代年轻的、低学历白人女性的总体肥胖患病率有不成比例的恶化迹象。与30年前相比，低教育水平在当代白人女性中是肥胖风险更强的指标。
