Chor Dóra, Andreozzi Valeska, Fonseca Maria J M, Cardoso Letícia O, James Sherman A, Lopes Claudia S, Faerstein Eduardo
1National School Public Health,Oswaldo Cruz Foundation,Rua Leopoldo Bulhões 1480,Room 813,Rio de Janeiro,RJ,CEP 21041-210,Brazil.
2Centre of Statistics and Applications,University of Lisbon,Lisbon,Portugal.
Public Health Nutr. 2015 Dec;18(17):3183-91. doi: 10.1017/S1368980015001032. Epub 2015 Apr 21.
In a cohort of government employees in Rio de Janeiro, Brazil, we investigated prospectively, sex-specific associations between education and BMI trajectories and their potential effect modification by race.
Of the 4030 participants in Phase 1 (1999), 3253 (81 %) participated in Phase 2 (2003) and 3058 (76 %) participated in Phase 3 (2006). Education was categorized as elementary, high school or college graduate. Study participants self-identified as White, Black or Pardo. BMI was calculated from measured weight and height. BMI trajectories were modelled using a generalized additive regression model with mixed effects (GAMM).
The Pro-Saúde Study, a longitudinal investigation of social determinants of health.
Women (n 1441) and men (n 1127) who participated in the three phases of data collection and had complete information for all study variables.
Women and men with less than high school, or only a high school education, gained approximately 1 kg/m(2) more than college graduates (women: 1·06 kg/m(2) (P<0·001) and 1·06 kg/m(2) (P<0·001), respectively; men: 1·04 kg/m(2) (P=0·013) and 1·01 kg/m(2) (P=0·277), respectively). For women only, race was independently associated with weight gain. Women identifying as Pardo or Black gained 1·03 kg/m(2) (P=0·01) and 1·02 kg/m(2) (P=0·10), respectively, more than Whites. No effect modification by race was observed for either men or women.
While both lower education and darker race were associated with greater weight gain, gender similarities and differences were observed in these associations. The relationship between weight gain and different indicators of social status are therefore complex and require careful consideration when addressing the obesity epidemic.
在巴西里约热内卢的一组政府雇员中，我们前瞻性地研究了教育与体重指数（BMI）轨迹之间的性别特异性关联，以及种族对其潜在的效应修正作用。
在第一阶段（1999年）的4030名参与者中，3253名（81%）参与了第二阶段（2003年），3058名（76%）参与了第三阶段（2006年）。教育程度分为小学、高中或大学毕业。研究参与者自我认定为白人、黑人或帕尔多（棕色人种）。BMI根据测量的体重和身高计算得出。BMI轨迹使用具有混合效应的广义相加回归模型（GAMM）进行建模。
健康促进研究，一项关于健康社会决定因素的纵向调查。
参与了三个阶段数据收集且所有研究变量信息完整的女性（n = 1441）和男性（n = 1127）。
高中以下学历或仅有高中学历的女性和男性比大学毕业生体重增加约多1kg/m²（女性分别为1.06kg/m²（P<0.001）和1.06kg/m²（P<0.001）；男性分别为1.04kg/m²（P = 0.013）和1.01kg/m²（P = 0.277））。仅对于女性，种族与体重增加独立相关。自我认定为帕尔多或黑人的女性比白人分别多增重1.03kg/m²（P = 0.01）和1.02kg/m²（P = 0.10）。未观察到男性或女性存在种族效应修正作用。
虽然较低的教育程度和较深的种族都与更多的体重增加相关，但在这些关联中观察到了性别上的异同。因此，体重增加与不同社会地位指标之间的关系很复杂，在应对肥胖流行问题时需要仔细考虑。
