Albrecht S S, Gordon-Larsen P, Stern D, Popkin B M
Carolina Population Center, University of North Carolina, Chapel Hill, NC, USA.
Department of Nutrition, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA.
Eur J Clin Nutr. 2015 Dec;69(12):1306-12. doi: 10.1038/ejcn.2015.71. Epub 2015 May 6.
BACKGROUND/OBJECTIVES: Little is known about whether waist circumference (WC) has increased disproportionately relative to body mass index (BMI) around the world.
SUBJECTS/METHODS: Data came from the US National Health and Nutrition Examination Survey (1988-1994 and 2007-2010), Health Survey for England (1992-1993 and 2008-2009); the Mexican Nutrition Survey (1999) and the Mexican National Health and Nutrition Survey (NHNS 2012); and the China Health and Nutrition Survey (1993 and 2011). Country- and sex-stratified (for the United States, also race-/ethnicity-stratified) multivariable linear regressions were used to estimate mean difference in WC over time relative to BMI at specified overweight and obesity cutoff points, adjusting for age and survey year.
Although mean WC and BMI shifted upward over time in all age-sex subpopulations in all four countries, trends in overweight prevalence were less consistent. However, WC relative to BMI increased at varying magnitudes across all countries and subpopulations, except US Black men. The magnitude of increase was largest for women in the youngest age group (20-29 years), particularly for women in Mexico (+6.6 cm, P<0.0001) and China (+4.6 cm, P<0.0001) (holding BMI constant at 25 kg/m(2)). For men, the increase was primarily evident among Chinese men (+4.8 cm, P<0.0001).
WC has increased disproportionately over time relative to overall body mass across the United States, England, Mexico and China, particularly among young women, with the largest increases occurring in the middle-income countries of Mexico and China. These patterns are potentially a cause for concern especially for countries undergoing rapid economic and nutritional transitions.
背景/目的：关于全球范围内腰围（WC）相对于体重指数（BMI）是否出现了不成比例的增加，目前所知甚少。
对象/方法：数据来自美国国家健康与营养检查调查（1988 - 1994年和2007 - 2010年）、英格兰健康调查（1992 - 1993年和2008 - 2009年）；墨西哥营养调查（1999年）和墨西哥国家健康与营养调查（2012年全国营养与健康调查）；以及中国健康与营养调查（1993年和2011年）。采用国家和性别分层（美国还按种族/族裔分层）的多变量线性回归，以估计在特定超重和肥胖切点下，随时间推移腰围相对于体重指数的平均差异，并对年龄和调查年份进行调整。
尽管在所有四个国家的所有年龄 - 性别亚组中，平均腰围和体重指数随时间向上移动，但超重患病率的趋势不太一致。然而，除美国黑人男性外，所有国家和亚组中腰围相对于体重指数均有不同程度的增加。年龄最小组（20 - 29岁）的女性增加幅度最大，尤其是墨西哥女性（增加6.6厘米，P<0.0001）和中国女性（增加4.6厘米，P<0.0001）（将体重指数保持在25千克/平方米不变）。对于男性，增加主要在中国男性中明显（增加4.8厘米，P<0.0001）。
在美国、英国、墨西哥和中国各地，随着时间的推移，腰围相对于总体体重出现了不成比例的增加，尤其是在年轻女性中，增幅最大的是墨西哥和中国这两个中等收入国家。这些模式尤其值得正经历快速经济和营养转型的国家关注。
