美国城乡成年人中的肥胖及与肥胖相关的行为

Obesity and obesity-related behaviors among rural and urban adults in the USA.

作者信息

Trivedi Tushar, Liu Jihong, Probst Janice, Merchant Anwar, Jhones Sonya, Martin Amy Block

机构信息

Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA.

出版信息

Rural Remote Health. 2015 Oct-Dec;15(4):3267. Epub 2015 Oct 13.

PMID:26458564

Abstract

INTRODUCTION

Previous studies have reported a higher prevalence of obesity among rural Americans. However, it is not clear whether obesity-related behaviors can explain the higher level of obesity among rural adults. The purpose of this study was to examine the differences in obesity-related behaviors across rural-urban adult populations in the USA.

METHODS

Data were obtained from the 1999-2006 National Health and Nutrition Examination Survey, restricted to 14 039 participants aged 20 years or more. Body mass index (BMI) was calculated using measured height and weight, and individuals with BMI≥30 kg/m2 were categorized as obese. Physical activity recommendations were used to define participants' physical activity levels: no leisure-time physical activity, less than, meeting, and exceeding the recommended levels. Sedentary behaviors were measured by hours sitting and watching TV or videos or using a computer (outside of work). Dietary intake was assessed by one-day 24 hour dietary recall. Residence was measured at the census tract level using the Rural-Urban Commuting Area Codes. Multiple logistic regression models were used to examine urban-rural differences after adjusting for sociodemographic, health, dietary, and lifestyle factors.

RESULTS

The prevalence of obesity was higher in rural than in urban residents (35.6% vs 30.4%, p<0.01), among both men (37.7% vs. 32.5%, p<0.01) and women (33.4% vs 28.2%, p<0.01). Compared to urban adults, more rural adults reported no leisure-time physical activity (38.8% vs 31.8%, p<0.01) and fewer rural adults met or exceeded physical activity recommendations (41.5% vs 47.2%, p<0.01). Rural adults had lower intake of fiber and fruits and higher intake of sweetened beverages. After adjusting for sociodemographic, health, diet, sedentary behaviors, and physical activity, the odds of being obese among rural adults were 1.19 times higher than that among urban adults (95% confidence interval: 1.06, 1.34).

CONCLUSIONS

Higher level of obesity, physical inactivity, and poor diet among rural residents and the persistent higher risk of obesity among rural adults after adjusting for obesity-related behaviors call for more research into 'obesogenic' environments in rural America. Effective programs are needed to help rural residents reduce high risks for obesity and unhealthy lifestyles.

摘要

引言

先前的研究报告称，美国农村地区肥胖症的患病率较高。然而，与肥胖相关的行为是否能够解释农村成年人中较高的肥胖水平尚不清楚。本研究的目的是调查美国城乡成年人群在与肥胖相关行为方面的差异。

方法

数据取自1999 - 2006年国家健康与营养检查调查，研究对象限定为14039名年龄在20岁及以上的参与者。根据测量的身高和体重计算体重指数（BMI），BMI≥30kg/m²的个体被归类为肥胖。采用身体活动建议来定义参与者的身体活动水平：无休闲时间身体活动、低于、达到和超过建议水平。久坐行为通过坐着看电视或视频或使用电脑（工作之外）的时长来衡量。通过一日24小时饮食回顾来评估饮食摄入量。使用城乡通勤区代码在普查区层面测量居住地。在调整社会人口学、健康、饮食和生活方式因素后，采用多元逻辑回归模型来研究城乡差异。

结果

农村居民的肥胖患病率高于城市居民（35.6%对30.4%，p<0.01），男性（37.7%对32.5%，p<0.01）和女性（33.4%对28.2%，p<0.01）均如此。与城市成年人相比，更多农村成年人报告无休闲时间身体活动（38.8%对31.8%，p<0.01），而达到或超过身体活动建议水平的农村成年人较少（41.5%对47.2%，p<0.01）。农村成年人膳食纤维和水果摄入量较低，甜味饮料摄入量较高。在调整社会人口学、健康、饮食、久坐行为和身体活动因素后，农村成年人肥胖的几率比城市成年人高1.19倍（95%置信区间：1.06，1.34）。