Murakami Keiko, Ohkubo Takayoshi, Hashimoto Hideki
Department of Hygiene and Public Health, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-ku, Tokyo, 173-8605, Japan.
Department of Health and Social Behavior, School of Public Health, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan.
BMC Public Health. 2017 Nov 25;17(1):903. doi: 10.1186/s12889-017-4912-5.
Associations between education and obesity have been consistently reported among women in developed countries, but few studies have considered the influence of marital status and husbands' education. This study aimed to examine differences in the association between education and overweight/obesity by marital status and to determine the contribution of husbands' education to overweight/obesity among community-dwelling Japanese women.
A questionnaire survey was conducted from 2010 to 2011 among residents aged 25-50 years in Japanese metropolitan areas. Of 2145 women who agreed to participate and completed the survey, 582 were unmarried and 1563 were married. Overweight/obesity was defined as body mass index ≥25 kg/m. Multiple logistic regression analysis was conducted to determine whether women's or their husbands' education was associated with overweight/obesity after adjusting for age, work status, and equivalent income.
The prevalence of overweight/obesity was 11.9% among unmarried women and 10.3% among married women. Women's own education was significantly associated with overweight/obesity among unmarried women but not among married women. The multivariate-adjusted odds ratio of high school education or lower compared with university education or higher was 3.21 (95% confidence interval: 1.59-6.51) among unmarried women. Among married women, husbands' education was significantly associated with overweight/obesity: women whose husbands' educational attainment was high school or lower had significantly higher odds of overweight/obesity than did those whose husbands had a university education or higher (1.67, 95% confidence interval: 1.10-2.55). Among married women whose educational attainment was college or higher, women whose husbands' educational attainment was high school or lower had a significantly higher risk for overweight/obesity when compared with women whose husbands' educational attainment was college or higher.
Associations between women's own education and overweight/obesity varied by marital status, and husbands' educational level was important for married women's overweight/obesity. These findings indicate that the social influences bound to educational background affect women's overweight/obesity.
在发达国家，女性的教育程度与肥胖之间的关联一直有报道，但很少有研究考虑婚姻状况和丈夫教育程度的影响。本研究旨在探讨按婚姻状况划分的教育程度与超重/肥胖之间关联的差异，并确定丈夫的教育程度对日本社区居住女性超重/肥胖的影响。
2010年至2011年对日本大都市地区25 - 50岁的居民进行了问卷调查。在同意参与并完成调查的2145名女性中，582名未婚，1563名已婚。超重/肥胖定义为体重指数≥25kg/m²。在调整年龄、工作状况和等效收入后，进行多因素逻辑回归分析以确定女性自身或其丈夫的教育程度是否与超重/肥胖有关。
未婚女性中超重/肥胖的患病率为11.9%，已婚女性中为10.3%。女性自身的教育程度在未婚女性中与超重/肥胖显著相关，但在已婚女性中并非如此。在未婚女性中，与大学及以上学历相比，高中学历及以下的多因素调整优势比为3.21（95%置信区间：1.59 - 6.51）。在已婚女性中，丈夫的教育程度与超重/肥胖显著相关：丈夫教育程度为高中学历及以下的女性超重/肥胖的几率显著高于丈夫为大学及以上学历的女性（1.67，95%置信区间：1.10 - 2.55）。在教育程度为大专及以上的已婚女性中，与丈夫教育程度为大专及以上的女性相比，丈夫教育程度为高中学历及以下的女性超重/肥胖风险显著更高。
女性自身教育程度与超重/肥胖之间的关联因婚姻状况而异，丈夫的教育水平对已婚女性的超重/肥胖很重要。这些发现表明，与教育背景相关的社会影响会影响女性的超重/肥胖。
