1Sergio Arouca National School of Public Health,Oswaldo Cruz Foundation/Ministry of Health,Rua Leopoldo Bulhões 1480,sala 803,Bonsucesso,CEP 21041210,Rio de Janeiro,RJ,Brazil.
2Department of Epidemiology and Biostatistics,Institute of Collective Health,Fluminense Federal University,Niterói,RJ,Brazil.
Public Health Nutr. 2018 Aug;21(11):2096-2102. doi: 10.1017/S1368980018000307. Epub 2018 Mar 4.
To verify the association of race, independent of socio-economic status (SES), with obesity among Brazilian adults.
We investigated data from the 2008-2009 Brazilian Household Budget Survey. Obesity was defined using the WHO classification. Self-declared race was classified as White, Black and 'Pardo' (Brown). Factor analysis with principal component extraction was used to derive the SES index. The association between race and obesity independent of SES, adjusted for demographic variables, was estimated using multiple logistic regression, accounting for the survey design. Interaction term between race and SES was tested.
Brazilian households (n 55 970).
Adults aged 20-65 years (n 80 702).
The prevalence of obesity was 14·9 %. The first factor explained 51 % of the variance and was used as a SES indicator. Odds of obesity increased with increasing SES level for men and for Black women, whereas Brown and White women showed a decrease of obesity. The association between race and obesity was modified by SES level in both sexes. At lower level of SES (-2 sd), Black and Brown in comparison to White men had 35 and 27 % decreased odds of obesity, respectively. For women, at lower SES level, only Black compared with White women had 30 % decreased odds of obesity. At the higher SES level (+2 sd), Black women compared with White presented a threefold increase of obesity.
Racial disparities in obesity are SES level- and sex-dependent in Brazil. Strategies exclusively targeting reductions in SES disparities are likely ineffective for decreasing racial disparities in obesity among women.
验证种族与社会经济地位（SES）独立相关，对巴西成年人肥胖的影响。
我们调查了 2008-2009 年巴西家庭预算调查的数据。肥胖使用世界卫生组织（WHO）分类进行定义。自我申报的种族分为白人、黑人及“棕色人种”（Brown）。采用主成分提取的因子分析来推导 SES 指数。使用多元逻辑回归，在调整人口统计学变量的基础上，评估种族与 SES 独立相关的肥胖程度，考虑到调查设计。测试了种族与 SES 之间的交互项。
巴西家庭（n 55 970）。
20-65 岁成年人（n 80 702）。
肥胖的患病率为 14.9%。第一个因子解释了 51%的方差，被用作 SES 指标。男性和黑人女性的肥胖患病几率随 SES 水平的增加而增加，而棕色人种和白人女性的肥胖患病几率则降低。种族与肥胖之间的关联在两性中均受到 SES 水平的调节。在 SES 水平较低（-2sd）时，与白人男性相比，黑人男性和棕色人种男性肥胖的患病几率分别降低了 35%和 27%。对于女性，在 SES 水平较低时，只有黑人女性与白人女性相比，肥胖的患病几率降低了 30%。在 SES 水平较高（+2sd）时，与白人女性相比，黑人女性肥胖的患病几率增加了三倍。
在巴西，肥胖的种族差异与 SES 水平和性别有关。仅针对 SES 差异减少的策略可能对降低女性肥胖的种族差异无效。
