Collaboration for Outcomes Research and Evaluation (CORE), Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, Canada.
Centre for Health Evaluation and Outcome Sciences, Providence Healthcare Research Institute, St. Paul's Hospital, Vancouver, Canada.
Int J Obes (Lond). 2019 Apr;43(4):774-781. doi: 10.1038/s41366-018-0178-y. Epub 2018 Aug 17.
To examine whether changes in food prices are associated with changes in obesity prevalence among women in developing countries, and assess effect modification by individual socioeconomic status (SES).
Longitudinal study of country-level food price inflation temporally and geographically linked to anthropometric data on non-pregnant adult women (n = 295,984) in 31 low-income and middle-income countries over the 2000-2014 time period, using separate multivariable multilevel growth models of five SES indicators. Post-estimation analysis computed the relationship between food price inflation and predicted mean probabilities of being obese, by SES.
Rising food price inflation was strongly associated with women's obesity prevalence, and SES consistently modified the relationship. Regardless of indicator used, higher food price inflation was positively associated with obesity among women in top SES categories, but was flat or negative among women in low SES categories, averaging over time. The SES differences were widest across educational strata and were most pronounced when food price inflation was highest. Overall, for every 1-unit increase in food price inflation, predicted mean obesity prevalence was between 0.02 and 0.06 percentage points greater in women of high SES compared to low SES women.
There is a strong link between food price inflation and obesity in adult women in developing countries which is clearly modified by individuals' SES. Greater food price inflation was associated with greater obesity prevalence only among women in higher SES groups, who may be net food buyers most at risk of obesity in low-income and middle-income countries.
研究发展中国家女性的食物价格变化是否与肥胖流行率的变化有关,并评估个体社会经济地位(SES)的调节作用。
对 2000 年至 2014 年期间 31 个低收入和中等收入国家的非孕妇成年女性(n=295984)进行了纵向研究,这些国家的食物价格通胀在时间和地理上与人体测量数据相关联,使用了五个 SES 指标的单独多变量多层增长模型。在估计之后的分析中,根据 SES 计算了食物价格通胀与肥胖预测平均概率之间的关系。
食物价格通胀的上升与女性肥胖率呈高度相关,SES 始终调节这种关系。无论使用哪个指标,较高的食物价格通胀与 SES 较高类别的女性肥胖呈正相关,但 SES 较低类别的女性肥胖率则持平或呈负相关,这是随着时间的推移平均得出的。SES 差异在教育阶层之间最为明显,在食物价格通胀最高时最为显著。总体而言,对于食物价格通胀每增加 1 个单位,SES 较高的女性肥胖预测平均患病率比 SES 较低的女性高 0.02 至 0.06 个百分点。
发展中国家成年女性的食物价格通胀与肥胖之间存在着很强的联系,而个体的 SES 则明显改变了这种联系。较高的食物价格通胀与 SES 较高的女性肥胖患病率增加有关,而 SES 较高的女性可能是最容易受到低收入和中等收入国家食物价格通胀影响的肥胖风险的净食物购买者。