Health Studies Program, Department of Kinesiology, University of Rhode Island, Kingston, Rhode Island, United States of America.
PLoS One. 2018 Dec 5;13(12):e0208268. doi: 10.1371/journal.pone.0208268. eCollection 2018.
Obesity is a critical public health issue, affecting over one-third of all Americans, and is an underlying cause of numerous health issues across the lifespan. For older adults, obesity is linked to premature declines in physical and mental health and cognitive functioning. The occurrence of obesity and related health behaviors and chronic diseases are higher in rural areas than in urban areas. Furthermore, rural areas of the United States have a higher proportion of older adults than urban areas. Few studies, to date, have explored rural-urban differences in the relationships between dietary patterns and obesity among older adults. Therefore, the purpose of this study is to assess rural-urban differences in obesity rates in older adults, and the potential for the associations between obesity and physical activity and dietary patterns to vary by rural-urban status.
Data were abstracted from respondents aged 65 and above from the 2012 Behavioral Risk Factor Surveillance System (BRFSS) database linked to Census-based county-level information on rural-urban status and socioeconomic status. Generalized linear models were utilized to assess rural-urban disparities in obesity, and the potential for associations between obesity and known risk factors (fruit consumption, green vegetable consumption and physical activity) to vary by rural-urban status, accounting for complex sampling and confounders.
Obesity rates were highest and fruit consumption was lowest in the most rural areas. However, for older adults in the most urban areas, there was a significant negative association between obesity and fruit and green vegetable consumption. This association was not observed in more rural older adults.
These findings underscore the need to take into account place-based factors such as rural-urban status, when designing and implementing policies and interventions designed to reduce obesity through risk factor mitigation in older adults. To reduce rural-urban disparities in older adults, all policies, programs, and interventions should address the unique barriers and needs specific to rural and urban older adults.
肥胖是一个严重的公共卫生问题，影响了超过三分之一的美国人，是一生中许多健康问题的根本原因。对于老年人来说，肥胖与身体和心理健康以及认知功能的过早下降有关。肥胖以及相关的健康行为和慢性疾病在农村地区的发生率高于城市地区。此外，美国农村地区的老年人比例高于城市地区。迄今为止，很少有研究探讨老年人饮食模式与肥胖之间的城乡差异。因此，本研究旨在评估城乡老年人肥胖率的差异，以及肥胖与身体活动和饮食模式之间的关联因城乡地位而变化的可能性。
从年龄在 65 岁及以上的 2012 年行为风险因素监测系统（BRFSS）数据库中提取数据，并与基于普查的县一级农村-城市地位和社会经济地位信息相关联。利用广义线性模型评估肥胖的城乡差异，以及肥胖与已知风险因素（水果消费、绿叶蔬菜消费和身体活动）之间的关联因城乡地位而变化的可能性，同时考虑到复杂的抽样和混杂因素。
最农村地区的肥胖率最高，水果消费最低。然而，对于最城市地区的老年人来说，肥胖与水果和绿叶蔬菜消费之间存在显著的负相关关系。这种关联在更农村的老年人中并不存在。
这些发现强调了在设计和实施旨在通过减轻风险因素来减少肥胖的政策和干预措施时，需要考虑到基于地点的因素，如城乡地位。为了减少城乡老年人之间的差异，所有政策、计划和干预措施都应针对农村和城市老年人的独特障碍和需求。
