国家文化对 BMI 的影响：53 个国家的多层次分析。
Effect of national culture on BMI: a multilevel analysis of 53 countries.
机构信息
Department of Dentistry and Oral Health, La Trobe Rural Health School, La Trobe University, Bendigo, Australia.
Division of Population and Patient Health, Dental Institute, King's College London, London, UK.
出版信息
BMC Public Health. 2019 Sep 3;19(1):1212. doi: 10.1186/s12889-019-7536-0.
BACKGROUND
To investigate the association between national culture and national BMI in 53 low-middle- and high-income countries.
METHODS
Data from World Health Survey conducted in 2002-2004 in low-middle- and high-income countries were used. Participants aged 18 years and over were selected using multistage, stratified cluster sampling. BMI was used as an outcome variable. Culture of the countries was measured using Hofstede's cultural dimensions: Uncertainty avoidance, individualism, Power Distance and masculinity. The potential determinants of individual-level BMI were participants' sex, age, marital status, education, occupation as well as household-wealth and location (rural/urban) at the individual-level. The country-level factors used were average national income (GNI-PPP), income inequality (Gini-index) and Hofstede's cultural dimensions. A two-level random-intercepts and fixed-slopes model structure with individuals nested within countries were fitted, treating BMI as a continuous outcome variable.
RESULTS
A sample of 156,192 people from 53 countries was included in this analysis. The design-based (weighted) mean BMI (SE) in these 53 countries was 23.95(0.08). Uncertainty avoidance (UAI) and individualism (IDV) were significantly associated with BMI, showing that people in more individualistic or high uncertainty avoidance countries had higher BMI than collectivist or low uncertainty avoidance ones. This model explained that one unit increase in UAI or IDV was associated with 0.03 unit increase in BMI. Power distance and masculinity were not associated with BMI of the people. National level Income was also significantly associated with individual-level BMI.
CONCLUSION
National culture has a substantial association with BMI of the individuals in the country. This association is important for understanding the pattern of obesity or overweight across different cultures and countries. It is also important to recognise the importance of the association of culture and BMI in developing public health interventions to reduce obesity or overweight.
背景
在 53 个中低收入国家中，研究民族文化与国家 BMI 之间的关系。
方法
使用中低收入国家 2002-2004 年世界卫生调查的数据。使用多阶段、分层聚类抽样选择 18 岁及以上的参与者。体重指数（BMI）作为因变量。使用 Hofstede 的文化维度衡量国家文化：不确定性规避、个人主义、权力距离和男性气质。个体层面 BMI 的潜在决定因素包括参与者的性别、年龄、婚姻状况、教育程度、职业以及家庭财富和所在地（农村/城市）。国家层面的因素包括平均国民收入（人均国民总收入）、收入不平等（基尼指数）和 Hofstede 的文化维度。采用个体嵌套于国家的两层随机截距和固定斜率模型结构，将 BMI 视为连续因变量进行拟合。
结果
本研究共纳入 53 个国家的 156192 人。这些 53 个国家的基于设计（加权）平均 BMI（SE）为 23.95（0.08）。不确定性规避（UAI）和个人主义（IDV）与 BMI 显著相关，表明个人主义或不确定性规避程度较高的国家的 BMI 高于集体主义或不确定性规避程度较低的国家。该模型表明，UAI 或 IDV 每增加一个单位，BMI 就会增加 0.03 个单位。权力距离和男性气质与个人 BMI 无关。国家收入水平也与个体 BMI 显著相关。
结论
民族文化与国家个人 BMI 有很大关系。这种关联对于理解不同文化和国家的肥胖或超重模式非常重要。认识到文化与 BMI 之间的关联在制定减少肥胖或超重的公共卫生干预措施方面的重要性也很重要。
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