Nuffield Department of Population Health, University of Oxford, Oxford, UK
HERC, Nuffield Department of Population Health, University of Oxford, Oxford, UK.
BMJ Open. 2022 Jun 22;12(6):e060892. doi: 10.1136/bmjopen-2022-060892.
Rates of overweight and obesity vary across England, but local rates have not been estimated for over 10 years. We aimed to produce new small area estimates of body mass index (BMI) by age and sex for each lower tier and unitary local authority in England, to provide up-to-date and more detailed estimates for the use of policy-makers and academics working in non-communicable disease risk and health inequalities.
We used generalised linear modelling to estimate the relationship between BMI with social/demographic markers in a cross-sectional survey, then used this model to impute a BMI for each adult in locally-representative populations. These groups were then disaggregated by 5-year age group, sex and local authority group.
The Health Survey for England 2018 (cross-sectional BMI data for England) and Census microdata 2011 (locally representative).
A total of 6174 complete cases aged 16 and over were included.
Modelled group-level BMI as mean and SD of log-BMI. Extensive internal validation was performed, against the original data and external validation against the National Diet and Nutrition Survey and Active Lives Survey and previous small area estimates.
In 94% of age-sex are groups, mean BMI was in the overweight or obese ranges. Older and more deprived areas had the highest overweight and obesity rates, which were particularly in coastal areas, the West Midlands, Yorkshire and the Humber. Validation showed close concordance with previous estimates by local area and demographic groups.
This work updated previous estimates of the distribution of BMI in England and contributes considerable additional detail to our understanding of the local epidemiology of overweight and obesity. Raised BMI now affects the vast majority of demographic groups by age, sex and area in England, regardless of geography or deprivation.
英格兰各地的超重和肥胖率存在差异，但已有 10 多年未对当地的肥胖率进行估计。我们旨在为英格兰每个低级别行政区和单一管理区按年龄和性别生成新的体质指数（BMI）小区域估计值，为从事非传染性疾病风险和健康不平等研究的政策制定者和学者提供最新和更详细的估计值。
我们使用广义线性模型来估计横断面调查中 BMI 与社会/人口统计学标记之间的关系，然后使用该模型来推断每个具有代表性地区的成年人的 BMI。然后将这些群体按 5 岁年龄组、性别和地方当局组进行细分。
英格兰健康调查 2018 年（英格兰横断面 BMI 数据）和 2011 年人口普查微观数据（具有代表性的当地数据）。
共纳入了 6174 名年龄在 16 岁及以上的完整案例。
以 BMI 的对数均值和标准差表示模型化的群体 BMI。进行了广泛的内部验证，与原始数据进行了比较，并与国家饮食与营养调查和活跃生活调查以及之前的小区域估计值进行了外部验证。
在 94%的年龄-性别组中，平均 BMI 处于超重或肥胖范围。较老和较贫困地区的超重和肥胖率最高，特别是在沿海地区、西米德兰兹、约克郡和亨伯。验证结果与之前的小区域和人口统计学群体的估计值非常吻合。
这项工作更新了英格兰 BMI 分布的先前估计值，并为我们对超重和肥胖的局部流行病学的理解提供了更多详细信息。无论地理位置或贫困程度如何，如今在英格兰，按年龄、性别和地区划分，绝大多数人口群体的 BMI 都有所升高。
