Longitudinal age-and cohort trends in body mass index in Sweden – a 24-year follow-up study

BMC Public Health

Sven-Erik Johansson³  Kristina Sundquist³  Jan Sundquist²  Patrik Midlöv¹  Susanna Calling³  Ozge Karadag Caman³ 

[1] Center for Primary Health Care Research, Lund University, Clinical Research Centre (CRC) Skåne University Hospital, Jan Waldenströms gata 35, 205 02 Malmö, Sweden;Stanford Prevention Research Center, Stanford University, Palo Alto, California, USA;Department of Clinical Sciences, Center for Primary Health Care Research, Lund University, Malmö, Sweden

关键词: Mixed models;    Longitudinal data;    Body mass index;    Birth cohort;    Age;   

Others  :  1161729
DOI  :  10.1186/1471-2458-13-893

 received in 2013-08-28, accepted in 2013-09-25,  发布年份 2013

【 摘 要 】

Background

The aim of this longitudinal study was to analyze whether mean Body Mass Index (BMI), assessed at four occasions, changed within different age groups and birth cohorts over time, i.e., between 1980/81 and 2004/05, after adjustment for possible confounders.

Methods

A sample of 2728 men and 2770 women aged 16–71 years at study start were randomly drawn from the Swedish Total Population Register and followed from 1980/81 to 2004/05. The same sample was assessed on four occasions during the 24-year study period (i.e., every eighth year). The outcome variable, BMI, was based on self-reported height and weight. A mixed model, with random intercept and random slope, was used to estimate annual changes in BMI within the different age groups and birth cohorts.

Results

Mean BMI increased from 24.1 to 25.5 for men and from 23.1 to 24.3 for women during the 24-year study period. The annual change by age group was highest in the ages of 32–39, 40–47 and 48–55 years among men, and in the ages of 24–31, 32–39, and 40–47 years among women. The highest annual changes were found in the youngest birth cohorts for both men and women, i.e., those born 1958–65, 1966–73, and 1974–81. For each birth cohort, the annual change in BMI increased compared to the previous, i.e., older, birth cohort. In addition, age-by-cohort interaction tests revealed that the increase in BMI by increasing age was higher in the younger birth cohorts (1966–1989) than in the older ones.

Conclusions

Public health policies should target those age groups and birth cohorts with the highest increases in BMI. For example, younger birth cohorts had higher annual increases in BMI than older birth cohorts, which means that younger cohorts increased their BMI more than older ones during the study period.

【 授权许可】

   
2013 Karadag Caman et al.; licensee BioMed Central Ltd.

【 参考文献 】

• [1]World Health Organization: Obesity and overweight. Fact sheet No. 311. Geneva: WHO; 2006.
• [2]World Health Organization: Global health risks: mortality and burden of disease attributable to selected major risks. Geneva: WHO; 2009.
• [3]World Health Organization Regional Office for Europe: European charter on counteracting obesity. WHO European Ministerial Conference on Counteracting Obesity (Istanbul, Turkey, 15–17 November 2006). Copenhagen: WHO; 2006.
• [4]Sobal J, Stunkard AJ: Socioeconomic status and obesity: a review of the literature. Psychol Bull 1989, 105:260-275.
• [5]Clarke P, O’Malley PM, Johnston LD, Schulenberg JE: Social disparities in BMI trajectories across adulthood by gender, race/ethnicity and lifetime socio-economic position: 1986–2004. Int J Epidemiol 2009, 38:499-509.
• [6]Sund ER, Jones A, Midthjell K: Individual, family, and area predictors of BMI and BMI change in an adult Norwegian population: findings from the HUNT study. Soc Sci Med 2010, 70:1194-1202.
• [7]Matsushita Y, Takahashi Y, Mizoue T, Inoue M, Noda M, Tsugane S: Overweight and obesity trends among Japanese adults: a 10-year follow-up of the JPHC study. Int J Obes (Lond) 2008, 32:1861-1867.
• [8]Sundquist J, Johansson SE, Sundquist K: Levelling off of prevalence of obesity in the adult population of Sweden between 2000/01 and 2004/05. BMC Public Health 2010, 10:119. BioMed Central Full Text
• [9]Lindstrom M, Isacsson SO, Merlo J: Increasing prevalence of overweight, obesity and physical inactivity: two population-based studies 1986 and 1994. Eur J Public Health 2003, 13:306-312.
• [10]World Health Organization: Obesity: preventing and managing the global epidemic. Geneva: WHO; 2000. [WHO technical report series No. 894, Vol 894]
• [11]World Health Organisation European Collaborative Group: European collaborative trial of multifactorial prevention of coronary heart disease: final report on the 6-year results. Lancet 1986, 1:869-872.
• [12]Berg C, Rosengren A, Aires N, Lappas G, Torén K, Thelle D, Lissner L: Trends in overweight and obesity from 1985 to 2002 in Goteborg, west Sweden. Int J Obes (Lond) 2005, 29:916-924.
• [13]Kastarinen M, Laatikainen T, Salomaa V, Jousilahti P, Antikainen R, Tuomilehto J, Nissinen A, Vartiainen E: Trends in lifestyle factors affecting blood pressure in hypertensive and normotensive finns during 1982–2002. J Hypertens 2007, 25:299-305.
• [14]Borena W, Stocks T, Strohmaier S, Strasak A, Manjer J, Johansen D, Jonsson H, Rapp K, Concin H, Hallmans G, Stattin P, Ulmer H: Long-term temporal trends in cardiovascular and metabolic risk factors. Wien Klin Wochenschr 2009, 121:623-630.
• [15]Marques-Vidal P, Bovet P, Paccaud F, Chiolero A: Changes of overweight and obesity in the adult Swiss population according to educational level, from 1992 to 2007. BMC Public Health 2010, 10:87. BioMed Central Full Text
• [16]Sundquist K, Qvist J, Johansson SE, Sundquist J: Increasing trends of obesity in Sweden between 1996/97 and 2000/01. Int J Obes Relat Metab Disord 2004, 28:254-261.
• [17]Kuskowska-Wolk A, Bergstrom R: Trends in body mass index and prevalence of obesity in Swedish men 1980–89. J Epidemiol Community Health 1993, 47:103-108.
• [18]Statistics Sweden: The Swedish survey of living conditions. Design and method. Statistics Sweden: Stockholm; 1996.
• [19]Mittendorfer B: Sexual dimorphism in human lipid metabolism. J Nutr 2005, 135:681-686.
• [20]Grundy SM: Multifactorial causation of obesity: implications for prevention. Am J Clin Nutr 1998, 67(3 Suppl):563S-572S.
• [21]Sundquist J, Johansson SE: The influence of socioeconomic status, ethnicity and lifestyle on body mass index in a longitudinal study. Int J Epidemiol 1998, 27:57-63.
• [22]StataCorp: Stata statistical software. Release 11. College Station, TX: StataCorp LP; 2009.
• [23]Mokdad AH, Bowman BA, Ford ES, Vinicor F, Marks JS, Koplan JP: The continuing epidemics of obesity and diabetes in the United States. JAMA 2001, 286:1195-1200.
• [24]Kuczmarski RJ, Flegal KM, Campbell SM, Johnson CL: Increasing prevalence of overweight among US adults. The national health and nutrition examination surveys, 1960 to 1991. JAMA 1994, 272:205-211.
• [25]Lewis CE, Jacobs DR Jr, McCreath H, Kiefe CI, Schreiner PJ, Smith DE, Williams OD: Weight gain continues in the 1990s: 10-year trends in weight and overweight from the CARDIA study. Coronary artery risk development in young adults. Am J Epidemiol 2000, 151:1172-1181.
• [26]Baltrus PT, Lynch JW, Everson-Rose S, Raghunathan TE, Kaplan GA: Race/ethnicity, life-course socioeconomic position, and body weight trajectories over 34 years: the Alameda county study. Am J Public Health 2005, 95:1595-1601.
• [27]Kahn HS, Cheng YJ: Longitudinal changes in BMI and in an index estimating excess lipids among white and black adults in the United States. Int J Obes (Lond) 2008, 32:136-143.
• [28]Drøyvold WB, Nilsen TI, Krüger O, Holmen TL, Krokstad S, Midthjell K, Holmen J: Change in height, weight and body mass index: longitudinal data from the HUNT study in Norway. Int J Obes (Lond) 2006, 30:935-939.
• [29]Nooyens AC, Visscher TL, Verschuren WM, Schuit AJ, Boshuizen HC, van Mechelen W, Seidell JC: Age, period and cohort effects on body weight and body mass index in adults: the Doetinchem cohort study. Public Health Nutr 2009, 12:862-870.
• [30]Leijon ME, Bendtsen P, Nilsen P, Ekberg K, Ståhle A: Physical activity referrals in Swedish primary health care - prescriber and patient characteristics, reasons for prescriptions, and prescribed activities. BMC Health Serv Res 2008, 8:201. BioMed Central Full Text
• [31]Lau DC, Dhillon B, Yan H, Szmitko PE, Verma S: Adipokines: molecular links between obesity and atherosclerosis. Am J Physiol Heart Circ Physiol 2005, 288:H2031-H2041.
• [32]Helmersson J: Prostaglandins and isoprostanes in relation to risk factors for atherosclerosis - role of inflammation and oxidative stress. Uppsala: Faculty of Medicine, University of Uppsala; 2005.
• [33]Wernstedt: Metabolic effects of interleukin-6. Gothenberg: Department of Internal Medicine, Sahlgrenska Academy, University of Gothenberg; 2005.
• [34]Calle EE, Kaaks R: Overweight, obesity and cancer: epidemiological evidence and proposed mechanisms. Nat Rev Cancer 2004, 4:579-591.
• [35]Kloting N, Bluher M: Extended longevity and insulin signaling in adipose tissue. Exp Gerontol 2005, 40:878-883.
• [36]Roth GS, Lane MA, Ingram DK, Mattison JA, Elahi D, Tobin JD, Muller D, Metter EJ: Biomarkers of caloric restriction may predict longevity in humans. Science 2002, 297:811.
• [37]James WPT, Jackson-Leach R, Mhurchu CN, Kalamara E, Shayeghi M, Rigby NJ, Nishida C, Rodgers A: Overweight and obesity (high body mass index). In Comparative quantification of health risks: global and regional burden of disease attribution to selected major risk factors. Volume 1. Edited by Ezzati M, Lopez AD, Rodgers A, Murray CJL. Geneva: World Health Organization; 2004:497-596.
• [38]Lahti-Koski M, Pietinen P, Heliövaara M, Vartiainen E: Associations of body mass index and obesity with physical activity, food choices, alcohol intake, and smoking in the 1982–1997 FINRISK studies. Am J Clin Nutr 2002, 75:809-817.
• [39]Kuskowska-Wolk A, Karlsson P, Stolt M, Rössner S: The predictive validity of body mass index based on self-reported weight and height. Int J Obes 1989, 13:441-453.
• [40]Kuskowska-Wolk A, Rössner S: The “true” prevalence of obesity. A comparison of objective weight and height measures versus self-reported and calibrated data. Scand J Prim Health Care 1989, 7:79-82.
• [41]Wärneryd B: Återintervjustudie i undersökningen av levnadsförhållanden 1989 (ULF) (living conditions. Reinterview in ULF 1989) appendix 12. In Swedish. Stockholm: Statistics Sweden; 1991.